Guidelines for quarantine and isolation in relation to covid-19 exposure and infection

Objectives

Provide a coordinated national framework for safe, dignified and quality-assured quarantine and isolation during the COVID-19 pandemic, covering the identification, establishment, operation and supervision of facilities, alongside self-quarantine and self-isolation where these can be undertaken safely.[1][2][3]The framework aims to reduce transmission by separating suspected or confirmed cases and close contacts from the community, monitoring for symptoms, and ensuring timely clinical assessment and referral.[3][4]

• Distinguish quarantine for asymptomatic people who may have been exposed to infection from isolation for people who are ill or test positive but do not require hospital admission.[2][5]
• Prioritise home-based quarantine or isolation where people have a separate room, can minimise contact with others, and can access healthcare if their condition worsens; use designated facilities where these conditions cannot be met or where compliance is not possible.[5][6][7]
• Protect residents’ rights and dignity while maintaining secure, safe and infection-controlled facility operations.[8][9]
• Protect groups identified as at elevated risk, including older people and people with underlying conditions, disabilities, or particular family and care needs.[10][11][3]
• Provide safe accommodation, essential supplies, primary healthcare, nutritious meals, potable water, sanitation, laundry, waste management, mental-health support and referral arrangements.[12][10][11][13]
• Apply a general 14-day quarantine period from exposure or entry, with clinical assessment and testing informing specified exceptions; require ongoing self-monitoring and symptom reporting after discharge where prescribed.[5][6][14]

Implementation

Implement the framework through coordinated national, provincial, district and facility-level action: identify and assess suitable sites, prepare facilities to required standards, assign operational management and clinical oversight, maintain surveillance and reporting, and coordinate entry, transport, discharge and referral pathways.[15][16][4]The material does not specify a budget, funding source, financing allocation or cost estimates, although it identifies extensive infrastructure, staffing, equipment and contracted-service requirements.[17][18][19]

• Coordinate governance through the National and Provincial Departments of Health, Department of Public Works and Infrastructure, provincial public-works authorities, municipalities, health districts, Port Health, the South African Police Service, emergency medical services and other relevant government structures.[15][20][4]
• Identify sites through public-works structures and nominations from government departments; maintain a consolidated master list, assess candidate sites using the COVID-19 Quarantine Infrastructure Checklist, quality-assure assessments, and submit daily availability information to the National Joint Operational and Intelligence Structure.[12][16]
• Deploy multidisciplinary assessment teams comprising infrastructure, disaster-risk, health, hospital, environmental-health, transport, municipal, police, fire, emergency, infection-prevention and local clinical representatives.[15]
• Select facilities that are securable and isolated from surrounding communities, outside known natural-hazard zones, accessible for controlled entry and emergency transport, and suitable for ventilation, sanitation, electricity, potable water, disability access and separated delivery routes.[15][12]
• Prepare facilities with cleanable beds and furnishings, appropriate occupancy and bed spacing, lighting, toilets, bathing facilities, laundry, communications, catering, cleaning supplies, healthcare-risk waste systems, and space for logistics, screening, clinical examination, sampling, triage and staff work.[12][10][21]
• Assign provincial health departments responsibility for operationalising facilities and appoint an operational manager at each site to manage residents, facility services, medical teams, daily queries, screening and clinical oversight.[16]
• Designate each site exclusively for quarantine or isolation, allocate separate rooms and beds where feasible, and operate physical zoning: red areas for rooms, treatment and bio-waste; yellow areas for transfers and controlled access; and green areas for supplies and non-essential personnel.[15][22][11]
• Provide controlled security through perimeter measures, designated access points, entry and exit registers, security staff, police liaison and additional patrols or assessments where required.[22][9][17]
• Establish standard operating procedures for non-medical and clinical teams covering staff and resident briefings, room allocation, rosters, communication, surveillance, triage, isolation, transfers, evacuation, complaints and escalation.[8]Train healthcare, support and newly assigned staff before deployment on infection prevention and control, personal protective equipment, cleaning, disinfection, data requirements and escalation processes.[10]
• Deliver clinical care through medical screening before admission, daily symptom surveillance, temperature checks, regular clinical review, treatment of minor ailments, and access or referral to infection-prevention practitioners, environmental-health practitioners, doctors, paediatricians, pharmacists, emergency services and mental-health professionals.[16][22][10]
• Refer residents who develop symptoms or deteriorate to designated hospitals or isolation facilities, normally by ambulance, while maintaining after-hours assessment, emergency contacts and hospital-access arrangements.[5][8][11]
• Operate support services including housekeeping, catering, sanitation, linen and laundry, food-safety controls, healthcare-risk waste collection, cleaning, terminal disinfection and secure delivery of supplies with minimal unnecessary contact.[22][13][14][20]
• Manage ports of entry through verification of arrivals, screening and clearance by Port Health, traveller information, approved-facility placement, transport coordination and, where required, law-enforcement escorts.[20][23]
• Monitor readiness and operations through facility checklists, reassessment before handover, daily capacity and occupancy reporting, clinical records, symptom and temperature monitoring, case and contact surveillance, and regular quality-assurance visits.[16][11][23]
• Record admissions, discharges, testing, confirmed cases, transfers, facility capacity and visitor movements; channel reporting through district and provincial health officials to national coordination structures.[9][11][13]
• Handle complaints through provincial procedures, escalate unresolved matters to the National Department of Health representative at the National Joint Operational and Intelligence Structure, and communicate regularly with residents about care arrangements and facility management.[8][14]

Monitoring & Evaluation

The guidance establishes an operational monitoring and accountability system for COVID-19 quarantine and isolation facilities, centred on facility-readiness assessments, routine clinical surveillance, daily capacity reporting, quality assurance, records, complaints escalation and corrective action.[16][11][23]

• Assess facility readiness through the COVID-19 Quarantine Infrastructure Checklist, with provincial infrastructure units reporting assessments through provincial coordinators to the National Department of Health infrastructure team.[16]
• Quality-assure proposed facilities, implement readiness interventions for state-owned sites, reassess them, and hand over only facilities found ready for provincial health department operationalisation.[16]
• Submit daily reports on quarantine spaces available to the National Joint Operational and Intelligence Structure, known as NATJOINT, and maintain information on approved facilities, incoming people of interest, placements, check-ins, discharges, occupancy, operational status and challenges.[16][23]
• Monitor quarantined and isolated residents through symptom screening, regular medical reviews, daily clinical examination, and temperature checks twice daily where specified.[24][16][10]
• Assess quarantined and isolated people at least twice daily in the relevant clinical arrangements, identify deterioration or illness exceeding mild-disease criteria, and refer those requiring higher-level care to designated hospitals.[11]
• Test people who develop symptoms or meet person-under-investigation criteria, while the guidance indicates that routine retesting is not required at the end of isolation or during and at the end of the standard quarantine period for people entering South Africa.[5][6]
• Require people discharged after 14 days to self-monitor for a further 14 days and report symptoms to a general practitioner, the National Institute for Communicable Diseases hotline, or a local health facility.[5][6]
• Maintain resident records and submit daily data on capacity, admissions, occupancy, discharges, testing, confirmed cases and transfers, including age-disaggregated data for positive cases in isolation facilities.[11]
• Record every person entering and leaving a facility, including their personal details, designation, and entry and exit times, to support movement control and contact identification.[9]
• Use daily screening rosters, periodic screening of cleaning and catering staff accessing higher-risk zones, and compliance officers to oversee correct putting on and removal of personal protective equipment.[22][10][9]
• Conduct daily monitoring visits by public-health and facility in-charge officers, record identified gaps, and implement corrective and preventive actions.[11][13]
• Undertake regular National Department of Health quality-assurance visits at activated facilities, including review of readiness, the experience of people of interest, follow-up of provincial issues and audits of flight manifests.[23]
• Use readiness checklists to record responsible organisations, yes-or-no completion status, update dates and comments for preparation, infrastructure, accommodation, services and consumable requirements.[18][19][25][21]
• Maintain daily symptom-monitoring tools containing contact, test, exposure, monitoring-method, facility and next-of-kin information, and immediately contact symptomatic people to arrange combined nasopharyngeal and oropharyngeal swab collection.[26]
• Train staff in prescribed statistics and data formats, standard operating procedures, complaints handling and escalation channels before work begins.[10]
• Provide complaints procedures to residents, families, staff and facility managers, escalating unresolved provincial complaints in writing to the National Department of Health representative at NATJOINT for deliberation and written response.[14]
• Track incoming travellers through verified manifests, advance notification for port entries, approved activated facility lists, Port Health screening and communication with national and provincial coordinators.[20]

The source does not specify a consolidated set of formal performance targets, outcome indicators, evaluation schedules, reporting templates, independent audits or broader public-accountability arrangements beyond the operational monitoring, reporting, supervision and quality-assurance mechanisms described.[8][17][19]

Costing & Financing

No budget, cost estimate, funding allocation, financing source, resource-mobilisation target, funding gap or economic assumption is specified in the supplied material.[2][16][4]

• Provide operational resources including accommodation infrastructure, ventilation, water, electricity, sanitation, laundry, communications, catering, cleaning, security, waste management, transport, clinical referral and emergency support.[12][22][4]
• Supply personal protective equipment, disinfectants, cleaning materials, linen, waste containers, stationery, medical equipment, basic medicines and trained personnel, without associated monetary values.[8][25][27]
• Arrange contracted services where required for private facilities, catering, laundry, cleaning, waste removal, security and transport, but without stated contract values or financing arrangements.[16][19]
• Note that residents may launder their own clothing at their own cost, although no amount is provided.[13]