Quarantine Guidelines for the Outbreak of COVID-19 in Antigua and Barbuda

Objectives

The guidance establishes a risk-based quarantine framework for Antigua and Barbuda during the COVID-19 outbreak. Its central purpose is to enable ministries, institutions and organisations to monitor people who may have been exposed, identify cases early, isolate suspected or confirmed cases, and reduce onward transmission.[1]It is grounded in the Quarantine Act, Chapter 661 of the Revised Laws of Antigua and Barbuda, and the International Health Regulations, with recommendations intended to evolve as knowledge of COVID-19 changes.[1]

• Apply quarantine to contacts of laboratory-confirmed or suspected COVID-19 cases and to people arriving from countries experiencing outbreaks.[1]
• Use risk assessment to determine appropriate quarantine placement, considering exposure, capacity for supervision, the proposed setting, individual maturity and responsibility, and the likelihood that a person could develop or transmit COVID-19.[2]
• Support safe quarantine through symptom monitoring, infection prevention and control, prompt isolation of suspected cases, testing where approved, and notification to the Ministry of Health, Wellness and the Environment.[3]
• Provide tailored arrangements for returning nationals and residents, students, children, older people, people with disabilities, people with underlying medical conditions, visitors, non-residents, and transit or in-transit passengers.[2][3]
• Maintain quarantine for a normal period of 14 days, while transferring people to isolation if they develop symptoms or receive a positive approved test result.[2]

Implementation

Implementation combines government oversight, risk-based placement, daily health surveillance, facility management and infection-control measures. The Ministry of Health, Wellness and the Environment leads assessment, monitoring and release decisions, while the Epidemiology and Surveillance Unit receives case notifications and daily reports for relevant groups.[2][3]Quarantine may be delivered in government facilities, hotels, private homes, yachts or sea vessels, dormitories and other settings that allow people to be safely separated and monitored.[1][2]

• Assess each person and assign government-facility quarantine, hotel or guest-house quarantine, or self-quarantine according to individual circumstances and the safety and supervision available.[2]Allow home self-quarantine for returning nationals, residents, students and some people who are older, have disabilities or have underlying medical conditions, where the Ministry considers this appropriate.[2][3]
• Provide supervised government-facility quarantine for children under 18 where a family member or guardian is available.[2]Arrange dedicated rooms or sections in hotels and guest houses for visitors and non-residents, and quarantine transit and in-transit passengers until their next flight.[2][3]
• Supply accommodation, food, water, hygiene materials, psychosocial support, security, personal protective equipment, monitoring personnel and necessary monitoring equipment throughout quarantine.[2]
• Monitor symptoms daily through designated personnel and equipment, including thermometers.[2]Require people quarantining at home or in student accommodation to monitor symptoms and report to the Ministry at least daily, or as otherwise instructed; healthcare providers may visit to check temperature or assess symptoms.[2]
• Use on-site nurses to monitor visitors and hotel guests daily, with an on-call physician responsible for clinical oversight and management.[3]Report each visitor or hotel guest daily to the Ministry’s Epidemiology and Surveillance Unit.[3]
• Identify fever or respiratory symptoms in any quarantined person as possible COVID-19, isolate the person immediately and report the case to the Ministry.[3]Notify the Epidemiology and Surveillance Unit immediately when a hotel or guest-house guest becomes symptomatic, and collect and package an appropriate test sample.[3]
• Use approved COVID-19 testing to inform release from quarantine or transfer to isolation.[2]Permit release following a negative test approved by the Ministry of Health, Wellness and the Environment.[2]
• Train quarantine-facility staff in standard infection prevention and control precautions through the Central Board of Health.[3]Promote hand and respiratory hygiene, avoidance of face-touching, mask use when interacting with others, and prompt medical consultation when symptoms emerge.[3]
• Clean and disinfect frequently touched surfaces and bathroom facilities daily, using diluted bleach or 70% ethanol where bleach is unsuitable.[3]Wash clothing and linen appropriately, and require cleaning personnel to use disposable gloves and perform hand hygiene before and after glove use.[3]

The guidance identifies operational inputs but does not specify a budget, funding source, cost estimates, resource-mobilisation mechanism, formal performance indicators, audit process or wider evaluation framework.[1][2][3]Its explicit accountability mechanisms are daily symptom monitoring and reporting, prompt notification of suspected cases, Ministry oversight of risk assessment and testing-related release decisions, and reporting to the Epidemiology and Surveillance Unit.[2][3]

Monitoring & Evaluation

Monitoring arrangements centre on daily symptom surveillance, escalation of suspected cases, testing, and notification to the Ministry of Health, Wellness and the Environment (MOHWE). Quarantine ordinarily lasts 14 days and uses personnel and equipment, including thermometers, to monitor people for COVID-19 symptoms.[2]

• Monitor people in self-quarantine at home or in student accommodation for symptoms, requiring them to report to the MOHWE at least daily or as otherwise directed. Healthcare providers may visit to measure temperature or assess symptoms.[2]
• Monitor hotel and guest-house residents daily through an on-site nurse, and report each visitor or hotel guest daily to the MOHWE Epidemiology and Surveillance Unit.[3]
• Isolate immediately any student, visitor, hotel guest or other quarantined person who develops COVID-19 symptoms, including fever or respiratory symptoms, and treat them as a suspected case.[2][3]
• Notify the MOHWE Epidemiology and Surveillance Unit immediately when a guest develops symptoms, with the on-site nurse and on-call physician responsible for notification in hotel and guest-house settings.[3]
• Collect and package an appropriate test sample for symptomatic guests, and use approved COVID-19 testing to support decisions on release from quarantine or transfer to isolation.[3][2]
• Transfer people who develop symptoms or receive a positive approved test result from quarantine to isolation; permit release after a negative test approved by the MOHWE.[2]

Accountability is operational rather than based on a formal performance-management framework. The MOHWE conducts risk assessments for placement in quarantine, while its Epidemiology and Surveillance Unit receives reports of symptomatic cases and daily reports concerning visitors and hotel guests.[2][3]The Central Board of Health is responsible for training quarantine-facility personnel in standard infection prevention and control precautions.[3]

The available material does not specify formal performance indicators, quantitative targets, evaluation methodologies, audit procedures, routine surveillance outputs, publication requirements, or governance arrangements beyond the named ministry, its Epidemiology and Surveillance Unit, and the Central Board of Health.[1][2][3]

Costing & Financing

Quarantine implementation requires a range of in-kind operational resources, but no monetary costing or financing framework is provided. Required inputs include suitable accommodation, monitoring staff and equipment, food, water, hygiene supplies, psychosocial support, security, and personal protective equipment for the quarantine period.[2]

• Provide quarantine accommodation through designated government facilities, hotels, private homes, yachts or sea vessels, dormitories, and other facilities capable of safely separating and monitoring people.[1][2]
• Deploy symptom-monitoring personnel and equipment, including thermometers, during quarantine and provide on-site nurses for daily monitoring in hotels and guest houses.[2][3]
• Engage an on-call physician to oversee and manage quarantined visitors and hotel guests.[3]
• Supply infection prevention and control materials and services, including personal protective equipment, cleaning and disinfection arrangements, hand-hygiene provisions, disposable gloves, and appropriate laundering of clothing and linen.[2][3]
• Provide food, water, hygiene provisions, psychosocial support, and security for people in quarantine.[2]
• Train quarantine-facility personnel in standard infection prevention and control precautions through the Central Board of Health.[3]

No budget, cost estimate, funding source, allocation, financing mechanism, resource-mobilisation plan, funding gap, payment arrangement, or economic assumption is specified for quarantine, testing, accommodation, staffing, infection prevention, or other related activities.[1][2][3]