IF SYMPTOMS PERSIST
By DR. JOSE PUJALTE , JR.
“And he touched her hand, and the fever left her: and she arose, and ministered unto them.”
— Matthew 8:15, The Holy Bible, King James Version
Health Secretary Francisco T. Duque III, MD, MSc, responding to the novel coronavirus threat, recently issued Department Memorandum No. 2020-0090. The subject is: Interim Guidelines on the Management of Persons under Monitoring (PUMs) suspected with Coronavirus Disease 2019 (COVID-19) for Home Quarantine.
Since human-to-human transmission has been confirmed, last January 30, 2020, the World Health Organization declared this viral pneumonia outbreak as a PHEIC or a Public Health Emergency of International Concern.
• Any person, regardless of nationality, race, and age, who does not exhibit any sign nor symptom, has history of travel to other areas of China and/or history of exposure to a confirmed case of COVID-19, within the past 14 days, shall be required to undergo monitored home quarantine.
• Any person, regardless of nationality, race, and age, who exhibits fever or any symptom of lower respiratory illness, and has a history of travel to other countries with a confirmed case of COVID-19 but without any history of exposure, shall be advised to undergo monitored home quarantine.
• Those undergoing home quarantine shall be prohibited to leave their rooms/homes where they are quarantined until they have been certified by the local health official to have finished the 14-day requirement for quarantine procedures.
A. Room Isolation and Contacts of Persons Under Monitoring (PUM)
1. Place the PUM alone in a well-ventilated room, preferably with toilet and
bathroom. If this is not possible, maintain a distance of at least one meter from the
PUM (e.g., sleep in a separate bed).
2. Assign one person who is in good health as caretaker of the PUM.
3. Visitors, family members, and even caregivers are not allowed in the PUM’s room,
4. Confine activities of the PUM in his/her room only. If this is not possible, ensure
that shared spaces (e.g. kitchen, bathroom) are well ventilated (e.g., keep windows
B. Use of Disposable Surgical Mask
1. The PUM should wear a surgical mask fitted tightly to the nose, mouth, and chin
When in the same room with another household member or when talking to other
people. The use of masks is not required for the person/s the PUM is/are
2. If alone, the PUM is not required to wear a mask.
3. Masks should not be touched or handled during use. If the mask gets wet or dirty
with secretions, it must be changed immediately and disposed properly.
4. Discard the used mask after a maximum use of 8 hours. Masks are not reusable
and should not be washed. After removal of mask, wash hands using water and
soap, or rub hands with 70% alcohol or any hand disinfectant.
C. Hand Hygiene Practice for ALL
1. All PUMs and household members should perform hand hygiene following
contact with PUM orifin contact with their immediate environment.
2. Perform hand hygiene by washing hands with soap and water. If hands are not
visibly soiled, 70% alcohol or any alcohol-based hand rub can be used.
3. When using soap and water, disposable paper towels to dry hands is desirable. If
not available, use dedicated cloth towels and replace them when they become wet.
4. Hand hygiene should also be performed before and after preparing food, before
eating, after using the toilet, and whenever hands look dirty.
5. Address safety concerns (e.g., accidental ingestion by children and fire hazards) on
the use of alcohol-based hand rubs.
D. Respiratory Hygiene and Standard Precaution for ALL
1. Respiratory hygiene/cough etiquette should be practiced by all at all times.
Respiratory hygiene refers to covering the mouth and nose during coughing or
sneezing using surgical masks, tissues, flexed elbow, sleeves of clothes, or inside
the neckline of shirts, followed by hand hygiene.
2. Avoid direct contact with body fluids, particularly oral or respiratory secretions,
and feces. Use disposable gloves to provide oral or respiratory care and when
handling feces, urine, and waste. Wash hands before putting on and after removing
3. Avoid other types of possible exposure to PUM or contaminated items in their
immediate environment (e.g. avoid sharing toothbrushes, cigarettes, towels,
washcloths, bed linen).
E. Food Handling of PUM on Home Quarantine
1. The assigned caretaker of the PUM shall serve their plates/meal trays only up to
the room door.
2. After eating, plates/meal trays should be picked up at the room door by the
caretaker using disposable gloves to avoid contamination. Perform hand hygiene
3. Eating utensils and dishes should be cleaned with soap or detergent and water
after use and maybe re-used instead of being discarded.
4. Do not share eating utensils, dishes, and drinks with PUM.
F. Disposal of Used Gloves, Tissues Papers, and Masks
1. Immediately discard materials used to cover the mouth or nose into the trash or
clean reusable items appropriately after use (e.g., wash handkerchiefs using regular
soap or detergent and water).
2. Gloves, tissues, masks, and other waste generated by PUM should be placed in a
container in PUM’s room before disposal with other household waste.
G. Cleaning and Disinfection
1. PUMs are encouraged to clean and disinfect frequently touched surfaces such as
bedside tables, doorknobs, bedframes, and other bedroom furniture daily with
regular household disinfectant containing a diluted bleach solution (1-part bleach
to 99 parts water).
2. Clean and disinfect bathroom and toilet at least once daily with regular household
disinfectant containing diluted bleach solution (1-part bleach to 99-parts water).
3. Clean clothes, bedclothes, bath and hand towels, etc., of PUM using regular
laundry soap and water or machine wash at 60-90 °C with common household
detergent, and sun-dry. Place used linen in a laundry bag. Do not shake soiled
laundry. Additional measures may be needed to prevent unhygienic reuse of
gloves, masks. Avoid direct contact of the skin and clothes with the contaminated
4. Use disposable gloves and protective clothing (e.g., plastic aprons) when cleaning
or handling surfaces, clothing or linen soiled with body fluids. Perform hand
hygiene before and after removing gloves.
1. PUM who developed symptoms should be reported immediately to Regional
Epidemiology and Surveillance Unit (RESU) or Local Surveillance Officer for
transport to nearest health facility.
2. All household members of PUM should be advised to seek immediate medical
care when signs and symptoms develop.
E-mail: [email protected]