ALGORITHM FOR TRIAGE OF PATIENTS WITH POSSIBLE COVID-19 INFECTION

IN PORTS OF ENTRY (as of 11 March 2020)

1 To be evaluated weekly by
Travel History History of Exposure within 14 days the ASEAN Biodiaspora
Virtual Center. Separate
TRAVELLER In the past 14 days to countries with NO advisory will be issued
A. Providing direct care for COVID-19
local transmission AND risk of every Wednesday to
patient determine countries to be
importation1 included.
B. Working together or staying in the same 2 Mild manifestations include
close environment of a COVID-19 fever, dry cough, fatigue,
YES sputum production, sore
C. Traveling together with COVID-19 patient
throat, headache, myalgia
in any kind of conveyance or arthralgia, chills, nausea
Symptoms D. Living in the same household as a or vomiting, nasal
Person Under COVID-19 patient
congestion, diarrhea
3 Severe manifestations
Monitoring Fever (≥38.0oC) AND/OR
include difficulty of
(PUM) NO Respiratory illness (cough breathing and/or respiratory
and/or colds) AND/OR rate ≥30/minute
4 Persons with underlying
Home Diarrhea
medical problems,
Quarantine YES NO including cardiovascular
disease, diabetes, cancer,
chronic lung disease, and
YES immunosuppression

Patients Under Investigation (PUI) Not PUI nor PUM

If with mild2 no co- If with mild +/- co-morbid +/-
Manage
morbid4, non-elderly, elderly and severe3
appropriately
provide instructions for manifestations, collect swab
home quarantine and refer to L2/L3 hospitals
 ALGORITHM FOR TRIAGE OF PATIENTS WITH POSSIBLE COVID-19 INFECTION IN
HEALTH CARE FACILITIES (as of March 11, 2020)
This algorithm is consistent with the PATIENT
WHO surveillance definition of ● Travel to or residence in a country/area reporting
COVID-19 as of 27 February 2020
local transmission of COVID-19 (see WHO situation
and may change depending on ACUTE
reports for an up-to-date list of countries) OR
evolving information on RESPIRATORY Did the
transmission patterns and ILLNESS ● CLOSE CONTACT with a confirmed COVID-19 case** YES
YES (any of the following) symptoms NO
pathogenicity of the virus. ● Fever (≥ 38ºC)
○ Providing direct care without proper PPE*** to occur
AND/OR
confirmed COVID-19 patient within 14
● Cough OR shortness
**CONFIRMED case – A person ○ Staying in the same close environment (incl. days of
of breath OR other
with laboratory confirmation of workplace, classroom, household, gatherings) exposure?
COVID-19 infection, irrespective of respiratory
symptoms AND/OR ○ Traveling together in close proximity (1 meter or 3
clinical signs and symptoms
● Diarrhea feet) in any kind of conveyance
YES
*** PROPER PERSONAL
PROTECTIVE EQUIPMENT (PPE) NO Patient Under Investigation (PUI)
1.Well-fitting N95 mask (fit-tested)
Person Under
2.Eye protection (goggles or face Verify & coordinate with RESU
shield)
Monitoring (PUM)
● A patient with severe acute respiratory Complete the case investigation form (CIF)
3.Impermeable gown
infection or atypical pneumonia AND MILD +/- Co-morbid +/- Elderly
4.Surgical gloves ASYMPTOMATIC patients
requiring hospitalization AND with no other YES MILD SEVERE & CRITICAL
The reader is referred to the ASYMPTOMATIC
with appropriate patients
Guidelines on Infection Control for with appropriate etiology to fully explain the clinical No Comorbid ADMIT to designated COVID-19
EXPOSURE history should isolation area
COVID-19. EXPOSURE history presentation, regardless of exposure history Non-Elderly
undergo home quarantine • Collect serum, NPS + OPS (in 1
should undergo home for ● Cluster of ILI cases in household or workplace
for 14 days to monitor • No need VTM/UTM) and a lower
COVID-19 – CoronaVIrus Disease quarantine for 14 days to to test
2019; PPE – personal protective
the development of respiratory tract specimen, if
monitor
symptoms. for the NO • Provide possible
equipment; RESU – Regional
Epidemiology and Surveillance Unit;
development of symptoms. instructions • Refer to CPG
CIF – Case Investigation Form; NPS - Inform
● Inform RESU.
RESU for home • Patients who refuse admission
– Nasopharyngeal swab; OPS – - Fill
Fill out
out CIF
CIF.completely.
Not PUI nor PUM quarantine
● must be referred for disposition to
oropharyngeal swab; VTM – viral - No
● NOneedNEED forfor testing.
testing. Refer to ER or other clinic for appropriate RESU
transport medium; UTM – universal work-up and management
transport medium