COVID-19: Centre issues new guidelines for home isolation of mild/ asymptomatic cases - Check out full list
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India recorded a single-day rise of 3,82,315 new coronavirus infections pushing the total tally of COVID-19 cases to 2,06,65,148, according to the Union Health Ministry data on Wednesday.

As many as 3,780 people succumbed to the disease in the country in the last 24 hours, taking the cumulative death toll to 2,26,188.

Amid a massive rise in the COVID-19 cases in India, the ministry of health and family welfare has issued revised guidelines for home isolation of mild/ asymptomatic COVID-19 cases.

Which patient is asymptomatic or has mild symptoms?

The asymptomatic cases are laboratory confirmed cases not experiencing any symptoms and having oxygen saturation at room air of more than 94%. Clinically assigned mild cases are patients with upper respiratory tract symptoms (&/or fever) without shortness of breath and having oxygen saturation at room air of more than 94%.

Which patients are eligible for home isolation?

The patient should be clinically assigned as mild/ asymptomatic case by the treating Medical Officer.

Such cases should have the requisite facility at their residence for self-isolation and for quarantining the family contacts.

A care giver should be available to provide care on 24x7 basis. A communication link between the caregiver and hospital is a prerequisite for the entire duration of home isolation.

Elderly patients aged more than 60 years and those with co-morbid conditions such as Hypertension, Diabetes, Heart disease, Chronic lung/liver/ kidney disease, Cerebro-vascular disease etc shall only be allowed home isolation after proper evaluation by the treating medical officer.

Patients suffering from immune compromised status (HIV, Transplant recipients, Cancer therapy etc.) are not recommended for home isolation and shall only be allowed home isolation after proper evaluation by the treating medical officer.

The care giver and all close contacts of such cases should take Hydroxychloroquine prophylaxis as per protocol and as prescribed by the treating medical officer.

Instructions to be followed by the patient

Patient must isolate himself from other household members, stay in the identified room and away from other people in 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.

Patient should at all times use triple layer medical mask. Discard mask after 8 hours of use or earlier if they become wet or visibly soiled. In the event of care giver entering the room, both care giver and patient may consider using N 95 mask.

Mask should be discarded only after disinfecting it with 1% Sodium Hypochlorite.

Patient must take rest and drink lot of fluids to maintain adequate hydration.

Don’t share personal items with other people.

Follow respiratory etiquettes all the time.

Ensure cleaning of surfaces in the room that are touched often (tabletops, doorknobs, handles, etc.) with 1% hypochlorite solution.

Patient must take rest and drink lot of fluids to maintain adequate hydration.

Frequent hand washing with soap and water for at least 40 seconds or clean with alcohol-based sanitizer.

Self-monitoring of blood oxygen saturation with a pulse oximeter is strongly advised and thermal screening is also advised.

A monitoring chart should be maintained to keep a check on the following measures.

Treatment for patients with mild/ asymptomatic disease in home isolation

Patients must be in communication with a treating physician and promptly report in case of any deterioration.

Continue the medications for other co-morbid illness after consulting the treating physician.

Patients to 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.

When to discontinue home isolation?

Patient under home isolation will stand discharged and end isolation after at least 10 days have passed from onset of symptoms (or from date of sampling for asymptomatic cases) and no fever for 3 days. There is no need for testing after the home isolation period is over.

When to seek medical attention?

Patient / Care giver will keep monitoring their health. Immediate medical attention must be sought if serious signs or symptoms develop.

These could include:

i. Difficulty in breathing

ii. Dip in oxygen saturation (SpO2 < 94% on room air)

iii. Persistent pain pressure in the chest,

iv. Mental confusion or inability to arouse

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