COVID - NEW GUIDELINES FOR MANAGING CASES AND CLOSE CONTACTS

 Filenews 10 January 2022

Updated guidelines for the management of COVID-19 cases and their close contacts

1. Management of positive cases:

By announcing the positive result after Rapid antigen test or PCR test (molecular test), the virus-positive person must:

• put directly into self-isolation,

• inform his/her Personal Doctor,

• inform his close contacts, the employer, the school, the camp, etc.,

• exits self-isolation only with the lapse of the days provided for by the release protocol, and after receiving a release sms.

It is forbidden to travel by any means of public transport (bus, taxi, plane and ship) for reasons of prevention of dispersal. Positive cases that have a scheduled trip are not allowed to do so before their official release from their Personal Doctor or the release team of the Ministry of Health. For citizens or tourists staying in hotels and for people who cannot observe the isolation in their home, there is provision for free state quarantine and transportation by means provided by the Ministry of Health. If they do not wish to be accommodated in the state quarantine, these individuals can choose to rent at their own expense a private accommodation (apartment, house, villa) and be transported by private vehicle to spend their self-isolation period there, after consultation with the Unit of Epidemiological Surveillance and Control of Infectious Diseases (MEE&ELN), but for no reason can continue to stay in a hotel.

It should be noted that the results of the rapid test sampling points are communicated to the MEE&ELN after the completion of the tests and within 24 hours the people with a positive result receive a text message (sms) with the Self-Isolation Instructions for confirmed cases of COVID19 on the mobile phone they declared during their examination. The virus-positive person must follow the self-isolation instructions they receive. If the person is a minor, a guardian's mobile phone should be declared and not the child's.

In the same sms, the positive case receives passwords and a link to confirm his details, to declare his contacts and his Personal Doctor so that he can monitor and release him and have the ability to issue the necessary release certificates when his quarantine is completed.

The social and family contacts of the case are declared immediately through the electronic platform, after they are declared by the positive case and then they receive self-isolation instructions and their samplings are scheduled by the coordination of the Public Health Clinics.

In the instructions received by the positive case there is also a relevant table that the case can declare additional close contacts after filling in the electronic form and send them by email to the contacttracing@moh.gov.cy.

The Personal Doctor is responsible for monitoring the health of his/her patients/beneficiaries and releasing the confirmed cases, in accordance with the release protocol and not earlier than 10 days from the diagnosis or onset of symptoms. Persons who do not have a Personal Doctor are released from the Release Team of MEE&ELN. Upon their release, all cases receive a text message stating the date of release that can be used for Safe Pass purposes. Alongside their release (10 days after the positive result), people who tested positive for the coronavirus can issue a European Digital Recovery Certificate to travel within the European Union through the https://www.eudcc.gov.cy/portal.

Sick leave is given by the Personal Doctor.

All the data collected by the MEE&ELN is used exclusively to identify the source of infection of the positive case, identify its contacts and understand the behaviour of the virus.

For general information, positive cases can be called 1474 (Monday to Sunday 08:00-20:00), while for reporting worsening symptoms, medical assessment or need to be transferred to a hospital they can call 1420 24 hours a day.

If someone has been diagnosed positive to the coronavirus and has not received a text message with the instructions within 24 hours, he/she should contact the laboratory or the individual who performed the test and make sure that his/her positive result has been declared and that the contact details kept by the laboratory are the correct ones (e.g. the wrong phone number).

It is understood that if the positive results are not declared by the laboratory or the person who conducted the examination at the Ministry of Health, the positive case will not be able to receive the required instructions, to monitor the course of his health, to declare his contacts, but also to receive all the supporting documents he is entitled to upon his release (e.g. SafePass, EU Digital Covid Certificate).

For release issues, positive cases can be contacted by the Release Team at the covidfollowup@moh.gov.cy email address or on 22605306 phone.

Cases with a positive coronavirus test, which have completed their vaccination or have recovered within more than 3 months, follow the procedure normally and are not exempt from self-isolation.

Antibody tests and self-test results are not acceptable methodologies for diagnosing a positive case.

Manage close contacts of cases

Close contacts are determined by specific criteria according to the following:

• Person living with a confirmed case

• Person who had direct physical contact with a confirmed case (e.g. handshake)

• A person who has had unprotected contact with infectious secretions of a confirmed case (e.g. saliva)

• Person who had face-to-face contact with a confirmed case at a distance of less than 2 meters and with a duration of more than 15 minutes

• Person found in an enclosed space (e.g. classroom, cinema, hospital waiting areas, etc. with a confirmed case for more than 15 minutes and at a distance of less than 2 meters

• A healthcare professional or other person who provided health care in a CASE of COVID-19 or laboratory staff who handled a sample of a confirmed case without using the appropriate protective equipment or if there is a rupture in its integrity

• A travel companion on an aircraft, people who travelled together or cared for the patient, crew members who served the part of the plane where the patient was sitting (probably all passengers who were seated in the same section of the plane and even all passengers of the flight can be considered as close contacts, if due to the existence of serious symptoms of the patient and the patient's movements on board the aircraft, more extensive exposure is involved)

It is emphasized that:

The close contact within educational units is determined by a relevant circular of the Ministry of Education and The Ministry of Education and The Ministry of Education and The School's Responsibility to declare close contacts.

Close contact within the workplace is declared by the Company's Safety and Health Officer.

For hospital staff, the instructions for returning to work may be different and under conditions set by the Hospital's Infections Committee.

What applies on a case-by-case basis to close contacts:

• Booster dose of vaccine ( booster), in effect from the same day from the booster dose:

It is not obliged to limit itself, provided that personal protection measures are observed (mask, hand hygiene, keeping distance from other people, reducing contacts, self-control for symptoms). Recommendation for *free Rapid Antigen Test on the 3^nd and^5th day of contact through the tracing process.

• Full vaccination with any vaccine recognized by the Republic of Cyprus (2 doses of vaccine or 1 dose of monododosic vaccine + 14 days) and the period of 7 months from the last dose has not elapsed:

It is not obliged to limit itself, provided that personal protection measures are observed (mask, hand hygiene, keeping distance from other people, reducing contacts, self-control for symptoms). Mandatory free* Rapid Antigen Test on the 3rd and 5th day of contact through the tracing process. Recommendation for PCR on the seventh day of contact.

• People who have previously been diagnosed/ill as positive cases with PCR or Rapid Antigen Test and have not elapsed 90 days since their release:

It is not obliged to limit itself, provided that personal protection measures are observed (mask, hand hygiene, keeping distance from other people, reducing contacts, self-control for symptoms). Mandatory free* Rapid Antigen Test on the 3th and 5th day of contact through the tracing process. Recommendation for PCR on the seventh day of contact.

• Full vaccination with any vaccine recognized by the Republic of Cyprus (2 doses of vaccine or 1 dose of monododosic vaccine + 14 days) but the period of 7 months from the last dose has elapsed:

He is required to self-limit himself for 14 days from contact with a confirmed case. Release earlier than 14 days can be done with PCR test (with negative result) on the 7th day of contact or later at a cost paid by the person concerned. Mandatory free* Rapid Antigen Test on the 3rd and 5th day of contact through the tracing process.

• People without a history of vaccination or disease or without having completed their vaccination regimen (e.g. only a dose of a dosing vaccine):

He is required to self-limit himself for 14 days from contact with a confirmed case. Release earlier than 14 days can be done with PCR test (with negative result) on the 7th day of contact or later at a cost paid by the person concerned. Mandatory free* Rapid Antigen Test on the 3rd and 5th day of contact through the tracing process.

*The planning for free rapid test on the 3rd and 5th day of the contact is scheduled by the Ministry of Health and the interested party is informed by telephone sms message about the place and time of sampling, at predetermined points that will be notified. At these points they should show the sms that says they are a close contact and give the code sent to them along with an identification information (ID, passport or ARC). A prerequisite for the close contact of the sms to receive the appointment is that the positive case has declared its contact through the electronic platform or the table received during its positivity. It is noted that if the 3rd day of contact has elapsed, only the test of the 5th day will be scheduled, while if the 5th day has passed, then no appointments will be scheduled and the contact should be examined via another route at its own expense.

For children under 6 years old, a free PCR test will be scheduled by telephone appointment from the Coordination of Public Health Clinics in their province of residence.

For verification of the above, the Cyprus police may request vaccination certificates or release certificates.

For hospital staff, the instructions for returning to work may be different and under conditions set by the Hospital's Infections Committee.

For all the above categories of close contacts, it is understood that when they present symptoms compatible with COVID-19, they should contact their Personal Doctor for assessment and planning a free PCR test through the Public Health Clinics.

For close contacts identified as contacts of some variant of concern (e.g. variant "omikron" or other) the instructions may be amended. In such a case, they will be informed by telephone by a state official of any variations in the procedures.

Those who are required to self-limit can remain in self-isolation in their place of residence as defined below. In case there is no possibility of applying the following, there is a quarantine provision - with an additional cost covered by the person concerned - in an appropriate quarantine hotel and can be arranged by phone at the 22691345 (This cost is fully covered by the Deputy Ministry of Tourism, if the close contact was a passenger on a plane and was called for instructions by an officer of the Ministry of Health). In any case, self-confinement in any hotel is prohibited due to the risk of dispersal. Private accommodation should be arranged or close contact should be transferred to the appropriate hotel.

Isolation instructions at home

• Ideally, the person should stay alone at home. If this is not possible, the suspected case is isolated in a room, which the other members will not use under any circumstances. If there are other suspected or even confirmed cases in the house, they should be isolated separately from each other.

• The room in which the suspected case resides should be adequately ventilated.

• They are not allowed to leave the house.

Self-confinement at home may be supervised either by on-site or telephone checks. Persons under house arrest are obliged to comply with the relevant decree. In case of non-compliance, they will be deemed criminally responsible.

• Visits are not allowed.

• It is recommended to use separate household utensils. If this is not possible, then disinfection should be carried out before and after each use with a common detergent or soap, rinsing and drying.

• It is recommended to use a separate bathroom and toilet. If there is no such possibility, then disinfection should be carried out in accordance with the instructions of the sanitary services (https://www.pio.gov.cy/coronavirus/pdf/4_3.pdf).

• If there is a scheduled trip before the release, it is NOT allowed to take place. An exception can be made in case the permanent residence is outside Cyprus, always in consultation with the Epidemiological Surveillance Unit for information and instructions, with a necessary negative PCR test with sampling less than 48 hours before the trip and provided that the person does not present any mixtures.

• Movement is allowed ONLY in case of medical emergency and after contacting the Personal Doctor or 1420. Where possible, transportation should be done without an escort and only by personal vehicle (not by bus or taxi).

• Until the end of the period of home self-isolation, the waste should be placed in a double bag and stored for 72 hours in a separate area from that of the specified collection. At the end of the 72 hours they can be placed in the usual place of collection.

• If the suspected case is under 15 years of age or is a person in need of care and does not self-serve, then a parent/guardian/caregiver can self-limit himself along with the suspected case to take care of them and also ask for special permission. For the person who chooses to stay in self-isolation along with the suspected case, the same guidelines for self-isolation at home and isolation from the rest of the roommates and the wider environment apply, as they apply to the suspected case.

• The only exception for the lifting of self-isolation is for the purposes of examination in public health clinics.

• No close contact is allowed to remain in a hotel beyond the appropriate hotels of the Deputy Ministry of Tourism. Private accommodation should be arranged or transferred to the appropriate hotel.

Next update/Sampling/Release

• The quarantine period is set at 14 days. The person defined as close contact can be released from quarantine earlier than 14 days if he/she performs a PCR test in a contracted laboratory on the 7th day of contact with a confirmed case or later (considering the day of contact as day zero) and has a negative result. The negative PCR result should be sent to the email contacttracing3@moh.gov.cy.

• Quarantine starts from the last day of contact with the case and not from the day of notification. The day of contact is defined as day zero, and the days of self-isolation begin to count from the next day.

• If close contacts are not isolated from the positive case (e.g. parents who are looking after a minor child, caregivers who care for people who do not serve themselves, etc.), then the last day of contact (day zero) is considered the day of release of the positive case, since until the last day before release the positive person is potentially contagious and the days of self-isolation are renewed.

• If a person has been declared as a close contact from the confirmed case, an officer of the Coordination of Public Health Clinics will contact the suspected case by phone within a few days to be informed about the sampling. Instructions will be given by telephone for the place and way to get there. From the process of tracing, a free test on every close contact is justified.

• For the result of the test will be informed within 72 hours by text message.

• If the person defined as close contact is not called for a test or does not wish to take the test, he can return to his activities after 14 days from the last contact with the case, as long as he does not show symptoms.

• Quarantine is automatically lifted over the days of self-isolation without further notice.

Personal Doctor

• There is no need to inform the Personal Doctor from the beginning, except in case of symptoms. Then the doctor can schedule further sampling if necessary.

• Daily thermometry by the person himself is recommended.

• In case there is no personal doctor, it is recommended to register immediately. If this is not possible, the person can contact the 1420 line for reporting and assessing symptoms.

Special permit

• It is possible to obtain a work permit from the Ministry of Health to people who were assessed as having had close contact with a confirmed case. The relevant file can also be filled in electronically in the following way:

1. On the page https://www.pio.gov.cy/coronavirus/ on the Information/Instructions tab there is the file Request for a certificate of absence from work for reasons of Public Health.

2. It is filled in and sent after the quarantine by fax (22771496) or via email (cycomnet1@cytanet.com.cy), as indicated on the form. The certificate will be shipped back in the same way.

3. The Certificate of Absence from Work for Reasons of Public Health issued by the Ministry of Health should be submitted to the Employer or the Social Insurance Services.

For general information, call the line 1474 (08:00-20:00).

For any additional instructions to indicate your close contacts and clarifications on the tracing process please contact the Tracking Team at the telephone numbers 22514264, 22514258, 22514259, 22771923 or email contacttracing2@moh.gov.cy (Monday-Sunday 08:00-00:00).

For symptom reporting, call your personal doctor or 1420 (24 hours).