May 12, 2023 - The Croatian Institute of Public Health published detailed recommendations on its official website after declaring the end of covid-19 pandemic was announced.

"With these recommendations, the Recommendations on testing for COVID-19, isolation of patients, and quarantine of close contacts (latest version: 23 of June 6, 2022, titled Treatment of patients, close contacts of patients and termination of isolation and quarantine) cease to be valid because due to the abolition of the epidemic status of the disease COVID-19, the obligation of isolation for the sick, the obligation to test for SARS-CoV-2 for specific categories of the population, and the quarantine for close contacts has already been abolished. Supervision over isolations and quarantines is no longer carried out ", they wrote in the introduction, as reported by 24Sata.

Testing

Further testing is recommended for all symptomatic people with clinical suspicion of COVID-19 and for people who have an increased risk of developing severe forms of COVID-19, people who enter a collective in the social welfare system, or people who go for hospital treatment (diagnosis), especially with the recommendation that they be tested with a PCR test.

We recommend SARS-CoV-2 testing for employees of health institutions and employees of social service providers of accommodation and accommodation for elderly and seriously ill adults and people with disabilities before returning to work IF: they have symptoms compatible with COVID-19, have participated in large gatherings where measures to prevent the spread of droplet infections were not followed; in the last 14 days.

Health workers and workers in homes for the elderly and seriously ill adults and adults with disabilities are recommended to wear an FFP2 mask for ten days after the last contact with the patient and avoid close contact as much as possible due to work tasks. It is recommended that they be tested immediately after exposure, every three days, and finally on the tenth day after the last exposure, where they can perform the test themselves.

It is also recommended that they avoid large gatherings, especially contact with elderly people, chronic patients, pregnant women, and immunocompromised people.

We recommend testing patients for whom hospitalization is planned and for whom diagnostic-therapeutic procedures that generate aerosol are planned in specialist-conciliar or hospital health care. In addition, other patients who require medical care (for example, when referring to a unified hospital emergency admission or specialist consultation treatment), if a high risk of exposure to infection is assessed when issuing a referral based on the anamnesis.

Due to the impossibility of conducting diagnostics within the given time limits for all patients, health institutions cannot condition the admission of patients with a negative BAT or PCR test that is not older than 48 hours, especially if the diagnostic or therapeutic procedure is urgent or a delay may cause the patient's health condition to deteriorate (such requirements from hospitals are particularly problematic for hospitalization after weekends, non-working days, etc.). If a health institution has a BAT or PCR diagnosis of SARS-CoV-2, it should be ensured that such patients are diagnosed in their institution in order to avoid burdening the system based on referrals from the chosen doctor.

Committees for the prevention and suppression of healthcare-related infections in healthcare institutions may, based on the local epidemiological situation, decide on the obligation of testing for specific categories of patients.

Isolation

We recommend isolation for people infected with the SARS-CoV-2 virus who are receiving hospital treatment and are users of homes for the elderly. In the case of these persons, isolation lasts five days from the onset of the disease (symptomatic persons), i.e., from the day when a swab was taken that was positive for SARS-CoV-2 (asymptomatic persons). It is recommended that they use FFP2 masks for another five days (up to the tenth day from the onset of the disease/positive smear) if their health condition allows it.

Isolation outside the health system and the social welfare system

It is recommended to carry out isolation for five days, wearing an FFP2 mask until the 10th day, for people who, due to the nature of their work, have to come into contact with elderly, chronically ill people, immunocompromised people, and pregnant women.

Close contacts

Close contacts are advised to wear a mask for ten days after the last risky contact, to monitor their health status in terms of the appearance of symptoms that may point to COVID-19, and to conduct self-testing on the 5th day after the last close contact. It is also recommended that they avoid larger gatherings and, in particular, contact with people at increased risk of developing more severe forms of the disease, COVID-19.
In case of symptoms, it is recommended to carry out the test immediately. In this case, testing in authorized laboratories is recommended.

Precautions

Health workers and workers in homes for elderly and seriously ill adults and adults with disabilities are recommended to wear an FFP2 mask for ten days after the last risky contact with the patient and avoid close contact as much as possible due to work tasks. It is recommended that they be tested immediately after exposure, every three days, and finally on the tenth day after the last exposure, where they can perform the test themselves. It is also recommended that they avoid large gatherings and, in particular, contact with people at increased risk of developing severe forms of the disease COVID-19 outside the work environment.

All infected persons, regardless of whether they carry out isolation or not, in contact with other persons, are recommended to wear an FFP2 mask for ten days from the onset of symptoms (symptomatic patients) or ten days from the day when a smear that is positive for SARS-CoV was taken.

In addition to wearing a mask, enhanced hand hygiene (hand washing and disinfection) should be performed during the same period, and symptomatic patients should also perform respiratory hygiene (use disposable tissues and dispose of them correctly, do not cough into the palm but into the forearm). A sick person during this period can especially endanger chronic patients, elderly people, pregnant women, and immunocompromised people, and contact with them should be avoided. Going to health facilities should also be avoided if it is not necessary for health care, and if going is still required, then the infected person should emphasize immediately upon arrival that he is infected with the SARS-CoV-2 virus and should not be denied the necessary therapy and/or health care. A person with clearly expressed symptoms who is positive for COVID-19 should also avoid any contact with a large number of people in a closed space, including public transport.

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