Interim Guidance for Isolation/De-

isolation of COVID-19 Patients and

Quarantine of Close Contacts

Version 1
(January 10th, 2021)
 Table of Contents

DEFINITIONS………………………………………………………………………………………………………………………. 3

ABBREVIATIONS………………………………………………………………………………………………………………… 5

1. BACKGROUND……………………………………………………………………………………………………………….. 6

2. SCOPE……………………………………………………………………………………………………………………………… 7

3. PURPOSE………………………………………………………………………………………………………………………….7

4. APPLICABILITY………………………………………………………………………………………………………………..7

5. RECOMMENDATION ONE: DE-ISOLATION COVID-19 PATIENTS…………………………………7

6. RECOMMENDATION TWO: QUARANTINE OF CLOSE CONTACTS………………………………..9

REFERENCES………………………………………………………………………………………………………………………... 10

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 DEFINITIONS

COVID-19: is a disease caused by a new strain of coronavirus.. Formerly, this disease was referred

to as ‘2019 novel coronavirus’ or ‘2019-nCoV.’ The COVID-19 virus is a new virus linked to the

same family of viruses named Severe Acute Respiratory Syndrome (SARS) and some types of

common cold.

COVID-19 Test -Polymerase Chain Reaction (PCR): is the standard test for the detection of the

virus that causes COVID19. It tests for the virus’ genetic material, and a positive test detects at

least two genes. The test is generally done from a swab taken from the nasopharynx.

Confirmed COVID-19: is a person with a positive polymerase chain reaction (PCR) test result for

COVID-19 infection that is reported by an approved laboratory, irrespective of clinical signs and

symptoms.

Close Contact: is someone having exposure to a person with COVID-19 (excluding people who

have had COVID-19 Disease diagnosed by PCR within the past 3 months prior to the exposure),

without using proper personal protective equipment (PPE), from 2 days before onset of

illness/date of positive swab to 10 days after.

Exposure: is defined as one or more of the following:

o Being within 2 meters of a COVID-19 case for 15 minutes or more.

o Direct physical contact with a COVID-19 case.

o Providing direct care for patients with COVID-19 disease either at home or in the

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 healthcare setting (without proper PPE).

o Living in the same household as a COVID-19 case.

Isolation: is the separation of infected patients (suspected or confirmed) from healthy individuals

so they can start the treatment journey without infecting others. Healthcare providers along

with the employer are responsible for choosing the best place for people who are subject to

isolation as per the relevant guidelines. People who have been isolated for a period as per the

relevant guidelines do not pose any health threat to others.

Personal Protection Equipment (PPE): includes gloves, medical masks, goggles or a face shield,

and gowns, as well as for specific procedures, respirators (i.e. N95 or FFP2 standard or equivalent)

and aprons.

Quarantine: is the restriction of movement of those who may have been exposed to an infectious

disease but do not have a confirmed medical diagnosis to ensure they are not infected. Healthcare

providers along with the employer are responsible for choosing the best place for people who are

subject to quarantine as per the relevant guidelines. People who are quarantined for a period as

per the relevant guidelines do not pose any health threat to others.

SARS-CoV-2: is the virus that causes coronavirus disease (COVID-19).

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 ABBREVIATIONS

COVID-19 : Corona Virus Disease for the year 2019

DHA : Dubai Health Authority

PCR : Polymerase Chain Reaction

PPE : Personal Protective Equipment

SARS : Severe Acute Respiratory Syndrome

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 1. BACKGROUND

Corona Virus Disease (COVID-19) is a novel disease that has spread globally since 2019.

Current knowledge about COVID-19 transmission is that it spreads from human to human

through droplets (coughing and sneezing) and through direct contact with contaminated

surfaces or hands. Symptoms may appear within two (2) to ten (10) days after exposure;

however several COVID-19 carriers remain asymptomatic. Although the majority of people

with COVID-19 cases are uncomplicated or suffer from mild illness (81%), some cases are

expected to develop severe illness requiring oxygen therapy (14%) and approximately 5%

will need treatment in an intensive care unit. Isolation of confirmed COVID-19 patients and

quarantine of close contacts have been common effective measures in containing the spread

of the disease.

Lately, there has been varying degrees of community transmission of SARS-CoV-2 (COVID-

19), increasing testing capacity and accumulating evidence on the viral shedding and

infectiousness. This has increased the need for a guidance on discharge and ending of isolation

of people with COVID-19 and their close contacts. This guidance reflects the best evidence

available at the time of publication and will be updated as more information on the incubation

period of SARS-CoV-2 infection and viral shedding becomes available.

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 2. SCOPE

2.1. Health, isolation and quarantine facilities involved in the management of COVID-19

patients and close contacts.

3. PURPOSE

3.1. To ensure the adoption of best practices to prevent and control the spread of COVID-

19 infection in the community.

3.2. To ensure timely discharge and ending of isolation/ quarantine period for COVID-19

patients and their close contacts as per recent national and international guidelines.

4. APPLICABILITY

4.1. Public health, healthcare professionals and facilities under DHA jurisdiction.

5. RECOMMENDATION ONE: DE-ISOLATION COVID-19 PATIENTS

5.1. For asymptomatic COVID-19 positive patients (excluding severely

immunocompromised patients), a time-based strategy should be adopted as follows:

5.1.1. De-isolation of patients can occur 10 days after the first positive COVID-19

PCR test, assuming the patient has not subsequently developed any

symptoms since testing positive.

5.1.2. This recommendation applies to both home quarantine and isolation centers

in the Emirate of Dubai.

5.2. For mild/moderate symptomatic COVID-19 positive patients (excluding

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 severely immunocompromised patients), a combined time and symptom-based

strategy should be adopted as follows:

5.2.1. De-isolation of patients in this category can occur after 10 days have

passed since the symptoms first appeared and both of the following

criteria are met:

a. Complete resolution of fever without the use of antipyretics for

at least 72 hours; and

b. Improvement in respiratory symptoms (e.g. cough, shortness of

breath).

5.2.2. This recommendation applies to patients who have been discharged to

home isolation and isolation centers in the Emirate of Dubai.

5.3. Moderate, severe, and critical symptomatic COVID-19 positive patients who

are hospitalized up to and beyond day 10 of illness, or severely

immunocompromised patients with any severity of COVID-19 disease, a test-

based strategy should be adopted as follows:

5.3.1. Patients can be de-isolated and/or transmission based precautions can be

stopped once they have all the following:

a. Two consecutive negative COVID-19 PCR respiratory specimens that

are ≥24 hours apart;

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 b. Patient is afebrile for at least 72 hours without the use of

antipyretics; and

c. Patient has improved/minimal respiratory symptoms.

6. RECOMMENDATION TWO: QUARANTINE OF CLOSE CONTACTS

6.1. Close contacts should undergo home quarantine for 10 days after last exposure

even if they have negative COVID-19 PCR test, and they should self-monitor for

any recognized COVID-19 related symptoms

6.2. Persons can discontinue quarantine after 10 days without testing as long as they

have remained entirely asymptomatic. They must continue to be vigilant for any

symptoms and report them immediately even if they occur after the 10 day period.

6.3. Persons who develop any related symptoms during the quarantine should

immediately report to the public health authority or their healthcare provider to be

tested for COVID-19.

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 REFERENCES

1. Centers for Disease Control and Prevention (2020). Duration of Isolation and

Precautions for Adults. Available at: https://www.cdc.gov/coronavirus/2019-

ncov/hcp/duration-isolation.html (accessed on 30/12/2020).

2. Centers for Disease Control and Prevention (2020). Discontinuation of Transmission-

Based Precautions and Disposition of Patients with COVID-19 in Healthcare Settings

(Interim Guidance). Available at: https://www.cdc.gov/coronavirus/2019-

ncov/hcp/duration-isolation.html (accessed on 30/12/2020).

3. European Center for Disease Control and Prevention (2020). Guidance for discharge and

ending of isolation of people with COVID-19. Available at:

https://www.ecdc.europa.eu/sites/default/files/documents/Guidance-for-discharge-

and-ending-of-isolation-of-people-with-COVID-19.pdf (accessed on 05/01/2021).

4. Ministry of Health and Prevention (2020). Interim Guidance for Discharge/ Deisolation

of COVID-19 Patients and Quarantine of Close Contacts. (Version 2.0, December 24,

2020). Available at:

https://www.dha.gov.ae/en/HealthRegulation/Documents/National%20Guidelines%2

0(interim)%20for%20De-isolation%20COVID%2019%20Patients.pdf (accessed on

03/01/2021).

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