Guidelines for low-risk COVID patients under medical care revised

The Director-General of Health Services today (January 27) issued revised guidelines on laboratory testing strategy for Covid-19, integrated home-based isolation and management of asymptomatic and mildly symptomatic patients and discharge criteria from treatment facilities.

In a communiqué, Dr. Asela Gunawardena said if the Covid-19 patient admitted to a treatment facility has improved from mild/moderate symptoms and fever free for 48 hours without antipyretics can be released from isolation after 7 days from the date of Rapid Antigen Test (RAT) or PCR positivity (or from the date of onset of symptoms).

Meanwhile, patients under home-based management system can be released from home isolation after 7 days from the date of RAT/PCR positivity (or from the date of onset of symptoms), if they have improved from mild/moderate symptoms and fever-free for 48 hours without antipyretics.

Exit PCR test or RAT is not required for them to be discharged from medical care.

However, those who have not improved mild/moderate symptoms and have fever for more than 48 hours are advised to contact the Medical Officer of Health (MOH) of their respective area for medical advice on further management.

Meanwhile, close contacts of Covid-19 patients who are fully vaccinated against the virus will not be quarantined if they do not indicate any syomtpms.

The health services chief said they can continue to work if employed. However, if they develop Covid-19 symptoms, a RAT or PCR should be performed.

All partially vaccinated or unvaccinated close contacts can be released from home quarantine after completion of 7 days from the date of RAT or PCR positivity (or from the date of onset of symptoms).

If they develop symptoms during the quarantine period, they should be referred to a RAT o PCR and if the test results turn out to be positive, they are required to inform the MOH in their area.

In a separate communiqué, Dr. Gunawardena specified instructions on identifying close contacts of Covid-19 patients.

Accordingly, a person who has had any of the following exposures to a confirmed case will be considered a close contact:
• Face-to-face contact with a probable or confirmed case within one meter and for at least 15 minutes
• Direct physical contact with a probable or confirmed case
• Direct care for a patient with probable or confirmed Covid-19 disease without the use of recommended PPE
• Other situations as indicated by local risk assessments

Exposure must have occurred during the infectious period of the case and is defined as follows:

Exposure to a symptomatic case: Two days before and 5 days after onset of symptoms of the case
Exposure to an asymptomatic case: Two days before and 5 days after the date on which the sample that led to confirmation was taken

Further, Dr. Gunawardena stated that in the indoor classroom setting, if the student(s) were beyond one meter of an infected student and if both the infected student and the exposed student(s) wore masks and if no face-to-face contact, there is no need for quarantine.

Only the unvaccinated students who fall into the definition of close contact should be quarantined.