PUM and PUI No More: Shift of Classifications to Suspect Case, Probable Case, and Confirmed COVID-19 Case

The Department of Health (DOH) ordered the shift of classifying individuals from Patients Under Investigation (PUI) and Persons Under Monitoring (PUM), to Suspect, Probable and Confirmed COVID-19 Cases. Note that for rapid test kits, a person who tests positive is not yet considered a Confirmed Case, but still a Probable Case. [If we may add, we do not like the new labels, as it resembles the labels we use in criminal cases, an unfortunate coincidence which does not help in quelling the discrimination against COVID-19 patients.] The new classifications under DOH Administrative Order No. 2020 – 0013 dated 9 April 2020, are as follows:


Suspect Case refers to a person who is presenting any of the conditions below:

a. All SARI cases where NO other etiology fully explains the clinical presentation. SARI stands for Severe Acute Respiratory Infection, which is an acute respiratory illness with onset during the previous 7 days requiring overnight hospitalization. A SARI case should meet the ILI case definition AND any one of the following: (a) shortness of breath or difficulty of breathing; (b) severe penumonia of unknown etiology, acute respiratory distress, or severe respiratory disease possibly due to novel respiratory pathogens (such as COVID-19). ILI stands for Influenza-like Illness, which is a condition with sudden onset (within 3 days of presentation and fever should be measured at the time of presentation) of fever of equal or greater than 38 degrees celcius and cough or sore through in the absence of other diagnoses. 

b. ILI cases with any one of the following:

  • ii. with no other etiology that fully explains the clinical presentation AND a history of travel to or residence in an area that reported local transmission of COVID-19 disease during the 14 days prior to symptom onset OR
  • ii. with contact to a confirmed or probable case of COVID-19 in the two days prior to onset of illness of the probable/confirmed COVID-19 case until the time the probable/confirmed COVID-19 case became negative on repeat testing.

c. Individuals with fever or cough or shortness of breath or other respiratory signs or symptoms fulfilling any one of the following conditions:

  • i. Aged 60 years and above
  • ii. With a comorbidity
  • iii. Assessed as having a high-risk pregnancy
  • iv. Health worker


Probable Case is a suspect case who fulfills anyone of the following listed below:

a. Suspect case whom testing for COVID-19 is inconclusive

b. Suspect who tested positive for COVID-19 but whose test was not conducted in a national or subnational reference laboratory or officially accredited laboratory for COVID-19 confirmatory testing


A Confirmed Case refers to any individual, irrespective of presence or absence of clinical signs and symptoms, who has laboratory confirmed for COVID-19 in a test conducted at a national reference laboratory, a subnational reference laboratory, and/or DOH-certified laboratory testing facility.

P&L Law

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