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COVID-19 Contact Tracing Guidance (Including Complex Settings) Health Protection Team Guidance Version 3.5 Publication Date: 29 April 2021

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COVID-19 Contact Tracing Guidance (Including Complex Settings) Health Protection Team Guidance Version 3.5 Publication Date: 29 April 2021 COVID-19 Contact Tracing Guidance (including complex settings) Health Protection Team Guidance Version 3.5 Publication date: 29 April 2021 This document is uncontrolled when printed. Before use check the COVID-19 page to verify this is the current version. Version history An archive of all previously published versions of this guidance and supporting resources that relate to COVID-19 is available on the PHS website. This includes resources that have been retired from the website because they have been superseded or are no longer required. Version Date Summary of changes V3.3 19/12/2020 Section 1: Introduction updated to include lateral flow devices and vaccines Section 4: Contact tracing updated to include lateral flow devices, testing of asymptomatic people in the community, participants in surveillance studies Section 6.1: Section on self-isolation period added, with details on change to 10 days for contacts and returning travellers Section 6.2: additional settings added, including care at home, early years and childcare settings. A section has been added for healthcare workers who test positive for COVID-19 whilst on duty during their infectious period Section 6.3: Link to SG COVID-19 protection levels added Section 7: initial follow up for cases updated with information for asymptomatic cases who have had LFD testing Section 8: self-isolation period updated from 14 to 10 days for contacts and returning travellers Section 11: PHS email address updated Section 12: Link to infection control addendum added Section 14: Confidentiality section updated about information that must be shared with contacts Appendices: Self-isolation period updated from 14 to 10 days for contacts and returning travellers. Contact details for HPTs updated with new email addresses. Addition of appendix 7 re self-isolation period for cases and contacts. V3.4 31/12/2020 Introduction updated to include the AstraZeneca vaccine Appendix 7 updated to Appendix 6 V3.5 29/04/2021 Guidance restructured with sections moved around for better flow Contact Tracing guidance for complex settings merged into this guidance, including appendices Section 1: Introduction updated to include regulatory approval of a number of vaccines Section 4: Access to universal rapid testing and Lateral Flow Devices (LFD) added Section 5: Added in what to do if a case tests positive within 90 days of an initial positive Section 6: Added in the need for all contacts to be tested Section 6.3: Added in additional scenarios of what to do if someone from outside the household visits either during the infectious period of a household case or their own infectious period Section 6.4: Self-isolation period updated to remove mentions of reduction of isolation period with effect from 14 December 2 Version Date Summary of changes Section 6.5 added in section for international travel and managed isolation (quarantine) Section 7: Added in a short summary of the Ct value of a PCR test Section 8: Proximity contact definition updated to include cumulative duration of contact during infectious period. Updated section on airline contacts to reflect current regulations and the need to carry out a risk assessment if more than one case is reported on a flight Section 9.1: complex settings updated to include settings that may have to close as a consequence of advice being given and settings where suspected clusters or outbreaks require further public health investigation. Section from guidance for complex settings added around following up community contacts and assessing risk of exposure Section 9.2: Links to setting specific guidance added and additional headings and sub-headings added for clarity for health and social care settings. Sections on general principles for patients and residents and appropriateness of PPE added from guidance for complex settings. Sub sections on PPE use, staff symptoms and what to do if a healthcare worker test positive updated Section 13: Associated legislation added from guidance for complex settings Appendix 1: Table 2 cumulative duration of contact updated for proximity contact Appendix 2 Table 1: guidance for travellers and contact categories updated with current travel regulations and the need to carry out a risk assessment if more than one case is reported on a flight Appendix 3: Contact tracing by setting-added in from guidance for complex settings Appendix 3 Table 2h: summary of occupational case and contact management in an aircraft updated with current regulations and additional information on managed isolation and self-isolation added, along with the SG’s list of acute risk countries Appendix 7: Table 1c updated with prisons/custody settings. Notes updated to remove 14th day of isolation. Additional scenarios added to include consideration for returning travellers developing symptoms during quarantine period and asymptomatic positive people who then develop symptoms within isolation periods. Self-isolation period for returning travellers updated Appendix 8 added in to provide additional clarity around self-isolation for a household Additional links to appendix 7 and 8 added in throughout Appendix 9 added in to provide clarity around travel regions and associated public health actions 3 Contents 1. Introduction .............................................................................................................................. 6 2. Purpose of this document ........................................................................................................ 6 3. Case definition ......................................................................................................................... 7 Case definition for individuals in the community ....................................................................... 7 Possible COVID-19 case (clinical criteria) ............................................................................ 7 4. Investigation and initial management of possible cases ........................................................... 8 5. Follow up of cases ................................................................................................................... 9 6. Follow up of contacts ............................................................................................................. 11 6.1 Testing of contacts ........................................................................................................... 11 6.1.1 Booking a test ............................................................................................................ 11 6.2 Advice for household contacts who live with the index case ............................................ 12 6.3 Advice for non-household contacts and household contacts who do not usually live with the case ........................................................................................................ 12 6.4 Self-isolation period .......................................................................................................... 13 6.5 International travel and managed isolation (quarantine) ................................................... 13 7. Understanding and managing a positive PCR test result for COVID-19 ................................ 14 8. Definition and classification of a contact ................................................................................ 15 Household contact .................................................................................................................. 15 Non-household contact ........................................................................................................... 15 Direct contact: ..................................................................................................................... 15 Proximity contact: ................................................................................................................ 16 Airline contacts ....................................................................................................................... 16 9. Contact tracing approach ....................................................................................................... 16 9.1 Management of complex settings and scenarios .............................................................. 16 9.2 General principles for assessment of exposures where PPE is being used ..................... 18 9.2.1 Health and social care settings .................................................................................. 18 PPE use .......................................................................................................................... 18 Staff symptoms ................................................................................................................ 18 Positive Healthcare worker (HCW) .................................................................................. 19 9.2.2 General principles for positive patients/residents are: ................................................ 19 9.2.3 Settings other than health and social care ................................................................. 20 9.3 Local geographical and incident specific variation ............................................................ 20 10. Contacts from other health boards or other countries .......................................................... 21 4 11. Identification of exposed settings ......................................................................................... 21 12. Data collection and recording ..............................................................................................
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