The latest guideline for the new policy of confirmed cases. What to do if you are confirmed to have Covid-19?

Last Updated on 12-30-2023

The global impact of the Covid-19 outbreak in the last two years has had a dramatic impact on the lives of people around the world.The Covid-19 virus not only spreads easily, but is also more potent with the subsequent emergence of Delta and Omicron variants.The number of cases in Taiwan has also been rising rapidly recently, but mostly in patients with mild or no obvious symptoms.With the rapid increase in the number of confirmed cases, what should we do if we find a confirmed case around us or a positive fast screening result? This article will give you a quick overview of the latest policy and related measures.

What should I do if confirmed? (After 2023.03.20)

Mild COVID-19 Cases

Starting from March 20, mild COVID cases are exempt from quarantine and reporting requirements and will instead follow a “0+n” for their self health monitoring period. Under the “0+n”, People with mild symptoms should avoid unnecessary trips outside and perform a 10-day self-health monitoring.

During this 10-day self-health monitoring period, people who are symptom-free or improving may go outside, but must wear a mask for their entire time outside. If they receive a negative result on a rapid test, the 10-day self-monitoring period can be ended early.

Severe COVID-19 Cases

If you have a moderate to severe case of COVID-19, you need to report your illness and immediately seek medical treatment. Severe symptoms or warning signs include “shortness of breath or trouble breathing, persistent pain or pressure in the chest, confusion, blue-colored skin/lips or nail beds, inability to eat, drink or take medications, no or a significant reduction in urine within 24 hours, systolic blood pressure below 90mmHg, and over 100 heartbeats per minute when not running a fever,” according to the Central Epidemic Command Center (CECC).

How do I know if I might be infected with Covid-19?

There are two ways to detect the risk of infection:

1. Antigen tests (Rapid Test Kit)
2. PCR tests

Antigen (nasal/oral examination) Rapid Test

The Antigen rapid test is a “Nasopharyngeal swabs” or “oral cavity” collection for the detection of viral proteins to determine the presence of Covid-19 infection.

The testing time is fast, antigen rapid tests are easy to determine if the person is” under infection”; however, there is still the possibility of false positive or false negative.

The results of the rapid test can be quickly determined (about 15-30 minutes) to be either negative or positive:

1. If the test result is “negative”, you can go self-health monitoring, if you find relevant symptoms, you can conduct another rapid test.
2. If the test result is “positive”, a PCR test must be performed to confirm the infection of Covid-19 in order to confirm Covid-19 infection.

Please go to a nearby community testing facility for further testing. Wear a mask and do not take public transportation. Please wrap the used rapid test in a sealed package and hand them over to the epidemic prevention staff at the testing facility. The epidemic prevention staff will assist you with the PCR test.

PCR test

Compared to home rapid test kits, which provide fast results, PCR tests are more time-consuming and labor-intensive.PCR test is also used to collect nasal/oral specimens, but the procedure for PCR is more specialized and requires specialized personnel to operate the equipment. The test is sent to a specialized facility for testing.

It takes a few hours to find out if the test results are negative or positive, so the epidemic prevention staff will ask people to go home first and wait for notification. A notification letter will be sent to the applicant after the test is completed. (For inbound testing, you will need to wait for the test results at the airport and then make follow-up arrangements based on negative/positive results.)

COVID-19 Confirmation Definition, what to do if I have a positive rapid test?

On May 25, the Central Epidemic Command Center (CECC) announced that it has revised the definition of a confirmed case of COVID-19, effective from May 26, to include: an individual, regardless of age or which group he or she is in, who tests positive for COVID-19 with an at-home rapid antigen test kit and whose test result is confirmed by a medical professional or who tests positive with a rapid antigen test performed by a medical professional.

The CECC reminded such individuals to cooperate in taking the steps listed below:

1. The individual should write his or her name and the date he or she took the test on the rapid test cassette/strip after testing positive with a rapid test.
2. Take a photo of the rapid test cassette/strip with his or her National Health Insurance card.
3. If it is necessary to have a doctor confirm the test result at a clinic, the individual should put the test cassette/strip in a zipper bag or plastic bag and seal it tightly before taking it to the clinic.
4. The individual should present the positive result of the test cassette/strip when having a video or onsite consultation with a doctor.
5. The individual must wear a mask at all times when outside and must not take public transportation. The individual can seek medical help by driving himself/herself, riding a scooter or bike, walking, or getting a ride from a friend or family member (with both parties keeping their masks on at all times).

Patients with no symptoms and mild illness can follow home care mode. For patients with severe illness, isolation treatment will be enhanced.

What is home care?

Home care is a way for CECC to alleviate the large number of recent Covid-19 confirmed cases and avoid the collapse of the healthcare system, considering that most of the recent confirmed cases are minor and asymptomatic patients, CECC announces Guidelines for Home Care Management of Confirmed COVID-19 Cases.

Medical resources will be reserved for patients with serious illnesses, while patients with minor or no symptoms will be cared for at home to reduce the burden on the medical system. There are two main ways to isolate patients who are eligible for home care: ​

Those who do not qualify for home care

Those who are eligible for home care

• No symptoms or mild symptoms
• Under 69 years of age and not 65 – 69 years of age living alone
• Children
• Those who are diagnosed with dialysis can be placed in home care and receive dialysis treatment at a designated dialysis clinic or hospital according to the plan of the Department of Health.

Those who do not qualify for home care but wish to undergo home care may do so after being evaluated by medical professionals.

Environmental conditions for home care

For confirmed cases:

• The principle of one room per person (separate room with bathroom) should be used. However, if there are people who are also confirmed cases , it is possible to have more than one room.
• If you are able to clean and disinfect the bathroom each time you use it, you can be isolated in a private room without a separate bathroom.
• Once the conditions for release from isolation are met, a 7-day period of independent health management will continue.

Those who live with the confirmed cases but have not been infected:

• Confirmed cases of home isolation in other rooms of the same household, to reduce the risk of cluster infection, the number of unconfirmed cases in the same household should not exceed four.
• Under the new 3+4 home isolation policy, the isolation date is 3 days from the date of confirmed cases of the latest infection in the same household + 4 days for self-health management.
• The contactor needs to do a rapid test once after being contact traced. If you need to go out during the self-health management, you must have a negative quick screening before you can wear the mask to work and buy necessities (not recommended for school).

Important notes during home care

Confirmed cases

• Be sure to monitor changes in your symptoms and contact 119, the Department of Health or call 1922 immediately if you suspect Covid-19-related symptoms.
• For other symptoms or medical consultation needs, please contact the telemedicine or home care medical team via mobile app or phone line for evaluation.

Those who live with the confirmed patient but have not been infected

• Monitor for symptoms related to the COVID-19 infection, such as fever, cough, shortness of breath, etc.
• Whenever possible, do not share bathrooms or leave the room. If you need to share bathrooms, clean them with diluted bleach or alcohol after each use.
• Open windows to ensure air circulation.
• Both the patient and the occupant must wear masks.
• When the patient leaves the room to use the bathroom.
• If a resident needs to enter the patient’s room or contact the patient for necessary care, he/she should wash his/her hands with soap or alcohol before and after taking care of the patient.

Special notes for children during home care

Release Conditions for Isolation (Updated at 5/17)

For confirmed cases

The conditions for release from isolation vary depending on the location of the confirmed case (home care, hospital, collective quarantine facility, quarantine hotel).

• Home care (generally for confirmed cases with no symptoms and minor illnesses)
  • After 7 days from the date of onset or confirmed diagnosis, you will be released from isolation and will continue with 7 days of self-health management.
• Isolated persons in hospitals, enhanced collective quarantine facilities, and enhanced quarantine hotels
  • When there is no symptom, or when the symptom is relieved
    • Negative on the two rapid tests, or 5 days from onset/examination date and negative on one rapid test
    • Release from isolation after 7 days from the onset or confirmation date
  • If any of the above conditions are met, you will be released from isolation and receive 7 days of self-health management
  • The above rapid test must be done by medical staff
• Hospitalized patients with moderate to severe illness
  • When symptoms resolve and a tracking PCR test is negative, or Ct ≥ 30, the patient can be discharged from the ICU

For resident who live with confirmed cases

CDC announced on May 17 that in order to centralize medical resources to care for patients with moderate to severe illnesses, a policy of rapid test instead of isolation will be implemented, targeting family members living with the confirmed cases.

• Those who have completed 3 doses of vaccine
  • Exemption from home quarantine, but need to cooperate with 7 days of self-initiated epidemic prevention.
  • If you need to go out to work or to buy necessities during the period of self-initiated epidemic prevention, you must undergo a rapid test and be allowed to go out if the result is negative.
• Those who have not completed 3 doses of vaccine
  • 3 days of home isolation + 4 days of self-initiated epidemic prevention are still required
  • Rapid tests will be conducted when the quarantine period is completed, and you should stay at home during the quarantine period and be prohibited from going outside, and after the completion of the quarantine period, 4 days of self-initiated epidemic prevention will continue.
  • If you need to go out to work or to buy necessities during the period of self-initiated epidemic prevention, you must undergo a rapid test and be allowed to go out if the result is negative

Prescribing Process

Taiwan CDC announced on May 25 that the policy of after a positive fast test is confirmed by medical personnel, will be classified as a confirmed case,and the prescribing process of COVID-19 treatment for confirmed cases will be adjusted.
After a positive rapid test, people can go to a medical institution or use telemedicine (using the 健康益友 App or telephone to contact telemedicine) to see a doctor. After reaching a consensus with the doctor or undergoing PCR testing, the doctor will prescribe the appropriate medication according to their symptoms, and people can take the medication according to the doctor’s instructions and carry out follow-up medical treatment.

Contact Tracing Self-reporting System for Confirmed Cases

To track the status of the COVID-19 outbreak, the CDC used to conduct telephone surveys manually. After the quick spread of the epidemic, the CDC launched the Contact Tracing Self-reporting System for Confirmed Cases on 5/1, which must be filled out by the confirmed patient in order to keep track of the epidemic.