Pan American Health Organization · 1st edition, 2 June 2020
Operational guidance for public health authorities in the Americas on implementing contact tracing, quarantine and monitoring during COVID-19 outbreaks.
- Issuer
- Pan American Health Organization
- Edition
- 1st edition, 2 June 2020
- Audience
- National health authorities, public health professionals, and officials implementing contact tracing policies and procedures
- Evidence
- Expert consensus based on WHO recommendations and international public health agency guidance
- Reviewed
- 20 Oct 2026 · GMJ
What this guideline says
GMJ summary
This Pan American Health Organization document provides comprehensive operational guidance for implementing contact tracing as part of the COVID-19 response in the Americas. It complements WHO’s global contact tracing guidance by offering region-specific recommendations for identifying, quarantining and monitoring contacts of confirmed or probable COVID-19 cases.
The guidance defines a contact as any person who experienced face-to-face interaction within 1 metre for more than 15 minutes, direct physical contact, or provision of care without proper PPE during the period from 2 days before until 14 days after symptom onset in a confirmed or probable case. All contacts must be quarantined for 14 days from last exposure and monitored daily for symptoms including fever ≥38°C, dry cough, shortness of breath, sore throat, muscle pain, loss of smell or taste, or diarrhoea.
The document emphasizes ethical obligations including data privacy, minimizing stigma, informed public engagement and timely data sharing. It describes complete workflows from case investigation through contact identification, quarantine implementation, daily monitoring, and performance measurement using specific indicators such as the percentage of cases originating from the contact list—a key quality metric for contact tracing effectiveness.
Key points
For clinicians — doses and thresholds as stated in the guideline
- A contact is defined as a person with face-to-face interaction within 1 metre for more than 15 minutes, direct physical contact, or provision of care without PPE to a case during 2 days before through 14 days after symptom onset
- All contacts must be quarantined for 14 days from last exposure to a confirmed or probable COVID-19 case
- Monitor contacts at least once daily (high-risk contacts such as healthcare workers twice daily) for fever ≥38°C or feeling feverish, cough, shortness of breath, sore throat, muscle pain, loss of smell/taste, or diarrhoea
- For asymptomatic confirmed cases, the contact period is measured as 2 days before through 14 days after the date the positive sample was taken
- Contacts who develop symptoms should immediately self-isolate and be referred for medical evaluation and testing
- Key performance indicator: percentage of COVID-19 cases who originated from the contact list (higher proportion indicates better identification of transmission chains)
- Contacts should be quarantined within 24 hours of confirming their exposure
- Contact tracing staff must protect privacy by disclosing minimum information required—contacts should be told of exposure but not the source person's identity
Information to collect in COVID-19 contact tracing forms
Table extracted from the guideline
| Type of information | Recommended minimum data |
|---|---|
| Contact identification (entered once) | Contact ID; Name (first, last); Address (and geolocation, where possible); Phone number and/or other contact details |
| Demographic information (entered once) | Age; Sex/Gender; Occupation (to identify HCWs) |
| Type of contact (entered once) | Type of contact (household, community, health facility, other); Date of last contact with the COVID-19 case |
| Daily follow-up of signs and symptoms (daily entry fields) | Fever (mention if perceived or measured, and whether reported or observed); Other signs and symptoms: sore throat, cough, shortness of breath or difficulty breathing, muscle pain, loss of smell (anosmia) or taste, or diarrhoea |
| Absence or loss to follow-up | Reasons for non-reporting of daily signs and symptoms (contacts are unavailable, relocated, lost to follow-up); Address (if known) of where the contact has relocated |
| Actions taken if symptomatic (entered once) | Referral criteria (based on clinical severity and presence of vulnerability factors); Contact's location (self-isolation at home, other self-isolation facility, hospital); Whether a sample has been taken, and date of collection |
Source: Pan American Health Organization, Considerations for the Implementation and Management of Contact Tracing for Coronavirus Disease 2019 (COVID-19) in the Region of the Americas. Reproduced in summary form.
From the guideline
Verbatim
“A contact is a person who experienced any one of the following exposures during the 2 days before and the 14 days after the onset of symptoms of a probable or confirmed case: Face-to-face contact with a probable or confirmed case within 1 meter and for more than 15 minutes.”
Editor’s perspective
Why this matters for Georgia and the region
Prof. Giorgi Pkhakadze, MD, MPH, PhD
Editor-in-Chief, Georgian Medical Journal · Chair, Public Health Institute of Georgia · WHO consultant, health and migration
As someone who has worked closely with WHO on health system strengthening in Georgia and the region, I find this document's systematic approach to contact tracing particularly valuable for our context. Georgia demonstrated significant contact tracing capacity during the early COVID-19 response, leveraging the NCDC's experience with TB contact investigations and outbreak response for vaccine-preventable diseases, but sustained implementation revealed workforce and resource challenges that this guidance directly addresses. The emphasis on ethical data management and privacy protection is critical—our region has experienced historical mistrust of government surveillance, and successful contact tracing depends entirely on voluntary cooperation and community trust, which the document rightly identifies as essential. For Georgian clinicians and public health professionals, I would stress the performance indicators on pages 13-16: measuring what percentage of new cases were already known contacts is the single best measure of whether your contact tracing system is actually interrupting transmission chains or merely documenting spread after the fact. The realistic caveat for implementation in Georgia and neighbouring countries is the 24-hour quarantine target and daily monitoring requirement—our experience showed this is achievable in Tbilisi and regional centres but requires significant adaptation for rural areas, where we successfully piloted SMS-based self-reporting systems and trained community health workers, an approach this document supports but does not detail sufficiently for resource-limited settings.
ORCID 0000-0001-7609-4515 · Perspective written for the GMJ Guidelines Library, 20 Oct 2026
Applicability
Georgia and the South Caucasus
For Georgia and the South Caucasus, this guidance remains highly relevant for preparedness given the ongoing global threat of respiratory pathogen outbreaks and the region’s experience with COVID-19. Georgia’s national public health surveillance system, coordinated through the National Center for Disease Control and Public Health (NCDC), would need to ensure adequate staffing for rapid contact tracing response, including call centre capacity and trained field epidemiologists. The emphasis on ethical data management aligns with Georgia’s data protection framework, though implementation would require careful consideration of privacy legislation and public trust in government health surveillance. The document’s tiered approach based on transmission intensity is particularly applicable given resource constraints—focusing contact tracing on high-risk settings (healthcare facilities, care homes) and vulnerable populations during periods of high transmission while maintaining robust capacity for early cluster detection. Remote and rural areas in Georgia and neighbouring Armenia and Azerbaijan may face challenges with the recommended 24-hour quarantine initiation timeframe and daily contact monitoring, necessitating adapted protocols using mobile technology and community health worker networks where telephone coverage is limited.
Questions this guideline answers
Quick answers
Who qualifies as a contact requiring quarantine and monitoring?
A contact is anyone who had face-to-face interaction within 1 metre for more than 15 minutes, direct physical contact, or provided direct care without proper PPE to a confirmed or probable COVID-19 case during the period from 2 days before symptom onset until 14 days after. For asymptomatic confirmed cases, the period is 2 days before through 14 days after the positive sample date.
How long should contacts be quarantined and monitored?
All contacts must be quarantined for 14 days from their last exposure to the COVID-19 case. During this period they should be monitored at least once daily for symptoms, with high-risk contacts such as healthcare workers contacted twice daily. If they remain asymptomatic throughout the 14 days, monitoring is closed but they should continue general public health measures.
What symptoms should be monitored in contacts?
Contacts should be monitored for fever (≥38°C or feeling feverish), dry cough, shortness of breath or difficulty breathing, sore throat, muscle pain, loss of smell (anosmia) or taste, and diarrhoea. Special attention is needed for elderly, immunocompromised or those taking antipyretics who may not present with fever. Any symptomatic contact should immediately self-isolate and be referred for medical evaluation and testing.
How can we measure if our contact tracing is working effectively?
The key impact indicator is the percentage of new COVID-19 cases who were already known contacts—the higher this proportion, the better you have identified transmission chains. Other important metrics include: percentage of cases with contacts identified, percentage of contacts quarantined within 24 hours, percentage of contacts followed daily, percentage lost to follow-up, and the average number of contacts identified per case.
Related on GMJ
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- Issuer
- Pan American Health Organization
- Type
- Procedures, manuals, guidelines
- Edition
- 1st edition, 2 June 2020
- Status
- Current
- Published
- 2020-01-01
- Languages
- English
- Scope
- Contact tracing implementation for COVID-19 in the Region of the Americas
- Audience
- National health authorities, public health professionals, and officials implementing contact tracing policies and procedures
- Licence
- CC BY-NC-SA 3.0 IGO
- Evidence
- Expert consensus based on WHO recommendations and international public health agency guidance
- Record history
- Created 20 Oct 2026 · updated 20 Oct 2026 · next check Apr 2027
Pan American Health Organization. Considerations for the implementation and management of contact tracing for coronavirus disease 2019 (COVID-19) in the Region of the Americas, 2 June 2020. Washington, D.C.: PAHO; 2020. Licence: CC BY-NC-SA 3.0 IGO.GMJ Guidelines Library records are original summaries written by the GMJ editorial team from the issuer’s published document and reviewed by a physician. They do not replace the full guideline. The document is the copyright of its issuer and is linked, not hosted. Spotted an error or a newer edition? Tell the Guidelines Desk.
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