Measures for Close Contacts of Confirmed Cases of COVID-19, PUMs, and PUIs

March 12, 2020

DEPED TASK FORCE COVID-19 MEMORANDUM NO. 03-20

 

The DepEd Task Force COVID-19 issues these guidelines, relative to the recent announcement of the Department of Health (DOH) of the 52 confirmed cases in the Philippines, and the exposure of some DepEd officials and personnel to a confirmed COVID-19 patient.

1. For reference, the table below provides the definition of terms used in this memorandum:

 

Confirmed case	A person with laboratory confirmation of COVID-19 infection, irrespective of clinical signs and symptoms
Appropriate exposure history	Pertains to any of the two following conditions: a. Travel to or residence in a country/area reporting local transmission of COVID-19 (based on the latest situation report of the World Health Organization accessible at http://bit.ly/whocovid19sitrep) b. Close contact with a confirmed COVID-19 case (any of the following): (1) Providing direct care without proper personal protective equipment (PPE) to a confirmed COVID-19 patient (2) Staying in a close environment (including workplace, classroom, household, gatherings) (3) Travelling together in close proximity (1 meter or less) with a COVID-19 patient in any kind of conveyance
Proper PPE	a. Well-fitting N95 mask (fit-tested) b. Eye protection (goggles or face shield) c. Impermeable gown d.  Surgical gloves
PUM	Person Under Monitoring
PUI	Patient Under Investigation
Symptoms of COVID-19	Acute Respiratory Illness a. Fever (≥38°C) and/or b. Cough OR shortness of breath OR other respiratory symptoms and/or c. Diarrhea

 

2. The table below, based on the Algorithm for Triage of Patients with Possible COVID-19 Infection in Health Care Facilities (as of March 11, 2020), is meant to guide concerned personnel and learners in identifying the DepEd internal color code and description that best fit them:

 

Appropriate Exposure History	Symptoms Occurred within 14 Days of Exposure	Co-morbid or Elderly	Category	Response
Home Quarantine	Admission to Designated COVID-19	Testing for COVID-19
YES	NO	-	PUM	Yes	No	No
YES	MILD	NO	PUI	Yes	No	No
YES	MILD	YES	PUI	No	Yes	Yes
YES	SEVERE AND CRITICAL	-	PUI	No	Yes	Yes
NO	SEVERE acute respiratory infection or pneumonia AND requiring hospitalization AND with no other clinical etiology to fully explain the clinical presentation	-	PUI	No	Yes	Yes

 

3. The table below shows the actions that must be taken by the individual depending on their respective color code:

 

Code	Actions to be Taken by the Individual
Yellow	1. Undergo 14-day quarantine to monitor the development of symptoms 2. Inform as soon as possible the immediate supervisor/school head (preferably through text messaging or phone call) and the QRRT COVID-19 Focal for monitoring at 09288718053 (Smart) and 09152053244 (Globe) 3. Inform (preferably through a phone call) the Regional Epidemiology and Surveillance Unit (RESU) at the Regional Center for Health Development (DOH Regional Office), or the nearest local epidemiology surveillance units located at the provincial, city, or municipal health office, and filling out the Case Investigation Form (CIF)
Orange	1. Inform as soon as possible the immediate supervisor/school head (preferably through text messaging or phone call) and the QRRT COVID-19 Focal for monitoring at 09288718053 (Smart) and 09152053244 (Globe) 2. Go to the nearest health facility for proper evaluation and management, including verification and coordination with the RESU and filling out the CIF 3. Undergo quarantine as instructed
Red	1. Inform as soon as possible the immediate supervisor/school head (preferably through text messaging or phone call) and the QRRT COVID-19 Focal for monitoring at 09288718053 (Smart) and 09152053244 (Globe) 2. Go to the nearest health facility for proper evaluation and management, including admission to the designated COVID-19 isolation area

 

4. Personnel and learners who will undergo home quarantine shall follow the following procedure, based on the DOH Circular No. 2020-0105, s. 2020.

a. Room Isolation and Contacts of Persons Undergoing Quarantine

i. Place the Persons Undergoing Quarantine alone in a well-ventilated room, preferably with toilet and bathroom. If this is not possible, maintain a distance of at least 1 meter from the Persons Undergoing Quarantine (e.g., sleep in a separate bed).

ii. Assign one person who is in good health as caretaker of the Persons Undergoing Quarantine.

iii. Visitors, family members and even caregivers are not allowed in the Persons Undergoing Quarantine's room, if possible.

iv. Confine activities if the Persons Undergoing Quarantine in his/her room only. If this is not possible, ensure that shared spaces are well ventilated.

b. Use of Disposable Surgical Mask

i. The Persons Undergoing Quarantine should wear a surgical mask fitted tightly to nose, mouth and chin when in the same room with another household member or when talking to other people. The use of masks is not required for the person/s the Persons Undergoing Quarantine is/are interacting with.

ii. If alone, the Persons Undergoing Quarantine is not required to wear a mask.

iii. Masks should not be touched or handled during use. If the mask gets wet and dirty with secretions, it must be changed immediately and disposed properly.

iv. Discard the used mask after a maximum of 8 hours. Masks are not reusable and should not be washed. After removal of mask, wash hands using water and soap, or rub hands with 70% alcohol or any hand disinfectant.

c. Hand Hygiene Practice for ALL

i. All Persons Undergoing Quarantines and household members should perform hand hygiene following contact with Persons Undergoing Quarantine or if in contact with their immediate environment.

ii. Perform hand hygiene by washing hands with soap and water. If hands are not visibly soiled, 70% alcohol or any alcohol-based hand rub can be used.

iii. When using soap and water, disposable paper towels to dry hands is desirable. If not available, use dedicated cloth towels and replace them when they become wet.

iv. Hand hygiene should be performed before and after preparing food, before eating, after using the toilet and whenever hands look dirty.

v. Address safety concerns (e.g., accidental ingestion by children and fire hazards) on the use of alcohol-based hand rubs.

d. Respiratory Hygiene and Standard Precaution for ALL

i. Respiratory hygiene/cough etiquette should be practiced by all times. Respiratory hygiene refers to covering the mouth and nose during coughing or sneezing using surgical masks, tissues, flexed elbow, sleeves of clothes or inside the neckline of shirts, followed by hand hygiene.

ii. Avoid direct contact with body fluids, particularly oral or respiratory secretions, and feces. Use disposable gloves to provide oral or respiratory care and when handling feces, urine and waste. Wash hands before putting on and after removing gloves.

iii. Avoid other types of possible exposure to Persons Undergoing Quarantine or contaminated items in their immediate environment (e.g., avoid sharing toothbrushes, cigarettes, towels, washcloths, bed linen).

e. Food Handling of Persons Undergoing Quarantine on Home Quarantine

i. The assigned caretaker of the Persons Undergoing Quarantine shall serve their plates/meal trays only up the room door.

ii. After eating, plates/meal trays should be picked up at the room door by the caretaker using disposable gloves to avoid contamination. Perform hand hygiene afterwards.

iii. Eating utensils and dishes should be cleaned with soap or detergent and water after use and may be re-used instead of being discarded.

iv. Do not share eating utensils, dishes and drinks with Persons Undergoing Quarantine.

f. Disposal of Used Gloves, Tissue Papers and Masks

i. Immediately discard materials used to cover the mouth or nose into the trash or clean reusable items appropriately after use.

ii. Gloves, tissues, masks and other waste generated by Persons Undergoing Quarantine should be placed in the container in Persons Undergoing Quarantine's room before disposal with other household waste.

g. Cleaning and Disinfection

i. Persons Undergoing Quarantines are encouraged to clean and disinfect frequently touched surfaces such as bedside tables, doorknobs, bedframes, and other bedroom furniture daily with regular household disinfectant containing a diluted bleach solution (1-part bleach to 99 parts water).

ii. Clean and disinfect bathroom and toilet at least once daily with regular household disinfectant containing diluted bleach solution.

iii. Clean clothes, bedclothes, bath and hand towels, etc. of Persons Undergoing Quarantine using regular laundry soap and water or machine wash at 60-90 degree Celsius with common household detergent and sun-dry.

iv. Use disposable gloves and protective clothing when cleaning or handling surfaces, clothing or linen soiled with body fluids. Perform hand hygiene before and after removing gloves.

h. Reporting

i. Persons Undergoing Quarantine who developed symptoms should be reported immediately to Regional Epidemiology and Surveillance Unit (RESU) or Local Surveillance Officer for transport to nearest health facility.

ii. All household members of Persons Undergoing Quarantine should be advised to seek immediate medical care when signs and symptoms developed.

5. All others who have visited places frequented by confirmed cases of COVID-19 are advised to self-monitor and if with symptoms, consult with health center or health units for appropriate management and monitoring.

(SGD.) ALAIN DEL B. PASCUAUndersecretary