Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697642755708.pdf (Antigua and Barbuda)
GOVERNMNET OF ANTIGUA AND BARBUDA MINISTRY OF HEALTH WELLNESS AND THE ENVIRONMENT Quarantine Guidelines for the Outbreak of COVID-19 in Antigua and Barbuda June 2 2020 1.

Introduction Coronavirus disease (COVID-19) is a new disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

There is still a lot that is not known about COVID-19.

SARS-CoV-2 can be transmitted by droplets, aerosols and being in contact with contaminated surfaces.
Affected persons can be asymptomatic or can have mild, moderate or severe disease requiring hospitalization and intensive unit care.

There is no specific treatment for COVID-19, nor is there a vaccine at this time.

The only available methods to prevent and manage COVID-19 are public health measures such as social distancing, physical distancing, practicing cough and sneeze etiquette, handwashing, the use of personal protective equipment such as masks, quarantine and isolation.
Quarantine involves the restriction of movement, or separation from the rest of the population, of healthy persons who may have been exposed to the virus, with the objective of monitoring their symptoms and ensuring early detection of cases.

The purpose of this document is to offer guidance to other ministries, 1 institutions and organizations on implementing quarantine measures for individuals in the context of the current COVID-19 outbreak.
The Quarantine Act, Chap 661, Revised Laws of Antigua and Barbuda provides the legal framework for persons to be placed in quarantine.

They have also been developed in accordance with the International Health Regulations.

This document is informed by current knowledge of the COVID-19 outbreak which is limited and changes rapidly.

The Ministry of Health Wellness and the Environment (MOHWE) will therefore update these recommendations as new information becomes available.

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Quarantine in the context of COVID-19 The objective of quarantine is to quickly detect COVID-19 in persons who may have been exposed to the virus, isolate them and in so doing limit the spread to others.

Therefore, the following persons will be subject to quarantine in Antigua and Barbuda.

• Contacts of laboratory confirmed cases of COVID-19 • Contacts of suspected cases of COVID-19 • Persons traveling to Antigua and Barbuda from countries where there are outbreaks of COVID-19.
A contact is defined as a person who is involved in any of the following from 2 days before and up to 14 days after the onset of symptoms in the patient: • Having face-to-face contact with a laboratory confirmed COVID-19 patient within 1 meter and for >15 minutes; 2 • Providing direct care for patients with COVID-19 disease without using proper PPE or using PPE incorrectly; • Staying in the same close environment as a COVID-19 patient (including sharing a workplace, classroom or household or being at the same gathering) for any amount of time; • Travelling in close proximity with (that is, within 1 m separation from) a COVID-19 patient in any kind of conveyance; 3.
Place for Quarantine Quarantine will be at a designated government facility, hotel, private home, yacht or sea vessel, dormitory or any facility that can allow persons to be safely separated from others and monitored for symptoms of COVID-19.

The MOHWE will conduct a risk assessment and determine where persons will be quarantined.

This assessment will take the following factors into account.
• Overall maturity and responsibility of the person • The facility where the quarantine will take place • The level of supervision available for quarantine • The level of exposure of the person to COVID-19 and their potential to develop symptoms and spread the disease.

Any facility used for quarantine must provide the following for the entire 14- day period.

• A suitable place for persons to be housed.

• Personnel to monitor persons for symptoms of COVID-19.
3 • Equipment for monitoring symptoms of COVID-19 such as a thermometer.

• Adequate food, water and hygiene provisions.

• Psychosocial support • Security.

• Personal Protective Equipment 4.

Quarantine Period The recommended quarantine period for COVID-19 is 14 days.

However this may change in the following circumstances.

• If a person develops symptoms of COVID-19 or test positive for the disease, using a test approved by the MOHWE quarantine will cease and he/she will be moved to isolation.
• If they test negative for COVID-19 using a test approved by the MOHWE, he/she may be released from quarantine 5.

Special Populations There will be special considerations for quarantine for certain populations.

These include the following.

Returning nationals and residents of Antigua and Barbuda Returning nationals and residents of Antigua and Barbuda may be allowed to self-quarantine at home depending on the assessment of factors listed in Section 3.
Such persons can monitor their symptoms at home and report to the MOHWE daily or a healthcare provider may visit to check their temperature and/or examine for signs of COVID-19.. 4 Students Students, particularly university students, may be allowed to self quarantine at their dormitories or private residences.

They will be required to monitor their symptoms at home and report to the MOHWE at least once daily or as instructed by the MOHWE.
A healthcare provider may visit to check their temperature and/or examine for signs of respiratory disease.

The university can assist with temperature checks and monitoring as part of their school health program.

Any student who develops symptoms must be immediately isolated and the case reported to the MOHWE’s Epidemiology and Surveillance Unit.
Elderly persons Elderly persons who require special care may be allowed to self-quarantine at home if appropriate care is not available at the government’s quarantine facility.

Children Persons less than 18 years will be placed in a government quarantine facility only if there is supervision from a family member or guardian.

Persons with disabilities There will be special provisions for persons with disabilities at any government quarantine facility.
If these cannot be provided, special arrangements will be made for self-quarantine at home.

5 Persons with underlying medical conditions Persons with certain underlying medical conditions may be allowed to self- quarantine at home.

This will be determined by the MOHWE and will be dependent on the medical condition and factors outlined in Section 3.

Visitors Special arrangements will be made for visitors and non-residents to be housed in hotels and guest houses.
These special measures include: • Dedicated rooms or sections for quarantine • The understanding that all visitors exhibiting symptoms of COVID-19 will be isolated.

• Daily monitoring of guests for symptoms of COVID-19 by an on-site nurse.

o An on call physician must be engaged to monitor and manage visitors and hotel guests under quarantine.

o There must be daily reporting to the MOHWE Epidemiology and Surveillance Unit on each visitor/hotel guest.
o The on-site nurse and on call physician must immediately notify the MOHWE’s Epidemiology and Surveillance Unit of any guest who develops symptoms of COVID-19.

They must also ensure that the appropriate sample is taken and packaged for testing.

Transit and In-transit Passengers Transit and in-transit passengers will be quarantined until their next flight.
6 Infection Prevention and Control (IPC) Measures in Quarantine The following IPC measures must be used to ensure a safe environment for quarantines persons and to also reduce transmission of COVID-19.

• Any person in quarantine who develops febrile illness (fever) or respiratory symptoms at any point during the quarantine period should be treated and managed as a suspected case of COVID-19.

They must be isolated and the case reported to the MOHWE.
• Hand hygiene must be performed frequently, particularly after contact with respiratory secretions, before eating, and after using the toilet.

Hand hygiene includes cleaning hands with soap and water and using an alcohol-based hand rub.

Alcohol-based hand rubs are preferred if hands are not visibly dirty; hands should be washed with soap and water when they are visibly dirty.
• All persons in quarantine must practice respiratory hygiene and be aware of the importance of covering their nose and mouth with a bent elbow or paper tissue when coughing or sneezing and then immediately disposing of the tissue in a wastebasket with a lid and then performing hand hygiene.

• Persons in quarantine should refrain from touching their eyes, nose and mouth.

• A non-medical mask must be worn when interacting with others.
• All personnel working in the quarantine facility will be trained by the Central Board of Health (CBH) on standard infection prevention and control precautions.
• Both staff and quarantined persons should understand the importance of promptly seeking medical care if they develop symptoms 7 • Frequently touched surfaces, such as bedside tables, bed frames and other bedroom furniture, should be cleaned and disinfected daily with regular household disinfectant containing a diluted bleach solution (that is, 1-part bleach to 99 parts water).

For surfaces that cannot be cleaned with bleach, 70% ethanol can be used.
• Bathroom and toilet surfaces should be cleaned and disinfected at least once daily with regular household disinfectant containing a diluted bleach solution (that is, 1-part bleach to 99 parts water).

• Clean clothes, bed linens, and bath and hand towels using regular laundry soap and water or machine wash at 60-90 °C (140–194 °F) with common laundry detergent, and dry thoroughly.
• Cleaning personnel should wear disposable gloves when cleaning surfaces or handling clothing or linen soiled with body fluids, and they should perform hand hygiene before putting on and after removing their gloves.

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