Guidelines for home isolation for mild or asymptomatic Covid19 cases

REVISED GUIDELINES FOR HOME ISOLATION OF MILD/ASYMPTOMATIC COVID19 CASES  

As per the guidelines, the patients who are clinically assigned to be mild/asymptomatic are recommended for home isolation.
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%.   

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The patient should be clinically assigned as mild/ asymptomatic case by the treating Medical Officer.
Patients suffering from immunocompromised 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. 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 24×7 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. 

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

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

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

Don’t share personal items with other people.

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

Follow respiratory etiquettes all the time.

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

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

Self-monitoring of blood oxygen saturation with a pulse oximeter is strongly advised.

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How to use Oximeter ?

Turn on the Pulse Oximeter. Ensure digits are visible in the screen

• Insert middle finger correctly within the Oximeter. Allow few seconds for the Pulse Oximeter to detect the pulse and display the oxygen saturation (SpO2)
• Take the reading and fill in the Form-1
•  ◊ Normal: SpO2 should be 95% or above
•  ◊ If SpO2 below 95 %, then person should be immediately referred to the supervisor/medical officer
• Clean finger with sanitizer or alcohol-based wipe for every person before use
• To avoid wrong reading, do not test on fingers with nail polish

The patient will self-monitor his/her health with daily temperature monitoring and report promptly

WHEN TO SEEK MEDICAL ATTENTION

1. Difficulty in breathing,
2. Dip in oxygen saturation (SpO2 < 94% on room air)
3. Persistent pain
4. Pressure in the chest
5. Mental confusion or inability to arouse

Detailed information regarding home isolation for mild and asymptomatic Covid19 patients can be read on : 
https://www.mohfw.gov.in/pdf/RevisedGuidelineshomeisolation4.pdf

In addition, the guidelines on home-quarantine for other members available at:
https://www.mohfw.gov.in/pdf/Guidelinesforhomequarantine.pdf, shall be also followed.