Considerations for quarantine of individuals in the context of containment for coronavirus disease (COVID-19)
WHO. Considerations for quarantine of individuals in the context of containment for coronavirus disease (COVID-19). World Health Organization, 2020, March 13
Review written by:
Nazneen Ali, edited by Elizabeth Harty
Green - This is a publication of the World Health Organization.
Quarantine includes the restriction of activities or the separation of persons who are not ill but who may have been exposed to an infectious agent or disease, with the objective of monitoring symptoms and ensuring early detection of cases. WHO recommends that contacts of patients with laboratory confirmed COVID-19 be quarantined for 14 days. A contact is defined as a person who 1) is involved in having face-to-face contact within 1 meter of a COVID-19 patient for more than 15 minutes, 2) having provided direct care without using proper PPE, 3) having stayed in the same close environment as a patient, 4) having travelled in close proximity, and 5) other situations as indicated by local risk assessment. The contact should have occurred from 2 days before and 14 days after the onset of symptoms. Possible settings for quarantine include hotels, dormitories, other facilities catering to groups, or the contact’s home.
WHO recommends that authorities ensure that the quarantine setting is appropriate and adequate food, water, and hygiene provisions be made available. If single rooms are not available, beds should be at least 1 meter apart. Proper environmental, infection control measures involving air filtration systems and waste management protocols should be used. Social distancing must be continued by quarantined persons. Appropriate levels of comfort should be maintained, for instance protection for baggage, appropriate medical treatment, and communication in a language the patient understands. Contact information for the local embassy and consular support should be provided. Quarantined persons should be able to communicate with family outside the facility, and access to the internet, news and entertainment should be provided. Special attention for older populations and other high-risk cases is essential.
The document outlines IPC measures that should be used to ensure a safe quarantine with proper administrative control and policies. These include:
Performing hand hygiene frequently after contact with respiratory secretions, before eating and before and after using the toilet.
Covering the nose and mouth with bent elbows or tissues (that should be disposed of in a wastebasket).
Refraining from touching the eyes, nose, and mouth
Environmental cleaning and disinfection of surfaces, clothes, linen and toilets should be followed consistently and correctly.
Quarantined persons should be followed up daily and screened for temperature and symptoms.
A medical mask is not required for asymptomatic patients. High risk cases require additional surveillance and access to medical treatments. Rest periods should be given for the staff at quarantine facilities. After quarantine periods are completed, respiratory samples must be sent for lab testing irrespective of the presence of symptoms.
These guidelines were announced March 19, 2020. As the pandemic evolves, some specifics are likely subject to change.