Home isolation is now an option for COVID-19 patients who are pre-symptomatic or have very mild symptoms

This has come at a time when hospitals in Chennai have started to shift asymptomatic and stable patients to quarantine facilities, to reserve beds for those in need of treatment

Published - May 05, 2020 02:52 pm IST - CHENNAI

Fire service workers in Chennai spraying disinfectants. Photograph used for representational purposes only

Fire service workers in Chennai spraying disinfectants. Photograph used for representational purposes only

In tune with guidelines of the Indian Council of Medical Research, persons clinically categorised as having very mild or pre-symptomatic coronavirus disease (COVID-19) will have the option of home isolation provided they have the requisite facility at their residence. They will have to submit an undertaking to adhere to self-isolation norms.

Based on a proposal of the Directorate of Public Health and Preventive Medicine, a Government Order was issued outlining the guidelines on home isolation for very mild/pre-symptomatic COVID-19 cases. This has come at a time when hospitals in the city have started to shift asymptomatic and stable patients to quarantine facilities to reserve beds in hospitals for those in need of treatment.

All individuals suspected to have symptoms of COVID-19 and awaiting results, and confirmed COVID-19 are currently being isolated and managed in a hospital with the intent to break the chain of transmission. During the containment phase, patients should be clinically assigned as very mild/mild, moderate or severe and accordingly treated in health facilities, according to the GO.

Who is eligible for home isolation?

The patient should be clinically assigned as a very mild case/pre-symptomatic case by the treating medical officer. They should have requisite facilities at their residence for self-isolation and also for quarantining family members, and a well-ventilated single-room, preferably with an attached/separate toilet.

A caregiver should be available 24 x 7, and a communication link between the caregiver and hospital is a prerequisite for the entire duration of home isolation. The caregiver and all close contacts should take hydroxychloroquine prophylaxis as per protocol and as prescribed by the treating medical officer. The patient and caregivers should be given a course of zinc, vitamin C/multivitamin tablets for 10 days including herbal concoctions nilavembu kudineer and kabasura kudineer.

They should download the Aarogya Setu app on their mobile phone and it should remain active at all times through bluetooth and Wi-Fi. The patient should agree to monitor his/her health and inform his/her health status to the District Surveillance Officer/Deputy Director of Health Services for follow-up, and fill in an undertaking on self-isolation and follow home quarantine guidelines.

The patient should self-monitor his/her health with daily temperature monitoring and report promptly in case of any deterioration of symptoms. They should use a triple-layer medical mask at all times, and discard after eight hours of use or earlier if it becomes wet or visibly soiled. Masks should be discarded only after disinfecting them.

They should stay in the identified room and away from other persons in the home especially the elderly and those with co-morbid conditions such as hypertension, cardiovascular diseases and renal disease. They should follow respiratory etiquette and wash hands often with soap and water. Their clothes and other linen should be washed and dried separately. Surfaces should be cleaned with disinfectants.

They should restrict movement within the house and should not attend any social/religious gathering such as weddings or condolences. The caregiver too, should wear a triple-layer medical mask when in the same room as the patient and use disposable gloves. They should follow hand hygiene and self-monitor their health.

Both the patient and caregiver should seek immediate medical attention if they develop the following signs and symptoms -- persistent cough/continuous fever of above 102 degrees/difficulty in breathing, persistent pain/pressure in the chest, mental confusion or inability to arouse the patient, somnolence and poor feeding in children, seizures, decreased urine output, persistent or worsening of initial symptoms beyond 72 hours and developing bluish discolouration of lips/face.

The home isolation will come to an end once the symptoms are clinically resolved and a medical officer certifies the patient to be free of infection after laboratory testing.

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