CLINICAL CRITERIA:

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• Do you have high fever measured above 38.0 degrees or are shivering and sweating? Y/N

• Do you have a recent cough, sore throat, or shortness of breath?  Y/N

• Do you have a runny nose, sneezing, post-nasal drip, loss of taste or sense of smell? Y/N

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                                        OR

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HIGH INDEX OF SUSPICION CRITERIA:

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In last 14 days have you:

• had contact with a confirmed or probable case Y/N

• had international travel Y/N

• had direct contact with a person who has traveled overseas (eg Customs and Immigration staff, staff at quarantine/isolation facilities) Y/N

• worked on an international aircraft or shipping vessel Y/N

• cleaned at an international airport or maritime port in areas/conveniences visited by international arrivals Y/N

      

    or

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• any other criteria requested by the local Medical Officer of Health 

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