Home Isolation Tips and Treatment for Patients with Mild and Moderate COVID -19

How Are Mild COVID-19 Cases Diagnosed to Be Managed at Home?

The clinically assigned mild or asymptomatic patients are advised for home isolation, as per the COVID-19 guidelines.

• The Clinically Assigned Asymptomatic Cases - They are laboratory-confirmed cases, and they do not experience any symptoms and have oxygen saturation at room air of more than 94 %.

• The Clinically Assigned Mild Cases - They are patients with upper respiratory tract symptoms with or without fever but do not experience shortness of breath and have oxygen saturation at room air of more than 94 %.

Who Are the Patients Eligible for Home Isolation?

1. The treating medical officer should clinically assign mild or asymptomatic cases.

2. Should have the requisite facility for self-isolation at home.

3. The caregiver should be available for 24 hours and all days.

4. There should be a communication link between the caregiver and the hospital.

5. Unless the treating medical officer properly evaluates elderly patients (above 60 years of age with co-morbidities) and immunocompromised patients for home isolation, they will not be allowed for home isolation.

6. The caregiver and all close contacts of such cases should follow the protocol by the treating medical officer.

What Are the Isolation Tips to Be Followed at Home by the Patients?

The instructions to be followed by the patients during home isolation are,

1. The patient needs to self-isolate themselves from house members.

2. The patient should especially stay away from elderly people with co-morbidities like hypertension, cardiovascular disease, renal disease, etc.

3. The patient should be in a well-ventilated room with windows kept open to allow fresh air to come in.

4. The patient should use a triple-layer medical mask.

5. Discard the mask when it becomes wet or visibly soiled.

6. When the caregiver enters the room, both caregiver and patient should wear an N95 mask.

7. The mask should be discarded after disinfecting with 1 % sodium hypochlorite.

8. For adequate hydration, the patient should drink lots of fluids and take a rest.

9. Respiratory etiquette should be followed at all times.

10. Frequently wash hands with soap and water for at least 20 seconds or use an alcohol-based sanitizer.

11. Do not share personal items with family members.

12. Clean the surfaces in the room that are often touched with 1 % hypochlorite solution.

13. It is important to self-monitor blood oxygen saturation with a pulse oximeter.

14. Also, self-monitor your health with daily temperature.

15. The heart rate, temperature, and all the symptoms regarding worsening, better or same, should be noted with a monitoring chart.

What Are the Instructions to Be Followed at Home by the Caregivers?

1) Wear a Mask:

The triple-layer medical mask should be worn by the caregiver and an N95 mask when in the same room with the ill person. The front portion of the mask should not be touched on usage, and if it gets wet with secretions, it should be changed immediately. Proper disposal of the mask along with good hand hygiene after disposal is needed. Also, avoid frequent touching of the face, nose, or mouth.

2) Follow Good Hand Hygiene:

When in contact with an ill person or present in their environment, make sure you have good hand hygiene after that. Hand hygiene should be practiced,

• Before and after preparing food.

• Before and after removing gloves

• Before eating.

• After using the toilet

• Whenever hands look dirty.

Wash your hands for 20 seconds with soap and water, or use an alcohol-based sanitizer. Use disposable paper towels to dry hands after hand wash; if not, use clean cloth towels and replace them when wet.

3) Safe Exposure With Patients:

• Avoid contact with the body fluids of the patient.

• When handling the patient, always use disposable gloves.

• Avoid exposure to the patient's contaminated items such as cigarettes, utensils, dishes, drinks, used towels, or bed linen.

• The food should be provided in the patient's room, and the utensils and dishes of the patient should be washed with soap or detergent and water wearing gloves.

• Clean the hands after taking off gloves and use disposable gloves while cleaning surfaces or clothes used by the patient.

4) Proper Waste Disposal:

Make sure to dispose of the waste properly to prevent the further spread of infection within the household.

How Are Mild or Asymptomatic COVID-19 Patients in Home Isolation Treated?

The mild or asymptomatic COVID-19 patients in home isolation are aimed to treat by relieving symptoms. The elderly patients should call their doctors as soon as symptoms start. Do not hesitate to ask questions to your doctor when in doubt.

1) Contact With Health Care Professionals - Patients should be in contact with the physicians and should always report in case of any deterioration.

2) Do Not Stop on Medications - The medications for other comorbidities should be continued unless said by the physician.

3) Symptomatic Management - Patients should follow symptomatic management for fever, running nose, and cough. Patients should have warm water gargles or steam inhalation twice a day.

4) Paracetamol, Ivermectin, Budesonide -

1. Suppose fever is not controlled with tablet Paracetamol 650 mg four times a day, consult the doctor to advise on other drugs.

2. Take tablet Ivermectin once a day on an empty stomach for 3 to 5 days.

3. If fever or cough persists for more than five days, take inhalational Budesonide with spacer at a dose of 800 mcg twice daily for 5 to 7 days.

5) Do Not Administer Remdesivir at Home - Administration of Remdesivir or any other investigational therapy should be decided by a medical professional and given only in a hospital setting and do not attempt to administer at home.

6) Steroids - In case of mild disease, systemic oral steroids should not be indicated. If there is persistent fever with worsening of cough for more than a week, consult the doctor to start with a low dose of steroids.

When Do You Seek Hospital Admission?

Always have continuous monitoring of yourself or your loved ones, and when the symptoms start to worsen, call the doctor. Immediate medical attention is needed if serious signs or symptoms develop. These include,

• Difficulty in breathing.

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

• Persistent pressure in the chest.

• Mental confusion.

• Bluish lips.

• Inability to stay awake.

Conclusion:

The home isolation can be ended after 10 days of onset of symptoms with the absence of fever for at least 3 days. When this home isolation period has ended, there is no need for testing again. Even when you are recovered from the disease, it is necessary to wear masks, frequently wash hands, practice social distance, sanitize the hands, and follow all the COVID-19 precautions to beat this pandemic.