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Quarantine

What is 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; 

• 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; 

• Traveling in close proximity with (that is, within 1 m separation from) a COVID-19 patient 

What is Self-Quarantine?

Self-Quarantine is a transparent self-restriction of persons’ activities when they are not ill with COVID-19. This protects unexposed members of the community from contracting the disease if the at-risk person becomes sick and facilitates early detection of the disease for rapid implementation of response measures. It therefore helps to prevent the spread of the disease to close friends, relatives and community members.

 At-risk persons

 Include travelers coming from countries/territories/areas with active transmission of COVID-19 as designated by the Ministry of Health, Wellness and the Environment and any individual who has been in close contact with a confirmed or probable case with COVID-19.

Self-Quarantine Guidelines

 Infection and Prevention Control Measures must be practiced at home, in the hotel room or any designated accommodation without mixing with the general public or family members for 14 days since the last contact with a confirmed or probable case or since arrival from countries/territories/areas with active transmission of COVID-19. Self-quarantined individuals will be followed up by surveillance officers either via phone or via physical visits, in appropriate personal protective equipment (PPE), during the period of quarantine.

Quarantine Breach

 Individuals who breach the self-quarantine orders will be placed under quarantine in a government facility and are punishable by law.

The quarantined person should practice the following:

If you have been identified as a contact to someone diagnosed with COVID-19, have returned from a country with local transmission for COVID-19 or have been assessed by the Ministry of Health Wellness and the Environment as a person who can introduce or spread COVID-19 in Antigua and Barbuda. In order to protect the public, you are being placed in self-quarantine. You must follow these guidelines for self-quarantine for 14 days from your last potential exposure to COVID-19: 

  • You are required to provide your name, physical address and telephone contact to authorities. 
  • You must take your temperature with a thermometer at least two times a day or anytime you feel like you may have a fever and monitor yourself cough or difficulty breathing.
  • Follow the Ministry of Health, Wellness and the Environments instructions on reporting your temperature and any symptoms. 
  • Do not go out in public. 
  • Stay home from school and work. 
  • Do not take public transportation, taxis, or ride-shares. 
  • Employees: Discuss your work situation with your employer before returning to work. 
  • Avoid contact with others. Stay alone in a well-ventilated room. 
  • Avoid sharing toothbrushes, utensils, dishes, drinks, towels, clothes or bed linen with anybody in your home. 
  • It is essential for you to have someone bring you supplies. 
  • Do not have any visitors during this time. Tell potential visitors that you are under COVID-19 quarantine. 
  • Keep your distance from others (about 6 feet or 2 meters). 
  • Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing. Dispose of the tissue into a covered bin then wash or sanitize your hands. 
  • Avoid touching eyes and mouth especially after sneezing or coughing. 
  • Wash hands often with soap and water for at least 20 seconds to avoid spreading the virus to others. If soap and water are not readily available, you can use an alcohol-based hand sanitizer that contains 60%-95% alcohol. Always wash hands with soap and water if hands are visibly dirty. 
  • Clean and disinfect frequently touched surfaces such as doorknobs/handles, bedside tables, bedframes, light switch and phones with regular household disinfectant (Lysol, Pine-sol & 62-70% Alcohol). Clean daily and allow to air dry. 
  • Clean floors weekly using soap and water first, and then use mild disinfectant like Pine-sol or 5% bleach (Mix one cup bleach to nine cups of water in a bucket for mopping and in spray container), allowing to air dry. 
  • Change and wash linen weekly or as needed if soiled. 
  • Restrict members of the household from utilizing the same bathroom. If you share the same bathroom and toilet facilities, ensure you disinfect it after use using regular household disinfectant or soap and water. 
  • If you get sick with fever, cough, shortness of breath, or other signs of respiratory illness, call the COVID-19 Support Hotline at (268) 462 6843 (46COVID). Tell them you are under COVID-19 quarantine. If available, wear a mask if experiencing respiratory symptoms or caring for someone who is sick. 
  • Seek medical advice if you need to seek medical care for other reasons, such as dialysis, call ahead to your doctor and tell them your symptoms and that you are being monitored for COVID-19. Avoiding contact with others and visits to medical facilities will allow health care providers to quickly direct you to the right health facility and help protect you and others from possible spread of COVID-19 and other viruses. 
  • If you develop signs and symptoms of COVID-19, members of your household MAY be classified as close contacts depending on your interaction with them and will be required to self- quarantine. It is therefore important to implement effective self-quarantine. 
  • Find healthy ways to reduce anxiety and fear during quarantine. Keep a routine to include fun activities, reassure children, connect with others, take breaks from news stories and social media, take care of your body (take deep breaths, stretch, or meditate; eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, avoid alcohol and drugs). 

Quarantined persons can be released from quarantine if no symptoms show within 14 days and consultation with Ministry of Health, Wellness and the Environment of Antigua and Barbuda confirms their release. Any person who contravenes or fails to comply with regulations for quarantine is in violation of the law of Antigua and Barbuda and shall be guilty of an offence punishable to a fine of ten thousand dollars and to imprisonment for 1 year.

Self Isolation

What is Self-Isolation?

Isolation separates persons diagnosed with COVID-19 from people who do not have the disease. It is a public health measure that is used to prevent the spread of COVID-19.

Most people with COVID-19 develop only mild symptoms (40%) or moderate disease (40%), approximately 15% develop severe disease that requires oxygen support and 5% have critical disease with complications such as respiratory failure, acute respiratory distress syndrome and multi organ failure.

Some confirmed cases of COVID-19 do not develop any symptoms or are asymptomatic.

Who is an asymptomatic person?

Asymptomatic COVID-19 cases and those with mild or moderate symptoms may not require emergency interventions or hospitalizations and may be isolated at home or in a community facility. Decisions will be made on a case by case taking the factors listed above into consideration.

How are assessments carried out to determine isolation Facility?

In Antigua and Barbuda all cases of COVID-19 are isolated to contain virus transmission. Isolation may be at a health facility, community facility, or at home. Each case is carefully assessed and the decision on where isolation takes place depends on the following:

  • The clinical presentation
  • Requirements for supportive care
  • Potential risk factors for severe disease (age > 60 years, smoking, obesity, and non-communicable diseases such as diabetes mellitus, cardiovascular disease, chronic lung disease, chronic kidney disease, cancer and immunosuppression)
  • Conditions at the home including the presence of vulnerable persons in the household.
  • The ability to monitor the clinical evolution of a person with COVID-19 at home.

Infection Prevention Control (IPC) Advice for Persons Providing Care at Home

  • Limit the patient’s movement around the house and minimize shared space. Ensure that shared spaces (e.g. kitchen, bathroom) are well ventilated.
  • Household members should avoid entering the room where the patient is located or, if that is not possible, maintain a distance of at least 1m from the patient.
  • Limit the number of caregivers. Ideally, assign one person who is in good health and has no underlying chronic conditions.
  • Visitors should not be allowed in the home until the person has completely recovered, shows no signs or symptoms of COVID-19 and has been released from isolation.
  • Perform hand hygiene before and after preparing food, before eating, after using the toilet, and whenever hands look dirty. If hands are not visibly soiled, an alcohol- based hand rub can be used. For visibly soiled hands, always use soap and water.
  • A medical mask should be provided to the patient, worn as much as possible by the patient (covering the nose and mouth) and changed daily and whenever wet or dirty from secretions.
  • Individuals should practice rigorous respiratory hygiene; that is, coughing or sneezing into a bent elbow or tissue and then immediately disposing of the tissue followed by hand hygiene.
  • Materials used to cover the mouth and nose should be discarded or cleaned appropriately after use (e.g. wash handkerchiefs, using regular soap or detergent and water).
  • Caregivers should wear a medical mask that covers their mouth and nose when they are in the same room as the patient. Masks should not be touched or handled during use. If the mask gets wet or dirty from secretions, it must be replaced immediately with a new clean, dry mask. Remove the mask using the appropriate technique, which is to untie it, rather than touching the front of the mask, to discard it immediately after use and then to perform hand hygiene.
  • Avoid direct contact with the patient’s body fluids, particularly oral or respiratory secretions, and stool. Use disposable gloves and a mask when providing oral or respiratory care, and when handling stool, urine and other waste.
  • Perform hand hygiene before putting on the mask and gloves and after removing gloves and the mask.
  • Do not reuse medical masks or gloves (unless the gloves are a reusable product such as a utility glove).
  • Gloves and protective clothing (e.g. plastic aprons) should be used when cleaning surfaces or handling clothing or linen soiled with body fluids. Depending on the context, wear either utility or single-use gloves.
  • Clean and disinfect surfaces that are frequently touched in the room where the patient is being cared for, such as bedside tables, bedframes, and other bedroom furniture at least once daily. Clean and disinfect bathroom and toilet surfaces at least once daily. Regular household soap or detergent should be used first for cleaning, and then, after rinsing, regular household disinfectant containing 0.1% sodium hypochlorite (i.e. equivalent to 1000 ppm) should be applied by wiping surfaces.
  • Use dedicated linen and eating utensils for the patient; these items should be cleaned with soap and water after use and may be re-used instead of being discarded.
  • Place contaminated linen in a laundry bag. Do not shake soiled laundry and avoid contaminated materials coming into contact with skin and clothes.
  • Clean the patient’s clothes, bed linen, and bath and hand towels using regular laundry soap and water, or machine wash at 60–90 °C (140–194 °F) with common household detergent, and dry thoroughly.
  • After use, utility gloves should be cleaned with soap and water and decontaminated with 0.1% sodium hypochlorite solution. Single-use gloves (e.g. nitrile or latex) should be discarded after each use. Perform hand hygiene before putting on and after removing gloves.
  • Avoid other types of exposure to contaminated items from the patient’s immediate environment (e.g. do not share toothbrushes, cigarettes, cutlery, crockery, towels, washcloths or bed linen)