New guidelines for Covid-19 mild-symptom patients at home: What do they say?

india

Updated: Apr 28, 2020 13:27 IST

The Union ministry of health has issued detailed guidelines for home isolation of people, who either have very mild symptoms of the coronavirus disease (Covid-19) or are in the pre-symptomatic phase.

“As per existing guidelines, during the containment phase, the patients should be clinically assigned as very mild/mild, moderate or severe and accordingly admitted to COVID Care Centre, Dedicated COVID Health Centre or Dedicated COVID Hospital, respectively,” the ministry said its new guidelines.

“However, very mild/pre-symptomatic patients having the requisite facility at his/her residence for self-isolation will have the option for home isolation,” it said.

The present guidelines are in addition to the one issued on April 7, which says all positive cases are isolated and treated at a facility.

Here are the new guidelines:

Who is eligible for home isolation?

* The person should be clinically assigned as a very mild case or pre-symptomatic case by the treating medical officer.

* Such cases should have the requisite facility at their residence for self-isolation and also for quarantining the family contacts.

* A caregiver should be available to provide care around the clock. A communication link between the caregiver and hospital is a prerequisite for the entire duration of home isolation.

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* The caregiver and all close contacts of such cases should take Hydroxychloroquine prophylaxis as per protocol and as prescribed by the treating medical officer.

* Aarogya Setu mobile app must be downloaded and it should remain active at all times through Bluetooth and wi-fi

* The patient shall agree to monitor his health and regularly inform his health status to the District Surveillance Officer for further follow up by the surveillance teams.

* The patient will fill in an undertaking on self-isolation and shall follow home quarantine guidelines. Such individual shall be eligible for home isolation.

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When must one seek medical attention?

Immediate medical attention must be sought if serious signs or symptoms develop:

* Difficulty in breathing

* Persistent pain/pressure in the chest

* Mental confusion or inability to arouse

* Developing bluish discolourations of lips/face

* As advised by treating medical officer

When can one discontinue home isolation?

Patients will end home isolation if symptoms are clinically resolved and the surveillance medical officer certifies them to be free of infection after laboratory testing

What are the instructions for care-givers?

* The caregiver should wear a triple layer medical mask appropriately when in the same room with the ill person. Front portion of the mask should not be touched or handled during use. If the mask gets wet or dirty with secretions, it must be changed immediately. Discard the mask after use and perform hand hygiene after disposal of the mask.

* They should avoid touching own face, nose or mouth.

* Hand hygiene must be ensured following contact with ill person or his immediate environment.

* Hand hygiene should also be practised before and after preparing food, before eating, after using the toilet, and whenever hands look dirty. Use soap and water for handwashing at least for 40 seconds. Alcohol-based hand rub can be used if hands are not visibly soiled.

* After using soap and water, use of disposable paper towels to dry hands is desirable. If not available, use dedicated clean cloth towels and replace them when they become wet.

* Exposure to the patient: Avoid direct contact with body fluids of the patient, particularly oral or respiratory secretions. Use disposable gloves while handling the patient. Perform hand hygiene before and after removing gloves.

* Avoid exposure to potentially contaminated items in his immediate environment (eg avoid sharing cigarettes, eating utensils, dishes, drinks, used towels or bed linen).

* Food must be provided to the patient in his room

* Utensils and dishes used by the patient should be cleaned with soap/detergent and water wearing gloves. The utensils and dishes may be re-used. Clean hands after taking off gloves or handling used items.

* Use a triple-layer medical mask and disposable gloves while cleaning or handling surfaces, clothing or linen used by the patient. Perform hand hygiene before and after removing gloves.

* The caregiver will make sure that the patient follows the prescribed treatment.

* The caregiver and all close contact will self-monitor their health with daily temperature monitoring and report promptly if they develop any symptom suggestive of COVID-19 (fever/cough/difficulty in breathing)

What are the instructions for patients?

* A patient should wear a triple layer medical mask all the time and discard it after eight hours or earlier if they become wet or visibly soiled.

* Mask should be discarded only after disinfecting it with 1% Sodium Hypo-chlorite.

* A patient must stay in the identified room and away from other people in the home, especially elderlies and those with co-morbid conditions like hypertension, cardiovascular disease, renal disease etc.

* A patient must take rest and drink a lot of fluids to maintain adequate hydration

* A patient must follow respiratory etiquettes all the time.

* They must wash their hands often with soap and water for at least 40 seconds or clean with alcohol-based sanitiser.

* They must not share personal items with other people.

* Surfaces in the room that are touched often—tabletops, doorknobs, handles, etc—must be cleaned with 1% hypochlorite solution.

* A patient must strictly follow the physician’s instructions and medication advice.

* A patient will self-monitor their health with daily temperature monitoring and report promptly if develops any deterioration of symptom as detailed below.