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Republic of the Philippines

Department of Health
OFFICE OF THE SECRETARY
May
12, 2020

DEPARTMENT MEMORANDUM
No. 2020 - _(1994

TO: ALL UNDERSECRETARIES AND ASSISTANT SECRETARIES;


DIRECTORS OF BUREAUS AND CENTERS FOR HEALTH
DEVELOPMENT; MINISTER OF HEALTH — BANGSAMORO
AUTONOMOUS __REGION MUSLIM___ MINDANAO); __IN_—

EXECUTIVE DIRECTORS OF SPECIALTY HOSPITALS AND


NATIONAL NUTRITION COUNCIL; CHIEFS OF MEDICAL
CENTERS, HOSPITALS, SANITARIA AND INSTITUTES;
PRESIDENT_OF THE PHILIPPINE HEALTH INSURANCE
CORPORATION; DIRECTORS OF PHILIPPINE NATIONAL
AIDS COUNCIL AND TREATMENT AND REHABILITATION
CENTERS AND ALL OTHERS CONCERNED

SUBJECT: Revised Criteria for Discharge and Recovered for COVID-19 Cases

BACKGROUND

The World Health Organization declared the Coronavirus Disease 2019 (COVID-19)
outbreak as a Public Health Emergency of International Concern last January 30, 2020
and classified it as pandemic last March 11, 2020. In the Philippines, a State of Public
Health Emergency was declared due to the acceleration and expansion of COVID-19
cases in the country.
In response to the evolving concerns and knowledge related to COVID-19, case
definitions and surveillance system for notification and reporting of COVID-19 should
be revisited and updated regularly. The availability of additional epidemiological
information on COVID-19 further directs the Department of Health on how to detect,
confirm, and report cases in the country.

These interim guidelines are hereby issued to provide guidance on the revised COVID-
19 criteria for discharge and recovery in hospitals and temporary treatment and
monitoring facilities (TTMF). These criteria shall be used in the interim while the
Administrative Order No. 2020-0013 is
in the process of amendment.

IL. IMPLEMENTING GUIDELINES

A. Criteria for Discharge


1. Criteria for discharge of Suspect COVID-19 Cases
a. Initial COVID-19 PCR test negative;is
AND
b. Anyof the following of the following conditions are met:
i.
ii.
There is
clinical improvement
There is no other indication for admission

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iii.
iv.
An alternative diagnosis is
available
The probability of COVID-19 has been ruled out

Criteria for transfer of Probable or Confirmed COVID-19 Cases from


hospitals to TTMF or home isolation:
a. Clinically recovered (physician assessed case to have been afebrile
for at least 3 days, with marked clinical improvement of COVID-19
related signs and symptoms, and hospitalization is no longer
required)
If for home isolation, demonstrated capacity to perform home
isolation, such as but not limited to separate bathroom or living
arrangement and available transportation arrangement for referral

Criteria for discharge of Probable and Confirmed COVID-19 Cases from


TTMF
to
a.
home:
Once criteria for recovered is met for confirmed cases
b. PCR test conducted at the end of the 14-day isolation period, is
NEGATIVE for SARS-CoV-2 AND clinically recovered for
probable cases

B. Criteria for Tagging Confirmed COVID-19 Cases as Recovered

Tagging a confirmed COVID-19 case as “Recovered” assumes that said case is


unlikely to infect others. This is based on the fulfillment of clinical, laboratory, and
isolation criteria using the latest available scientific evidence and based on test
availability. A confirmed COVID-19 case shall be classified as “Recovered” after
fulfilling the following criteria:

1. For asymptomatic close contacts who, upon testing, are then classified as
confirmed cases of COVID-19, and continued to be asymptomatic from
date of laboratory sample collection to date reported as a confirmed case,
the following should be fulfilled for him/her to be classified as
“Recovered”:
a. Completed a 14-day isolation based on the date sample was
collected and remained asymptomatic at the end of the 14 days;
AND
Did not develop any sign or symptom at the end of 14 days; AND
PCR test, conducted at the end of the 14-day isolation period, is
NEGATIVE for SARS-CoV-2

OR

Antibody test (FDA approved, RITM or DOST validated)


conducted at the end of the 14-day isolation period reveals presence
of IgG and absence of IgM

If neither antibody test or PCR is available at the end of the 14-day


isolation period, a physician shall decide if a patient is appropriate
to discontinue isolation and be labeled “Recovered” based on
clinical judgement.
2. Ifthe confirmed COVID-19 case was symptomatic at time of consultation,
admission, or reporting, the following should be fulfilled for him/her beto
classified as “Recovered”:
a. Asymptomatic or clinically recovered (physician assessed case to
have been afebrile for at least 3 days, with marked clinical
improvement of COVID-i9 related signs and symptoms, and
hospitalization is no longer required); AND
Completed a 14-day isolation (preferably in a TTMF) after he/she
was assessed to be asymptomatic or clinically recovered, and no
recurrence or progression of COVID-19 related signs or symptoms
was observedat the end of the 14 days; AND
PCR
test, conducted at the end of the 14-day isolation period, is
NEGATIVE for SARS-CoV-2

OR

Antibody test (FDA approved, RITM or DOST validated)


conducted at the end of the 14-day isolation period reveals presence
of IgG and absence of IgM

If neither antibody test or PCR is available at the end of the 14-day


isolation period, a physician shall decide if a patient is appropriate
to discontinue isolation and be labeled “Recovered” based on
clinical judgement.

Confirmed cases who do not fulfill ALL of the clinical, isolation, and laboratory
criteria at the end of the 14-day isolation shall continue to be isolated and assessed
every seven days using an FDA-approved and locally validated antibody test (if
available) or PCR (if available) or clinical criteria (if neither PCR or antibody test is
available) until he/she fulfills the criteria for “Recovered”.

For strict compliance.

ISCO ¥. DUQUE IIL, MD, MSe


Secretary of Health