COVID-19 RISK ASSESSMENT TOOL

*The Risk Assessment tool is subjected to changes with the changing pattern of disease transmission
Questions Instruction
Number

Q#
1a. Have you travelled from Mainland China/Iran/South Korea/ Italy /
other high burden area/region/ country***of COVID-19 infection in the
last 14 days?
1b. OR If “No” tick on No 0
Have you had close contact with any person, who has returned from “Zero”
Mainland China/Iran/South Korea/ Italy / other high burden country ***
of COVID-19 infection in the last 14 days?
1c. OR
Have you had close contact with confirmed case of COVID-19 in If “Yes” tick on Yes 2
last 14 days? “Two”
1d. OR
Are you currently living with confirmed case of Corona since last 14
days?
2a. Did you develop fever after arrival from Mainland China/Iran/South
Korea/ Italy / other high burden country*** of COVID-19 infection in
the last 14 days?
OR No 0
If “No” tick on
2b. Did you develop fever after close contact with any person, who has
“Zero”
returned from Mainland China/Iran/South Korea/ Italy / other high
burden country*** of COVID-19 infection in the last 14 days?
OR
If “Yes” tick on
2c. Did you develop a fever after close contact with a probable or Yes 1
“One ”
confirmed case of COVID-19 in last 14 days?
OR
2d. Did you develop a fever while living with a probable or confirmed case
of COVID-19 ?
3a. Did you develop cough / cold / sore throat / shortness of breath after
arrival from Mainland China/Iran/South Korea/ Italy / other high
burden country*** of COVID-19 infection in the last 14 days? (circle
appropriate symptom)
OR No 0
If “No” tick on
3b. Did you develop cough / cold / sore throat / shortness of breath after
“Zero”
close contact with any person , who has returned from Mainland
China/Iran/South Korea/ Italy / other high burden country *** of
COVID-19 infection in the last 14 days?
OR
3c. Did you develop cough / cold / sore throat / shortness of breath after If “Yes” tick on Yes 1
close contact with a probable or confirmed case of COVID-19 in last 14 “One ”
days?
OR
3d Did you develop cough / cold / sore throat / shortness of breath while
living with a probable or confirmed case of COVID-19 in last 14 days?

Adapted from CDC & WHO

 Calculate your Score
0 1 2 3 4
No Chance for development Low probability of Moderate to High
of COVID -19 disease COVID -19 probability
of COVID
-19

 If you have scored 2 or less than 2, you have No Chance for

development of COVID -19 But
 If your score is 3 or more than 3, you have a chance for
development of COVID -19. Further, you need medical
assistance, please visit the following designated hospitals for
further medical workup.
FJCGH
SZH
BH

Instruction for individuals who got 3 or more than 3 score

1. Isolate yourself in a separate room of your home and limit your movement
there.
2. Keep items of your personal use separate from other family members
3. Use mask 24 hours and change it when it becomes soaked or dirty
4. Wash your hands with water and soap regularly for at least 20 seconds.
***Other Countries with High Burden of Transmission:
5. Japan
6. Hong Kong
7. Malaysia
8. Other European countries : Germany, Spain , France, U.K , Switzerland,
Norway , Sweden
9. USA
10.Australia
11.Canada
12.Kuwait
13.Bahrain
-