This article focusses on:
- Eligibility for home isolation
- When to seek medical attention
- When to discontinue home isolation
- Instructions for care-givers
- Instructions for the patient
DETAILED SUMMARY :
Eligibility for home isolation
- The treating medical officer should assign the patient as very mild case/ pre-symptomatic case.
- Requisite facilities at their residence for self-isolation should be available and also for quarantining the family contacts.
- A caregiver should be available to provide care on 24 x7 basis. A communication link between the caregiver and hospital is a prerequisite for the entire duration of home isolation.
- Hydroxychloroquine prophylaxis as per protocol should be given to the care giver and all close contacts.
- Arogya Setu App should be downloaded on mobile (available at: https://www.mygov.in/aarogya-setu-app/) and it should remain active at all times (through Bluetooth and Wi-Fi)
- The patient should monitor his health and regularly inform his health status to the District Surveillance Officer for further follow up by the surveillance teams.
- The patient should fill an undertaking on self-isolation (Annexure I) and should follow home quarantine guidelines.
When to seek medical attention
- Immediate medical attention must be sought if serious signs or symptoms develop. These include
(i) Difficulty in breathing,
(ii) Persistent pain/pressure in the chest,
(iii) Mental confusion or inability to arouse,
(iv) Developing bluish discolorations of lips/face
When to discontinue home isolation
- When symptoms are clinically resolved and the surveillance medical officer certifies him to be free of infection after laboratory testing.
Instructions for care-givers
- A triple layer medical mask should be worn 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. The mask should be discarded after use and hand hygiene should be performed after disposal of the mask.
- Touching his/her own face, nose or mouth should be avoided.
- Hand hygiene must be ensured following contact with ill person or his immediate environment and should be practiced before and after preparing food, before eating, after using the toilet, and whenever hands look dirty. Hand washing should be performed for at least for 40 seconds using soap or water. Alcohol-based hand rub can be used, if hands are not visibly soiled.
- After washing hands disposable paper towels should be used to dry hands. If not available, use dedicated clean cloth towels and replace them when they become wet.
- Exposure to patient: Avoid direct contact with body fluids of the patient, particularly oral or respiratory secretions. Use disposable gloves while handling the patient. Hand hygiene should be performed before and after removing gloves.
- Exposure to potentially contaminated items in his immediate environment (e.g. avoid sharing cigarettes, eating utensils, dishes, drinks, used towels or bed linen) should be avoided
- 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 by wearing gloves.
- The caregiver should make sure that the patient follows the prescribed treatment.
- They should 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)
Instructions for the patient:
- Patient should use triple layer medical mask all the time.
- The masks should be discarded after 8 hours of use or earlier if they become wet or visibly soiled. They should be discarded only after disinfecting it with 1% Sodium Hypo-chlorite.
- He / she must stay in the identified room and away from other people in home, especially elderlies and those with co-morbid conditions like hypertension, cardiovascular disease, renal disease etc.
- Proper rest and a lot of fluids should be given to maintain adequate hydration.
- Respiratory etiquettes should be followed all the time.
- Hands must be washed often with soap and water for at least 40 seconds or clean with alcohol based sanitizer.
- Personal items should not be shared with other people.
- The surfaces in the room that are touched often (tabletops, door knobs, handles, etc) should be cleaned with 1% hypochlorite solution.
- The patient must strictly follow the physician’s instructions and medication advice.
- The patient should self-monitor his/her health with daily temperature monitoring and report promptly if he develops any deterioration of symptoms.