Guidelines for isolation of COVID positive person at home


Richard D’Souza
Kemmannu News Network, 05-07-2020 08:54:55


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The guideline for home isolation of COVID-19 cases has been issued by Ministry of Health and Family Welfare-Govern ment of lndia. ln view of evolving situation of COVID-19 in the state, the following guidelines are issued:

The persons who have tested COVID positive shall be permitted to be in "home isolation" with the following conditions:

 1. Only those who are asymptomatic or mild symptomatic shall be allowed to be in isolation at home

2. They shall be oriented to the protocol of home isolation

3. Health team from district health authority/ BBMP/ authorised private institution/agency shall visit the house and assess the suitability of house for home isolation and also do triage of the person.

4. Dedicated tele-monitoring link shall be established for daily follow-up of the person during the entire period of home isolation

5. The person shall report to the physician/ health authorities about their health status every day

6. The person shall have pulse oximeter, digital thermometer and personal protective equipment (facemasks, gloves) to be used during home isolation.

7. The release of the person from home isolation shall be as per the existing discharge protocol of the state for COVID-19 (vide below sl. no.10)

8. The home isolation shall be with the knowledge of the family members, neighbours, treating physician and local health authorities.

The detailed guidelines for home isolation are as follows:

1.       lnitial assessment and triage of person by health team at person’s house

2.        After receipt of Covid positive report, the person shall isolate himself/herself at home in a separate room. Health team shall visit and assess the suitability of the house for isolation of the person at home and also do triage of the person

3.        Ask regarding following symptoms: Fever, cold, cough, throat pain, difficulty in breathing, etc. .

4.       The health staff shall assess the following parameters (Triage)

 Thermal scanning for fever o Pulse oximetry for Spo2and pulse rate

o Glucometer for random blood sugar

o Blood pressure recording using BP apparatus  The person shall be clinically assigned as asymptomatic/mild case by the treating medical officer/ physician

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 on a 24 x7 basis. A regular communication link between the caregiver and hospital is a pre-requisite for the entire duration of home isolation

 Mild fever < 380 c (< 1oo.4o F) . Oxygen saturation should be > 95% . Age shall be less than 60 years r lf the person has the following co-morbidities- Hypertension, diabetes mellitus, obesity, thyroid disease; they are well managed and under good clinical control as assessed by medical officer/physician o Shall not have any comorbid conditions like kidney diseases including persons on dialysis, heart diseases, stroke, Tuberculosis, cancer, people living with HlV, immunecompromised, on steroids and immune-suppressants, etc.

 The person shall provide a signed undertaking on self-isolation (Annexure-1) and follow guidelines of home isolation o The person shall agree to monitor his/her health (Annexure-2) and regularly inform their health status to the physician and District Surveillance Officer (DSO) for further follow up by the surveillance teams. o Home isolation shall not be applicable for pregnant women 4 weeks before expected date of delivery (EDD) 3. Requisite facility at home for isolation .

Separate well ventilated room with a separate toilet for the person in isolation

 The person shall stay in the identified room and awav from other persons in the home(especially the elderly and those with comorbid conditions like hypertension, cardiovascular disease, renal disease, etc.) 6t tl the person does not lit to the above criterio for home isolation ot the house is not suitoble lor home isolotion, then isoldtion ot d locility (CCC/DCHC/DCH) is recommended

 Enquire for co-morbidities like hypertension, diabetes, obesity, thyroid disease, cancer, kidney disease including persons on dialysis, heart disease, stroke, Tuberculosis, people living with HlV, immune-compromised, on steroids and immune-suppressants, etc. o Link the person to tele-monitoring centre for daily follow-up o For further daily follow-up of the person, tele-monitoring through government or private institution/agency shall be arranged as desired by the person.

2. Eligibility for Home lsolation

. The person shall be clinically assigned as asymptomatic/mild case by the treating medical officer/ physician

 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 on a 24 x7 basis. A regular communication link between the caregiver and hospital is a pre-requisite for the entire duration of home isolation

Mild fever < 380 c (< 1oo.4o F) . Oxygen saturation should be > 95% .

Age shall be less than 60 years

 lf the person has the following co-morbidities- Hypertension, diabetes mellitus, obesity, thyroid disease; they are well managed and under good clinical control as assessed by medical officer/physician

 Shall not have any comorbid conditions like kidney diseases including persons on dialysis, heart diseases, stroke, Tuberculosis, cancer, people living with HlV, immunecompromised, on steroids and immune-suppressants, etc.

The person shall provide a signed undertaking on self-isolation (Annexure-1) and follow guidelines of home isolation

 The person shall agree to monitor his/her health (Annexure-2) and regularly inform their health status to the physician and District Surveillance Officer (DSO) for further follow up by the surveillance teams.

Home isolation shall not be applicable for pregnant women 4 weeks before expected date of delivery (EDD)

3. Requisite facility at home for isolation .

Separate well ventilated room with a separate toilet for the person in isolation

 The person shall stay in the identified room and awav from other persons in the home(especially the elderly and those with comorbid conditions like hypertension, cardiovascular disease, renal disease, etc.)

5.       When to seek further medical advice

6.        Further medical advice shall be immediately sought if the following symptoms and signs develop; o Difficulty in breathing o Oxygen saturation S 94% using fingertip pulse oximeter o

7.       Perslstent fever of >380 C (100.40 F) for more than 24 hours . Persistent pain/pressure in the chest . Mental confusion or inability to arouse e Slurredspeech/seizures

8.        Weakness or numbness in any limb or face

9.        Developing bluish discolorations of lips/face

10.    Any other symptom the person considers serious r As advised by treating physician

5. lnstructions to health staff monitoring the person in home isolation

Ensure strict enforcement of isolation of person at home

 Home isolation notice shall be pasted on the front door ofthe house o Hand stamping shall be done for the person in home isolation for a duration of 17 d ays

 Quarantine watch app shall be downloaded and used for daily monitoring

 lnform at least two neighbours regarding isolation of person at home

 Three member team in the ward/ village/ booth level/ resident welfare or apartment owners’ association shall oversee compliance of the person to isolation at home

 lf the person is found violating the protocol of home isolation, action will be taken under the Disaster management Act read with lpC and he/she shall be shifted to ccc.

 Link the person to tele-monitoring centre for daily follow-up o IVRS outbound calls through Apthamitra helpline (14410) shall be made to the person on a daily basis The caregiver and all close contacts of such cases shall take Hyd roxychloroq uine prophylaxis as per protocol and as prescribed by the treating medical officer/physician Telephonically or using tele-monitoring mode, check the person for development of new symptoms or fever or deterioration in oxygen saturation

6. lnstructions to the person in home isolation

The person shall wear medical facemask/ N-95 facemask at all times.

The mask shall be discarded after 8 hours of use or earlier if it becomes wet or visibly soiled.

Mask shall be discarded only after disinfecting it with 1% sodium hypo-chlorite solution

The person must stay in the identified room only and maintain a physical distance of 2 meters/ 6 feet from other people in the home, especially elderly and those with comorbid conditions like hypertension, cardiovascular disease, renal disease, etc.

The person shall take rest and drink a lot of fluids to maintain adequate hydration.

Drink atleast 2 litres of water per day. Use boiled and cooled water for drinking. Shall follow cough etiquettes at all times

Hands shall be washed often with soap and water for at least 40 seconds or cleaned with an alcohol-based sanitizer.

Do not share personal items like utensils, towels, etc. with other family members. Keep them separate.

 Clean surfaces in the room that are touched often (table-tops, doorknobs, handles, etc.) with 7% Lysol or 1% sodium hypochlorite solution

Clean and disinfect bathroom and toilet surfaces at least once daily.

Regular household soap or detergent should be used first for cleaning, followed by1% sodium hypochlorite solution.

The person shall strictly follow the physician’s instructions and medication advice (Annexure-3)

The person shall self-monitor his/her health with a fingertip pulse oximeter and digital thermometer daily

The person shall report promptly if he/she develops any worsening of symptoms, as mentioned above (Sl no.

4) The person shall take healthy and nutritious diet.

A Model diet plan is given vide annexure-4

 Smoking, chewing tobacco and alcohol intake shall be strictly avoided

 The person shall receive counselling services when necessary

Download Arogya Setu App on mobile (available at https://www.mygov.in/aarogyasetuapp/) and it should remain active at all times (through Bluetooth and Wi-Fi) a a a a a a a a a a 7.

lnstructions to caregivers

 The caregiver shall wear medical facemask/ N-95 facemask appropriately when in the same room with the ill person.

The front portion of the mask should not be touched or handled during use. lf the mask gets wet or dirty with secretions, it shall be changed immediately. Discard the mask after use and perform hand hygiene after disposal of the mask into separate closed bin. .

He/she shall avoid touching eyes, nose or mouth.

Hand hygiene shall be ensured following contact with the person.

Hand hygiene shall be practised before and after preparing food, before eating, after using the toilet, and whenever hands look dirty. Use soap and water for hand washing at least for 40seconds. 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. .

Exposure to a person:

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

 Avoid exposure to potentially contaminated items (e.g. avoid sharing food, utensils, dishes, drinks, used towels or bed linen). . Food must be provided to the person in his/her room.

Utensils and dishes used by the person shall 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.

Person’s clothes, bed linen, and bath and hand towels shall be washed separately using regular laundry soap and warm water or machine wash at 60-90 "C (I4O-I94 "F) with common household detergent, and sundried thoroughly. . Gloves and protective clothing (e.g. plastic aprons) shall be used when cleaning surfaces or handling clothing or linen soiled with body fluids. Single-use gloves shall be used and discarded after each use. Perform hand hygiene before putting on and after removing gloves.

 The caregiver shall make sure that the person follows the prescribed treatment. . The caregiver shall ensure counselling services to the person, whenever necessary.

 The caregiver and all close contacts will self-monitor their health with daily temperature monitoring and report promptly if they develop any symptom suggestive of COVID-19 (fever, cough, cold, sore throat, difficulty in breathing, etc.)

8. lnstructions to the family members of person in home isolation .

Do not panic. Do not stigmatise. o Keep the person cheerful and boost their morale .

Ensure that the person is in strict home isolation o Maintain a physical distance of at least 2 metres/ 6 feet

 Visitors are strictly not allowed until the person has completely recovered and has no signs or symptoms of COVID-19 o Remember, the fight is against the disease and not the person . For any assistance, please call Apthamitra helpline - 14410 9. lnstructions to neighbours of persons who are home isolated . Do not panic. Do not stigmatise. . Support the person and his/her family by providing essential items like medicines, ratlons, vegetables, etc. until they get cured as may be required .

Keep a vigil on the person in home isolation to ensure strict home isolation. . Maintain a physical distance of 2 metres/6 feet. o Remember, the fight is against the disease and not the person o For any assistance, please call Apthamitra helpline

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