HEALTH ISSUES NEW GUIDELINES FOR HOME-SEPARATION FOR MILD AND ASYMPTOMATIC COVID-19 PATIENTS
The Central Government is leading the fight in coordination and co-operation with all the States as well as the Union Territories in responding and managing the Kovid- 19 epidemics. A number of strategic decisions have been made for covid prevention, infection prevention, and management. In the same series, the Union Ministry of Health today issued new guidelines for home-segregation for mild and asymptomatic Covid-19 patients, thus revoking the earlier guidelines issued on July 2, 2020.
According to the revised guidelines, Covid patients who have no symptoms of the disease or even mild symptoms are recommended to stay in home isolation.
Asymptomatic covid patient: –
Asymptomatic covid patients are patients who have been infected with covid but have no symptoms and whose oxygen level is more than 94 percent in the room. Also in medical terms, patients with mild symptoms are those who have mild symptoms (or / and fever) of infection in the upper respiratory tract. However, there is no difficulty in breathing and the level of oxygen in the room is more than 94 percent, the patient said.
1. Eligible patients for home-isolation
i. The medical officer treating the patient should certify that they are medically mild / asymptomatic.
ii. Such patients should have adequate facilities for self-segregation at home, as well as other family living facilities in isolation.
iii. Someone should be available 24 hours a day to take care of such patients. Also, there will be a prerequisite for contact between the caregiver and the hospital / doctor during the entire home-separation period of the patient.
iv. Individuals over 60 years of age or who have other comorbidities, such as high blood pressure, diabetes, heart disease, lung / liver / kidney disease, neurological disorders, may be allowed home-separation only after a thorough examination by a doctor.
v. It is not recommended to keep patients in a home-isolated area with immunosuppressive diseases (HIV, organ transplants, cancer, etc.). Home-separation can only be allowed after a thorough examination by their doctor.
vi. All individuals caring for and contacting such patients should take hydroxycinchloroquine prophylaxis in accordance with the protocol and the doctor’s recommendation.
vii. In addition, guidelines for other persons with home-segregation patients are available at : https://www.mohfw.gov.in/pdf/Guidelinesforhomequarantine.pdf .
2. Instructions for patients:
i. The patient should isolate himself from other people in the house. Stay in the same room and out of contact with other people. Especially keep yourself away from the elderly and other ailments in the home.
ii. The room with the patient should be well ventilated and the windows should be kept constantly open so that fresh air can enter the room.
iii. The patient should wear a full time triple layer medical mask. Change the mask every 8 hours or if it gets wet. If the caregiver is about to enter the room, the person and the patient should wear an N95 mask.
iv. The mask should be removed only after disinfection with a liquid containing 1% sodium hypochlorite.
v. The patient should get plenty of rest and drink fluids to prevent dehydration.
vi. All the rules of full time breathing should be followed.
vii. Wash your hands frequently with soap and water for at least 40 seconds. Or clean with an alcohol-based sanitizer.
viii. Your personal belongings should not be used by anyone in the house.
ix. Parts of the room / objects that the patient frequently touches (tables, doors, handles, etc.) should be cleaned with 1% sodium hypochlorite liquid.
x. It is strongly recommended that the level of oxygen in the blood be checked frequently by the patient with the help of an oximeter.
xi. The patient should check his fever daily on his own and if any changes are noticed in the table given below, he should immediately inform the caregiver.
3. Instructions for the caring person
The caregiver should wear a triple layer medical mask. The N95 mask should be worn when visiting the patient’s room.
Do not touch the front of the mask during use.
· If the mask gets wet, or dirty, it should be replaced immediately.
Destroy the mask after use and wash hands after removing the mask.
The person should not touch your face, nose and mouth.
ii. Hand Disinfection:
Hand washing should be done immediately after coming in or around a sick person.
Hands should be washed before and after cooking, before meals, before and after using the toilet, and when hands are unclean.
· Wash hands with soap and water for at least 40 seconds or use an alcoholic liquid.
· Tissue paper should be used to dry hands after using soap and water. If it is not available, use a single napkin / towel. And replace it as soon as it gets wet.
Thoroughly clean hands before and after wearing gloves.
iii. Contact with the patient / patient’s surroundings
o Avoid direct contact with the fluid coming out of the patient’s body , especially the drops coming out of the mouth or breath. Use disposable gloves when handling the patient .
o Avoid contact with potentially contaminated objects in its vicinity (e.g. sharing cigarettes , utensils , dishes , drinks , used towels or sheets ).
o Meals should be given to the patient in his room. Patients and utensils used by the patient should be washed clean with soap / detergent and socks with water. Utensils and trays can be reused.
Wash hands after removing gloves or handling items used by patients. Use triple layer medical masks and disposable gloves when cleaning or handling patient-used surfaces , clothing or sheets.
Keep hands clean before and after wearing gloves
iv. Biomedical course jaivavaidyakiya waste disposal
• house and infection to effectively ensure the disposal of waste to prevent spread. Dispose of waste (masks , disposable items , food packets etc.) as per CPCB guidelines (available at: http://cpcbenvis.nic.in/pdf/1595918059_mediaphoto2009.pdf )
4. Treatment of benign / asymptomatic patients in home isolation
i. Patients should be interacted with the doctors who treat them, and in the event of failure of the health and want to tell you now
ii. Continue medication for other ailments / diseases after consulting the treating doctor .
iii. Fever , runny nose and cough patients for symptoms of grants.
iv. Patients can sneeze or steam with warm water twice a day .
v. High fever tablets dosadvare if perasitamola is not controlled 650 Give mg four times a day, and which can advise other drugs like non-steroidal anti-drug imphlemetari (enaesaeayadi). (E.g. Tab. Naproxen 250 mg twice a day) , consult a doctor treating this . .
vi. Tab A Vermectin ( 200 mcg / kg once a day , on an empty stomach) for 3 to 5 days.
vii. If symptoms (fever and / or cough) persist after 5 days of onset of the disease , inhalation budesonide ( twice daily for 5 to 7 days by inhalers with 800 mcg dose spacer)
viii. Remedicavir or any other diagnostic therapy should be decided by medical professionals and should only be performed in a hospital. Don’t try to buy or give home remedies.
ix. Systemic oral steroids are not necessary in mild illness . If symptoms persist for more than 7 days (persistent fever , increased cough, etc.), consult a doctor treating you with oral steroids.
x if oxygen levels fall, or if you have difficulty to breath the person must be hospitalized and their on take immediate doctor’s advice / attention Squad that treatment.
5 .. When to seek medical help
The patient / caregiver will monitor their health. In case of severe signs or symptoms, immediate medical attention should be sought. This may include:
i. Difficulty breathing ,
ii. Decreased oxygen levels ( less than SpO2 94 in room air )
iii. Persistent chest pain / pressure ,
iv. Mental confusion
6. When to close home separation
At least 10 days after the onset of symptoms (or from the date of the asymptomatic sample) and 3 days without fever, the isolation of the patient in home isolation will end.
No testing is required after the home separation period is over.
7. Role of State / District Health Officer
i. States / Districts should monitor all patients in home segregation .
ii. Field staff / monitoring teams should monitor the health status of people in home segregation on a daily basis with a dedicated call center by personal visit.
iii. The clinical status of each incident will be reported by the field staff / call center (body temperature , pulse rate and oxygen saturation). The field staff will guide and instruct the patient to measure the parameters (for patients and their carers).
iv. The details of patients under home segregation should also be updated on the Kovid- 19 portal and facility app (as DSO users). Senior State and District Officers should monitor the updating of records.
v. In the event of a violation or the need for treatment, it is necessary to establish and implement a system to move the patient. Adequate dedicated ambulance service should be provided for this. For this , wide publicity should be given through the society .
vi. All family members and close contacts will be monitored and tested by field staff as per regulations.