MINISTRY OF HEALTH

DIRECTIVE NO. 13-21

AUTHORIZING ISOLATION AND QUARANTINE MEASURES TO PREVENT AND MITIGATE CORONAVIRUS DISEASE 2019 (COVID-19)

WHEREAS, Coronavirus Disease 2019 (COVID-19) is a severe acute respiratory illness that was first identified in December 2019, and that occurs through human-to-human respiratory transmission and presents symptoms that are similar with influenza; and

WHEREAS, COVID-19 presents a major threat to public health in the Republic, and is particularly dangerous to the elderly or those with respiratory or other underlying medical conditions; and

WHEREAS, as of May 4, 2021, there are over 153 million confirmed cases globally, including confirmed cases in every jurisdiction with direct air or sea transportation to the Republic and that new variants of the virus have been identified in numerous jurisdictions globally; and

WHEREAS, the World Health Organization (WHO) declared the COVID-19 outbreak as a Public Health Emergency of International Concern (PHEIC) on February 11, 2020, and further characterized it as a Pandemic on March 12, 2020. The WHO and CDC recommend that all countries and territories implement aggressive measures to prevent and control the transmission of COVID-19; and

WHEREAS, the Minister of Health has certified the ongoing COVID-19 pandemic as an unavoidable emergency in the Republic, channeling all efforts toward establishing adequate testing protocols, and appropriate facilities for isolation and quarantine of effected persons; and

NOW THEREFORE, by virtue of the authority vested in me as the Director of Public Health of the Ministry of Health, I hereby authorize Isolation and Quarantine pursuant to 34 PNC § 102(m) and 34 PNC § 701 and the Ministry of Health Rules & Regulations for Isolation and Quarantine of Contagious Diseases to prevent import and mitigate the spread of COVID-19 in the Republic of Palau, as follows:

Section 1. Isolation. The isolation of persons infected by COVID-19 is hereby authorized as follows:

• Any person proven or strongly suspected to be infected with COVID-19 shall be isolated for a period up to fourteen (14) days; and
• Infection may be proven or strongly suspected based on a presumptive test result, and/or a confirmatory test result by means of authorized assays for viral testing include those that detect SARS-CoV-2 nucleic acid or antigen.

Section 2. Quarantine. The quarantine of persons exposed to COVID-19 is hereby authorized as follows:

• Any person determined to have been exposed to COVID-19 shall undergo mandatory quarantine for a period up to fourteen (14) days, unless otherwise specified below; and
• Any person who has had direct contact with a person infected by COVID-19 shall be considered to have been exposed to COVID-19 and quarantined for a period up to fourteen (14) days; and
• Any person who has had indirect contact with COVID-19, such as contact with potentially contaminated surfaces, may be considered to have been exposed to COVID-19 and quarantined for an appropriate period; and
• Any person who has had indirect contact with a person who has been exposed to COVID-19 may be considered to have been exposed to COVID-19 and quarantined for an appropriate period.

Section 3. Quarantine and Testing Requirements Applicable to International Travel into the Republic:

• All travellers entering the Republic from High Risk COVID-19 areas must submit proof of complete COVID-19 vaccination with final dose administered at least fourteen (14) days prior to departure to Palau. Vaccine received must be approved or have been granted Emergency Use Authorizations from either the US Food and Drug Administration (FDA) or the World Health Organization (WHO). Travellers are required to complete a fourteen (14) day period of self-restriction of movement before departure. Travellers must also provide a negative result of a Polymerase Chain Reaction (PCR) COVID-19 test, taken within seventy-two (72) hours prior to departure to the Republic; and
• Travellers from High Risk COVID-19 areas who have not been fully vaccinated against COVID19 and fully vaccinated travellers traveling with said unvaccinated travellers shall be considered to have been potentially exposed to COVID-19 and may only enter the Republic through a Low Risk COVID-19 jurisdiction where he/she will be quarantined for at least fourteen (14) days prior to departure to the Republic. Unvaccinated travelers under eighteen (18) years of age traveling with fully vaccinated parents/guardians from High Risk COVID-19 areas may be exempt from this requirement; and
• All travelers entering the Republic from a Low Risk COVID-19 area must submit a negative result of an approved COVID-19 test taken within seventy-two (72) hours prior to departure. To be considered originating from a Low Risk COVID-19 area, a traveler must have spent at least fourteen (14) consecutive days within that jurisdiction prior to departure to the Republic; and
• All travelers entering the Republic must undergo a restriction of movement/self-monitoring period of seven (7) days upon arrival into the Republic and must undergo appropriate COVID-19 testing upon arrival; and
• Restriction of movement is defined as limiting movement to only essential travel such as from residence to workplace/worksite, bank, grocery store and accessing medical care and not attending large gatherings or public events or visiting public places; and
• Jurisdictions with ongoing COVID-19 community transmission and/or presence of any COVID-19 variant of concern are deemed High Risk COVID-19 areas, whereas jurisdictions having no community transmission nor the presence of variants of concern over the past twenty-eight (28) days are deemed as Low Risk COVID-19 areas; and
• The crew of any commercial aircraft or vessel entering the Republic must provide negative PCR COVID-19 test results and proof of full COVID-19 vaccination and/or provide official documentation on infection control measures implemented for aircraft operations and health management protocols for personnel; and
• Any crew member of any air or water vessel that disembarks into the Republic of Palau shall be subject to these regulations and shall undergo mandatory quarantine, except in cases wherein an air or water vessel breaks down unexpectedly within the territory of the Republic. In such cases, any crew member disembarking such vessel shall be quarantined for an appropriate period or until the vessel is repaired and ready to depart Palau, at which time quarantined crew members may be permitted to re-board their vessels. Crew members of such disabled vessels shall be securely transported to and from official quarantine facilities, and at no time shall any crew member be permitted to contact the general population without completing the appropriate period of mandatory quarantine.

Section 4. Isolation Facilities.

• The Alternate Care Site (ACS) at Kalau Gym in Meyuns, Koror shall be the primary Isolation and care Facility for non-critical infected persons; and
• The isolation rooms of Belau National Hospital shall be reserved for infected persons in need of critical care; and
• The Ministry of Health (MOH) shall identify other appropriate and adequate facilities, either public or private property to be designated as Isolation Facilities for COVID-19 infected persons as necessary.

Section 5. Quarantine Facilities.

• MOH shall identify appropriate and adequate facilities, either public or private property, to be designated as Quarantine Facilities for exposed and potentially exposed persons; and
• If any quarantined person is found to be infected, that person shall be promptly relocated to an appropriate isolation facility.

Section 6. Delegation of Authority.

• Pursuant to 34 PNC § 101 and Section 4.10 of the MOH Rules & Regulations for Isolation and Quarantine of Contagious Diseases, Authority to order the isolation or quarantine of persons found to be infected or exposed within the Republic of Palau or upon arrival into the Republic either by sea or at the Palau International Airport, is hereby delegated to the Director of the Bureau of Public Health Services.

Section 7. Exemptions.

• No exemptions to the isolation or quarantine requirements of this directive may be made, except by the Director of Public Health and in writing. The Director may issue exemptions on an individual, case-by-case basis, only based on an articulable medical justification.

Section 8. Term.

• This directive supersedes and replaces MOH Directive No. 12-21, which was issued March 29, 2021. This directive shall take effect on May 22, 2021 and unless cancelled, revoked or re-issued, shall remain in effect for 90 days from effective date.

Issued this 6th day of May 2021 at the Ministry of Health in Koror, Republic of Palau.

Sherilynn Madraisau
Director of Public Health
Ministry of Health