If you are a person who tested positive for coronavirus disease but showed no symptoms or without life-threatening symptoms, you will not be sent to a hospital. Instead, you will be placed in isolation for 14 days to prevent the spread of the virus.
This according to Dr. Marjorie Culas, Davao City assistant city health officer. Dr. Culas said isolation and quarantine are the most important components to end transmission of any infection or to stop the spread of a contagious disease and should be done immediately as soon as positive tests come out.
Among those needing isolation at the Temporary Treatment and Monitoring Facilities (TTMFs) for 10-14 days are confirmed Covid-19 mild and asymptomatic cases and 60 years old patients and below without pre-existing conditions. The number of days in isolation units will be determined by the licensed medical doctor assigned in each TTMF.
Those admitted to TTMFs are encouraged to have personal monitoring tools needed to continue self-assessment like digital BP apparatus, thermometer, pulse oximeter, and their maintenance medications, mobile phones, and hygiene kits.
Who will be brought to the hospital?
Patients who are showing symptoms of Covid-19 are brought to the Southern Philippines Medical Center (SPMC) for evaluation, laboratory work-up, and further observation and management.
Persons with co-morbidities, the elderly, those who are considered as moderate to severe cases, and patients who need extra medical care and management are also brought to the hospital (SPMC).
After a thorough evaluation by medical doctors and infectious specialists, they will either be brought to TTMF to finish the 10-14 days isolation or they remain at SPMC for care and treatment.
Isolation protocol
The isolation protocol currently being implemented is based on the Omnibus Interim Guidelines on Prevention, Detection, Isolation, Treatment, And Reintegration (PDITR) Strategies for Covid-19, DM2020-0439, and approved resolutions of the Davao City Covid Task Force headed by Mayor Inday Sara Duterte.
The procedure
Once a person is confirmed positive through an RT-PCR, which is considered as the gold standard for Covid-19, triaging is done by the Davao City designated referring physician. The patient will be contacted using the information provided by the patient on the case investigation form (CIF). The referring physician will conduct an assessment, evaluation, and categorization of the index case as asymptomatic or symptomatic, mild case, moderate case, severe case, or critical case.
“If the patient is showing respiratory symptoms like difficulty in breathing, coughing, loss of smell, and sore throat and with co-morbidities or pre-existing illnesses, they will be sent directly to the hospital,” Culas explains.
How about patients showing mild symptoms?
Mild symptomatic individuals have manageable symptoms and do not need to be hospitalized but need to be quarantined. Patients showing moderate symptoms also need to be hospitalized. They are those who are experiencing difficulty breathing, severe cough, lung problems like pneumonia, and other organ complications like chest pains and difficulty urinating or those with critical conditions (having severe symptoms and needing mechanical ventilation and intubation).
The referring physician will either endorse the patient to SPMC or to a government-owned TTMF or a private TTMF — if the latter is preferred by the patient, the cost will be shouldered by the patient.
Covid-19 positive patients will be transported to the facility (SPMC or TTMF) by the Rapid Action Team (RAT) of the City Government of Davao, which is the only authorized transport system for Covid-19.
The list of positive cases will be forwarded to the District Health Office in the area where the patient resides for proper and immediate contact tracing within the next hour or the next four hours after notification.
For contact tracing, the patient will be asked to disclose the identities and details of people they were in contact with. The first generation contacts or close contacts are called F1.
F1s will be advised to observe self-isolation and self-assessment. They will be scheduled for immediate swab testing. While waiting for their results, they will be quarantined in facilities provided by the city government.
The other people whom the Covid-19 positive patient were in contact with are called F2 and F3. They will be closely monitored and they are advised to observe minimum health standards of protection.
Discharge Protocol
Asymptomatic Covid-19 cases may be discharged from TTMF on the 10th day if they show no symptoms for the whole duration of their isolation.
For mild cases, if there are no symptoms for three consecutive days, they may be discharged from TTMF.
The moderate and severe cases are admitted to the hospital and they may be discharged on the 21st day after being observed to be asymptomatic for several days.
No repeat swabbing
There will be no repeat swabbing after discharge. If in case after 14 days the RT-PCR remains positive, a test can be done again on the personal capacity of the patient. Specialists say the virus is no longer infectious or the person is not contagious anymore after 14 days. The virus that may be detected are only remnants and are no longer transmissible to other individuals.
For persons exposed but with negative RT-PCR, it is highly recommended that they complete the 14-day home quarantine, self-isolation, and self-assessment — remembering always that the incubation period of the virus is 14 days. There is a high possibility that symptoms manifest on the 14th day of the infection.
At home, persons with negative RT-PCR tests and undergoing home quarantine must have a separate bedroom and bathroom for the protection of other household members.
It is important to observe physical distancing from other family members. The wearing of face masks and regular hand-washing using soap and water or alcohol-based hand rub are recommended.
