• The advice reinforces current recommendations encouraging exclusive breastfeeding in infants, with gradual introduction of a variety of foods from around age six months to meet the increased nutrient requirements of the child
• Complementary feeding is the term now used to refer to the introduction of solid foods. Early introduction of solid foods (i.e. before age four months) has been associated with an increased risk of infants becoming overweight or obese.
• Gradual introduction of foods with lumpy textures and a reduced reliance on pureed foods is encouraged to prevent feeding difficulties in older children and to promote an increased intake of vegetables and fruit
• Repeated exposure to a variety of foods is required so that the child becomes more familiar with these foods and with a range of flavours
• The introduction of common allergy-causing foods before age one year is recommended as research shows that this may reduce the incidence of allergy to those foods
• Foods offered to infants and young children should be low in sodium and have no added sugar to prevent taste preferences developing
• Food should only be offered in response to hunger or fullness cues. This supports the child’s natural ability to self-regulate their food intake and promotes ongoing healthy eating behaviours. Food should not be offered for other reasons, e.g. as a reward or to control behaviour.
• Advice about supplements is given for infants and young children who may be at risk of deficiency of nutrients such as iron, iodine, vitamin D, vitamin B12

The Ministry of Health (MOH) has produced a living document “Interim Guidance – Clinical Management of COVID-19 in Hospitalised Adults”. This document is being regularly updated and does include some clinical information for the initial assessment of patients and grading of severity. It includes links to international guidelines, however, most of these have more of a focus on patients who require secondary care.

Also included on the MOH website is “Interim guidance for health staff implementing home care of people not requiring hospitalisation for COVID-19”, however, this document is dated 23 March, 2020 and the detail on clinical care is limited.

Links to international community-based guidance that may be of use to New Zealand primary care clinicians include:

• Hamilton Family Medicine (HFAM) pathway from Ontario, Canada, which has been produced specifically for primary care and covers the assessment, monitoring and management of COVID-19 in the community
• McMaster Family Medicine Youtube video with Dr Dee Mangin (GP, and joint Professor at the University of Otago, Christchurch and McMaster University Canada) which takes you step by step through the primary care pathway referred to in the link above (26 mins)
• Ministry of Health, Ontario, Canada, Clinical guidance for primary care providers which is a broader resource that includes assessment, management and recovery but also guidance for rest homes, palliative care and people with long COVID
• UK National Health Service (NHS) guide on the principles of remote monitoring of patients with COVID-19 using pulse oximetry and the accompanying standard operating procedure document which includes more specific clinical material on home monitoring  
• UK National Institute for Health and Care Excellence (NICE) clinical guideline which provides advice for the management of patients with COVID-19 in all care settings. The information on assessment and management of patients in the community is largely found near the beginning of the document (Pages 39 – 45).
• Australian National COVID-19 clinical evidence taskforce website which contains some material directed towards primary care, e.g. a flowchart for the management of adults with mild COVID-19