Government Trinidad And Tobago Ministry Of Health

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Governmentof the Republic ofTrinidad and TobagoMinistry of HealthQuarantine Protocols forPassengers Entering intoTrinidad and TobagoEffective March 7th, 2022Updated as at 7th March, 2022

ContentsContentsAcknowledgements1. Background2. Objectives of the Protocols3. Legal and Policy Framework4. Quarantine Protocols for Passengers Enteringinto Trinidad and Tobago5. Implementation of the Protocols6. Monitoring and Evaluation7. Reference8. Appendices8.1.1 Legal Notice No. 34 (Corrigendum)8.1.2 Legal Notice No. 348.1.3 Legal Notice No. 358.1.4 Quarantine Act Chap. 28:05 7 (1) to (3)8.1.5 Fines related to Breach of Regulations An Act to amend the Quarantine ActChap. 28:05, Act No. 12 of 2021234555999101011131416

AcknowledgementsThe Ministry of Health would like to acknowledge the contributions of thefollowing officers for the information and research compiled for theseProtocols: Dr. Roshan Parasram, Chief Medical Officer; Dr. Maryam Abdool-Richards,Principal Medical Officer (Institutions); Dr. Osafo Fraser, County Medical Officer of Health, St. George East; Dr. Tiffany Hoyte, County Medical Officer of Health, Tobago; Dr. Antony Parkinson, Director of Health,North West Regional Health Authority; Ms. Anesa Doodnath-Siboo, Principal Pharmacist,Drug Inspectorate; Mr. Lawrence Jaisingh, Director, Health Policy,Research and Planning; and Ms. Cindi Siewdass, Research Officer II,Directorate, Health Policy, Research and Planning.3

1. BackgroundPandemic outbreaks such as COVID-19 have the potential to destabilize anddisrupt health systems and may have a profound effect on all aspects of acountry’s economy and the mental and physical health of the population.On March 11th, 2020, the World Health Organisation (WHO) declared theCOVID-19 to be a pandemic and as of June 28th, 2021, there were6ft181,176,715 confirmed cases with 3,930,496 deaths across 216 countries (WHOSituational Report)1.In Trinidad and Tobago, as at June 29th, 2021, there were thirty-two thousand,five hundred and twenty-eight (32,528) positive cases with effect from 12thMarch, 2020 and eight hundred and thirty-three (833) deaths with over226,082 unique patient tests conducted. The key objectives of these protocolsare to educate, engage and empower people to change their behaviour toensure the transmission of COVID-19 is adequately controlled - thecommunities would be educated, engaged and empowered to adjust to the“new normal” utilizing the following protocols: Wear masks when you go out in public (masks are mandatory inpublic spaces); Keep your distance from others (6ft); Stay home if you are ill; Wash your hands often with soap and water or use an alcoholbased sanitizer; Cough into a tissue or into the crook of your elbow; Avoid touching your face; and Clean then sanitize surfaces (e.g. table tops, door knobs and cellphones).The Guidelines for Returning Passengers were sourced from World HealthOrganization (WHO), and the Centers for Disease Control and Prevention (CDC)for COVID-19. The key source document was derived from the following d19.who.int/table

2. Objectives of the ProtocolsTo provide protocols on the quarantine and care of passengers via Ports of Entryfrom ‘ALL’ countries into Trinidad and Tobago, to minimize the risk of entry ofCOVID-19 Variants of Concern (VOC’s) and Variants of Interest (VOI’s) to our shores.3. Legal and Policy FrameworkOn January 31st 2020, the proclamation of COVID-19 as a dangerous infectiousdisease was made under the Public Health Ordinance, Chap. 12 No. 4, in order totrigger the special provisions under the Ordinance and the Quarantine Act Chapter28:05 that are pertinent to the curtailment and management of infectious diseasessuch as notification, special inspections and offences (Legal Notices Nos. 34 and 35and excerpt from the Quarantine Act 7(1) appended). Also, the adherence to the2004 Occupational Safety and Health Act, Chap. 88:88.4.Quarantine Protocols for Passengers Enteringinto Trinidad and TobagoGiven the current epidemiological state of the COVID-19 with community spread,there is a need to mitigate and minimize the risk of spread of VOI’s and VOC’s frompersons entering from other countries, which may potentially affect the existingresidential population.In this regard, individuals will be required to be assessed by Port Health officials,after which they would be categorized to determine disposition.In the first instance, the vessel Captain should report to the Port Health Authoritieson the status of all passengers prior to disembarkation. This includes the thoroughreview of all related documentation. The County Medical Officer of Health (CMOH)should provide direct oversight of this process to ensure compliance.Additionally, passengers will be subject to health screening by the Port HealthDivision of the Ministry of Health, including the observation of passengers for anynoticeable signs or symptoms, thermal scanning and the review of the healthdeclaration form for each passenger.

The above preliminary assessment will enable the Port Health Officer to conduct arisk assessment in order to classify the passengers for disembarkation by the degreeof illness for the appropriate medical attention.Five (5) categories of passengers have been identified as detailed below:Category One – Passengers (not requiring immediate medical attention) and areUnvaccinated (ALL individuals require 72 hours pre boarding PCR).1.Passengers are immediately taken to a designated State SupervisedQuarantine Facility for seven (7) days;2.Each passenger undergoes a medical assessment within 24hrs of arrival,which includes a medical history and PCR test for COVID-19 (swab)on the 7th day;3.Daily temperature monitoring and symptom checks are done by thedesignated medical team;4.Passengers who test negative for COVID-19 and complete their remainingseven (7) day quarantine period and are asymptomatic are allowed home.Final decision to be made by the CMOH.5.Passengers who test positive for COVID-19 (during the quarantine period) areimmediately transferred to a hospital in the parallel health care system forclinical assessment and assignment, samples should also be sent for genesequencing via the established pathway.Category Two – Returning Passengers (requiring immediate medical attention)1.Severe/Critically Ill passengers are quarantined at hospital (as per GlobalMedical Response of Trinidad and Tobago protocols for ambulance patients), whichcan accommodate their level of care with the following options based on clinicassessment:a.if patients require less than 7 days for stabilization/recovery, they should betransferred to a quarantine facility to complete the 7-day period and treatedunder the same protocols as described in Category One; andb.If patients require more than 7 days for stabilization/recovery, they shouldbe tested (swabbed) in hospital in this first instance, and if negative betransferred to the hospital where non-COVID-19 protocols are observed.2.Passengers who are ill but stable and in need of outpatient medicalmanagement (e.g. clinic visits for cancer treatment and Non-Communicable Diseasetreatment) should be transferred to a designated quarantine facility and treatedunder the same protocols as described in Category One. These passengers will be

transported to and from hospital for treatment for their illness via ambulance whennecessary; and3.Passengers who test positive for COVID-19 (either upon arrival in Trinidad andTobago or during the quarantine period) are immediately transferred to ahospital in the parallel health care system for treatmentCategory Three – Fully Vaccinated Individuals1.2.3.PCR Test 72 hours prior to arrival;Proof of vaccination (WHO approved);No quarantine required.A fully vaccinated individual is defined as a person who has received the requirednumber of doses of a WHO approved vaccine and it has been two weeks post thefinal recommended vaccine dose(s).A list of WHO approved vaccines can be found at www.health.gov.tt or at thefollowing -and-issues-interim-policy-recommendationsCategory Four – ChildrenA child is defined in Trinidad and Tobago as a person under the age of 18 years ofage. It must be noted at this time WHO has not approved the use of vaccines in thiscategory (with the exception of the Pfizer Biontech vaccine (Cominarty); which isauthorized for ages 12 years and above, however, at this time, remains largelyunavailable to the people of Trinidad and Tobago.Unvaccinated ChildrenThe following conditions will be applied:1.2.3.PCR Test 72 hours prior to arrival;Repeat of a PCR test between days 3 to 5;All test results, both positive and negative to be reported to the CMOH and/orCMO. Those who are positive will be required to isolate immediately at thediscretion of the CMOH and an additional quarantine order will be applied.Note: Families in which all adults are unvaccinated and thus require State SupervisedQuarantine, the unvaccinated children will also accompany the parent(s)/guardian(s)into State Supervised Quarantine.

Fully Vaccinated ChildrenThe same conditions for fully vaccinated adults will be applied to fully vaccinatedchildren ( under 18 years old), as indicated in Category Three.Category Five – Individuals Entering Trinidad and Tobago via SeaportsQuarantine for Seaports will mirror the quarantine for airports in general however,this section is produced to clarify some operational matters which do not arise ifentering via airports.Fully Vaccinated Persons1.2.3.PCR Test 72 hours prior to arrival;Proof of vaccination (WHO approved);No quarantine required.Note: If PCR test is not met on arrival, passengers are required to remain on thevessel and have a PCR done on board. Once this PCR test is negative, then thepassenger will be allowed to disembark.Unvaccinated Persons1.2.3.4.5.6.PCR Test 72 hours prior to arrival;Passengers will be immediately taken to a designated State SupervisedQuarantine Facility or quarantined on board the vessel at the discretion of theCMOH/Port Health Officer for seven (7) days;Each passenger undergoes a medical assessment within 24hrs of arrival,which includes a medical history and PCR test for COVID-19 (swab) on the7th day;Daily temperature monitoring and symptom checks are done by thedesignated medical team;Passengers who test negative for COVID-19 and complete their remainingseven (7) day quarantine period and are asymptomatic are allowed todisembark the vessel. Final decision to be made by the CMOH/Port HealthOfficer;Passengers who test positive for COVID-19 (during the quarantine period) areimmediately transferred to a hospital in the parallel health care system forclinical assessment and assignment. Samples should also be sent for genesequencing via the established pathway.Note: The CMOH or his/her designate, reserves the right to declare the final point ofisolation or quarantine.

5.Implementation of the ProtocolsThe County Medical Officers of Health (CMOHs) will officially communicate theprotocols for passengers to Port Health Officers, and ensure compliance as it relatesto the documentation and the treatment and care for passengers. Thereafter,continuous assessment and reporting on the adherence of these protocols shouldbe implemented to ensure full compliance.6. Monitoring and EvaluationThe CMOHs will provide continuous assessment and reporting to the Chief MedicalOfficer on the implementation of these protocols through continuous site visits andinspection of the Ports of Entry. This is to ensure the strict adherence to theprotocols for the entry of passengers as they may pose a higher risk of spread ofCOVID-19.7. Referencei.The Centers for Disease Control and Prevention, August 25th, 2020,‘After You v/travelers/after-travel-precautions.html.

8. Appendices8.1.1 Legal Notice No. 34 (Corrigendum)10

8.1.2 Legal Notice No. 3411

12

8.1.3 Legal Notice No. 3513

8.1.4 Quarantine Act Chap. 28:05 7 (1) to (3)14

15

8.1.5 Fines related to Breach of Regulations - An Act to amend theQuarantine Act Chap. 28:05, Act No. 12 of 202116

17

2. Objectives of the Protocols 5 3. Legal and Policy Framework 5 4. Quarantine Protocols for Passengers Entering into Trinidad and Tobago 5 5. Implementation of the Protocols 9 6. Monitoring and Evaluation 9 7. Reference 9 8. Appendices 10 8.1.1 Legal Notice No. 34 (Corrigendum) 10 8.1.2 Legal Notice No. 34 11 8.1.3 Legal Notice No. 35 13

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