Dilg Doh Jao 2020 0001
Dilg Doh Jao 2020 0001
The LCTF, BHERTs, Sanitation Officer, and an assigned LIGTAS COVID manager
shall jointly identify:
• existing infrastructure in the LGU that can be converted into LIGTAS COVID Centers
• a temporary structure can be established in accordance with the requirements of this
policy
• arrangements according to law with private sector entities to build or refurbish
existing infrastructure and operate the same as LIGTAS COVID Centers
Specific Guidelines
B. Requirements for LIGTAS COVID Centers
1. Space
• can either be a permanent or temporary structure (e.g. school , gym, multipurpose hall,
church, or other establishment) equipped with utilities and basic amenities granting that
the requirements set in DOH DM No. 2020-0I23 are followed
• In compliance with IPC protocols, each suspect and probable case of COVID-19 shall
have his/her dedicated individual room with own toilet and bath. If and only if dedicated
individual rooms are not available, beds shall be spaced at least two (2) meters apart,
preferably with an opaque impermeable sheet or divider (e.g. tarpaulin , shower curtain,
etc) between them
• Shared toilets and baths shall be cleaned and disinfected by staff wearing the appropriate
PPEs at least twice a day. Patients using shared toilets and baths shall be trained and
assisted in cleaning and disinfection immediately after each use. Ensure that all toilets and
baths, either dedicated or shared, are well-ventilated with natural or mechanical or hybrid
ventilation
Specific Guidelines
B. Requirements for LIGTAS COVID Centers
2. Staff
• staff of each LIGTAS COVID Center shall be trained on proper use of PPEs and infection
control measures
• Composed of: (1) Manager; (2) Sanitation Officer; (3) Facility Physician (either physically
present or remote but accessible thru telehealth 24/7); (4) Nurse or Midwife (2 shifts);
(5) BHW or Community Health Volunteer (1 shift); (6) Data Manager; (7) Security &
Maintenance Officer (1 shift);
• shall be engaged by the LGU and shall receive their salaries and applicable benefits from
the city or municipality in which the LIGTAS COVlD Center is located
• deployment of deputized physicians and nurses under the NDP, whose contracts of
service shall be under the DOH
• DOH shall provide LGUs with an updated roster or pool of physicians and deputized
physicians it shall engage
Specific Guidelines
B. Requirements for LIGTAS COVID Centers
3. Supplies
• Must have PPEs and comply with DOH policy on its rational use, non critical patient-care
equipment (stethoscope, thermometer, sphygmomanometer), hygiene kits and food supply for
patients, supportive medication
4. Special Services
• No visitors are allowed but communications thru remote means is allowed (mobile phones)
• Mental health and psychosocial support
• Provide safe, comfortable and free board and lodging for staff (off and on duty days) to be
sourced from PhilHealth reimbursements
5. Financing
• Sources of funds include Quick Response Fund; 20% Development Fund; Bayanihan Grants
• Should there be funding gaps, cities/municipalities/barangays may submit a resolution to its
respective provinces in coordination with DOH, DILG and DBM
• patients who sought consult at the Mega LIGTAS COVID Centers or LIGTAS COVID Centers
but were later on assessed to be capable of home quarantine or isolation shall be counted as
patients of the respective facilities until the completion of their prescribed quarantine or isolation
period
Specific Guidelines
C. Identification of COVID-19 Cases in the Community
• The LCTF shall setup or adopt an existing hotline dedicated to case finding
and monitoring that community members can call if they report symptoms or
any contact with a confirmed case of COVID-19
• dedicated cellular phone or landline that is disinfected regularly; dedicated
healthcare worker with training on the COVID-19 patient algorithm for triage
and hospitalization; and adequate dissemination of the hotline number in the
respective LGU
• The dedicated HCW shall classify households based on exposure of members
to COVlD-19 and report information on suspect, probable, and confirmed
cases of COVID-19 to the BHERTs thereafter
• Family without exposure to COVID-19
• Family on home quarantine
• Family with Ligtas COVID or healthcare facility admission
Specific Guidelines
C. Identification of COVID-19 Cases in the Community
• The HCW shall carefully assess household members based on the COVID-19
patient algorithm for triage and hospitalization. The algorithm shall guide the
HCW whether admission to the LIGTAS COVID Center or home
quarantine/self-isolation will be advised
• While admission to a LIGTAS COVID Center or Mega LIGTAS COVlD
Center is preferred especially where these facilities are available, home
quarantine is allowed for suspect and probable cases of COVID-19 who are
either asymptomatic or with mild symptoms only, provided that ALL the
requirements in the home care checklist are complied with
• The HCW shall assess the household's capability using the home care checklist.
The assessment includes ocular inspection and family interview.
Home Care Checklist
Infrastructure Accommodations Resource for Patient Care &
Support
• Line for communication with • Ability to provide a separate • Primary caregiver who will remain
family and health workers bedroom for the patient, or in the residence and who is not at
• Electricity separate bed with enough distance high risk for complications, and is
• Potable water (>3 feet or 1 meter) so long as educated on proper precautions
• Cooking source there are no vulnerable persons in • Medications for pre- existing
• Bathroom with toilet and sink, if the household conditions, as needed; family
possible a separate one for the • Accessible bathroom in the planning supplies as desired
family member affected (if none, residence; if multiple bathrooms are • Digital thermometer, preferably one
disinfect on a regular basis) available , one bathroom designated per patient, disinfected before and
• Solid waste and sewage disposal for use by the patient after use
• Meal preparation
• Essential shopping
• Mask, tissue, hand hygiene product
• Laundry
• Household cleaning products
Specific Guidelines
C. Identification of COVID-19 Cases in the Community
• All members of families that have at least one member who is a suspect, probable,
or confirmed COVID-19 case regardless of place of quarantine or isolation shall be
tested according to the guidelines prescribed by DOH
• The Barangay having jurisdiction over the place of residence of patients who shall
practice home quarantine/self-isolation shall provide the patient and his/ her family
with nutritious food and basic necessities that his/her household may need during
the entire time of home quarantine/isolation.
• The Barangay shall also ensure that the patient and the members of his/her
household shall stay at home. For the purposes of this provision, the Barangay may
seek assistance from the PNP to strictly yet compassionately and respectfully
monitor and implement the same, while protecting the household from any acts of
violence that may arise from discrimination
• If self-isolation is not possible based on assessment, the contact, suspect, probable,
or confirmed case of COVID-19 with mild symptoms shall be admitted to a
LIGTAS COVID Center
Specific Guidelines
D. Admission of Identified COVID-19 Cases to the LIGTAS COVID Center
• The HCW shall exercise due care and compassion in disclosing the presumptive
diagnosis and management plan to the patient and family representative/s.
• HCWs shall accomplish the COVID-19 Case Investigation Form and secure
informed consent from the contact, suspect, probable or confirmed case of
COVID-19 (with mild symptoms) before admission to the LlGTAS COVID Center.
• Should the patient refuse to be admitted, the HCW shall notify the Manager; the
Manager and the HCW shall compassionately explain the rationale for admission
and implement the same even if involuntarily, making a notation in the patient's
chart of such refusal and the medical justification for the enforcement as a rapid
containment, quarantine and isolation measure pursuant to law.
• A patient chart should be kept for every patient containing an admitting history,
monitoring sheet, and administered medications.
Specific Guidelines
E. Case Management in the LIGTAS COVID Center
• All patients shall be reminded of respiratory etiquette and home care
instructions.
• HCWs shall instruct and/or assist patients on how to monitor oneself and
record in a daily monitoring sheet twice a day (8 AM-4 PM) the following:
• body temperature; respiratory symptoms (fever, cough, colds, sore throat); and other
symptoms (e.g. , body malaise , fatigue, etc.), and to call the attention of a HCW if with
any symptom.
I. Discharge Protocols
• Patients in the LIGTAS COVID Centers may be discharged, and persons under
home quarantine may end home quarantine once asymptomatic for the
number of days prescribed in the latest clinical practice guidelines.
• The local health officer or his/ her designated physician shall issue a
Certificate of Completion of Quarantine or Isolation to those who are
discharged or who shall be ending home quarantine
Specific Guidelines
J. Referral and Transport of Patients and Specimens
• The LCTF shall immediately identify the nearest field or referral hospital catering to
probable and confirmed COVID-19 cases. In the event of clinical deterioration of a
patient, the LCTF in coordination with the MESU/CESU /HESU/PESU/RESU shall
provide referral and transport mechanisms to designated field or referral hospitals.
The LCTF shall also provide transport mechanisms for patients who are discharged
to lower-level facilities, or to home.
• The LGU shall provide access to at least a Type I Basic Life Support Ambulance.
Where applicable, the LGU may make arrangements with the local chapter of the
Philippine Red Cross or other reputable and reliable institutions/entities for the
purpose of this provision.
• During ambulance conduction, the patient will be accompanied solely by a
healthcare worker with proper PPE and monitor the well-being of the patient while
in transit from the place of pick-up to the receiving health facility.
• The driver shall also observe the appropriate infection controls and avoid contact
with the patient. After the patient is accepted by the receiving facility, the
ambulance shall be disinfected by its owner/operator in coordination with the
LIGTAS COVID sanitation officer
Specific Guidelines
J. Referral and Transport of Patients and Specimens
• PNP shall provide the appropriate services to ensure the compassionate, safe
and secure transfer of patient between LIGTAS COVID Centers and other
health faciIities
• For the purposes of laboratory testing of suspect COVID-19 cases,
specimens shall be collected on-site at the level of care/facility closest to the
patient's place of residence or work.
• The LGU with the assistance of the PNP and BFP (as well as the AFP and
DPWH, upon request) shall ensure that these samples are transported from
the point of collection to the designated laboratory. LGUs shall coordinate
the timing of sample collection with the chain of specimen transport to
ensure the quality and reliability of the specimen for laboratory purposes
Specific Guidelines
K. End of Life Care, Management of the Dead and Bereavement Care for
Families
• Healthcare workers shall provide end-of-life and bereavement care for all patients
and their families, aligned with protocols for mental health and psychosocial
support
• Care for dying patients includes:
• management of pain and symptoms, ensuring support for family members, assigning primary and
back-up family caregiver, establishing expectations on end-of-life or improvement and care
planning.
• Health providers should ensure different needs are discussed within the family,
including psychological and physical health, social, spiritual, cultural, financial and
practical elements.
• Health care workers shall assist families in planning how these needs can be
addressed. Possible actions can be noted as the family's bereavement plan.
Bereavement support includes communication to the family following death and
allowing the family to discuss needs and act on the bereavement plan.
• DOH provides guidelines on the disposal and shipment of the remains of confirmed
cases of COVID-19. Other existing guidelines on the disposal and shipment of the
remains of human bodies apply for non-COVID-19 cases
Reporting and Coordination
• The LIGTAS COVID Center Manager shall draft and submit a brief
daily situation report including a census of contacts, suspect, probable
and confirmed cases, including daily monitoring using the COVID-19
information system prescribed by the DOH to the BHERT, which in
turn shall review and endorse the same to the LCTF and MESU/CESU
who shall in turn submit a consolidated report to the PESU and RESU
THANK YOU !