Revised guidelines for home quarantine for asymptomatic patients and caregivers

The third wave of Covid has broken out in the country. Covid cases are increasing rapidly across all cities. The new variant Omicron is also increasing rapidly. Until now, the majority of the people infected with Omicron are reporting mild symptoms.

Cases of Covid-19 that are asymptomatic or with very mild symptoms can be treated at home with regular communication with a medical expert and precautions. The Ministry of Health and Family Welfare has released the revised list of guidelines for home quarantine for asymptomatic and patients with very mild symptoms on January 5, 2021.

Guidelines for Home isolation of asymptomatic/ mild Covid-19 cases

The asymptomatic cases are laboratory-confirmed cases who are not experiencing any symptoms and have oxygen saturation at room air of more than 93%.

Instructions for the patients:

Patient must isolate himself/herself from other household members, stay in a well-ventilated, identified room and be away from other people in the home, especially the elderly and those with co-morbid conditions such as hypertension, cardiovascular disease, renal disease among others.

The patient should stay in a well-ventilated room with cross ventilation and windows should be kept open to allow fresh air.

The patient should at all times use a triple-layer medical mask. They should discard the mask after 8 hours of use or earlier if the mask becomes wet or is visibly soiled. In the event of the Caregiver entering the room, both Caregiver and the patient may preferably consider using an N-95 mask.

Mask should be discarded after cutting them to pieces and putting them in a paper bag for a minimum of 72 hours.

The patient must take rest and drink a lot of fluids to maintain adequate hydration.

Follow respiratory etiquettes at all times. Undertake frequent hand washing with soap and water for at least 40 seconds or clean with an alcohol-based sanitizer.

The patients shall not share personal items including utensils with other people in the household.

Need to ensure cleaning of frequently touched surfaces in the room (tabletops, doorknobs, handles, etc.) with soap/detergent & water. The cleaning can be undertaken either by the patient or the caregiver duly following required precautions such as the use of masks and gloves.

Self-monitoring of blood oxygen saturation with a pulse oximeter for the patient is advised.
The patient shall self-monitor his/her health with daily temperature monitoring (as given below) and report promptly if any deterioration of symptom is noticed.

Treatment for patients with mild symptoms

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/illnesses 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 Tab. 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.

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.

Guidelines for the Caregiver:

The caregiver should wear a triple layer medical mask. N95 mask may be considered when in the same room with the infected person.

Hand hygiene must be ensured following contact with the infected person or his immediate environment.

Avoid exposure to potentially contaminated items in his immediate environment (e.g. avoid sharing eating utensils, dishes, drinks, used towels or bed linen).

Food must be provided to the patient in his room. Utensils and dishes used by the patient should be cleaned with soap/detergent and water while wearing gloves. The utensils may be re-used after proper cleaning.

Effective and safe disposal of general wastes such as disposable items used food packets, fruit peel offs, used water bottles, left-over food, disposable and food plates should be ensured. They should be collected in bags securely tied for handing over to waste collectors.

Medical Attention must be sought immediately under the following cases-

i. Unresolved High-grade fever (more than 100° F for more than 3 days)
ii. Difficulty in breathing
iii. Dip in oxygen saturation (SpO2 ≤ 93% on room air at least 3 readings within 1 hour) or respiratory rate >24/ min
iv. Persistent pain/pressure in the chest,
v. Mental confusion
vi. Severe fatigue and myalgia