INFECTION CONTROL COMMITTEE

Date : April 27, 2020

TO : JANE CLEOFE – PANALIGAN, MD

COVID19 Task Force – Head

THRU : ROCHEL DALAY – EDADES, MD

OIC – Infection Control Committee
IM – Infectious Diseases Specialist

CC : MEDICAL DIRECTOR / HOSPITAL ADMINISTRATOR

FROM : INFECTION CONTROL COMMITTEE

RE : EXPANDED TESTING FOR COVID19 – RECOMMENDATION

COVID19 Expanded Testing is defined as testing all individuals who are at risk for contracting COVI19 infection. This includes
the following groups:

a. Suspected cases
b. Individuals with relevant history of travel and exposure (or contact) whether symptomatic or asymptomatic.
c. Healthcare workers with possible exposures whether symptomatic or asymptomatic.

The following reflects the sub-groups of a risk individuals arranged in order of greatest to lowest need for testing:

a. Subgroup A: Patients or healthcare workers with severe / critical symptoms, relevant history of travel / contact.
b. Subgroup B: Patients or healthcare workers with Mild symptoms, relevant history of travel / contact, and considered
vulnerable.
c. Subgroup C: Patients or healthcare workers with mild symptoms, relevant history or travel / contact.
d. Subgroup D: Patients or healthcare workers with no symptoms but relevant history of travel / contact.

Due to global shortage of testing kits and limitations in local capacity for testing, there is a need to rationalized available test and
prioritize subgroups A and B.

However, in view of the expansion of testing capacity and to ensure healthcare workers safety, subgroup C will be tested and
healthcare workers prioritized.

All symptomatic healthcare workers should be isolated and tested using RT – PCR test. All symptomatic healthcare workers
who test POSITIVE using RT – PCR must be isolated or hospitalized depending on the severity of symptoms or assessment of
the attending physician. After 14 days without symptoms, the healthcare worker can be subjected to antibody testing. All
symptomatic healthcare workers who test NEGATIVE using RT – PCR may return to work upon resolution of symptoms, then
be subjected to guidelines for asymptomatic health care workers.

All asymptomatic healthcare workers with unprotected exposure should be isolated and tested with RT – PCR. If cleared using
a NEGATIVE RT – PCR, they are allowed to return to duty granted that they have remained asymptomatic. If they developed
symptoms, they shall be prioritized for RT – PCR testing and shall follow protocol indicated for symptomatic
management.

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Due to the evolving nature of the etiology of COVID19, protocols for discharge criteria and management shall apply:

1. Confirmed positive cases on admission SHOULD ONLY be discharged if ALL of the following conditions are fulfilled:

a. Two (2) negative RT – PCR tests for COVID19 done 48 hours apart.
b. Afebrile and symptomatic (including cough and respiratory symptoms) for 48 hours.
c. Laboratory and radiologic tests done according to clinical case management (Chest X-Ray, WBC, platelet count,
CPK, liver functions tests, plasma sodium) previously abnormal returning to normal.

2. Confirmed COVID19 cases admitted as per DOH Decision Tool, shall be discharged upon NEGATIVE COVID19
TEST from RITM. Until then confirmed cases shall be admitted in isolation even if asymptomatic. Repeat testing for
patient’s / healthcare care workers with an initial negative COVID19 test result may be performed if a high index for
suspicion for COVID19 remains despite an initial negative test result.

Everyone is advised to refrain from sharing unverified reports / results and / or false news regarding patients and healthcare
worker’s status to avoid undue stress and worry due to misinformation’s.

Thank you and God Bless!

Sincerely,

LARIZZA ANN C. RAMOS, RRT, MSRT CRISCARLSON C. GALENDEZ,

MAN, RN
Designate OIC – Infection Control Committee Infection Control Nurse
Infection Control Team – Scientific Committee Officer

Noted by:

ROCHEL DALAY – EDADES, MD

OIC – Infection Control Committee

Approved by:

JANE CLEOFE – PANALIGAN, MD

COVID19 Task Force - Head

3.

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