Epidemiological Surveillance

Epidemiological Surveillance

General Aspects
  • All students, teachers and employees must make a daily report of their health status in the form provided in the PowerSchool platform before leaving home.
  • Each person is responsible for complying with self-care measures both on and off campus.
  • It is the commitment of the entire educational community to make a timely report upon the appearance of symptoms or close contact with a confirmed case of COVID-19.
  • Colegio Bolivar has a Biosafety Response Team who will address and follow-up on suspected or confirmed cases of COVID-19 and issue biosafety guidelines for the school.
Definitions for surveillance

Close Contact: Any person, with unprotected exposure, who has shared a space of less than two meters and for more than 15 minutes with a person with a confirmed diagnosis of COVID-19, regardless of whether or not he/she has symptoms.

*Having shared the same space for more than 120 minutes with a person (one is a confirmed case).

*A person who has direct, unprotected contact with infectious secretions from a SARS-CoV-2/COVID-19 case (e.g., coughing or handling used tissues).

Note that close contact is NOT considered short-term interactions, eye contact, or casual contact.

Close contact in transportation: In aircrafts or other modes of transportation, close contact is considered to be crew/driver who had unprotected contact or exposure to a person with a confirmed diagnosis of COVID-19 and passengers within a two-seat radius of that confirmed case for more than 15 minutes.

Cluster: A cluster will be considered any grouping of 2 or more cases with active infection in which an epidemiological link has been established i.e. they share characteristics of time, place and person.

Incubation period: The time between exposure to COVID-19 and onset of symptoms is usually around 5 to 6 days, but can vary from 2 to 14 days.

Infectious period: the period of time during which a case can transmit a disease to others. The infectious period begins 2 days before someone develops symptoms.

Operational case definition: Operational case definitions are subject to change and will be updated according to the adjustments made in the national guidelines issued by the Ministry of Health and Social Protection, the National Institute of Health and the Secretary of Health of Valle del Cauca.

CASE TYPEDEFINITION

Suspected Case
Any student, faculty or employee of the school with exposure to confirmed or probable cases of COVID-19, presenting two or more symptoms suggestive of acute respiratory infection, such as fever, cough, respiratory distress, odynophagia, fatigue, adynamia, or gastrointestinal symptoms, like diarrhea, vomiting, or abdominal pain. The presence of dysgeusia or anosmia are also considered symptoms of COVID-19 and may or may not be associated with respiratory symptoms.

Asymptomatic student, teacher or employee who has had close contact with a suspected or confirmed case of COVID-19 within the past 14 days.

Probable Case
Student, faculty or employee with suspected or asymptomatic clinical picture, with exposure to a confirmed case of COVID-19 who meets at least one of the following conditions:

A positive rapid antibody test taken from 11 days after symptom onset.

An inconclusive Polymerase Chain Reaction (PCR) for the identification of SARS-CoV-2/COVID-19.

Includes persons for whom testing is not feasible for any reason.
Confirmed CaseStudent, teacher or employee with positive RT-PCR or antigenic test for SARS-CoV-2, regardless of the presence or absence of symptoms.
Case DismissedA person who meets the definition of a suspected or probable case and has a negative result for SARS-CoV-2, real-time PCR or antigenic test.
Recovered CaseA case is considered recovered by acute clinical criteria when 10 days have passed since the onset of symptoms and at least 72 hours without fever, without the use of antipyretics and improvement of respiratory symptoms, i.e. cough and dyspnea. If 10 days after isolation, the patient continues with symptoms, perform a medical evaluation in search of complications associated with COVID-19.

Case reporting: Timely reporting should be made upon:

Onset of symptoms associated with COVID-19:

  • General malaise (muscle and/or joint pain)
  • Feeling of unexplained weakness or fatigue
  • Fever
  • Headache
  • Nasal congestion
  • Sore throat
  • Cough
  • Difficulty breathing
  • Diarrhea
  • Vomiting
  • Loss of smell or taste

Close contact with a confirmed case of COVID-19.

If someone else in your household suspects that they may have COVID-19.

Case reporting channels:

The main channel for reporting is through the school’s web page in the link “Report COVID-19 cases”  , here you will find a form where you can report the main characteristics of your case.

You can also report your case to the Medical Service e-mail cbserviciomedico@colegiobolivar.edu.co

Another option is to report through your immediate supervisor, who will alert the Medical Service of your case so that they can carry out the proper direction and follow-up.

After reporting a case: Once the case is reported, the person reporting the case will receive a call from the Medical Service who will perform the case characterization through questions such as: date of onset of symptoms or risk contact, presence of comorbidities, testing, vaccination against COVID-19 and will track close contacts.

It is the responsibility of the person reporting the case to provide complete and truthful information for the configuration of this, this helps us to cut the chain of transmission and prevent contagion within the campus.

The Medical Service staff will issue the indications for diagnosis, isolation or quarantine and recommendations to follow.

Contact tracing: Contact tracing is the process of identifying those who were or are in contact with persons who have been diagnosed with a communicable disease (case) such as: measles, COVID-19. The goal of contact tracing is to limit community transmission of COVID-19 by finding links between cases and working to prevent further spread.

Window of opportunity: period that allows potential cases to be found before they become infectious and can infect someone else.

Construction of the epidemiological fence:
  • The Medical Service will inquire about all persons with whom the case under follow-up had close unprotected contact for 48 hours prior to the onset of symptoms.
  • In the case of asymptomatic persons, if the person who infected the asymptomatic case is known, the date is calculated from the last contact with the asymptomatic case. If the person who infected the asymptomatic case is not known, the date is calculated from the date of sampling.
  • The Medical Service professional following up on the case will contact each of the persons identified in the epidemiological encirclement to inform them of their possible exposure to a person with the infection and will indicate that they should remain in quarantine until 14 days after their last unprotected contact with the case.
  • In the case of students, their parents will receive an email informing them of the risk and the dates of isolation or quarantine. Subsequently, they will receive a follow-up call.   
  • The privacy of the confirmed or suspected case will be protected in all circumstances.
Pathway for the care of a person who develops symptoms compatible with COVID-19 at school.
  • Contact will be established with the school’s Biosafety Response Team via telephone, through the secretaries of the sections, who in turn have received the previous message of a possible suspected case of a student, from teachers or any member of the community, who observes and/or manifests the presence of the aforementioned symptomatology.
  • The Medical Service Team will go to the place where such situation is detected, and will proceed to its transfer to the Isolation Space (container), which has been designated for that purpose, which will be equipped with the necessary implements for the management of such cases.
  • In the case of a student, parents or legal guardians will be contacted immediately so that they can come to the school, pick him/her up, and receive instructions from their health service or treating physician. Alternatively, the School’s Director and the section’s Director will be notified.
  • In the case of a school employee, the head of Human Resources, the Health Services Provider (EPS) and the Labor Risks Administrator (ARL) will be notified.
  • In the aforementioned space their clinical condition will be evaluated. In case of detecting signs of severity or respiratory difficulty with evidence of decreased oxygen saturation, support will be given by means of a mask, and immediately Coomeva’s Emergency Medical Service (CEM) will be activated. In case of symptoms such as fever, headache and general malaise, oral antipyretics (Dolex/Acetaminophen) will be administered.
  • The affected person is considered a suspect case and should remain isolated at home until the results of the diagnostic tests are available. The siblings of the suspected case should also remain at home until the results of the tests are available, as they are cohabiting family contacts. If the case is confirmed, they should not attend school and should remain in isolation until 14 days have elapsed, and at least 3 continuous days without symptoms.
    • It should be taken into account that in some cases the time of reintegration will depend on the course of the disease.
    • If the result of the tests is negative, that is to say, the diagnosis of COVID-19 is ruled out, the student will only be able to attend school when he/she is asymptomatic.
Addressing the case and its close contacts

Suspected case: You must remain in strict isolation and consult your Health Services Provider (EPS) for diagnosis and management of the disease. In case the COVID-19 diagnostic test is negative, you may return to the school campus as soon as you have overcome the symptoms.

Note: In the case of respiratory symptoms associated with allergic processes (asthma, bronchial hyperreactivity, rhinitis), the student or employee must present a certificate from the treating physician certifying that the symptoms present are associated with the allergic process and not with COVID-19.

Confirmed case: Must remain in strict isolation for a minimum of 10 days from the onset of symptoms (the day of onset of symptoms is counted as day 0) or until discharged by their Health Services Provider (EPS). In the case of asymptomatic persons, the days will be counted from the date of taking the test. In any case, the medical service staff will perform a daily follow-up and if after the isolation period is considered a recovered case, the employee or student may return in person, otherwise the isolation will be extended according to the evolution of the case and indication of the Health Services Provider (EPS).  

NOTE: *A positive result of any of the two techniques (RT-PCR or antigens) confirms the diagnosis of COVID-19, and a second test, by a different technique, should not be performed to confirm this result. While the sensitivity of the rapid antigen test is lower, a negative result of this does not rule out the infection, since it can occur for different causes, unrelated to the absence of the disease.  If a test is negative and the suspicion is high, a second test should be performed, which should be RT-PCR, between 24 and 72 hours later (Colombian Association of Infectious Diseases – ACIN).

Close contact: Should remain in quarantine from the moment he/she is notified of possible exposure to a suspected or positive case of COVID-19, perform a diagnostic test on day 7 after the last unprotected contact (at least after day 5) if asymptomatic. If symptomatic, the test should preferably be taken after at least 72 hours of evolution of symptoms. If the result is negative, the patient should remain in quarantine for 7 more days; if positive, he/she should remain in strict isolation for at least 10 days from the date the sample was taken and/or from the onset of symptoms.

Close contact cohabitant: Persons living with a close contact of a positive case must remain in quarantine until the result of the close contact test.  In case of a negative result the quarantine is suspended and they may return to the campus in person. In case of a positive result they must comply with the close contact protocol.

Recommendations for isolation compliance

For a COVID-19 positive case
  • As a precautionary measure, all cohabitants should refrain from leaving the home, since there is a high probability that they are also infected.
  • The person should wash his/her hands with soap and water frequently, for 60 seconds: whenever they are visibly dirty, after coming into contact with their secretions and going to the bathroom, before leaving the room (which should be avoided), before handling and consuming food, before putting on and taking off the face mask.
  • The person should use a face mask or surgical mask.
  • Do not share plates, glasses, cups, cutlery, towels or bed linen with other people or pets in your home. After using these items, these should be washed thoroughly with soap and water.
  • As much as possible, you should stay in a single room with open windows.
  • If possible, use a separate bathroom.
  • Do not handle or touch pets or other animals.
  • When coughing or sneezing, cover your nose and mouth with the inside corner of your elbow or with a tissue, which should be disposed of immediately in a bag before placing it in a covered wastebasket. Afterwards, you should wash your hands.
  • Do not kiss, hug or shake hands. Avoid touching your eyes, nose and mouth.
  • Persons suspected or confirmed cases of COVID-19 should not handle or prepare food for consumption by others.
For caregivers
  • Assign the care of the person in isolation to a family member in good health who does not have chronic or pre-existing illnesses and is not in the older adult group.
  • The caregiver should wash his/her hands frequently.
  • Hand washing should be carried out strictly according to proper technique and for 60 seconds: after any contact with the person in home isolation or their immediate environment, before and after preparing food, and before eating, after using the toilet and whenever hands are dirty.
  • The caregiver should wear a face mask or surgical mask when in the same room as the person in home isolation.
  • The caregiver should avoid direct contact with body fluids of the positive case, especially oral and respiratory secretions.
  • The caregiver must use disposable gloves when in contact with oral and respiratory secretions and when handling feces, urine and waste. Hand hygiene should be performed before and after removing gloves.
  • If there is direct contact with body fluids, immediately change clothes and wash with soap and water.
  • Gloves and masks should not be reused.

Notification to the territorial entity
The report of all confirmed cases will be made to the Public Health Office of Cali in the format provided for this purpose “Positive cases and close contacts”, the photographic record of cleaning and disinfection will be attached and a referral letter will be added where the relevant characteristics of the cases are described, making it clear whether or not it is a conglomerate. 

Notification to the Labor Risks Administrator (ARL)
In the event that a case of occupational transmission is considered, contact will be made with the Labor Risks Administrator’s advisor assigned to Colegio Bolivar to activate the case report pathway.