Click here to download this circular as a pdf

TO:
HEADS OF PROVINCIAL HEALTH DEPARTMENTS DISTRICT,
HOSPITAL AND PHC MANAGERS
HEALTH CARE WORKERS

 

CHANGES TO COVID-19 QUARANTINE, ISOLATION AND CONTACT TRACING

 

Introduction

  1. As the COVID-19 pandemic evolves, new knowledge regarding the nature of COVID-19 infection, greater appreciation of the costs associated with current practices, as well as rising vaccination rates and immunity to COVID-19 infection amongst South Africans, have necessitated substantial revision of recommendations regarding quarantine, isolation and contract

 

Recommendations

 The following should be implemented with immediate effect.

 

2.            Isolation for Asymptomatic COVID infection

 People with asymptomatic COVID infection do not need to However they should be advised to:

    • Wear a mask whenever interacting with people, for the next 5 days from the date of the test
    • Avoid social gatherings (3 or more people) for 5 days from date of test
    • Avoid being with others socially in indoor spaces, for 5 days from date of test
    • Specifically avoid socially interacting with the elderly (>60 years) and anyone with co-morbidities (diabetes, lung disease, heart disease, kidney disease, cancer, uncontrolled HIV, immunocompromised), for 5 days from date of
  • A special scenario is asymptomatic COVID infection in individuals who are admitted to hospital, or in a congregate setting with people at risk of severe disease, such as a care In such settings, individuals with asymptomatic infection should be isolated in a separate room, or in a COVID ward, for 5 days from the date of the test.
  • Asymptomatic COVID infected staff at health facilities and care homes, should stay away from the workplace for 5 days from the date of the Where possible to do so, they should work remotely from home.

 

3.          Isolation for Mild Symptomatic COVID infection

 Those with symptomatic COVID infection who have mild disease (they do not require hospitalisation for COVID pnuemonia) should isolate for 7 days from the date of start of symptoms. There is no need for testing prior to de-isolation.

 

4.          Isolation for Severe Symptomatic COVID infection

 Those with symptomatic COVID infection who have severe disease (they have been admitted to hospital for COVID pnuemonia) should continue to isolate for 7 days from the date on which they no longer require oxygen therapy. There is no need for testing prior to de-isolation.

 

5.            Quarantine

 All quarantine should be This applies to everyone including health care workers.

  • An exception to this is where a cluster of COVID cases (3 or more people COVID infected in a group within the same time-period) occurs in a health facility or care
  • Those with ongoing exposure to asymptomatic COVID infected persons (since these people are not isolating) or to symptomatic COVID infected persons (e.g. the caregiver of symptomatic infected child) do not need to
  • Those who had exposure to COVID should closely watch out for COVID symptoms, and isolate if any symptoms

 

6.            Contact Tracing 

  • Active contact tracing should be stopped
  • An exception is where a cluster of COVID cases (3 or more people COVID infected in a group within the same time-period) occurs in a health facility or care
  • Passive contact informing by alerting (either by a clinician or an sms) people with COVID to inform others that they have been exposed to the coronavirus and should watch out for COVID symptoms, should continue.

 

7.          Outbreak Investigation and Containment

Investigations and containment activities (quarantine and active contact tracing) of a cluster of COVID cases (3 or more people COVID infected in a group within the same time-period) should be limited to health facilities and care homes.

 

8.          Complex scenarios for Isolation, Quarantine and Contact Tracing 

While the above recommendations on isolation, quarantine and contact tracing cover most scenarios, there might be some unique complex scenarios not covered by the above, and in those unique situations the clinician/s involved should use their discretion on how to proceed, by balancing the safest option against the socio-economic cost.