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
DEVELOPMENT ___(CHDs);_ MINISTER OF HEALTH-
BANGSAMORO AUTONOMOUS REGION _IN MUSLIM
MINDANAO - CHIEF: ;_

DICAL
CENTERS, HOSPITALS, SANITARIA AND 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.

This Department Memorandum (DM)

is
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.
all
I. PREVENT
A. Wearing of Masks

1. Wearing of face masks in the

indoor and outdoor settings shall be voluntary, however,
it is highly encouraged in following settings:
a. Healthcare facilities, including, but not limited to, clinics, hospitals,
laboratories, nursing homes, and dialysis clinics, and;
b. Medical transport vehicles, such as ambulances and paramedic rescue
vehicles.

B. Hygiene and disinfection

1. 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
at
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.

Building 1, San Lazaro Compound, Rizal Avenue, Sta. Cruz, 1003 Manila Trunk Line 8651-7800 local 1113, 1108
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, Ensure ventilation requirements for air quality in all facilities are met as stipulated
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.

For individuals with mild symptoms and those who are not at-risk of progression
to severe disease, testing shall be optional. They shall isolate immediately,
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.

Testing of the asymptomatic close contacts who are not at-risk of progression to
severe disease regardless of vaccination status shall be optional. If testing will be
done, use of RT-PCR shall remain the gold standard for COVID-19 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

contacts
individuals, shall not be required to undergo quarantine.

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
symptoms, whichever
healthcare provider.
is earlier. Isolation may be shortened upon the advice of the

Confirmed COVID-19 positive cases _with moderate to severe symptoms, OR

immunocompromised_ individuals, are recommended to isolate for at least 10
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.

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

Philippine COVID-19 Living Recommendations. While there are existing
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 of
Adult Patients with COVID-19
2. Annex D - Drugs in the Management of
Pediatric Patients with COVID-19
 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, asnecessary.

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
proper assessment aswell as corresponding management and interventions.

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.

B. Promote 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.

VI. VACCINATION

Despite the lifting of the COVID-19 Public Health Emergency in the country, COVID-19
vaccination is recommended to 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.

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 life
stage. For further details, the Omnibus Health Guidelines per Life Stage may be
at
accessed https://bit.ly/OmnibusHealthGuidelines.
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
reducethe risk of transmission of disease.

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

generation and communication interventions with immunization program
interventions. Utilize evidence-based planning through the microplanning process
co-developed with WHO and UNICEF. Modules for Risk Communication,
Community Engagement, and Microplanning may be accessed through
https://bit.ly/CHDMicroplanProcess.

D. Expand partnerships with civil society organizations, non-government organizations,

academe, and other development partners for co-creation, implementation, and
evaluation of RCCE interventions.

VIII. 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,
or
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 site processes.

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,

Officer-In-Charge
CESO
III
ffice of the Secretary
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
1. 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

Resource for Patient Care and Support

1. 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
precautions
N Medications for pre-existing conditions as needed; family planning supplies as
desired
wH
per
Digital thermometer, preferably one patient, disinfected before and after use
Meal preparation
MAME
Masks, tissues, and other hygiene products
Laundry
Household cleaning products

Personal Protective Equipment

For the patient: surgical mask per day for each day
1.
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

Home Monitoring Kit

1. Vital signs recording mechanism
2. Thermometer
3. 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
all
personal items for eating and hygiene.
8. Medicines to manage common symptoms of COVID-19
Annex B. Updated masking, quarantine and isolation protocols*

Asymptomatic close contact e@

Masking / Quarantine
/
No need to quarantine; and
Isolation Protocols

exposed to confirmed
COVID-19 positive individual
e@
Wear a well-fitted face mask for at least 10 days.

Asymptomatic but confirmed e Home isolation for 5 days OR until afebrile/

COVID-19 positive case fever-free for at least 24 hours without using
antipyretics (e.g., Paracetamol) and with
improvement of respiratory symptoms, whichever
Confirmed COVID-19 positive is earlier; and
case with mild symptoms OR
individuals with acute e@
Wear a well-fitted face mask for at least 10 days.
respiratory symptoms
Note: Isolation may be shortened upon the advice of
your healthcare provider.
Confirmed COVID-19 positive Isolation for at least 10 days from onset of signs
case with moderate to severe and symptoms following advice of the attending
symptoms, OR physician, including whether to be admitted in
immunocompromised 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 For Mild-Moderate COVID-19 in Non-Hospitalized Adult
Patients*

Recommended Indication Medicine Link to COVID Certainty of

(based on COVID LCPG) LCPG Evidence Evidence and
Review Strength of
Recommendation

Non-hospitalized patients with at Remdesivir https: mi Moderate certainty

least 1 risk factor** for progression org/remdesivir-evid of evidence; Strong
to severe disease ence-summary-3/ recommendation

Non-oxygen requiring patients with Molnupiravir https://www.psmid, Very low certainty

at least one risk factor*** for org/molnupiravir-e of evidence;
progression (within 5 days of vidence-summary- Weak
symptom onset) 2/ recommendation

Unvaccinated, symptomatic adult Nirmatrelvir + https:/Avww.psmid. Moderate certainty

patients with high risk**** for Ritonavir org/paxlovid-evide of evidence; Strong
progression to severe disease (within (Paxlovid) nee-summary/ recommendation
5 days of symptom onset)

Symptomatic, non-hospitalized Casirivimab + https://www.psmid. Very low certainty

patients with risk factor***** for Imdevimab org/casitivimab-im of evidence;
severe COVID-19 (only when the devimab-evidence- Weak
predominant circulating variant
Omicron SARS-CoV-2)
is
not summary-4/ recommendation

Unvaccinated non-hospitalized Tixagevimab https://www.psmid. Very low certainty

patients with mild to moderate +Cilgavimab org/tixagevimab-cil of evidence; Weak
COVID-19 infection with at least 1 gavimab-evidence- recommendation
risk factor****** for progression to summary-2/
severe disease
*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

*KHKKARISK 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

10
Treatment For Moderate-Severe COVID-19 in Hospitalized Adult Patients*

Recommended Indication Medicine Link to COVID Certainty of

(based on COVID LCPG) LCPG Evidence Evidence and
Review Strength of
Recommendation

Patients with COVID-19 infection Remdesivir + https://www.psmi Low certainty of

requiring oxygen supplementation but Dexamethasone d.org/remdesivir-e evidence; Weak
do not require mechanical ventilation vidence-summary- recommendation
(For patients who progress toinvasive 3/
mechanical ventilation while on
remdesivir, the drug can be
continued)

Hospitalized critical COVID-19 Baricitinib https://www.psmi Moderate certainty

patients on high-flow nasal cannula + d.org/baricitinib-e of evidence; Strong
oxygenation, noninvasive ventilation, Corticosteroids vidence-summary- recommendation
or invasive mechanical ventilation 2/

Patients showing rapid respiratory Tocilizumab + https://www.psmi Moderate certainty

deterioration and/or requiring high systemic d.org/tocilizumab- of evidence; Strong
doses of oxygen (high-flow nasal steroids evidence-summar recommendation
cannula, noninvasive or invasive y/
mechanical ventilation) and with
elevated biomarkers of inflammation
(CRP)

Hospitalized patients with moderate, Standard dose https://www.psmi Low certainty of

severe or critical COVID-19 disease prophylactic d.org/anticoagulati evidence; Weak
unless there are any contraindications anticoagulation on-evidence-sum recommendation
mary-3/

Patients with severe and critical Dexamethasone https:/Awww.psmi Moderate certainty

COVID-19 (up to 10 days of use) d.org/corticosteroi of evidence; Strong
**Standard dose at 6mg to 12mg/day ds-evidence-summ recommendation
among adults with severe and critical ary-2/
COVID-19

Patients with severe and critical Methylpredniso https://www.psmi Very low certainty
COVID-19 (up to 5- 10 days of use) lone d.org/corticosteroi of evidence; Weak
1-2mg/kg/day ds-evidence-summ recommendation
ary-2/
*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 Medicine Link to Certainty of

(based on COVID LCPG) COVID LCPG Evidence and
Evidence Strength of
Review Recommendation

Hospitalized or ambulatory Remdesivir https://www.ps Very low certainty

children with mild to moderate mid.org/remdes of evidence; Weak
COVID-19 infection with at least ivir-evidence-su recommendation
one (1) risk factor for disease mmary-3/
progression

Unvaccinated, symptomatic Nirmatrelvir+ https://www.ps Low certainty of

pediatric patients 12 years and Ritonavir mid.org/paxlovi evidence; Weak
older weighing
high risk for
atleast 40 kg with
progression to
(Paxlovid) d-evidence-sum
mary/
recommendation

severe disease
*Should be used with the supervision of a physician

Treatment For Hospitalized Moderate to Severe COVID-19 in Children*

Recommended Indication Medicine Link to Certainty of

(based on COVID LCPG) COVID LCPG Evidence and
Evidence Strength of
Review Recommendation

Children with COVID-19 Remdesivir + https:/Awww.ps Very low certainty

infection requiring oxygen Dexamethasone mid.org/remdes of evidence;
supplementation but do not ivir-evidence-s Weak
require mechanical ventilation ummary-3/ recommendation

*Should be used with the supervision of a physician

12
Annex E, Prioritization framework

Categories of Priority Populations for COVID-19 Vaccination

Priority Group Description

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 COVID-19 referral hospitals designated by the DOH;
Al.2 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
(Expanded Al) next four months
A1.9 Immediate family members of health care workers which refers to all
(Expanded A1) 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 in
Institutionalized senior citizens including those registered nursing homes
and other group homes with elderly working together (e.g. convents).
A2.2 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.
[Priority Group A3 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
Autoimmune disease
HIV/Malignancy
Cancer
mone
Transplant patients
Undergoing steroid treatment
Patients with poor prognosis/Bed-ridden patients

Pediatric A3 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
 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
(Severe Obstructive Sleep Apnea, Tracheomalacia, Stenosis,
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.
k. Hepatobiliary Diseases: Chronic Liver Disease, Cirrhosis,
Malabsorption Syndrome.
1. Immunocompromised state due to disease or treatment: Bone
marrow or stem cell transplant patients, solid organ transplant
recipients, hematological malignancies (leukemia, anemia,
thalassemia), cancer patients on chemotherapy, severe aplastic
anemia, autoimmune or autoinflammatory disorders requiring
long-term immunosuppressive therapy (e.g. Systemic Lupus
Erythematosus, Rheumatoid Arthritis), patients receiving
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.
Expanded A3 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
Priority Group A4 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

Employees in government agencies and instrumentalities, including

A4.2 government-owned or controlled corporations (GOCCs) and local
government units
Informal sector workers and self-employed who work outside their homes
A4.3
and those working in private households
Poor population based on the National Household Targeting System for
Priority Group A5 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