key: cord-0699456-855ftxsk
authors: Masoodi, Naseer; Abou-Samra, Abdul-Badi; Bertollini, Roberto; Halabi, Anas; Haidar, Fatima; Anzi, Nadya Al; Butt, Adeel A.
title: Steps and Challenges in Creating and Managing Quarantine Capacity During a Global Emergency – Qatar’s Experience
date: 2021-02-09
journal: J Infect Public Health
DOI: 10.1016/j.jiph.2021.01.018
sha: 62015eebc0eae621b1c560838c508d4232a56edd
doc_id: 699456
cord_uid: 855ftxsk

BACKGROUND: COVID-19 pandemic has exposed the lack of adequate and appropriate quarantine capacity globally. Most countries lack the knowledge and/or capacity to set up and manage quarantine facilities at a national scale. METHODS: The State of Qatar developed a systematic plan to create and manage quarantine facilities for persons with confirmed or suspected COVID-19 infection or returning travelers and residents. A checklist was developed to streamline the process and to help other institutions requiring such guidance. RESULTS: Three distinct stages were identified: acquisition, commissioning and active operations. Steps required for each stage were identified and added to the checklist. CONCLUSION: We share our experience and a checklist for setting up new quarantine capacity at a national level. Such checklists can serve as a critical tool to quickly and efficiently ramp up capacity in this setting.

Background COVID-19 pandemic has exposed the lack of adequate and appropriate quarantine capacity globally. Most countries lack the knowledge and/or capacity to set up and manage quarantine facilities at a national scale.

The State of Qatar developed a systematic plan to create and manage quarantine facilities for persons with confirmed or suspected COVID-19 infection or returning travelers and residents. A checklist was developed to streamline the process and to help other institutions requiring such guidance.

Three distinct stages were identified: acquisition, commissioning and active operations.

Steps required for each stage were identified and added to the checklist.

We share our experience and a checklist for setting up new quarantine capacity at a national level. Such checklists can serve as a critical tool to quickly and efficiently ramp up capacity in this setting. The ongoing COVID-19 pandemic has strained global healthcare capacity to the breaking point in many countries. [1] [2] [3] [4] Some countries appear to have been better prepared to handle the surge than others. Three distinct groups with some overlap and occasional cross-over have stretched these limits. First, non-critically ill patients requiring hospitalization have led to filling of general hospital beds rapidly. Secondly, critically ill patients requiring intensive care beds have overwhelmed local, regional and sometimes national intensive care unit capacity. Third group includes asymptomatic infected persons or those with mild symptoms and those who came into contact with definite or suspected cases. This last group, while not requiring hospitalization, requires a robust plan to quarantine or isolate them in facilities or areas safe for them and for the general population. While home isolation is an obvious and quick solution, it may not be available, practical, feasible or acceptable in all such cases.

The State of Qatar has a population of 2.78 million persons, with expatriates accounting for approximately 85% of the total population. 5 First case of COVID-19 in Qatar was identified on February 29, 2020 in a returning traveler. 6 

In Qatar, all returning travelers, contacts of confirmed cases and those with suspected or confirmed infection in the community who did not have a safe home environment were quarantined. Initially, the quarantine duration was 14 days, but was reduced to 7 days and more data became available regarding the duration of possible infectiousness. All persons had an initial nasopharyngeal swab before beginning the quarantine and an intake history was documented by a physician. Each quarantined person was provided with instructions on when and how to access a healthcare provider, who was always present at each quarantine site. Any person who developed respiratory symptoms was reassessed and a repeat nasopharyngeal swab for SARS-CoV-2 PCR was performed. If positive, they were transferred to a designated facility; if negative, they were monitored via subsequent telephone consultation.

In rapidly emerging infectious diseases related global emergencies, countries may need to quickly build substantial capacity for isolation and quarantine of cases and contacts.

situation. 

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