LOADING CLOSE

Institutional Quarantine (at Accommodations Facilities) and Home Isolation Protocols

8/10/1442 -20/5/2021

Institutional Quarantine (at Accommodations Facilities) and Home Isolation Protocols, and The Mechanism for Dealing with Travelers Coming from Outside the Kingdom

8/10/1442 -20/5/2021

Introduction

Isolation and quarantine are considered as one of the most important approaches to limit the movement of the infected or suspected cases in order to control and prevent the spread of highly infectious diseases in hospital and health care facilities. This also applies to homes that can be used for quarantine or isolation. Quarantine or isolation is applied until there is no longer a risk of transmitting the disease to others.

The Target Group of this Guidelines
This guideline targets the following groups:

  • Health practitioners working at points of entry into the Kingdom.
  • Health practitioners working in health care facilities.
  • Travelers coming from outside the Kingdom of Saudi Arabia.
  • Those working in quarantine facilities.

The purpose of these guidelines:
This guideline helps in reducing the spread of COVID-19 by:

  • Providing directives to health practitioners working in points of entry, public health, workers in quarantine facilities, and hospitals on how to deal with travelers coming from outside the Kingdom and confirmed COVID-19 cases.
  • Applying preventive measures in facilities for quarantine and medical isolation.
  • Following the rules and instructions for persons under quarantine and medical isolation in a designated facility or at home.
  • Providing quarantine laws and regulations and penalties for violators.
  • Requirements for the quarantine place in the designated facility.
  • Following home isolation requirements.

Definitions

 

Quarantine:

Restricted activities or separation of asymptomatic persons without positive results but suspected to have been exposed to an infection source in order to reduce the spread of infection. Quarantine shall be in a designated facility or home that fulfills specific requirements.

Isolation:

Separation of the infected or symptomatic person having a positive result to reduce the spread of infection. Isolation is either at the hospital or home depending on the patient’s health condition.

Institutional Quarantine:
Hosting air travelers arriving in the Kingdom of Saudi Arabia through airports in specific places designated for quarantine at their own expense.

Quarantine facility:
Accommodating Facilities that have been prequalified for quarantine.

Immune:
For citizens or residents: classified immune in the Tawakkalna application. They include those who have completed their COVID-19 vaccinations; those who have completed 14 days after their first dose; and those who have recovered from confirmed COVID-19 in a period not exceeding 6 months.

For non-residents and non-citizen: who have completed 14 days since receiving all recommended vaccine doses (using any of the vaccines authorized in the Kingdom of Saudi Arabia). Such persons will provide proof of vaccination according to, the requirements of the Ministry of Health.

The approved vaccines for use in the Kingdom are:

  • Pfizer BioNTech Vaccine (2 doses)
  • Oxford AstraZeneca Vaccine (2 doses)
  • Moderna Vaccine (2 doses)
  • Johnson & Johnson’s Janssen Vaccine (1 dose)

Dealing with travelers coming from outside the Kingdom

Before Arrival 

All non-Saudi travelers, except for passengers under (the age of 8) *, must present a negative COVID-19 PCR test. The test must have been carried out not more than 72 hours before the scheduled departure.

* Taking into consideration the regulations of the country related to children PCR test.

 

Upon Arrival

 

  1. Ensure and confirm that all travelers arriving through the various ports of arrival are registered in Tawakkalna immediately they reach the accredited quarantine facility or within 8 hours from arriving at home quarantine. This will enable the health authority to follow up and monitor quarantined persons.
  2. Ensure individuals are properly informed of what is expected of them during self-quarantine at home by providing them with brochures and instructions.
  3. Health care workers stationed in epidemiological monitoring centers at the points of entry will access those returning from outside the Kingdom using visual triage to detect potentially symptomatic individuals.
  4. Visual triage will be used to determine quarantine or home isolation status and according to the following categories:

 

2.1 Travelers Arriving Without Symptoms:

 

  • All travelers must undergo quarantine as shown in the table below.
  • Quarantine will be applied according to the categories in the below table.
  • Travelers must fill out pledge to register on the Tawakkalna application within 8 hours from their arrival. They must follow the precautions measures described in the application. Lastly, they should ensure that all the information provided in the pledge is correct.

Dealing with travelers coming from abroad as follow

StatusNon-vaccinatedvaccinated

(according to Tawakkalna or by providing proof)

CategoryFirst category:

● Saudi citizens

● Citizen’s wife; citizen’s husband; the citizen’s children; and domestic workers accompanying them.

● Cabin crew*

● Official delegations*

● Diplomats and their residing families and domestic workers accompanying them.

● Wife and domestic workers who accompanying an immune resident.

● Those involved in health supply chains, as determined by MOH*

● Under-18 person (accompanying or not) an immune citizen or resident.

● Family members/companions of immunized health practitioners working in the government sector, including those under the age of 18

● Exceptional cases as determined by the concerned authorities.

Second category:

Non-citizen travelers or those who are not mentioned in the first category.

First and second category
provide a proof of a negative PCR test which does not exceed (72) hours from scheduled the time of departureRequired; Saudi citizens exemptedProof is requiredRequired, except Saudi citizens
Quarantine type and durationHome isolation for 7 daysInstitutional quarantine for 7 daysNot required
Number of PCR tests required after arrivalOnceTwiceNot required
When to do the PCR test?From day 6On the 1st and 7th dayDoes not apply.
*Cabin crews, official delegations, and supply chains workers are exempted from institutional quarantine; they are to be handled according to precautionary measures approved by the Ministry of Health.

Non-Vaccinated travelers arriving through airports

Non-Vaccinated travelers arriving through airports
For Saudi citizens and those exempted from institutional quarantine arriving at airports, the process is as follows:

  • Self-quarantine at home for 7 days as long as they have no symptoms. However, if the home does not meet the quarantine requirements, according to the exceptions below, the quarantine will be at a private institution
  • PCR test should be done starting from the sixth day of quarantine.
  • The home quarantine can be stopped starting from day 8 if the test is negative and lack symptoms
  • Cabin crews, official delegations, and supply chains workers will be handled according to precautionary measures approved by the Ministry of Health.

Non-citizens and Non-Exempted categories:

  • They will be quarantined will be at a dedicated facility (the institutional quarantine facility) for a period of 7 days as long as they do not have symptoms of infection.
  • The PCR test should be done twice: on day 1 and 7 of arrival in the kingdom.
  • Persons having negative PCR tests and without symptoms are permitted to terminate the quarantine starting from day 8.
    Health practitioners:
  • Non-immunized health practitioners working in government sectors and their family members/companions including those under18 years are to be placed under institutional quarantine in government housing for 7 days with a PCR examination performed at the end of the quarantine.
  • Non-immunized health practitioners working in the private sector are to be placed under institutional quarantine (Hotels) and must have 2 PCR tests done on the first and seventh day. All institutional quarantine procedures will be applied.

The process regarding immune (according to Tawakkalna) Saudis and non-Saudis arriving in Saudi Arabia. Being immune in Tawakkalna implies that they have completed their vaccinations against (COVID-19), those who have passed 14 days after their first dose or providing a certificate or proof that he completed all the vaccine doses in accordance with the requirements set by the Ministry of Health):

  • They are not required to do a PCR test or be subjected to home quarantine.

General points for all categories:

  • Children under 8 years arriving from outside the Kingdom are exempted from the PCR test requirement.
  • All positive samples must be sent to the Public Health Authority’s laboratory in Riyadh.

It is permitted for the following persons to arrive through land ports and seaports:

  • Saudi citizens, citizen’s wife, citizen’s husband, citizen’s children, and domestic workers accompanying them.
  • Immune citizens or residents and persons under 18 years accompanying them.
    (Home quarantine for 7 days, with PCR test at the end of the quarantine period, starting from the sixth day will be applied to non-vaccinated people)
  • Those holding a diplomatic visa, diplomats and their residing families and domestic workers accompanying them. (They must undergo home quarantine in accordance with the ministry of health (MOH) approved regulations)
  • Crews of ships.
  • Those involved in health supply chains as determined by the MOH.
  • Truck drivers and their assistants arriving through all ports of entry.
  • Exempted cases as determined by the concerned authorities
    (They must undergo the precautionary measures approved by the Ministry of Health)

Health practitioners:

  • Health practitioners working in the government sector who are not immunized and their family members/companions, including those under the age of 18, are institutionally quarantined in government housing for 7 days with a PCR examination performed at the end of the quarantine.
  • Family members/companions of immunized health practitioners working in the government sector, including those under the age of 18 (provided that home quarantine is applied to unvaccinated persons from the above categories with a PCR examination performed at the end of the quarantine period starting from the sixth day)

Exceptions from Home Quarantine:

  • Failure to adhere to home quarantine according to TATAMAN and/or the competent authorities reports.
  • If there is no internet.
  • No smartphone.
  • If the house is not equipped for home quarantine, according to the public health report in the region.

 

2.2 Travelers Arriving Symptomatic:

 

Isolate travelers who develop symptoms and treat them as suspected cases after their health condition is evaluated. They should be tested within the first 24 hours of arrival, either at the point of entry or at the nearest health center (as determined by the region’s public health). The place of isolation is determined based on the following:

  1. If the arriving traveler’s condition is stable, isolation will be at home or an institutional quarantine facility until the test result is available. This depends on the category. Please note that home isolation can only occur in homes where conditions are met.
  2. Affected persons must commit to adhering to the instructions home isolation or institutional quarantine until test results are available or the end of the period of isolation (as determined by the region’s public health).
  3. If the test result is positive and the health condition of the case is stable and does not require admission, the patient will complete the isolation at home or institutional quarantine, according to the category that applies.
  4. If symptoms worsen or the patient’s condition becomes unstable, he should be transferred to the hospital.

Confirmed Cases

Self- Isolation at home or in institutional quarantine facilities

 

Self-Isolation Definition:

 

Separation of an infected person with a contagious disease at home (or at institutional quarantine facilities) to reduce the spread of infection. All such cases should be registered in Tawakkalna to ensure follow up.

 

Cases that Require Home Isolation

 

Self-isolation for confirmed cases of COVID-19 as following:

 

  • Confirmed cases that have mild symptoms do not require admission as determined by the region’s public health authorities.
  • Confirmed cases that have mild symptoms and have recovered (to complete the isolation period at home), whether the result of a follow up test is positive or negative.
  • Close contacts with confirmed cases who do not have symptoms or have mild symptoms with pending test results based on the evaluation of the region’s public health authorities.

 

 

Standards for Confirmed Cases undergoing Home Self-Isolation

 

  • Ensure that patients are in good condition so that they can recover at home and do not require admission in hospital for medical reasons.
  • Provide patients with the necessary instructions and brochures during their self-isolation.
  • Confirm they are registered in
  • Impress upon them that, if they develop additional symptoms, they should contact 937 or go to the emergency room at the nearest health facility.

 

 

Standards for Confirmed Cases undergoing Self-Isolation at institutional quarantine facilities

 

Individuals who are PCR positive will be dealt with, accordingly to their health conditions, as follow:

  • Individuals whose health conditions do not require hospitalization will continue their isolation in institutional quarantine facilities.
  • Individuals will be transferred to hospitals if their health conditions necessitate.
  • Positive cases requiring medical care will be dealt with in accommodation facilities by the Ministry of Health.
  • Authorities responsible for providing medical care for cases (the Ministry of Health, private hospitals, or the Red Crescent) must be informed if the patient’s condition required medical care.

 

Ending Self-Isolation for Positive Cases

 

Confirmed Case without Symptoms:

A patient who did not show symptoms and has spent 10 days or more since the last positive test is considered recovered without the need to undergo another PCR test; it also ends his period of observation.

 

Confirmed Case with Symptoms:

 

The patient who had mild symptoms and spent 3 days or more with none (no fever without using a fever-reducing medication, and improved respiratory symptoms) is considered recovered without the need to undergo another PCR test (provided that he/she spent 10 days or more since the last positive test). The patient’s observation period will be ended.

  • Decisions to end isolation for positive cases with severe symptoms in hospitals will be according to the protocols of Health Practitioners.
  • Health practitioners are exempted from what has preceded; rather, procedures special to them are applied.

Quarantine and Isolation Requirements

Requirements for Quarantine or Isolation Facility:

 

Before imposing self-isolation, or quarantine at home to an individual who was in contact with a confirmed case or persons arriving from outside the Kingdom, the home is evaluated by the region, governorate, or health center’s public health team and decide whether the house is suitable for the isolation or not.

 

This evaluation can be conducted by phone or direct assessment depending on the public health authorities’ decision:

  • Having a separate and well-ventilated room with a toilet. Use a separate bathroom from the rest of the household where possible.
  • There should be a person who will supervise and assist the patient. Provide the patient or the person who is caring for him/her with personal protection tools (gloves and masks).
  • Reduce to the barest minimum possible the number of persons taking care of the patient at home. Educate them about disease transmission methods, how to wash their hands, and the proper way to wear the mask.

 

 Guidance While in Quarantine and Isolation:

 

  • Do not leave your home except to seek medical care.
  • Do not go to work, school, or public areas; and avoid using public transportation or taxis as much as possible.
  • Isolate yourself from others: You should stay in a separate room from the rest of the household especially the elderly, persons with chronic diseases, or pregnant women. Avoid close contact with pets.
  • Visitors are not allowed during this period.
  • Use face covering (mask): Wear a mask when leaving the house is unavoidable as in going to the hospital or while spending time in shared areas. Stay one and a half meters away from other people to reduce the spread of the disease.
  • Cover coughs and sneezes: Cover your mouth and nose with a tissue when you cough or sneeze; dispose of used tissues in the waste bin and wash your hands immediately with soap and water for at least 40 seconds. When soap and water are not available, clean your hands with a hand sanitizer that contains at least 60% of alcohol.
  • Clean your hands: Wash your hands with soap and water for at least 40 seconds, particularly after coughing, sneezing, and using the bathroom, and before eating or preparing food. You should also avoid touching your face before washing your hands.
  • Avoid sharing personal items: You should not share dishes, cups, towels, or bedspreads with other or pets in your home.
  • Regular cleaning of frequently touched surfaces: Regularly clean frequently touched surfaces include doors, computer keyboards, mobile phones, and others using alcohol or chlorine sterilizers.
  • Adequate ventilation: Make sure shared areas are well-ventilated by opening windows where possible.
  • Monitor your symptoms: When you have a cough, high temperature, or shortness of breath, call 937 directly. Avoid visiting health center or hospital emergency to reduce spreading the infection to others

 

 

Guidance for People Who Live in the Same Household as a Patient in Isolation/ Quarantine:

  • Continuously observe a distance of at least one and a half meters from the infected person and avoid unnecessary close contact.
  • Relatives who are taking care of sick family members must wear a mask while in close contact.
  • Wear a mask and gloves when cleaning the room and toilet.
  • Pay attention to your hygiene: this includes using the patient’s dishes; using disposable tissues and disinfection of surfaces that are frequently touched such as lights switches and door handles.
  • Wash hands with soap and water for at least 40 seconds before and after touching the patient, his/her medication, food, contact lenses, or other things related to the patient.
  • Use disposable gloves and wash your hands immediately after touching the patient’s clothes and bed covers.
  • Wash the patient’s clothes and bed covers with warm water and detergent for as long as possible. Then dry them with a clothes dryer.

Requirements for (Quarantine – Isolation) in a Designated Facility (Institutional Quarantine facilities)

Requirements for facilities that are designated to function as Institutional Quarantine Centers

  • All employees and workers in the facility must be immunized against Covid-19 and that will be reflected in Tawakkalna, or conduct a PCR test every seven days.
  • Evaluate the appropriateness of the place based on the following:
    1. The quarantine facility must contain a fully functional private bathroom for every room.
    2. An isolation room should be provided for suspected cases. It should be single occupancy and not shared with other patients in quarantine. However, the following categories are exempted:
      • Families (First-degree relatives).
      • The elderly or persons with special needs
    3. The room must have essential services such as electricity, hot water, communications. The air-conditioning must be functional to ensure adequate ventilation.
    4. Essential services such as food and water must be provided.
    5. Provide health care workers that can provide care persons in quarantine.
    6. Provide personal protection tools, disinfectants, and medical waste supplies.
    7. Provide entertainment devices such as the Internet and TV.
    8. Provide means of health awareness about the disease.
    9. Provide well-trained housekeeping staff well trained in cleaning and disinfection of public facilities according to scientific guidelines.
  • The air carrier or facility shall make a contract with one of the laboratories accredited by the Public Health Authority (PHA) to collect samples from people in quarantine.
  • The laboratory must commit to the guidelines issued by the PHA about handling specimens (storage, transport, testing, and sending positive specimens to the PHA’s laboratory in Riyadh.
  • The facility shall prevent quarantined individuals from using gyms and entertainment lounge, swimming areas as well as meeting rooms inside the facility. Sitting in the lobby should also be prevented.
  • Quarantined persons should not be allowed to leave the facility before they end of the institutional quarantine period.
  • The facility must monitor and observe the quarantine rooms and all buildings related to it using CCTV cameras. It must enable the government auditor to review recordings at any time to ensure the implementations of preventive measures inside the facility.
  • If a violation occurred from a quarantined individual as regards the preventive measures that must be followed, the facility must immediately inform the competent authorities.

Procedures that should be followed by the supervisors of the institutional quarantine

  • Supervisors must be immunized against Covid-19 and this must be reflected in Tawakkalna. Or they must conduct a PCR test every seven days.
  • Supervisors must ensure that all quarantined individuals register and activate the Tawakkalna application on their phones within 24 hours from entering their rooms.
  • Supervisors must provide awareness for the quarantined persons as regards instructions and requirements that they should adhere to as well as place awareness posters in every room.
  • Supervisors should take an appropriate sample (for PCR test) from quarantined persons within 24 hours from arriving.
  • Another sample must be taken (for PCR testing) on the 7th day.
  • Supervisors must ensure that the quarantine period should not be less than 7 days.
  • Supervisors should be kind to all travelers and respect everyone’s rights and freedoms.
  • Supervisors should treat the quarantined travelers with respect for their dignity, human rights, and the fundamental freedoms associated with these measures. This includes treating all the quarantined travelers with kindness and respect.
  • Apply all infection control precautions when collecting samples as indicated in the relevant section of this protocol.
  • Monitoring the health status of quarantined persons.
  • Ensure that workers and quarantined persons follow preventive measures such as washing hands and wearing a medical mask.
  • Use disposable utensils for eating and drinking.
  • Ensure daily disinfection of all frequently touched surfaces and tools This should be done using approved disinfectants and by trained personnel wearing appropriate personnel protection equipment (PPE) [gloves, respiratory masks and medical gowns] during cleaning.
  • Deep disinfection is not necessary for the room after the patient departs. An exception is when the quarantined individual leaves secretions in the room after he develops symptoms.
  • When laundering quarantined individuals’ clothes, it is important to use PPE using warm water and detergent for as long as possible. Dry them in a clothes dryer.
  • Ensure that the quarantine room is well ventilated.
  • Disposing of medical waste in a safe way.
  • The supervisor of the quarantine facility must be informed when quarantined persons or workers develop high temperature or respiratory symptoms in the facility. The situation must be medically evaluated and expected procedures followed.
  • The supervisor must inform the MOH and the Red Crescent of quarantined persons requiring transfer to a medical facility for medical care.
  • The supervisor should inform competent security authorities when quarantined persons do not comply with health requirements. These include:
  • If the person does not reach the designated quarantine facility within 4 hours of arrival in the kingdom.
  • If the quarantined person does not cooperate in giving a swab for the COVID-19 test.
  • If any quarantined person leaves the facility before he ends the quarantine period.
  • If a quarantined person refuses to stay in his room.

Rules for People Who are Under Quarantine

  • Tawakkalna application must be activated within 24 hours from entering the quarantine room.
  • Use face covering (mask): Wear a mask when leaving your room for necessity (for example, going to the hotel lobby) or if you need to spend time in shared areas. You should also keep a distance of at least one meter away from other people to reduce the spread of the disease.
  • Visitors from outside the quarantine facility are prohibited from visiting quarantined persons. Similarly, visitations between quarantined persons within the same facility are prohibited inside private rooms or any closed area.
  • Maintain clean hands by methodically washing them with soap and water for at least 40 seconds. Or by using alcohol rub for at least 20 seconds.
  • Cover your mouth and nose with a tissue or clothes sleeves when you cough or sneeze. Dispose of used tissues in the waste bin and wash your hands immediately.
  • Wear a medical mask if other people are inside your room. These include health workers, room service, and cleaning workers.
  • The sharing of eating or drinking utensils and personal items with others is prohibited. Eating and drinking in the common areas of the facility are also prohibited.
  • The use of bathrooms in common areas inside the facility is prohibited. Use the bathroom inside your room.
  • Inform the health staff if you develop respiratory symptoms such as coughing, shortness of breath, or a high temperature.

Guidance and regulations when collecting specimens

General instructions:

  • The practitioner authorized to collect specimens must not enter the patent’s room except when taking the sample at a distance not exceeding one meter from the room door.
  • The sample must be taken within one meter inside the room.
  • The practitioner authorized to collect specimens should use PPE appropriately and wash his hands.
  • The team who is responsible for collecting specimens should consist of at least 2 persons (one for collecting the specimens and the other assisting and monitoring the process).
  • Mobile tables or trolleys should not be taken inside the person’s room. It should be kept as far away as possible from the room.
  • The patient must stand at the door at the time of collecting the sample without coming out. He should only open the door when samples are about to be taken.

 

Infection control instructions:

  • The sampling team must adhere to the precautionary and infection control measures when collecting specimens (universal and droplet precautions).
  • Allocate place to wear the PPE and another place to remove them on every floor of the hotel.
  • Allocate PPE for each floor and do not take them to another floor.
  • Educate patients to not take the masks off except when taking the sample.

 

Basic and Droplet Precautions

Wearing PPE:

  • Washing hands with soap and water or by using sanitizer for 40 seconds before donning PPE.
  • Start by wearing the long-sleeved gown, followed by plastic gown, fit-tested particulate respirators (N95 or equivalent, or higher level of protection masks), face shield, and gloves in that order.

 

Removing PPE:

  • It is not necessary to change all protective equipment when collecting specimens from patients, except in the following cases:
    1. If the patient has suspected respiratory symptoms.
    2. In case of breaching infection control precautions during specimen collection.
    3. If the patient sneezes or the tools are exposed to droplets from the patient while taking the sample.

In these cases, the PPE must be fully changed:

  • Change the plastic gown and the gloves when moving from one patient to another, and wash hands after taking every sample.
  • Remove the PPE after completing all patient on the same floor in the designated place in the following sequence:
    • Gloves
    • Face shield
    • Medical gown
    • High-grade respirators (N95)

Violation Penalty

Whoever violates the instructions of isolation or quarantine shall be punished with a fine not exceeding SR 200,000, imprisonment for a period not exceeding two years, or both imprisonment and fine.

In the situation where the violation recurs, the fine imposed for the previous violation shall be doubled.

 

An expatriate who violates the rules will be deported from the Kingdom and permanently banned from returning to the country after his punishment is executed.