Amended Health Guidelines on COVID-19 Cases

July 21, 2022

OCA CIRCULAR NO. 189-2022

 

Taking into consideration the latest Department Memorandum No. 2022-0013 (Updated Guidelines on Quarantine, Isolation, and Testing for COVID-19 Response and Case Management for the Omicron Variant) issued by the Department of Health (DOH) on 14 January 2022, there is a need to amend the existing health guidelines for the first and second level courts as contained in OCA Circular No. 101-2020 (Health Guidelines due to COVID-19 Cases) dated 30 June 2020, particularly on the period of lockdowns due to confirmed Corona Virus Disease (COVID-19) cases, as well as the corresponding directives relative thereto.

In view thereof, all the first and second level courts, as well as the judicial offices therein, shall be guided by the following:

1. Judges and court personnel who will be tested positive for the COVID-19 virus via rapid antibody-based test kits (Antigen) shall immediately undergo a Reverse Transcription-Polymerase Chain Reaction (RT-PCR) to confirm the presence of the virus. As the RT-PCR test still remains as the gold standard in confirming the presence of the COVID-19 virus, no court may be placed on lockdown without an RT-PCR test result with a positive finding.

2. Once the confirmatory RT-PCR test yields a positive result, a copy thereof must immediately be submitted to the concerned Deputy Court Administrator/Assistant Court Administrator (DCA/ACA) who will determine whether or not there is an actual COVID-19 case in the exposed court/judicial office, and if a lockdown is in order. In this regard, the exposed court must likewise submit a report directly to the concerned DCA/ACA disclosing, among others, the last day that the infected judge/personnel physically reported for work as this information is vital in evaluating the situation and in issuing the corresponding directives to address the same.

3. Considering that the majority of the population is now vaccinated and/or have been given booster shots, and the severity of the effects of the COVID-19 virus upon those infected has been noted to be significantly less compared to recorded cases in 2020 and 2021, and further taking into account the latest issuances of the Department of Health (DOH) and the Inter-Agency Task Force for the Management of Emerging Infectious Diseases (IATF) on our present COVID-19 situation, a court/judicial office with a confirmed COVID-19 case should be closed for not more than seven (7) calendar days and shall immediately be disinfected.

4. In case of a lockdown, the exposed court/judicial office should still be accessed or reached through its hotline number and/or official PJ 365 email address during the lockdown period.

5. As much as possible, and if the judge of the exposed court is found negative for the virus, videoconferencing hearings should still be conducted for cases already set during the lockdown period.

6. In order to carry out the directives of the concerned DCA/ACA with respect to the confirmed COVID-19 case in a particular court/judicial office, a memorandum should be issued on the matter by the concerned Executive Judge, or Presiding Judge for single-sala courts, as notice to the public, copy furnished the concerned DCA/ACA and the SC PIO, the latter at its judiciary account ([email protected]), using the official PJ 365 account.

7. The court/judicial office lockdown of not more than 7 days, however, is without prejudice to the respective isolation and quarantine periods of infected individuals and their close contacts as prescribed in DOH Memorandum Order No. 2022-0013. 1

8. For confirmed COVID-19 cases in the first and second level courts, contact tracing must still be conducted in accordance with DOH Department Memorandum No. 2020-0189 (Updated Guidelines on Contact Tracing of Close Contacts of Confirmed Corona Virus Disease [COVID-19] Cases) dated 17 April 2020.

9. Regardless of whether the COVID-19 results are based on Antigen or RT-PCR tests, the same must immediately and directly reported to the concerned DCA/ACA for proper disposition.

10. All Executive Judges in multi-sala courts and Presiding Judges of single-sala courts shall continue to ensure that compliance with the minimum health standards are strictly observed within their respective stations, without prejudice to whatever additional health and safety measures that they may impose in their respective jurisdictions, taking into account the latest DOH and IATF issuances and those issued by the Court relative to the prevailing COVID-19 situation.

11. Whenever disinfection activities will be conducted by the concerned LGU on a court/judicial office or station, the same shall be with the prior clearance from the Office of the Court Administrator (OCA) and, as much as possible, to be undertaken beginning 4:00 o'clock in the afternoon of the scheduled date to avoid disrupting court operations, unless otherwise allowed by the OCA for such disinfection to be done at a different time.

12. Any action that may be taken by the courts/judicial offices due to COVID-19 (e.g., court lockdown, work from home or modified work arrangement, physically reporting to the court/judicial office during the lockdown period, etc.) must first be cleared with the OCA.

13. All other previous related issuances, including OCA Circular No. 101-2020, which are inconsistent with or contrary to this Circular, are hereby deemed repealed, amended, or modified accordingly. All other provisions of existing issuances not affected by this Circular shall remain valid and in effect.

For the strict compliance and observance of all concerned.

(SGD.) RAUL B. VILLANUEVACourt Administrator

ATTACHMENTS

Department of Health

January 14, 2022

DEPARTMENT MEMORANDUM

 

I. BACKGROUND

The presence of a highly transmissible COVID-19 variant, Omicron, highlights the need for adaptive changes to ensure continued availability of health and essential services. Because mass vaccination has significantly reduced the individual's chances of getting severe disease and dying, our policies and guidelines on testing, quarantine and isolation are being updated to reflect the current state of information and achieve a favorable risk-benefit ratio.

Based on the current Omicron situation and updated recommendations from the Philippine COVID-19 Living Recommendations and Department of Health (DOH) Technical Advisory Group (TAG), these guidelines are hereby issued to update protocols for isolation, quarantine and testing for COVID-19 across all age groups, as stipulated in the provisions of Department Memorandum No. 2020-0512 "Revised Omnibus Interim Guidelines on Prevention, Detection, Isolation, Treatment, and Reintegration Strategies for COVID-19" that were reiterated in the DOH Administrative Order No. 2021-0043 "Omnibus Guidelines on the Minimum Public Health Standards for the Safe Reopening of Institutions." However, this does not preclude the DOH to revert to previously issued protocols and issue necessary updated guidelines based on current evidences and trends.

II. IMPLEMENTING GUIDELINES

A. QUARANTINE OF ASYMPTOMATIC CLOSE CONTACTS

1. Fully vaccinated asymptomatic close contacts of individuals with symptoms, suspect, probable, or confirmed cases shall quarantine for at least 5 days from the date of the last exposure. Quarantine can be discontinued at the end of the set quarantine period if they have remained asymptomatic during the whole recommended quarantine period regardless if testing has been done and resulted negative.

2. Partially vaccinated or unvaccinated asymptomatic close contacts of individuals with symptoms, suspect, probable, or confirmed cases shall quarantine for at least 14 days from the date of the last exposure. Quarantine can be discontinued at the end of the set quarantine period if they have remained asymptomatic during the whole recommended quarantine period regardless if testing has been done and resulted negative.

3. All asymptomatic close contacts shall not be required testing unless symptoms will develop, and should immediately isolate regardless of test results.

4. All asymptomatic close contacts shall conduct symptom monitoring for at least 14 days, regardless of shortened quarantine period. They shall strictly observe minimum public health standards, including physical distancing, hand hygiene, cough etiquette, and wearing of masks, among others, regardless of vaccination status.

5. Hospital Infection Prevention and Control Committees (IPCC), Health Offices from Provinces, Highly Urbanized Cities, and Independent Component Cities coordinated with their corresponding hospital IPCC, and other sectors authorized by the IATF with strict industry regulations on infection prevention and control (IPC) shall be authorized to implement further shortening of quarantine duration up to 0 days for their fully vaccinated workers with boosters who are close contacts based on the institution's individualized risk and needs assessment.

6. Intensive contact tracing and testing of asymptomatic close contacts are not recommended priority interventions in areas with large scale community transmission.

B. ISOLATION OF INDIVIDUALS WITH SYMPTOMS AND SUSPECT, PROBABLE, AND CONFIRMED CASES

1. All asymptomatic and fully vaccinated confirmed cases, shall isolate for at least 7 days from sample collection date. Isolation can be discontinued without the need for repeat testing, provided they have remained asymptomatic during the whole recommended isolation period. If symptoms develop within or after the prescribed period, the individual shall complete the required days of isolation depending on the severity of symptoms.

2. All asymptomatic and partially vaccinated or unvaccinated confirmed cases, shall isolate for at least 10 days from sample collection date. Isolation can be discontinued without the need for repeat testing, provided they have remained asymptomatic during the whole recommended isolation period. If symptoms develop within or after the prescribed period, the individual shall complete the required days of isolation depending on the severity of symptoms.

3. All individuals with symptoms and suspect, probable, and confirmed cases presenting with mild symptoms, including individuals under priority groups A2 and A3 who are fully vaccinated, shall isolate for at least 7 days from onset of signs and symptoms. Isolation can be discontinued without the need for repeat testing upon completion of the recommended isolation period, provided that they do not have fever for at least 24 hours without the use of any antipyretic medications, and shall have improvement of respiratory signs and symptoms.

4. All individuals with symptoms and suspect, probable, and confirmed cases presenting with mild symptoms, including individuals under priority groups A2 and A3 who are partially vaccinated or unvaccinated, shall isolate for at least 10 days from onset of signs and symptoms. Isolation can be discontinued without the need for repeat testing upon completion of the recommended isolation period, provided that they do not have fever for at least 24 hours without the use of any antipyretic medications, and shall have improvement of respiratory signs and symptoms.

5. All individuals with symptoms and suspect, probable, and confirmed cases presenting with moderate symptoms, regardless of vaccination status, shall be isolated for at least 10 days from onset of signs and symptoms. Isolation can be discontinued without the need for repeat testing upon completion of the recommended isolation period, provided that they do not have fever for at least 24 hours without the use of any antipyretic medications, and shall have improvement of respiratory signs and symptoms.

6. All individuals with symptoms and suspect, probable, and confirmed cases presenting with severe and critical symptoms, regardless of vaccination status, shall be isolated for at least 21 days from onset of signs and symptoms. Isolation can be discontinued without the need for repeat testing upon completion of the recommended isolation period, provided that they do not have fever for at least 24 hours without the use of any antipyretic medications, and shall have improvement of respiratory signs and symptoms.

7. All symptomatic immunocompromised confirmed cases, as outlined below, shall be isolated for at least 21 days from onset of signs and symptoms, regardless of vaccination status. These shall include patients with:

a. Autoimmune disease

b. HIV

c. Cancer/malignancy

d. Undergoing steroid treatment

e. Transplant patients, and

f. Patients with poor prognosis or bed-ridden.

Isolation can be discontinued upon completion of the recommended isolation period, provided that they do not have fever for at least 24 hours without the use of any antipyretic medications, and shall have improvement of respiratory signs and symptoms. Repeat RT-PCR testing shall also be recommended for this group. If results turn out negative, they may be discharged from isolation. If results turn out positive, refer to an Infectious Disease Specialist who may issue clearance and discharge if warranted.

8. Hospital IPCC, city and provincial health offices coordinated with provincial or city HIPCC, and other sectors authorized by the IATF with strict industry regulations on IPC shall be authorized to implement further shortening of isolation protocols up to 5 days for their fully vaccinated workers with boosters who are suspect, probable, and confirmed cases whether asymptomatic, mild, or moderate, based on the institution's individualized risk and needs assessment.

9. Repeat testing nor medical certification is not required for the safe reintegration into the community, except for immunocompromised individuals. Time based isolation is sufficient provided the affected individual remains asymptomatic.

C. TESTING PRIORITIZATION

1. Testing, especially using RT-PCR, shall be recommended and prioritized for instances where the result of testing will affect the clinical management. Specifically, this will include those who are at risk for developing severe disease such as Priority Groups A2 (persons above 60 years old) and A3 (persons with comorbidities).

2. Testing, especially using RT-PCR, shall also be recommended and prioritized for groups at highest risk for infection such as Priority Group A1 or healthcare workers as deemed necessary.

3. Testing using Antigen tests shall be recommended only for symptomatic individuals and in instances wherein RT-PCR is not available, consistent with previously issued guidelines.

4. Testing shall be optional for other groups not stated above, including for community level actions wherein case management of probable and confirmed cases remain the same. Specifically:

a. Testing shall NOT be recommended for asymptomatic close contacts. Instead, symptom monitoring is recommended. Should testing still be used, testing should be done at least 5 days from the day of last exposure.

b. Testing shall NOT be recommended for screening asymptomatic individuals.

5. All government agencies and instrumentalities, as well as private sectors are recommended to align with the updated guidelines on quarantine, isolation, and testing for COVID-19 response consistent with the new policy directions. Implementation of the updated testing policy with regards to other agency's guidelines shall take effect as indicated there.

D. HOME QUARANTINE AND ISOLATION

1. Department Circular 2022-0002 "Advisory on COVID-19 Protocols for Quarantine and Isolation" provisions on home quarantine and isolation for individuals with no symptoms, mild symptoms, and moderate symptoms and for step-down management are further clarified that in extreme circumstances (e.g., unavailability of TTMFs, and multiple household members are infected with no single rooms available), individuals who are suspected of COVID-19 may be placed together in a shared room provided that the bed shall be spaced at least 2 meters apart, with proper ventilation, and temporary partitions to ensure patient privacy shall be placed between them.

2. To ensure promotion of their psychosocial well-being, individuals in quarantine and isolation are recommended to maintain and continue lines of communication to family and friends. They may also download the DOH Lusog-Isip Mobile Application for free (available in both Apple store or Google play store) or access the National Center for Mental Health (NCMH) Crisis Hotline or the DOH Regional Helplines (See Annex C) for mental health and psychosocial support concerns.

3. All quarantined and isolated individuals, including locally stranded individuals, are recommended to be quarantined or isolated in the area in which they are located instead of being transported to outside of their area of origin to undergo quarantine or isolation.

III. REPEALING CLAUSE

DOH DM 2020-0258 and 0258-A "Updated Interim Guidelines on Expanded Testing for COVID-19," DM 2020-0512 "Revised Omnibus Interim Guidelines on Prevention, Detection, Isolation, Treatment, and Reintegration Strategies for COVID-19," and other issuances inconsistent with or contrary to this DM are hereby repealed, amended, or modified accordingly. All other provisions of existing issuances which are not affected by this DM shall remain valid and in effect.

For strict compliance.

(SGD.) FRANCISCO T. DUQUE III, MD, MScSecretary of Health

ANNEX A

Summary of Updated Quarantine and Isolation Protocols

 

General Public

Healthcare workers and authorized sectors**

QUARANTINE

Asymptomatic close contact	Fully vaccinated	At least 5 days from exposure***	At least 5 days from exposure IPCC may shorten up to 0 days if with booster
Partially Vaccinated or Unvaccinated	At least 14 days from exposure	At least 14 days from exposure

ISOLATION

Asymptomatic case	Fully vaccinated	At least 7 days* from positive test (sample collection date)	At least 7 days* from positive test (sample collection date) IPCC may shorten up to 5 days if with booster
Partially Vaccinated or Unvaccinated	At least 10 days* from positive test (sample collection date)	At least 10 days* from positive test (sample collection date)
Symptomatic, suspect, probable or confirmed case with MILD symptoms	Fully vaccinated	At least 7 days* from onset of symptoms	At least 7 days* from onset of symptoms IPCC may shorten up to 5 days if with booster
Partially Vaccinated or Unvaccinated	At least 10 days* from onset of symptoms	At least 10 days* from onset of symptoms
Symptomatic, suspect, probable or confirmed case with MODERATE symptoms	Regardless of vaccination status	At least 10 days* from onset of symptoms	At least 10 days* from onset of symptoms
Symptomatic, suspect, probable or confirmed case with SEVERE and CRITICAL symptoms	Regardless of vaccination status	At least 21 days* from onset of symptoms	At least 21 days* from onset of symptoms
Immunocompromised*Autoimmune disease, HIV Cancer/	Regardless of vaccination status	At least 21 days* from onset of symptoms with negative repeat RT-PCR	At least 21 days* from onset of symptoms with negative repeat RT-PCR

* Isolation can be discontinued upon completion of the required days, provided that, they shall not develop fever for at least 24 hours without the use of any antipyretic medications and shall have improvement of respiratory symptoms. Except for immunocompromised individuals, repeat testing nor medical certification is not required for safe reintegration into the community. Time based isolation is sufficient provided the affected individual remains asymptomatic.

** Hospital IPCC, PHO coordinated with provincial HIPCC, and other sectors authorized by the IATF with strict industry standards on IPC shall be authorized to implement further shortening of quarantine and isolation protocols for their fully vaccinated workers with boosters who are close contacts, suspect, probable, and confirmed cases whether asymptomatic, mild, or moderate, based on the institution's individualized risk and needs assessment.

*** All asymptomatic close contacts should continue symptom monitoring for 14 days, strictly observe MPHS which includes wearing well-fitted masks, physical distancing, among others.

 

ANNEX B

Updated Testing Protocols

 

Who is being tested?	Why is testing being done?	Should you test?	Remarks
A1 or Health Care Workers	Surveillance to plan for adequate health system capacity	YES*	Use antigen test only when symptomatic, and when RT-PCR is not available
A2 Senior Citizens or A3 Persons with Co-morbidities Including those at high risk for severe disease	Confirming COVID-19 to know if investigational drugs can be given	YES

All except A1, A2 and A3 — no symptoms	Confirming COVID-19 after exposure to positive case	OPTIONAL, quarantine ASAP, and monitor symptoms
All except A1, A2 and A3 — mild symptoms	Confirming COVID-19 after onset of symptoms	OPTIONAL, isolate ASAP, teleconsult, home care if with capacity to be managed at home

* Hospital IPCC, PHO coordinated with provincial HIPCC, and other sectors authorized by the IATF with strict industry standards on IPC can determine need for testing upon careful assessment of benefits and risks.

 

ANNEX C

DOH Regional Helplines

 

REGION	CENTER	SERVICES	HOTLINE
NATIONWIDE	National Center for Mental Health	24/7 Crisis Hotline Telemental Health Psychological/Psychiatric Referrals & Management	1553 0917-899-8727 0966-351-4518 0908-639-2672 bit.ly/mhusaptayo
4-B MIMAROPA	MIMAROPA HEMS Helpline	HEMS MHPSS COVID-19 Mental	0945-992-9323 0929-295-6595
6 WESTERN VISAYAS	Capiz Provincial Health Office	MHPSS	0916-241-1596 0921-991-2064
7 CENTRAL VISAYAS	Central Visayas MHPSS Helpline	PFA, PSP, Substance Abuse Referrals, Swab concerns	0916-343-7016 0933-644-3488
Tawag Paglaum	24/7 Crisis Hotline Suicide Prevention	0939-937-5433 0939-936-5433 0927-654-1629
Biliran Provincial Hospital	MHPSS, PFA	0953-356-0296 0920-181-8809
8 EASTERN VISAYAS	DOH-CHD Region 8	MHPSS Psychiatric referrals	0966-531-6464 0947-423-8423
Northern Samar Provincial Health Office	PFA to agencies, LGUs (by appointment)	0999-927-4848 0949-776-7389 0919-278-3337 0921-217-7701 0928-350-1846 0907-832-7760 0948-341-8981 0930-770-2679
10 NORTHERN MINDANAO	DOH-CHD Region 10	MHPSS	0997-359-0888 0965-055-6777 0965-835-6888
11 DAVAO REGION	DOH-CHD Region 11	PFA	0977-760-8610 0939-768-3627 0933-404-1072
12 COTABATO REGION	Cotabato Regional Medical Center	Crisis Hotline Psychiatric Referrals	0935-574-4500

	HEMS	Health Emergency Management Staff	PFA	Psychological First Aid
	MHPSS	Mental Health & Psychosocial Support	PSP	Psychosocial Processing

 

April 17, 2020

DEPARTMENT MEMORANDUM

 

I. BACKGROUND

On January 30, 2020, the World Health Organization (WHO) declared the Corona Virus Disease 2019 (COVID-19) as a Global Public Health Emergency of International Concern (PHEIC). This declaration was a call to action for all countries to prepare for containment, which include active surveillance, early detection, isolation, case management, and contact tracing to prevent further spread. By March 11, 2020, the WHO declared COVID-19 a pandemic, with 118,000 reported confirmed cases affecting 110 countries and territories. On March 12, 2020, President Rodrigo Roa Duterte raised the national code alert for COVID-19 to Code Red Sublevel 2.

On March 24, 2020, the President announced the creation of a National Task Force for COVID-19, adopting a whole-of-government approach in addressing COVID-19. Hence, there is a need to update the Department of Health (DOH) Department Memorandum (DM) 2020-0068, entitled "Interim Guidelines on Contact Tracing for Confirmed 2019 Novel Corona Virus Acute Respiratory Disease (2019-nCoV ARD) Cases" to also adopt these approach.

II. DEFINITION OF TERMS

A. Contact tracing — the identification, listing, and follow-up of persons who may have come into close contact with a confirmed COVID-19 case. Contact tracing is an important component in containing outbreaks of infectious diseases. Under Code Red Sublevel 2, contact tracing is aimed at mitigating the spread of the disease.

B. Close contact — a person who may have come into contact with the probable or confirmed case two days prior to onset of illness of the confirmed COVID-19 case (use date of sample collection for asymptomatic cases as basis) until the time that said cases test negative on laboratory confirmation or other approved laboratory test through:

1. Face-to-face contact with a probable or confirmed case within 1 meter and for more than 15 minutes;

2. Direct physical contact with a probable or confirmed case;

3. Direct care for a patient with probable or confirmed COVID-19 disease without using proper personal protective equipment; OR

4. Other situations as indicated by local risk assessments.

C. Confirmed COVID-19 case — any individual who tested positive for COVID-19 through laboratory confirmation at the national reference laboratory, subnational reference laboratory, or a DOH-certified laboratory testing facility.

D. Probable COVID-19 case — a suspect case who fulfills anyone of the following listed below:

a. Suspect case whose testing for COVID-19 is inconclusive; or

b. Suspect who tested positive for COVID-19 but whose test was not conducted in a national or subnational reference laboratory or officially accredited laboratory for COVID-19 confirmatory testing.

c. Suspect case who died without undergoing any confirmatory testing.

E. Suspect COVID-19 case — a person who is presenting with any of the conditions below:

a. All SARI cases where NO other etiology that fully explains the clinical presentation.

b. ILI cases with any one of the following:

i. with no other etiology that fully explains the clinical presentation AND a history of travel to or residence in an area that reported local transmission of COVID-19 disease during the 14 days prior to symptom onset; or

ii. with contact to a confirmed or probable case of COVID-19 disease during the 14 days prior to the onset of symptoms.

c. Individuals with fever or cough or shortness of breath or other respiratory signs or symptoms fulfilling any one of the following conditions:

i. Aged 60 years and above;

ii. With a comorbidity;

iii. Assessed as having a high-risk pregnancy; and/or

iv. Health worker.

III. GENERAL GUIDELINES

A. Contact tracing is one of the main public health interventions for COVID-19 response and shall be the responsibility of the whole government.

1. The Department of Health, through the Epidemiology Bureau (EB), shall provide guidelines and oversight for all contact tracing activities.

2. The external agencies engaged in COVID-19 response shall comply with their specific roles and corresponding operational guidelines issued by the National Task Force for COVID-19 response.

B. The goals of contact tracing are as follows:

1. To interrupt ongoing transmission and reduce the spread of infection;

2. To alert close contacts to the possibility of infection and offer preventive counselling or care; and

3. To understand the epidemiology of a disease in a particular population.

C. Contact tracing shall be initiated after case investigation of every reported confirmed COVID-19 cases, to include the following actions:

1. Identify settings where the contacts have visited or social interactions where the contacts have been exposed.

2. Identify all social, familial, work, and health care worker contacts who have had contact with a continued case from 2 days before symptom onset of the case (use date of sample collection for asymptomatic cases as basis) until the time that said case test negative on laboratory confirmation.

3. Create a line list, including demographic information and geographic information at barangay and sitio levels, date of first and last exposure or date of contact with the confirmed or probable case, and, for symptomatic close contacts, date of onset of fever, respiratory symptoms, or other significant signs and symptoms;

4. Thoroughly document the common exposures and type of contact with the confirmed or probable case for any contact who become infected with COVID-19.

D. Contact tracing shall prioritize listing of the following close contacts:

1. Health workers who attended to the confirmed COVID-19 case

2. Individuals who lived with the confirmed COVID-19 case

3. Individuals who worked with the confirmed case, and

4. Vulnerable populations as identified in the demographic vulnerabilities tool

E. For suspect COVID-19 cases, we shall list the individuals they were in contact using these same guidelines and advise these individuals accordingly. This list shall facilitate contact tracing for suspect cases who may become re-classified as probable or confirmed cases.

F. In order to ensure that the data privacy rights of the patient/data subject are respected and that the data or information processed are protected, the provisions on data privacy under Republic Act No. 11332 or the Mandatory Reporting of Notifiable Diseases and Health Events of Public Health Concern Act, the provisions of the Data Privacy Act of 2012, its Implementing Rules and Regulations (IRR) and other issuance of National Privacy Commission (NPC) shall be strictly complied with. The aforementioned law, rules and issuances shall also govern in case disclosure shall be made by the DOH or other agencies involved in the contact tracing to third parties. The guidelines for processing and disclosure of the personal information of patient/data subject are attached in Annex A.

G. As stated in DILG Memorandum Circular 2020-062, "Barangay Health Emergency Response Teams (BHERTs) are designated to help combat the spread of COVID-19 by managing, on the barangay level, Persons Under Investigation, and those who came in contact with them. BHERT members are also tasked with the monitoring and reporting of PUIs within an LGU jurisdiction." Hence, Barangay LGUs, through the BHERTs, shall, after acting as the navigator during contact tracing, monitor the health status of all close contacts. Furthermore, LGUs may add barangay population volunteers to BHERTs.

H. Classification of patients for reporting purposes shall follow the AO 2020-0013 re: Revised Administrative Order No. 2020-0012 "Guidelines for the Inclusion of the Corona Virus Disease 2019 (COVID-19) in the List of Notifiable Diseases for Mandatory Reporting to the Department of Health" dated March 17, 2020.

IV. SPECIFIC GUIDELINES

A. Identification of Contacts of Suspect COVID-19 Cases

1. For identified suspect COVID-19 cases, data fields of the COVID-19 Case Investigation Form (CIF) (See Annex B) shall be submitted, including the initial list of contacts for suspect COVID-19 cases using the definition stated in this issuance.

2. Information in the CIF shall be encoded in a DOH-registered COVID-19 Information System.

3. All suspect cases shall be advised that this list shall be endorsed to the concerned local government unit who shall a) inform identified contacts of the possible exposure, b) advise them to practice self-quarantine and self-monitoring, and report development or progression of sign or symptoms, and c) update them as to laboratory status of suspect COVID-19 case and re-classify them, as needed.

B. Case Investigation and Contact Tracing for Probable and Confirmed COVID-19 Cases

1. DOH-EB shall immediately notify the concerned RESU for each new reported confirmed COVID-19 case. The RESU shall immediately notify the Regional and Assistant Regional Directors of Centers for Health Development regarding the new confirmed COVID-19 case, who in turn shall inform concerned provincial, city or municipal LGU through its Provincial Epidemiology and Surveillance Unit (PESU) and City Epidemiology and Surveillance Unit (CESU) or Municipal Epidemiology and Surveillance Unit (MESU).

2. The following shall conduct case investigation and collect data fields of the COVID-19 Case Investigation Form (CIF) (Annex B) and Travel History Form (Annex C), or any information technology system registered to DOH and/or validated by DICT. They shall generate a list of close contacts (Annex D) upon completion of case investigation that shall be forwarded to the local contact tracing teams.

a. C/MESU for local government units who have established them

b. PESU for health offices at the municipal and component city level in the absence of city or municipal personnel capable of conducting case investigation

c. RESU for health offices of provinces and highly urbanized cities in the absence of personnel capable of conducting case investigation

3. All health facilities that conducted sample collection and/or testing, consultation, and/or admission of confirmed COVID-19 cases shall ensure that P/C/MESUs are provided access to the complete medical record of the confirmed COVID-19 case and shall help facilitate the interview of the confirmed COVID-19 cases, and his/her relatives, caregivers, and/or guardians.

4. Upon receipt of close contact lists from R/P/C/MESUs, local contact tracing teams (LCTTs) shall rigorously locate, profile (Annex E), and assess (Annexes F and G) all close contacts. The LCTTs shall identify symptomatic close contacts who fit the COVID-19 case definition based on AO 2020-0013 and test and isolate using the same guidelines.

5. For close contacts not fitting any of the COVID-19 case definitions, the LCCT shall classify and test these close contacts based on DM 2020-0180 Revised Interim Guidelines on Expanded Testing for COVID-19.

6. Sample collection shall be performed by the concerned P/C/MESU.

7. If close contacts reside outside the jurisdiction of the concerned P/C/MESU but reside in the same region, the RESU shall endorse the list of these close contacts to the appropriate P/C/MESU.

8. If close contacts reside both outside the jurisdiction of the concerned P/C/MESU and the region, the RESU shall endorse the list of these close contacts to the appropriate RESU, who shall endorse to the appropriate P/C/MESU.

C. Contact Tracing in Areas with Community Transmission

1. All P/C/MESUs in areas with community transmission shall continue conducting case investigation, testing, and contact tracing to reduce transmission of COVID-19.

2. The LCTTs in these areas may conduct contact tracing until 2nd generation transmission, and/or prioritize less affected communities and/or high risk close contacts, which includes health workers, non-health workers with high risk exposure, and people working with vulnerable populations (e.g., elderly care workers).

3. Conduct of case investigation, testing, and contact tracing in these areas shall be complemented by other measures, such as work/school suspension, community quarantine and physical distancing, to effectively reduce COVID-19 transmission.

D. Composition and Coordination with Local Contact Tracing Teams (LCTT)

1. The LCTT shall be composed of the following:

Team Leader: City or Municipal Health Officer

Co-Team Leader: City or Municipal Philippine National Police Chief

Members: City or Municipal Philippine National Police, physicians, nurses, midwives, and/or sanitary inspectors from the City or Municipal Health Office, local population officers, workers and volunteers from the City or Municipal Population Office, Bureau of Fire Protection, City or Municipal Disaster Risk Reduction and Management Office, Barangay Health Emergency Response Team; other staff or individuals who shall be designated/deputized by the Team Leaders.

2. DOH Centers for Health Development may deploy Human Resources for Health for contact tracing.

3. Other agencies, such as the Commission on Population and Development, and the Armed Forces of the Philippines, may also be deputized to assist in contact tracing.

E. Monitoring of Close Contacts under Quarantine

1. The Barangay LGU, through the BHERT, supported by other volunteers and contact tracing personnel shall monitor close contacts under quarantine for the development or progression of signs and symptoms of the disease.

2. The BHERT shall update all contacts' Signs and Symptoms Log Forms (Annex H) daily.

3. Any previously asymptomatic close contact who develops signs and symptoms shall be referred by the BHERT to the P/C/MESU and shall be re-assessed, re-classified, managed depending on classification as specified in Annex D.

4. Any symptomatic close contact who by the end of the 14-day quarantine remained symptomatic but still does not fit suspect case definition, should be re-assessed and managed as per current clinical practice guidelines. Said close contact should remain in self-isolation while undergoing said assessment.

F. Certificate of Quarantine Completion

1. The Provincial, City or Municipal Health Officer, upon the recommendation of the P/C/MESU, shall issue a Certificate of Quarantine Completion (Annex I) to all close contacts who shall successfully complete the 14-day home-based quarantine and is asymptomatic at the end of the 14-day quarantine.

2. Close contacts who remained symptomatic by the end of the 14-day quarantine shall be issued a certificate of quarantine completion by the physician who monitored his clinical course until resolution of his medical condition.

G. Recording and Reporting

1. All P/C/MESUs shall submit information gathered during case investigations to the RESU daily by 5:00 PM. The RESU shall in turn submit these to EB immediately.

2. All LCTTs shall submit information gathered during contact tracing to the P/C/MESUs, who shall submit to the RESU daily by 5:00 PM. The RESU shall in turn submit these to EB immediately.

3. All BHERTs shall submit daily monitoring data of contacts to the P/C/MESUs, who shall submit to the RESU and EB by 10:00 AM the following day.

4. Hospitals shall submit status updates of admitted COVID-19 cases (Annex J) to the RESU. The RESU shall submit these updates daily to EB by 5:00 PM.

5. In the interim, a ladderized information flow (Annex K) shall be observed, starting from LCTTs, to P/C/MESUs, to RESUs, and to EB. In the future electronic submission of contact tracing data shall be utilized to ensure timely submission and validation of data at all levels.

H. Use of Information and Communications Technologies related to Contact Tracing

1. All contact tracing applications or technologies should include the necessary data fields, conform to DOH contact tracing protocols, and shall be cleared by the national lead of contact tracing following the standards developed by the Knowledge Management and Information Technology Service (KMITS) of DOH.

2. All entities interested to develop contact tracing applications and technologies should be registered to the National Privacy Commission and should conform to the provisions of the Data Privacy Act of 2012 including, but not limited to, assigning data protection officers and ensuring policies on data protection and breach management protocols.

I. Protecting Data Privacy of COVID-19 Cases and Close Contacts

1. Pursuant to Data Privacy Act of 2012, declaration forms shall be given to and signed by COVID-19 patients and close contacts, or their relatives, caregivers, and/or guardians, prior to conducting epidemiologic investigation or close contact interviews. A privacy notice shall be provided to inform patients and contacts on the processing of information.

2. All identified close contacts shall be assigned anonymised identification for the purpose of information sharing to or data analysis by individuals other than the personal information controller or those designated to have access to personal and sensitive information. Names and other unique identifiers shall NOT be released publicly or shared with entities not directly involved in the care of the patient, or entities unauthorized by law or other legal instruments to process such information, without the patient's consent. Violations of this provision shall be punishable by the penalties set under the Data Privacy Act.

3. Only information relevant to the contact tracing shall be collected. The DOH reserves the right to release information on COVID-19 cases that are relevant for public health interventions without full disclosure of the case's identity.

4. The DOH with other government agencies involved and/or contributing to the contact tracing shall form a memorandum of agreement on data sharing to ensure proper use and accountability of personal information being collected.

5. The Epidemiology Bureau shall be the personal information controller who will be responsible for directing all actions related to the data, including the use of personal information needed for the conduct of COVID-19 response activities such as contact tracing.

6. The RESU, the P/C/MESU, other surveillance units, and deputized agencies shall identify their personal information processors and shall be responsible for assigning a data protection officer and data protection controls such as privacy and breach management.

V. ROLES AND RESPONSIBILITIES

A. The EB shall:

1. Provide technical supervision on the joint contact tracing activity by the RESU and concerned LGU;

2. Design recording and reporting systems and applications to ensure timely submission of complete and valid data; and,

3. Coordinate with appropriate national government agencies to secure records and documentations needed for contact tracing.

B. The KMITS shall:

1. Develop standards for applications and technologies for contact tracing and other COVID-19 mitigation efforts and ensure that they conform to mutually agreed protocols.

2. Undertake appropriate monitoring and evaluation activities to ensure quality of system implementation, including adequacy of control mechanisms, security management, and feedback system; and,

3. Provide direction on resolving technical issues and concerns related to the development, implementation, and use of the contact tracing applications or technologies.

C. The RESU shall:

1. Ensure timely and appropriate coordination with concerned LGU and other regional and local offices, institutions, and officials, as needed;

2. Ensure timely endorsement of list of confirmed cases to concerned P/C/MESU;

3. Supervise conduct of case investigations;

4. Facilitate collection of laboratory specimens while the LGUs and health facilities are not yet trained in specimen collection, storage, and transport;

5. Regularly monitor conduct of contact tracing and provide technical assistance to the LGU and catchment hospitals;

6. Ensure timely submission of all data gathered to EB, preferably using standardized forms and the COVID-19 Information System; and,

7. Orient and/or train LGU, health facilities, and concerned agencies on contact tracing guidelines and recording and reporting systems, even in the absence of confirmed COVID-19 cases in the LGU.

D. The LGU and its P/C/MESU shall:

1. Draft case investigation plans;

2. Conduct case investigation and specimen collection;

3. Conduct appropriate management and referral, as needed, of symptomatic close contacts;

4. Facilitate transportation for suspect and probable cases that need to be referred to higher level of care, as well as for samples to be submitted to the laboratory;

5. Ensure timely submission of close contact profiles and monitoring to RESU; and,

6. Orient and/or train the local contact tracing and monitoring teams.

E. The LCTT Leader and Co-Team Leader shall:

1. Draft contact tracing plans;

2. Secure the list of confirmed COVID-19 cases from the P/C/MESU concerned;

3. Locate all confirmed cases and secure the areas where the cases are located;

4. Prepare and provide needed logistics for contact tracing;

5. Regularly coordinate with the P/C/MESU for updates;

6. Ensure that reports are submitted on time to the P/C/MESU;

7. Ensure that members of the LCTTs are oriented and trained;

8. Ensure that the data privacy rights of patients and individuals subjected to contact tracing are protected; and

9. Utilize the Demographic Vulnerability Tool downloadable from the POPCOM website (http://popcom.gov.ph) in planning and implementing its task.

F. The members of the LCTT shall:

1. Conduct contact tracing;

2. Conduct immediate transport of close contacts for health facility isolation;

3. Provide health education to close contacts;

4. Submit accomplished forms to the Team Leader and Co-Team Leader;

5. Conduct daily monitoring of close contacts for 14 days each;

6. Assess previously asymptomatic close contacts presenting with symptoms at any point during the duration of the quarantine; and,

7. Refer symptomatic close contacts to the Team Leader or Co-Team Leader for assessment and facilitate transport for immediate referral, as needed.

G. The BHERTs shall:

1. Serve as the navigator of the LCTT and help to locate all contacts;

2. Conduct regular monitoring and assessment of close contacts under quarantine;

3. Submit timely and accurate Individual Signs and Symptoms Log Forms to the P/C/MESU; and,

4. Immediately refer to the LESU all close contacts who shall develop signs and symptoms while under quarantine.

H. The health facilities (public and private) shall:

1. Cooperate fully with the DOH-EB and its regional and local counterparts by ensuring that LCTTs are provided access to medical records, facilitating case interviews, and conducting other case investigation and contact tracing activities by virtue of R.A. 11223 and R.A. 11332; and,

2. Submit Case Investigations Forms and Travel History, Places Visited, and Events Attended Forms using the COVID-19 Information System.

(SGD.) FRANCISCO T. DUQUE, III, MD, MScSecretary of Health

Footnotes

1. See Annex A (Summary of Updated Quarantine and Isolation Protocols) of DOH Memorandum Order No. 2022-0013, p. 6.