Instructions for persons under home-based isolation

Quarantine is used when a person is possibly infected with a disease but is not yet symptomatic. Isolation applies to patients with symptoms of infectious disease.

The Chief Epidemiologist is authorized to take such measures according to article 12 of the Act on Health Security and Communicable Diseases.

Isolation:

Individuals that are suspected to have the COVID-19 infection or are laboratory confirmed and do not require hospital stay, should be isolated at home or at locations specified by the Department of Civil Protection and Emergency Management or the health care system.

At onset of home-based isolation, the following should be reviewed with the person concerned, by the COVID-19 clinic, primary care clinic or 1700 (Laekna- vaktin-on call doctors):

  • A healthcare professional provides detailed information on infection pathways and symptoms of the COVID-19 infection. The information can also be found on the website of the Directorate of Health.
  • Contact and droplet contamination spread the disease. This means that there is risk of spreading the virus when an infected person sneezes, coughs, or blows their nose, and a healthy person inhales these droplets or they land on their hands and they then touch their eyes, nose or mouth.
  • If interaction with others is inevitable, the patient should pay close attention to hand hygiene and wear a facemask if coughing or sneezing frequently. If a facemask is not available, covering their mouth and nose with a tissue when coughing or sneezing is important. The tissue should be discarded into a plastic bag immediately after use and hands cleaned thoroughly.
  • A person in isolation should stay in the household and have contact with as few people as possible.
    • A person in isolation must not leave the household unless necessary, e.g. to seek necessary health care services, after consulting with the COVID-19 clinic/primary care clinic/1700 (+354 544 4113)/112. Routine medical or dental check-ups, attending physiotherapy or visits to medical specialists that are not related to the COVID-19 virus are not considered essential health care while in isolation and all such service should be rescheduled. If illness (worsening COVID-19 disease or other illness) or an accident occurs while in isolation and medical attention is required, the person who contacts the health care services should notify the responder of the need for isolation precautions. This allows the responder to arrange the necessary precautions for the medical staff involved in providing care, but should NOT delay or inhibit access to necessary healthcare.
  • A person in isolation must not use public transport or taxis. If she/he needs to seek necessary health care services, she/he may use a private car if she/he, or someone that is also in isolation in his household, is able to drive, otherwise ambulance assistance should be obtained by calling 1700 (+354 544 4113)/112.
  • A person in isolation must not attend school or work with other people. A medical certificate from the COVID-19 outpatient clinic might be needed. Employers have been instructed to be considerate of the need for isolation for an employee until they are fit to come to work again.
    • The patient must not attend any gatherings, whether it concerns his work, family or social life. For example, work meetings or gatherings, union meetings, confirmations, funerals, home-based social gatherings, choir rehearsal, concerts, etc.
    • The patient must not visit fitness centers, swimming pools, theatres, cinemas, shopping malls, or other places where people come together.
    • The patient must not himself go for supplies/necessities, i.e. pharmacy, grocery store, post office, banks, etc.
    • The patient must not stay in shared spaces in apartment buildings, i.e. stairwell, laundry rooms, or shared yards/outdoor areas. Hand hygiene is very important and common surfaces such as elevator buttons should be sanitized by the individual in quarantine after they are touched.
    • The patient may not welcome guests in the home during isolation.
    • The patient can go out to a balcony or private garden. If there are other people there, the patient must go inside again and pay attention to hand hygiene before touching door handles etc.
    • Individual in isolation can take out the trash if healthy enough, if there are no others in the household that can do it. The isolated individual should wear a facemask if he is likely to meet others in shared spaces, or carry a tissue to use when coughing and sneezing and clean hands before and after opening the garbage chute/trashcan/trash room and wipe of any handles with 70% alcohol or other disinfectants after contact.
  • Ideally, isolation is on an individual basis. A family/group who shares the same exposure can be quarantined together but run the risk of extending their own quarantine and may increase their own risk of infection, for example if they cannot maintain the proper distance from the isolated person(s), or if others fall ill during the quarantine. Family members who are well should stay beyond 2-meter distance from the patient as much as possible and pay careful attention to hygiene.
    • Windows in shared spaces should be kept open, such as kitchen and bathroom.
    • Shared spaces and contact surfaces should be cleaned thoroughly, such as the handle of the refrigerator, light switches and doorknobs.
    • The patient should have access to toilet facilities for their use only. If this is not possible, a separate towel is necessary and common surfaces should be disinfected after each use, for example the door handles, faucets, toilet-flushing mechanism etc.
    • The patient should sleep in a separate room from others, or a separate bed if another room is not available.
    • Wash hands or use hand sanitizer after contact with the patient or his environment. (see guidelines on hand hygiene and infection prevention on the Directorate of Health´s website)
    • Tissues used by the patient for covering or wiping the face should be disposed of immediately in a plastic bag, which can then be discarded in the general trash receptacles.
    • Hand sanitizer should be accessible in the patient‘s environment.
  • Contact with other people must be strictly limited. Therefore, a patient in isolation may need assistance with necessities. If someone in the household is in isolation, other members of the same household must be under quarantine if they were around the patient when first symptoms appeared.
    • When the whole household is in isolation or quarantine, friends and relatives may assist with necessities and leave at the front door.
    • If delivery of food and other necessities is available in the area, this service can be utilized during quarantine.
    • It is possible to contact the Red Cross for necessities if needed. Anyone that is quarantined in Iceland can contact the Red Cross helpline at 1717 (+354 580 1710 for foreign numbers) or online at www.1717.is. There you can ask for assistance, get support or information and talk to someone in confidence. The helpline is open 24/7 is free of charge.
    • If the patient requires assistance or care, the same person should provide it for the duration of illness. Avoid direct contact with secretions (mucus, vomit, stool etc.). Keep single use gloves handy for use if contact with secretions is unavoidable. The person assisting the patient during the illness increases their own risk of illness leading to isolation and at the least will extend their own quarantine until 14 days after the last possible transmission, possibly as much as 14 days after isolation ends.
    • Wash hands or use hand sanitizer after contact with the patient or his environment
  • A contact from the COVID-19 clinic or local health care services should be in daily contact with the patient by phone or visit for the duration of the isolation.
    • The patient must measure and record their body temperature daily.
    • If a patient develops worsening symptoms they should get in touch with their health care contact or call 1700 (on an Icelandic line) or +354 544 4113 (from any phone) for further guidance.
    • If a patient under isolation becomes suddenly seriously ill requiring transfer to hospital by ambulance, when calling 112 the suspicion of or confirmed COVID-19 infection must be made clear.

Isolation for COVID-19 can be lifted by a doctor when BOTH the following criteria are met:

  • 14 days have passed from the confirmation of COVID-19 illness

    AND

  • The patient has been symptom free for at least 7 days

After the period of isolation, the convalescent patient should continue to avoid contact with individuals with risk factors for severe disease for 14 days. Continued careful attention to hygiene and hand washing is strongly recommended. In instances where the above criteria are not clear repeated swabs for diagnosis of the virus, or antibody testing, might be required. If repeated viral swabs are negative or antibodies are present then contact with vulnerable populations is not prohibited.

Special cases:

  • Individuals who are generally healthy and who have no or mild symptoms the entire time can be discharged when 10 days have passed from the confirmation of disease and they have been completely symptom-free for 3 days.
  • Asymptomatic individuals: Individuals must be afebrile without any symptoms of illness, lethargy, aches, cough, shortness of breath or runny nose.
  • Cohabitants together in quarantine and isolation: Quarantine of a cohabitant of an individual in isolation can be lifted at the same time as per the decision of the Landspitali Covid team. The individual in quarantine then needs to undergo a screening test to lift the quarantine. The quarantine is lifted if the test is negative. This applies to all individuals living together, including children.
  • Special circumstances of cohabitants in quarantine and isolation, if the individuals are totally separated in the household, i.e. on separate floors or at least separate bedroom/bathroom or strict cleaning/disinfecting of common areas, then the household member in quarantine can undergo testing after 7 days from beginning of isolation of the infected person and quarantine lifted if the test is negative. The Landspitali Covid team makes the decision in this matter.
  • Cohabitants all in isolation together: When the first individual has recovered, he/she can be discharged (as above) with the condition that the other affected individuals continue isolation towards the discharged person and others. It is important that all members of the household adhere to strict personal hygiene and thoroughly clean the house before isolation is lifted. This applies to all individuals living together, including children.
  • Health care staff: Same rules apply as for others. However, special consideration must be taken regarding certain job descriptions involving vulnerable populations. Physician and supervisor will consider this on a case-by-case basis.

Fyrst birt 04.11.2020

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