Guidelines for Home Isolation of mild/asymptomatic COVID-19 cases
During this catastrophic second wave, numerous cases are advised for home isolation. This article summarises the revised guidelines for COVID-19 mild/asymptomatic cases given by the Indian government. Although, it’s imperative to consult a doctor prior in all circumstances.
Some notable points for COVID-19 home isolation:
Replace paranoia with precautions required for COVID-19 Management.
What is COVID-19 Mild/Asymptomatic cases?
Asymptomatic COVID-19 cases –
Laboratory confirmed cases not experiencing any symptoms
Having oxygen saturation at room air of more than 94%.
Mild COVID-19 cases –
Patients with upper respiratory tract symptoms (&/or fever) without shortness of breath
Oxygen saturation at room air of more than 94%.
Patients Eligibility
The patient should be clinically assigned as a mild/ asymptomatic case by the treating Medical Officer.
Availability of requisite facility at their residence for self-isolation and for quarantining the family contacts
# The caregiver should take Hydroxychloroquine prophylaxis as per protocol and as prescribed by the treating medical officer.
Instructions – Patients
Should at all times use a triple-layer medical mask. Discard mask after 8 hours of use or earlier if required.
Keep the patient in a well-ventilated room with cross ventilation.
Clean all surfaces in the room that with 1% hypochlorite solution.
Day of symptoms and time (every 4 hourly) Temperature Heart rate (from pulse oximeter) SpO2 % (from pulse oximeter) Feeling: (better /same /worse)
Breathing: (better / same/ worse)
Instructions for Caregivers
The caregiver should wear a triple-layer medical mask. Wear an N95 mask when in the same room with the ill person.
Ensure strict hand hygiene following contact with an ill person or his immediate environment.
Discard biomedical waste safely, to prevent further spread of infection within households.
Treatment
Patients must be in communication with a treating physician and promptly report in case of any deterioration and fresh complaints.
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 a 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.
In case of falling oxygen saturation or shortness of breath, the person should require hospital admission and seek immediate consultation from their treating physician.
When to seek medical attention?
Patients / Caregivers will keep monitoring their health. Seek medical attention immediately if serious signs or symptoms develop.
Difficulty in breathing
Dip in oxygen saturation (SpO2 < 94% on room air)
iii. Persistent pain/pressure in the chest
Mental confusion or inability to arouse
When to discontinue home isolation?
Patients under home isolation will end isolation after at least 10 days have passed from the 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.
