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Explained: New Covid guidelines on home isolation, managing fever, and use of remdesivir

The Covid-19 positive patient should continue the medications for other co-morbid illnesses after consulting the treating physician.

The Health Ministry has issued revised guidelines for home isolation of mild/asymptomatic Covid-19 cases, giving specific instructions on treatment in home isolation.

It also specified the drugs that can be prescribed by treating doctors to patients in home isolation.

General recommendations of treatment for patients with mild/asymptomatic disease in home isolation.

First, the guidelines state that patients must be in communication with a treating physician and promptly report any deterioration in their condition.

Second, the Covid-19 positive patient should continue the medications for other co-morbid illnesses after consulting the treating physician.

Specific recommendations on treatment in home isolation

First, the guidelines recommend that patients should follow symptomatic management for fever, running nose, and cough, as warranted.

Second, it recommends that patients may perform warm water gargles or take steam inhalation twice a day.

If the fever is not controlled

The guidelines recommend that if the fever is not controlled with a maximum dose of Tab. Paracetamol (650 mg four times a day), the patient should consult the treating doctor “who may consider advising other drugs like a non-steroidal anti-inflammatory drug (NSAID)”.
They recommend that the treating doctor may prescribe NSAID such as Naproxen (250 mg twice a day).

Further, the guidelines state: “Consider Tab Ivermectin (200 mcg/kg once a day, to be taken on empty stomach) for 3 to 5 days.”

If the fever persists beyond five days of onset of disease

The guidelines state Inhalational Budesonide (given via inhalers with spacer at a dose of 800 mcg twice daily for 5 to 7 days) to be given if symptoms (fever and/or cough) are persistent beyond 5 days of disease onset.
What if symptoms persist beyond 7 days

First, the guidelines state that systemic oral steroids are not indicated in mild disease. However, if symptoms persist beyond 7 days – persistent fever, worsening cough – patients should consult the treating doctor for treatment with low dose oral steroids.

Guidance on the use of remdesivir

The decision to administer remdesivir or any other investigational therapy must be taken by a medical professional and administered only in a hospital setting. “Do not attempt to procure or administer remdesivir at home,” it states.

It strongly recommends that in case of falling oxygen saturation or shortness of breath, the person should seek hospital admission and immediate consultation of their treating physician/surveillance team.