Republic of the Philippines
Department of Health
OFFICE OF THE SECRETARY
__
February 6, 2024
DEPARTMENT MEMORANDUM
No. 2024 -
(073
TO:
ALL UNDERSECRETARIES AND ASSISTANT SECRETARIES;
DIRECTORS OF BUREAUS AND CENTERS FOR HEALTH
___(CHDs);_
DEVELOPMENT
MINISTER
OF
HEALTH_IN
BANGSAMORO AUTONOMOUS REGION
MUSLIM
CHIEF:
MINDANAO
DICAL
AND
SANITARIA
CENTERS, HOSPITALS,
INSTITUTES; DOH
ATTACHED AGENCIES AND INSTITUTIONS AND ALL
OTHERS CONCERNED
;_
gov.ph
SUBJECT:
uidelines
on
D-19
through the PD.
+ Strate
On July 21, 2023, through Proclamation No. 297, the President declared the lifting of
the Public Health Emergency throughout the Philippines due to COVID-19.
is
This Department Memorandum (DM)
hereby issued to provide an update to the
existing protocols, aligning them with the latest policy shifts and to provide guidance to
relevant stakeholders and the general public.
I.
all
PREVENT
A. Wearing of Masks
1.
indoor and outdoor settings shall be voluntary, however,
in the
in following settings:
Wearing of face masks
it is highly encouraged
a.
b.
B.
Healthcare facilities, including, but not limited to, clinics, hospitals,
laboratories, nursing homes, and dialysis clinics, and;
Medical transport vehicles, such as ambulances and paramedic rescue
vehicles.
Hygiene and disinfection
1.
at
Practice frequent and proper handwashing using soap and clean water for
least
20 seconds. Use an alcohol-based hand sanitizer if soap and water are not
available.
Observe the following respiratory etiquette mainly when sneezing and coughing,
especially when in public and crowded places:
a. Cover mouth and nose with tissues or wipes.
b. Properly dispose of used tissues or wipes immediately after.
Trunk Line 8651-7800 local 1113, 1108
Building 1, San Lazaro Compound, Rizal Avenue, Sta. Cruz, 1003 Manila
Direct Line: 711-9502; 711-9503 Fax: 743-1829 @ URL: http://www.doh.gov.ph; e-mail: dohosec(@doh.
c. If tissue is not available, use one’s upper sleeve or arm.
d. Avoid coughing into hands which can easily spread viruses.
e. Wash hands with soap and water after coughing or sneezing, after contact with
an infected person, and after touching potentially contaminated surfaces.
Refrain from touching one’s eyes, nose, and mouth, especially with unwashed
hands, and after touching potentially contaminated instruments and surfaces.
Ensure regular disinfection, particularly of frequently touched surfaces and objects
that may be contaminated with the virus.
C. Ventilation
1,
for
air quality in all facilities are met as stipulated
Ensure ventilation requirements
in Department of Labor and Employment (DOLE) Department Order (DO)
224-21 “Guidelines on Ventilation for Workplaces and Public Transport to Prevent
and Control the Spread of COVID-19” dated March 03, 2021, which can be
accessed through this link: https://bit.ly/DOLEGuidelineson Ventilation.
Il. DETECT
A. Public health surveillance: Surveillance objectives and processes for COVID-19
shall follow the objectives and processes for pan-respiratory illness surveillance as
described in Department Memorandum No. 2022-0526 (Interim Guidelines on the
Pilot Implementation of Integrated Sentinel Surveillance for SARS-CoV-2, Severe
Acute Respiratory IlInesses, and Influenza-like Illnesses).
1.
Cases shall continue to be classified and reported following the prescribed
surveillance case definitions of COVID-19 based on Department Memorandum
No. 2022-0501 (Interim Revised Case Definitions for COVID-19). The
Epidemiology Bureau shall release updated guidelines for pan-respiratory virus
surveillance once available.
RT-PCR testing shall continue to be the gold standard used for confirmatory
testing for surveillance purposes. Severe and critical COVID-19 cases and cases
connected to large clusters or unusual events shall be prioritized for surveillance
testing, ideally using multiplex influenza/SARS-CoV-2 tests offered by referral
laboratories in line with Department Memorandum No. 2022-0106 (Advisory on
the use of Multiplex Testing Kits and Updated Testing Algorithm in the Detection
of Respiratory Viruses in the ILI and SARI Surveillance).
Health care workers are not required to undergo regular COVID-19 testing, unless
otherwise determined by their Infection Prevention and Control Committees.
4.
Centers for Health Development shall continue
to:
a. Check their case and health care metrics regularly to determine which areas
are at increasing risk for respiratory illness spread and impact. A list of such
areas shall be regularly provided to the Epidemiology Bureau; and
b. Ensure submission compliance and monitoring of Disease Reporting Units
(DRUs) and other health facilities, including those that perform facility-based
rapid antigen testing.
5.
Identified areas with increased risk shall implementthe following activities:
a. Active case finding and contact tracing, especially for cases confirmed to be
positive for Variants of Concern or of Interest and sublineages under close
monitoring;
b. Increased RT-PCR testing in the region, especially targeting suspect cases and
identified symptomatic close contacts; and
c. Sending of samples for whole genome sequencing (WGS)
to
meet the quota in
line with Department Memorandum No. 2021-0182 (Interim Guidelines for
the Biosurveillance of SARS CoV-2 and Management of Cases of Variants of
Concern).
B.
Testing for clinical management
1.
Individuals who are at-risk of progression to severe disease, especially senior
citizens, individuals with comorbidities, and the immunocompromised, are
recommended to undergo confirmatory testing prior to the start of any COVID-19
treatment regimen.
are
For individuals with mild symptoms and those who
not at-risk of progression
shall
isolate immediately,
to severe disease, testing shall be optional. They
preferably at home if requirements for home isolation are met (see Annex A), and
monitor for progression of signs and symptoms guided by health care workers
onsite or through teleconsult for appropriate management.
are
not at-risk of progression to
Testing of the asymptomatic close contacts who
vaccination
shall
be
disease
status
of
regardless
optional. If testing will be
severe
COVID-19
done, use of RT-PCR shall remain the gold standard for
testing.
RT-PCR shall remain the gold standard for COVID-19 testing. Rapid antigen tests
shall be used for immediate management of symptomatic cases and when RT-PCR
is not readily available. If rapid antigen test is negative, RT-PCR shall be used for
confirmatory testing.
Self-administered antigen testing shall be recommended only for symptomatic
individuals within 7 days from onset of symptoms, especially if capacity for
timely RT-PCR results is limited or not available. Self-administered antigen test
kits shall not be recommended for (1) asymptomatic close contacts and (2)
screening of asymptomatic individuals. For other cases not stated above,
self-administered antigen testing shall be optional, including for community level
actions wherein case management of probable and confirmed cases remain the
same.
If the self-administered antigen test is positive, the patient shall seek appropriate
consultation with a physician for further assessment and management, and
facilitate proper coordination for disease reporting. For further guidance, please
refer to DOH DM 2022-0033 “Guidelines on the Use of Self-Administered
Antigen Testing for COVID-19” which can be accessed through this link:
https://bit.ly/DM20220033 UseofSelfRATforCOVID19.
Testing for screening asymptomatic individuals, particularly patient watchers and
patients for consultation or prior to admission in hospital and other medical
facilities is not recommended. However, with regard to the implementation of the
national guidelines and protocols for COVID-19, all hospitals and health facilities
are given the authority to establish and maintain their own Infection Prevention
and Control Committee (IPCC).
Ill.
QUARANTINE
and ISOLATE
The following are the quarantine and isolation protocols that must be observed regardless of
vaccination status in order to prevent and reduce the risk of transmission of COVID-19.
However, the following individuals should wear a well-fitted face mask for at least 10 days.
Please refer to Annex B for the summary.
close
A. Quarantine
1,
who were exposed to confirmed COVID-19 positive
individuals, shall not be required to undergo quarantine.
contacts
B.
Isolate
Asymptomatic
1.
Individuals with acute respiratory symptoms OR confirmed COVID-19 cases who
are _asymptomatic or with mild symptoms, are recommended to undergo home
isolation for 5 days OR until afebrile/ fever-free for at least 24 hours without
using antipyretics (e.g. Paracetamol) and with improvement of respiratory
earlier. Isolation may be shortened upon the advice of the
symptoms, whichever
healthcare provider.
is
Confirmed COVID-19 positive cases _with moderate to severe symptoms, OR
individuals,
isolate for at least 10
immunocompromised_
are recommended
days from the onset of signs and symptoms following advice of the attending
physician, including whether to be admitted in a health care facility. For severe
disease and immunocompromised, isolation can be discontinued only upon the
advice of your healthcare provider.
to
C.
Requirements for home isolation can be found in Annex A.
IV. TREAT
A. Clinical management guidelines are based on the updated recommendations by the
Recommendations.
While there are existing
Philippine COVID-19 Living
international guidelines and living systematic reviews on COVID-19, there is a need
to localize the recommendations from the evidence in our setting by local experts,
end-users, and other pertinent stakeholders.
An updated list of drugs for the treatment and management of COVID-19 can be
found in the following annexes:
1. Annex C - Drugs in the Management
Adult Patients with COVID-19
Pediatric Patients with COVID-19
2. Annex D - Drugs in the Management
of
of
Recommended drugs or medicines with no valid Certificate of Product Registration
(CPR) issued by the Philippine Food and Drug Administration (FDA) may be
accessed through other regulatory pathways (i.e., Emergency Use Authorization or
Compassionate Special Permit) subject to evaluation and/or conditions set by the
FDA. For further details on the aforesaid pathways, please refer to Administrative
Order No. 2020-0028 entitled “Amendment to Administrative Order No. 4 s. 1992
entitled “Policy Requirements for Availing Compassionate Special Permit (CSP) for
Restricted Use of Unregistered Drug and Device Product/ Preparation” or other
issuances promulgated by the FDA,
necessary.
as
B.
Individuals experiencing COVID-like symptoms are highly encouraged to consult
with the nearest primary care provider or call the DOH National Patient Navigation
and Referral Center (NPNRC) through 1555 and select option (2) for immediate and
well as corresponding management and interventions.
proper assessment
as
Vv.
REINTEGRATE
A. Neither repeat testing (showing a negative COVID-19 test) nor requiring medical
certificates are required for resumption of work or entrance to school.
mental health and psychosocial support especially to individuals in
quarantine and isolation. They may also download the DOH Lusog-Isip Mobile
Application for free (available in both Apple store or Google play store) or access the
National Center for Mental Health (NCMH) Crisis Hotline or the DOH Regional
Helplines for mental health and psychosocial support concerns.
B. Promote
VI. VACCINATION
Despite the lifting of the COVID-19 Public Health Emergency in the country, COVID-19
vaccination is recommended
all eligible populations pursuant to Administrative Order
(AO) No. 2022-0005 entitled Omnibus Guidelines on the Implementation of the National
Deployment and Vaccination Plan for COVID-19 vaccines. The prioritization framework
(Annex E) shall be followed in allocation decisions for the roll-out of the vaccines.
to
A. The expansion of eligibility for additional doses or booster vaccination of other
COVID-19 vaccine products shall be based on future amendments to the
authorizations of the FDA. Current stocks of COVID-19 vaccines shall be used for
primary series, additional dose, and booster dose vaccination for all eligible
populations based on prevailing guidelines.
B. The COVID-19 vaccine acquired through donations shall be allocated to the priority
groups Al to A3.
C.
No Wrong Door Policy in All Vaccination Sites: For vaccine recipients who seek to
complete the necessary COVID-19 primary series and booster doses, as eligible to
their priority group, shall be provided, scheduled, or advised to have their
recommended COVID-19 vaccination. If the requesting party is not eligible for a
COVID-19 vaccine, they shall be offered other primary care services, based on
stage. For further details, the Omnibus Health Guidelines per Life Stage may be
accessed
https://bit.ly/OmnibusHealthGuidelines.
life
at
VIL.
Risk Communication and Community Engagement (RCCE)
A. Localize and disseminate the preventive measures discussed in Section I, including
changes in evidence and protocols, to make preventive behaviors easier to do and
reduce
risk of transmission of disease.
the
Promote healthy behaviors including the practice of the seven healthy habits (Health
is Life campaign) and promotion of primary care and disease prevention (KonsulTayo
campaign) through the communication packages disseminated by the Health
Promotion Bureau (HPB) and Centers for Health Development Health Promotion
Units.
Ensure integration of planning, implementation, and recalibration of demand
and
communication
interventions
with
immunization
generation
program
interventions. Utilize evidence-based planning through the microplanning process
co-developed with WHO and UNICEF. Modules for Risk Communication,
and
Microplanning
through
Community
Engagement,
may be accessed
https://bit.ly/CHDMicroplanProcess.
D. Expand partnerships with civil society organizations, non-government organizations,
academe, and other development
evaluation of RCCE interventions.
VIII.
partners for co-creation,
implementation,
and
Integration of COVID-19 Vaccination into the Immunization Programs and Other
Relevant Health Services
The National Immunization Program (NIP) and the Emerging and Re-emerging Infectious
Disease (EREID) team shall work towards the technical and operational integration of
COVID-19 vaccination into immunization programs, primary health care, and other
relevant health services to improve coverage and efficiency of immunization programs by
cost sharing and maximizing opportunities for vaccination of target populations.
A. Vaccinators
Utilize the workforce trained for COVID-19 vaccination to support other vaccination
programs through the NIP, to strengthen immunization services, optimize resources,
and enhance vaccination coverage for both COVID-19 and routine vaccines.
Cold Chain capacity
Integrate with the storage and logistics of other programs which require cold chain
facility. Utilize this to store and distribute vaccines such as under the NIP, various
medications and biological products that require temperature-controlled storage.
Regular inventory and reporting of all vaccines, medicines, and commodities with
particular focus on near expiry and stock out of supplies shall be conducted.
Service Delivery
Incorporate planning for COVID-19 Vaccination Program along with other
immunization programs and service delivery plans (e.g. local investment plan for
health, annual operational plan, annual investment plan, work and financial plan).
Offer and recommend other routine health services corresponding to the vaccine
recipient’s life stage (e.g. reproductive health, nutrition, immunization, deworming,
health screening services for various diseases
disorders, linkage or coordination for
further management, if necessary), provided that provision of medicines, drugs, or
vaccines do not have a contraindication to co-administration, or that the additional
service provided does not unduly delay the vaccination
processes.
or
site
IX.
REPEALING CLAUSE
Issuances inconsistent with or contrary to this DM are hereby repealed, amended, or
modified accordingly. All other provisions of existing issuances which are not affected by
this DM shall remain valid and in effect.
For guidance and dissemination.
GLORIA J. BALBQA, MD, MPH, MHA, CEO VI, CESO
Officer-In-Charge
ffice of the Secretary
III
Annex A. Requirements for Home Isolation
A. Infrastructure
1.
Well-ventilated room
2. Line for communication with family and health workers
3. Utilities such as electricity, potable water, cooking source, etc.
4. Solid waste and sewage disposal
Accommodation
Ability to provide a separate bedroom for the patient, or separate bed with
enough distance (>3 feet or 1 meter) so long as there are no vulnerable persons
(e.g. immunocompromised, elderly) in the household
2. Accessible bathroom in the residence; if multiple bathrooms are available, one
bathroom designated for use by the patient
1.
Resource for Patient Care and Support
Primary caregiver who will remain in the residence and who is 1) fully
vaccinated, 2) not at high risk for complications, and 3) is educated on proper
1.
precautions
N
wH
Medications for pre-existing conditions as needed; family planning supplies as
desired
Digital thermometer, preferably one
patient, disinfected before and after use
Meal preparation
MAME
per
Masks, tissues, and other hygiene products
Laundry
Household cleaning products
Personal Protective Equipment
For the patient: surgical mask per day for each day
of isolation
2. For at least one caregiver, but preferably for the whole household: surgical mask
per day for each day of isolation
3. For disinfection: gown, head covering, gloves for disinfection
1.
Home Monitoring Kit
1. Vital signs recording mechanism
2.
3.
Thermometer
Pulse oximeter
4. BP apparatus, if with history of hypertension
5. Recommended meal plan or information materials on proper nutrition and access
to basic necessities, including delivery services
6. Psychosocial support materials or proposed activities during isolation
7. Family health plan and instructions to caregivers, to include proper wearing,
removal, and disposal of PPE, instructions on disinfection, avoidance of
household members being unmasked when eating or drinking, and sharing of
personal items for eating and hygiene.
8. Medicines to manage common symptoms of COVID-19
all
Annex B. Updated masking, quarantine and isolation protocols*
Masking / Quarantine
Asymptomatic close contact
exposed to confirmed
COVID-19 positive individual
Asymptomatic but confirmed
COVID-19 positive case
Confirmed COVID-19 positive
case with mild symptoms OR
individuals with acute
respiratory symptoms
Isolation Protocols
e@
No need to quarantine; and
e@
Wear a well-fitted face mask for at least 10 days.
e
Home isolation for 5 days OR until afebrile/
e@
fever-free for at least 24 hours without using
antipyretics (e.g., Paracetamol) and with
improvement of respiratory symptoms, whichever
is earlier; and
Wear a well-fitted face mask for at least 10 days.
Note: Isolation may be shortened upon
your healthcare provider.
Confirmed COVID-19 positive
case with moderate to severe
symptoms, OR
immunocompromised
/
the advice of
Isolation for at least 10 days from onset of signs
and symptoms following advice of the attending
physician, including whether to be admitted in
a health care facility; and
Wear
a well-fitted face mask for at least 10 days.
Note: For severe disease and immunocompromised,
discontinue isolation only upon the advice of your
healthcare provider.
*regardless of vaccination status
Annex C. Treatment
Patients*
For
Mild-Moderate
Recommended Indication
(based on COVID LCPG)
Medicine
Non-hospitalized patients with at
Remdesivir
COVID-19 in Non-Hospitalized Adult
Evidence
Review
least 1 risk factor** for progression
to severe disease
Non-oxygen requiring patients with
Link to COVID
LCPG
Molnupiravir
at least one risk factor*** for
progression (within 5 days of
symptom onset)
Unvaccinated, symptomatic adult
patients with high risk**** for
progression to severe disease (within
5 days of symptom onset)
Nirmatrelvir +
Symptomatic, non-hospitalized
patients with risk factor***** for
severe COVID-19 (only when the
not
predominant circulating variant
Omicron SARS-CoV-2)
Casirivimab +
Imdevimab
Unvaccinated non-hospitalized
patients with mild to moderate
COVID-19 infection with at least 1
risk factor****** for progression to
severe disease
Tixagevimab
Ritonavir
(Paxlovid)
is
+Cilgavimab
Certainty of
Evidence and
Strength of
Recommendation
Moderate certainty
mi
https:
org/remdesivir-evid
of evidence; Strong
ence-summary-3/
recommendation
https://www.psmid,
org/molnupiravir-e
vidence-summary-
2/
Very low certainty
of evidence;
Weak
recommendation
https:/Avww.psmid.
org/paxlovid-evide
nee-summary/
Moderate certainty
of evidence; Strong
recommendation
https://www.psmid.
org/casitivimab-im
devimab-evidence-
summary-4/
Very low certainty
of evidence;
Weak
recommendation
https://www.psmid.
org/tixagevimab-cil
gavimab-evidence-
Very low certainty
of evidence; Weak
recommendation
summary-2/
*Should be used with the supervision of a physician
**Risk factors for progression: age >60 years, hypertension, cardiovascular or cerebrovascular disease,
diabetes mellitus, obesity, immunocompromised, chronic mild or moderate kidney disease, chronic liver disease,
chronic lung disease, current cancer, or sickle cell disease
***Risk factors for progression: age >60 years, active cancer, chronic kidney disease, chronic obstructive
pulmonary disease, obesity, serious heart conditions or diabetes mellitus
****Risk factors: >60 years of age, BMI >25 kg/m2; cigarette smoking, immunocompromised; chronic lung,
cardiovascular, kidney or sickle cell disease, hypertension, diabetes, cancer, neurodevelopmental disorders or
other medically complex conditions, or medical-related technological dependence
****4Risk factors: age >50 years, obesity, cardiovascular disease (including hypertension), chronic lung
disease (including asthma), chronic metabolic disease (including diabetes), chronic kidney disease (including
receipt of dialysis), chronic liver disease, and immunocompromised conditions
factors: age >65 years, body-mass index 235 kg/m2, cardiovascular disease (including
hypertension), chronic lung disease (including asthma), chronic metabolic disease (including diabetes), chronic
kidney disease (including receipt of dialysis), chronic liver disease, and immunocompromised conditions
*KHKKARISK
10
Treatment For Moderate-Severe COVID-19 in Hospitalized Adult Patients*
Recommended Indication
(based on COVID LCPG)
Medicine
Patients with COVID-19 infection
requiring oxygen supplementation but
do not require mechanical ventilation
invasive
(For patients who progress
mechanical ventilation while on
remdesivir, the drug can be
continued)
Remdesivir +
Dexamethasone
Hospitalized critical COVID-19
patients on high-flow nasal cannula
oxygenation, noninvasive ventilation,
or invasive mechanical ventilation
Baricitinib
+
Corticosteroids
Patients showing rapid respiratory
deterioration and/or requiring high
doses of oxygen (high-flow nasal
cannula, noninvasive or invasive
mechanical ventilation) and with
elevated biomarkers of inflammation
(CRP)
Tocilizumab +
systemic
steroids
Hospitalized patients with moderate,
severe or critical COVID-19 disease
unless there are any contraindications
Standard dose
prophylactic
anticoagulation
Patients with severe and critical
COVID-19 (up to 10 days of use)
**Standard dose at 6mg to 12mg/day
among adults with severe and critical
COVID-19
Dexamethasone
Patients with severe and critical
COVID-19 (up to 5- 10 days of use)
Methylpredniso
lone
1-2mg/kg/day
Link to COVID
to
Certainty of
Review
Evidence
Evidence and
Strength of
Recommendation
https://www.psmi
d.org/remdesivir-e
vidence-summary-
Low certainty of
evidence; Weak
recommendation
LCPG
3/
https://www.psmi
d.org/baricitinib-e
vidence-summary-
Moderate certainty
of evidence; Strong
recommendation
2/
https://www.psmi
d.org/tocilizumabevidence-summar
Moderate certainty
of evidence; Strong
recommendation
y/
d.org/anticoagulati
Low certainty of
evidence; Weak
recommendation
https:/Awww.psmi
d.org/corticosteroi
ds-evidence-summ
of evidence; Strong
https://www.psmi
on-evidence-sum
mary-3/
Moderate certainty
recommendation
ary-2/
https://www.psmi
d.org/corticosteroi
ds-evidence-summ
ary-2/
Very low certainty
of evidence; Weak
recommendation
*Should be used with the supervision of a physician
11
Annex D. Drugs in the Management
of Pediatric Patients with COVID-19
Treatment For Mild COVID-19 in Children*
Recommended Indication
(based on COVID LCPG)
Medicine
Link to
COVID LCPG
Evidence
Review
Certainty of
Evidence and
Strength of
Recommendation
Hospitalized or ambulatory
children with mild to moderate
COVID-19 infection with at least
one (1) risk factor for disease
progression
Remdesivir
https://www.ps
mid.org/remdes
ivir-evidence-su
mmary-3/
Very low certainty
of evidence; Weak
recommendation
Unvaccinated, symptomatic
pediatric patients 12 years and
older weighing
least 40 kg with
risk
for
high
progression to
severe disease
Nirmatrelvir+
https://www.ps
Ritonavir
(Paxlovid)
mid.org/paxlovi
d-evidence-sum
Low certainty of
evidence; Weak
recommendation
at
mary/
*Should be used with the supervision of a physician
Treatment For Hospitalized Moderate to Severe COVID-19 in Children*
Recommended Indication
Medicine
Link to
COVID LCPG
Evidence
Review
Certainty of
Evidence and
Strength of
Recommendation
Remdesivir +
Dexamethasone
https:/Awww.ps
Very low certainty
of evidence;
Weak
recommendation
(based on COVID LCPG)
Children with COVID-19
infection requiring oxygen
supplementation but do not
require mechanical ventilation
mid.org/remdes
ivir-evidence-s
ummary-3/
*Should be used with the supervision of a physician
12
Annex E, Prioritization framework
Categories of Priority Populations for COVID-19 Vaccination
Description
Priority Group
Eligible Population Group A
Priority Group Al Frontline workers in health facilities both national and local, private and
public, health professionals and non-professionals like students in health
and allied professions courses with clinical responsibilities, nursing aides,
janitors, barangay health workers, etc.
Sub-priority
Al.1
Al.2
COVID-19 referral hospitals designated by the DOH;
Public and private hospitals and infirmaries providing COVID-19 care, as
prioritized based on service capability, starting from level 3 hospitals, to
level 2 hospitals to level 1 hospitals, and then infirmaries; Among hospitals
with a common service capability, the order of priority shall be from
facilities owned by the DOH, then facilities owned by LGUs, and then
facilities owned by private entities;
Al13
Isolation and quarantine facilities such as temporary treatment and
monitoring facilities and converted facilities (e.g. hotels, schools, etc) that
cater to COVID-19 suspect, probable, and confirmed cases, close contacts,
and travellers in quarantine;
Al.4
Remaining hospitals including facilities of uniformed services not catering
to COVID-19 cases;
A15
Government owned primary care based facilities such as Urban Health
Centers, Rural Health Units and Barangay Health Stations, birthing homes,
and Local Health Offices to include members of BHERTS, contact tracers,
social workers; vaccinators
Al.6
Stand-alone facilities, clinics and diagnostic centers, and other facilities and
health care workers otherwise not specified (e.g. clinics, dialysis centers,
dental clinics, and COVID-19 laboratories), dealing with COVID-19 cases,
contacts, and specimens for research purposes, screening and case
management coordinated through their respective local government units;
and
Al1.7
Closed institutions and settings such as, but not limited to, nursing homes,
orphanages, jails, detention centers, correctional facilities, drug treatment
and rehabilitation centers, and Bureau of Corrections.
Al1.8
Outbound Overseas Filipino Workers (OFW)s for deployment within the
next four months
(Expanded Al)
A1.9
(Expanded A1)
Immediate family members of health care workers which refers to all
members 18 years old and and above, of the household where the health
care worker lives to include house mates, helpers, and drivers
13
Priority Group A2 | Senior citizens aged 60 years old and above
Sub-Priority
A2.1
A2.2
[Priority Group A3
in
Institutionalized senior citizens including those
registered nursing homes
and other group homes with elderly working together (e.g. convents).
All other senior citizens, including bed-ridden senior citizens at home. A2
plus one household member shall be in constant close contact with, and/or
living in the same household with Senior Citizens.
Adults with comorbidities not otherwise included in the preceding
categories.
Priority shall be given to adult whose comorbidities are among the top
causes of COVID-19 and national morbidity and mortality for prioritization
to include chronic respiratory disease, hypertension, cardiovascular disease,
chronic kidney disease, cerebrovascular disease, malignancy, diabetes,
obesity, chronic liver disease, neurologic disease, and immunodeficiency
state.
A sub-group under the Priority Group A3 which needs to secure medical
clearance prior to vaccination shall include the following:
os
mone
Pediatric A3
Autoimmune disease
HIV/Malignancy
Cancer
Transplant patients
Undergoing steroid treatment
Patients with poor prognosis/Bed-ridden patients
Comorbidities for the Pediatric A3 needing to secure medical clearance
prior to vaccination shall include the following:
a. Medical complexity: long term dependence on technical support e.g.
tracheostomy associated with developmental delay and/or genetic
anomalies
b. Genetic conditions: Down’s Syndrome (Trisomy 21),
Glucose-6-phosphate dehydrogenase deficiency (G6PD), genetic
disorders affecting the immune systems such as primary
immunodeficiency disorders, thalassemia, and other chromosomal
abnormalities
c. Neurologic conditions: Seizure Disorder, Autism Spectrum
Disorders (ASDs), Cerebral Palsy, Stroke in the Young, Chronic
Meningitis e.g. Tuberculosis, chronic neuromuscular diseases, and
chronic demyelinating diseases
d. Metabolic/ endocrine diseases: Diabetes Mellitus (DM),
Hypothyroidism, Diabetes Insipidus (DI), Adrenal insufficiency,
Hypopituitarism, and other hereditary metabolic diseases.
e. Cardiovascular diseases: Hypertension, Congenital Heart Diseases
(CHDs), Cardiomyopathy, Rheumatic Heart Disease (RHD), Mitral
Valve Disease, Pulmonary Hypertension with Right Heart Failure.
f. Obesity: BMI > 95th percentile for age and height
g.
HIV Infection
h. Tuberculosis: Pulmonary (collapse/ consolidations, with empyema,
14
Expanded A3
Priority Group A4
and miliary), Extrapulmonary, (pleural effusion, pericarditis,
abdominal, genitourinary, central nervous system, spinal column,
bone, joint, cutaneous, ocular and breast), and Disseminated
(involvement of two (2) or more organs).
i. Chronic
Respiratory Diseases: Chronic Lung Diseases
(Bronchiectasis, Bronchopulmonary Dysplasia, Chronic Aspiration
Pneumonia), Congenital respiratory malformation, Restrictive Lung
Diseases, neuromuscular disorders, syndromic with hypotonia,
skeletal disorders, chronic upper and lower airway obstruction
Obstructive Sleep Apnea, Tracheomalacia,
Stenosis,
(Severe
Bronchial Asthma).
j. Renal Disorders: Chronic Kidney Diseases, Nephrotic Syndrome,
End-Stage Renal Disease (ESRD), patients on dialysis and continuous
ambulatory peritoneal dialysis (CAPD), Glomerulonephritis (e.g.
lupus nephritis), Hydronephrosis.
Diseases:
Chronic Liver Disease,
k. Hepatobiliary
Cirrhosis,
Malabsorption Syndrome.
1.
Immunocompromised state due to disease or treatment: Bone
marrow or stem cell transplant patients, solid organ transplant
anemia,
(leukemia,
hematological
malignancies
recipients,
thalassemia), cancer patients on chemotherapy, severe aplastic
anemia, autoimmune or autoinflammatory disorders requiring
immunosuppressive
therapy (e.g. Systemic Lupus
long-term
Rheumatoid
Arthritis),
patients
receiving
Erythematosus,
immune-modulating biological therapy [e.g. Anti - Tumor Necrosis
Factor (TNF), rituximab, among others], patients receiving long-term
systemic steroids [> one (1) month], functional asplenia, patients who
underwent splenectomy.
Pregnant and lactating women
Private sector workers required to be physically present at their designated
workplace outside of their residences; employees in government agencies
and instrumentalities, including government-owned and controlled
corporations and local government units; and informal sector workers and
self-employed individuals who may be required to work outside their
residences, and those working in private households.
A4.1
Private sector workers who work outside their homes
A4.2
Employees in government agencies and instrumentalities, including
government-owned
or controlled corporations (GOCCs) and local
government units
A4.3
Informal sector workers and self-employed who work outside their homes
and those working in private households
Priority Group A5
Poor population based on the National Household Targeting System for
Poverty Reduction (NHTS-PR) or other verification mechanisms of the
local government not otherwise included in the preceding categories
Rest of the Adult Population (ROAP)
Rest of the Pediatric Population (ROPP)
15
References
.
.
.
.
.
.
.
.
.
Department of Health Administrative Order No. 2022-0051 “Revised National Policy
on Infection Prevention and Control in All Public and Private Health Facilities”
Department of Health Administrative Order No. 2022-0005 “Omnibus Guidelines on
the Implementation of the National Deployment and Vaccination Plan for COVID-19
vaccines”
Department of Health Department Circular No. 2023-0324 “Updated Health Protocols
following Lifting of the COVID-19 Public Health Emergency”
Department of Health Department Memorandum No. 2022-0433 “Updated Guidelines
on the Minimum Public Health Standards for the Continued Safe Reopening of
Institutions” dated 13 September 2022
Department of Health Department Memorandum No. 2022-0501 “Interim Revised
Case Definitions for COVID-19”
Philippine COVID-19 Living Clinical Practice Guidelines
https://www.psmid.org/philippine-covid-19-living-recommendations-3/
Philippine Food and Drug Administration
World Health Organization (2023). Infection prevention and control in the context of
coronavirus diseases (COVID-19): A guideline
https://app.magicapp.org/#/guideline/Lr2a8
World Health Organization. Therapeutics and COVID-19: Living guideline, 10
November 2023
https://iris.who. int/bitstream/handle/10665/373975/WHO-2019-nCoV-therapeutics-20
23.2-eng.pdf?sequence=1
16