The Union Health Ministry on Wednesday issued revised guidelines for home isolation of mild/asymptomatic COVID-19 patients following a rapid increase in daily COVID-19 cases in the country.
“Over the past two years, it has been seen globally as well as in India that majority of cases of COVID-19 are either asymptomatic or have very mild symptoms. Such cases usually recover with minimal interventions and accordingly may be managed at home under proper medical guidance and monitoring,” the ministry pointed out.
The present guidelines are applicable to COVID-19 patients who have been clinically assessed and assigned as mild /asymptomatic cases of COVID-19.
• 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 caregiver (ideally someone who has completed his COVID-19 vaccination schedule) should be available to provide care on 24 x7 basis. A communication link between the caregiver and a Medical Officer 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, Cerebrovascular 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.
• While a patient is allowed home isolation, all other members in the family including other contacts shall follow the home quarantine guidelines.
Instructions for the patient:
• Patient must isolate himself from other household members, stay in the identified room and away from other people in home, especially elderly and those with co-morbid conditions like hypertension, cardiovascular disease, renal disease, etc.
• Patient should stay 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. They should discard mask after 8 hours of use or earlier if the mask becomes wet or is visibly soiled. In the event of caregiver entering the room, both caregiver and patient may preferably consider using N-95 mask.
• Mask should be discarded after cutting them to pieces and putting in a paper bag for a minimum of 72 hours.
• Patient must take rest and drink lot of fluids to maintain adequate hydration.
Treatment for patients with mild /asymptomatic disease in home isolation:
• Patients must be in communication with a treating Medical Officer and promptly report in case of any deterioration.
• The patient must continue the medications for other co-morbidities/ illness after consulting the treating Medical Officer.
• Patients to follow symptomatic management for fever, running nose and cough, as warranted.
• Patients may perform warm water gargles or take steam inhalation thrice a day.
• If fever is not controlled with a maximum dose of tablet Paracetamol 650 mg four times a day, consult the treating doctor.
• Do not rush for self-medication, blood investigation or radiological imaging like chest X ray or chest CT scan without consultation of your treating Medical Officer.
• Steroids are not indicated in mild disease and shall not be self-administered. Overuse & inappropriate use of steroids may lead to additional complications.
• Treatment for every patient needs to be monitored individually as per the specific condition of the patient concerned and hence generic sharing of prescriptions shall be avoided.
• In case of falling oxygen saturation or shortness of breath, the person may require hospital admission and shall seek immediate consultation of their treating Medical Officer/surveillance team /Control room.
When to seek medical attention:
Patient / Caregiver will keep monitoring their health. Immediate medical attention must be sought if serious signs or symptoms develop. These could include.
• Unresolved High-grade fever (more than 100° F for more than 3 days)
• Difficulty in breathing
• Dip in oxygen saturation (SpO2 ≤ 93 per cent on room air at least 3 readings within 1 hour) or respiratory rate >24/ min
• Persistent pain/pressure in the chest
• Mental confusion or inability to arouse
• Severe fatigue and myalgia
When to discontinue home isolation:
Patient under home isolation will stand discharged and end isolation after at least 7 days have passed from testing positive and no fever for 3 successive days and they shall continue wearing masks. There is no need for re-testing after the home isolation period is over. Asymptomatic contacts of infected individuals need not undergo Covid test and monitor health in home quarantine.