Know Revised Guidelines For Treatment Of Covid Patients In Home Isolation

Delhi: The Ministry of Health & Family Welfare on Thursday released revised guidelines for Home Isolation of mild/asymptomatic Covid-19 cases

The guidelines have been updated after the norms were first laid out and issued last year in the month of July. As per the guidelines, the patients who are clinically assigned to be mild/asymptomatic are recommended for home isolation.

The asymptomatic cases have been defined as "laboratory confirmed cases" that not experiencing any symptoms and having oxygen saturation at room air of more than 94 percent.

On the other hand, clinically assigned mild cases are defined as patients with "upper respiratory tract symptoms (and/or fever) without shortness of breath and having oxygen saturation at room air of more than 94 percent".

Instructions For Patients

Following are the norms that need to be taken care of in cases of home isolation: 

• The patient must isolate himself from other household members, stay in the identified room, and away from other people in the home, especially elderlies and those with co-morbid conditions like hypertension, cardiovascular disease, renal disease, etc.
• The patient should be kept in a well-ventilated room with cross ventilation and windows should be kept open to allow fresh air to come in.
• The patient should at all times use a triple-layer medical mask. Discard masks after 8 hours of use or earlier if they become wet or visibly soiled. In the event of the caregiver entering the room, both caregiver and patient may consider using N 95 mask.
• Mask should be discarded only after disinfecting it with 1% Sodium Hypochlorite.
• The patient must take rest and drink a lot of fluids to maintain adequate hydration.
• Frequent handwashing with soap and water for at least 40 seconds or clean with an alcohol-based sanitizer.
• Don’t share personal items with other people in the household.
• Ensure cleaning of surfaces in the room that are touched often (tabletops, doorknobs, handles, etc.) with 1% hypochlorite solution.
• Self-monitoring of blood oxygen saturation with a pulse oximeter is strongly advised.
• The patient needs to self-monitor his/her health with daily temperature monitoring and report promptly if any deterioration of symptoms is noticed.

Following guidelines need to be carefully followed in treating mild cases of Coronavirus infection:

• Patients must be in communication with a treating physician and promptly report in case of any deterioration.
• Continue the medications for other co-morbid illnesses after consulting the treating physician.
• Follow symptomatic management for fever, running nose, and cough, as warranted.
• Patients may perform warm water gargles or take steam inhalation twice a day.
• If fever is not controlled with a maximum dose of Tab. Paracetamol 650mg four times a day, consult the treating doctor who may consider advising other drugs like non-steroidal anti-inflammatory drug (NSAID) (ex: Tab. Naproxen 250 mg twice a day).
• Consider Tab Ivermectin (200 mcg/kg once a day, to be taken empty stomach) for 3 to 5 days.
• 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.
• 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.
• Systemic oral steroids not indicated in mild disease. If symptoms persist beyond 7 days (persistent fever, worsening cough, etc.) consult the treating doctor for treatment with low-dose oral steroids.

Patient/Caregivers will keep monitoring their health. Immediate medical attention must be sought if serious signs or symptoms develop. These could include:

• Difficulty in breathing
• Dip in oxygen saturation (SpO2 < 94% on room air)
• Persistent pain/pressure in the chest
• Mental confusion or inability to arouse
• In case of falling oxygen saturation or shortness of breath, the person should require hospital admission and seek immediate consultation from their treating physician/surveillance team.

Home isolation for Coronavirus patients shall be ended after at least 10 days have passed from the onset of symptoms (or from the date of sampling for asymptomatic cases) and when there has been no fever for 3 days. There is no need for testing after the home isolation period is over, the Union Health Ministry advises.