Republic ofthe Pigines Department of Health OFFICE OF THE SECRETARY February $,2020 DEPARTMENT CIRCULAR No, 2020 TO: ALLUNDERSECRETARIES AND ASSISTANT SECRETARIES: SUBJECT: Reiteration of the Interim Guidelines on Contact Tracing for wel Coronavirus Acute Respiratory Disease {2018:nCoV ARD) Cases ‘The Department of Health reiterates Department Memorandum No, 2020-0068 entitled “Interim Guidelines on Contact Tracing for Confirmed 2019 Novel Coronavirus Acute Respiratory Disease (2019-nC0V ARD) Cases.” This is to provide guidance to all partners and stakeholders to tke the necessary steps to address the engoing 2019-nCoV Acute Respiratory Disease (ARD) situation, Dissemination ofthe information to all concemed is requested eT | £8 10 207 | ga cea gr | re enn T1380, 1950 Fe 1-109 ORL: Mies go ent BeeS pb the Pigs 3 Deparment of Hain yi] OFFICE OF THE SECRETARY 3 February 2020 DEPARTMENT MEMORANDUM No.2020- 0068 10: SUBJECT: Interim Guidelins on Contact Tracing for Confirms 2019 Nosel ‘Coronavirus Acute Resplratory Disease (2019-nCoV ARD) Cases 1. BACKGROUND [After a cluster of pneumonia cases of unknown etiology was reported in Wuhan City, Hubei Province of China last December 31, 2019, Chinese health authorities ‘preliminarily identified the eause ofthis viral pneumonia as 2 new or novel type of coronavirus (2019-2C0V). ‘With an increasing number of cases spreading to various teritores and confirmed human-to-human ttansmission the World Health Organization declared the outbreak as-a Public Health Emergency of International Concem (PHEIC) last January 30, 2020. “The Department of Health (DOH) hereby issues interim guidelines on contact tracing to control and lmitthe spread ofthe 2019-nCoV ARD. H._ DEFINITION OF TERMS As used inthis Department Memorandum, the following terms shall mean: 1. Contact tracing ~theidentifiaton, listing and follow-up of persons who may have come into contact with an infected person. Contact tracing plays an ‘important role in containing outbreaks of infectious diseases. The main purposes fof contact tracing are t: (1) confirm diagnosis, (2) determine the extent of Secondary transmission and (3) identify appropriate control measures for the spect disease, CERTIFIED TRUE COPY, ne bine 71-38, HL-AS Fa eO9 « Uhre por ema: RdoeBSAB DE(aw 2.0 934 AdOO 3NUL G31SUAID 2, Close contact — a person who may have come into contact with an infected person. Close contacts are categorized into four categories. Offies directly responsible fr tracing of each contact eategotes ate preseribed in Annex A. 3, Person Under Investigation (PUD) ~ refers to any person, rezanlless of nationality, race and age, who exhibits fever andor cough, and has at least one of the following: (1) history of travel to China 14 days prior to onset of symptoms, and () has a history of exposure 14 days prior to onset of symptoms, and shal be referred to hospital quarantine 4. Person Under Monitoring for Facility Quarantine (PUM-F) - refers to any pron, regardless of nationality, race and age, who does not exhibit any sign nor Symptom, but has a history of travel t© Hubei, China and/or has a history of exposure, and shal be refered to facility quarantine. 5, Person Under Monitoring for Home Quarantine (PUM-H) - refers to any person, regardless of nationality, race and age, who does not exhibit sny sign nor ‘symptom, ha history of travel fo other areas of China andor history of exposure, and shall be referred to home quarantine GUIDELINES A, Initiation of Contact Tracing [Contact tracing shall be one of the major strategies to contain the outbreak inthe carly stage where epidemiological evidence shows first and second generation transmission of 2019-n100V ARD. 2. Contact tracing and monitoring stall be considered only for the initial eases found fat the start of the outbreek. Contact tracing shall focus on the subset of the Population most likely to be at risk of infections and in the network of 3. Contact tracing forthe first 100 confirmed cases inthe country shal be mandatory to contain and limit the spread of infection 1B, Identification of Close Contacts I. AIL close ‘contacts shall be identfed. ‘The Regional Fpidemiology and Surveillance Unit (RESU) and Epidemiology Bureau (EB) shall lead in the identification of close contacts, in coordination with the designted/concermed Iocal epidemiology and rurveillace unit (LESU). 2, The Bureau of Quarantine (BOQ) shall immediately provide the concemed RESU and the ER with the manifest and other pertinent identification documents on lose contacts under categories A and B. The RESU shall coordinate with the fconcemed transport service company for contact deals of the passengers and ‘row. Information about close contacts canals be obtained ffom interviews ofthe patient, family members, workplace or school associates, or others with Knowledge about the case's cent activites and travels. 3, The EB shall inform the Bureau of International Health Cooperation (BIHC) of foreign nationals identified as close contacts. 4 ‘The RESU and LESU shall properly coordinate with concemed government and private officials and personnel for initiation of contact traci 5, Ih the event that a close contact cannot be contacted through phone, ED shall tvordinate ‘with Crime Investigation and Detection Group (CIDG) of the Philippine National Police for assistance.C. Management 1, All close contacts that do ot exhibit signs and symptoms upon sereening shall be ‘lassfed as PUM-Hs and should undergo home-based quarantine for monitoring for atleast 14 days from date of last exposure. They shall have their temperature taken and checked for cough, sore throat and other symptoms of respiratory nesses at least tice daily by the LESU and/or RESU staf. They shall also be ‘observed forthe development of fever andior respiratory illnesses. 4) Any close contact that develops fever and/or respiratory illnesses during the [day observation period shall be re-classified as a PUL by the LESU and should be reported [IMMEDIATELY to the City or Municipal Health Office (CHOMHO) where the patient resides. 'b) The CHO/MHO shal immediately notify the RESU. ¢) The CHOMHO shall notify the designated health facility of the arrival ofthe PUL, They shall also arrange for the immediate and appropriate transport of said elose contact to the designated referral facility 2, All lose contacts that exhibit fever andlor respiratory illnesses upon screening Shall be re-classfied by the LESU as PUIs and should be IMMEDIATELY reported to the CHO or MHO. 8) ‘The CHOIMHO shall immediately notify the RESU. 1) The CHOMMHO shall notify the designated health facility of the arival of the PUL. They shall also arrange for the immediate and appropriate transport of sti close contact to the designated referral facility D. Recording and Reporting All close contacts should be listed ia the Close Contact Line List Form. (See Annex B) 2, Each close contact shall have an indvidval Signs and Symptoms Log Form for ‘monitoring, Daily monitoring date shall be logged in the Signs and Symptoms Log Form. (See Annex ©) 3. This line list and fog form shall be updated daily and submited to the EB for ‘consolidation by 10:00 AM, , Termination of Contnet Tracing ‘Once there is evidence of sustained community transmission (3 or higher generation twansmission) in a particular area, contact tracing efforts will provide litle benefit in ‘controling disease spread and should be terminated. At this pont, the use of broad Community containment measures (eg. social distancing, school closures) which ‘equi fewer resources will provide the most benefit in eonttolling the spread. IV, ROLES AND RESPONSIBILITIES OF OFFICES A. The EB shal 1. Provide technical supervision onthe joint contact identification activity by the RESU and designatedconcerned LESU. 2, Inform the BIH of foreign nationals identified as close contacts, 5 Facilitate data sharing and consolidation with the CIDG at SPM daily and hold Coordination meetings the next morning for updating and progress reporting 1B. The BOQ shall immediately rrieve the manifest, contact information, and other pertinent ideatfication documents on close contacts under categories A and B, from 3 cam 40 834 AdO9 3NML Ga1s43O H. The BINC shal coordinate wit foreign embassies ofthe foreign nationals identified as close contacts for updates on the slats oftheir stay inthe country. For stit compliance of all concerned CERTIFIED TRUE COPY FEB 7 0a eles esas secon sai :COT. DUGUE 111, MD, Mse Secretary of Health[Annex A. Close Contact Categories A. CLOSE CONTACT CATEGORIES, DEFINITIONS, AND OFFICES RESPONSIBLE FOR TRACING ‘OFFICES CATEGORY DEFINITION a ‘Category A | These are passengers and ew (pilot, aptain, diver, | OQ conductor ight atendans, and other staff who EB Serviced the vessel ofa flight ors vesc, bus, BKC ‘tala, o other ransporaton/vehicle where 3 RESU confirmed ease who i stil inthe Philippines LESU rodeiused ‘Category B | These are passengew and crew (plot, apa, ever, | BOQ conductor, light attendants, and other staff who EB Serviced the vessel ofa ight a ea vessel, bus, BIC ‘tain, or othe tansporttcn/veicle where @ RESU confirmed ease who had already left the Philippines Lesu for another county rodelused ‘Category © | These ate persons who have hid exposure when they | REST lived with, worked wit, or eared for a confirmed Lesu case Hospitals ‘Category D | These are pesons who were a passenger or crew of RESU same vehicleivessel as, lived with, worked with LESU, fared fora patent under nvestigtion (PUD oF Hospital person under monitoring (PUM) who ded during their Leday monitoring period CLOSE CONTACTS CLASSIFIED INTO PUIs and PUM “CLASSIFICATION ‘CATEGORY Person Under Investigaion | Category A,B, Cor D with signs and symptoms Ge, wun Fever >= 38°C, cough andor colds Person Under Monitoring | Category A,B,C or D without signs and Smpioas (PUMA, Contimed Case (CC) Category A, B, Cor D wih laboratory coafimation of ection wi Ca¥ ARD.Annex B. Close Contact Line List Form ‘CONFIRMED CASE 1D: coe | Names ateeruaw | Contre | Bing contacto | Taemey | At Natimtiy | Conta, | "Eaperee | MS, | mmtrt ‘ramew, | “oon” | Osa conc H=Heuo WS = Work Ste $= SeAnnex C, Signs and Symptoms Log Form CConfimed Case ID. Date Region: (Close Contact Name: Date of Last Exposure: Date of Voluntary Quarantine Period Ends Date [Date [Date [Date [Date [Date | Date | Date | Date Symptom ‘AM [PM [AM] PM [AM | PM [AM [PM [AM [PM | AM | PAE [AM | Px | AM [PM | AM [Pa No Symptom Fever (temp) Cough Sore Throat “Took Antivirals Preumonia Diarrhea ther Symptoms 1 2 3 ‘Sought Consult