In revised guidelines for home isolation of mild or asymptomatic cases of Covid-19, the Union health ministry on January 5 said that patients under home isolation will stand discharged after at least seven days from testing positive and no fever for three successive days.
Here are some of the guidelines issued by the Ministry:
1) People should not rush for self-medication, blood investigation or radiological imaging like chest X-ray or CT scan without consultation of treating medical officer.
2) Steroids are not indicated in mild disease and should not be self-administered; overuse and inappropriate use of steroids may lead to additional complications
3) Treatment for every patient needs to be monitored individually as per the specific condition of the patient concerned and hence generic sharing of prescriptions should be avoided
4) Patients under home isolation will stand discharged and end isolation after at least seven days have passed from testing positive and no fever for three successive days, but they shall continue wearing masks. Earlier, the duration of home isolation ended after 10 days of onset of symptoms.
5) There is no need for re-testing after the home isolation period is over.
6) Asymptomatic contacts of infected individuals need not undergo Covid test and monitor health in home quarantine.
7) Information floating through social media, mentioning non-authentic and non-evidence based treatment protocols, can harm patients. Misinformation leading to creation of panic and in-turn undertaking tests and treatment which are not required has to be avoided.
8) District administration under the overall supervision of the State Health Authority shall be responsible for monitoring patients under home isolation.
9) Elderly patients aged more than 60 years and those with co-morbid conditions such as Hypertension, Diabetes, Heart disease, Chronic lung/liver/ kidney disease, Cerebrovascular disease, shall only be allowed home isolation after proper evaluation by the treating medical officer
10) Patients suffering from immune compromised status (HIV, transplant recipients, cancer therapy) are not recommended for home isolation;
they shall only be allowed home isolation after proper evaluation by the treating medical officer.
Assessment of the Patients by Teams Concerned
Teams (ANM, sanitary inspector, MPHW etc) shall be responsible for initial assessment of the patient and whether the requisite facilities are there for home isolation.
The health worker should contact the patient daily, preferably in-person or over telephone/ mobile, and obtain the details of temperature, pulse, oxygen saturation, patients overall wellness and worsening of signs/symptoms.
The teams may also provide home isolation kits to the patient/caregiver as per the policy of the state government.
The kit may contain masks, hand sanitisers, paracetamol along with a detailed leaflet to educate patients and family members in local language.
The surveillance teams shall also undertake patient education on the disease, its symptoms, warning signs, COVID-19 appropriate behaviour and need for vaccination for all eligible members.
Listing the responsibilities of district/sub-district control room, the guidelines stated that they will be made operational and their telephone numbers well publicised
So that people under home-isolation may contact the control rooms for seamless transfer of patients through ambulance from home to the dedicated hospital.
Definition of Asymptomatic and Mild Cases
According to the guidelines, asymptomatic cases are laboratory confirmed cases who are not experiencing any symptoms and have oxygen saturation at room air of more than 93 per cent.
Clinically assigned mild cases are patients with upper respiratory tract symptoms with or without fever, without shortness of breath and having oxygen saturation at room air of more than 93 per cent.
The patient should be clinically assigned as mild/ asymptomatic case by the treating Medical Officer to be eligible for home isolation.
Further, a designated control room contact number at the district/sub district level shall be provided to the family to get suitable guidance for undertaking testing, clinical management related guidance, assignment of a hospital bed, if warranted.
“Such cases should have the requisite facility at their residence for self-isolation and for quarantining the family contacts,” they said.
