The Karnataka government has allowed asymptomatic and mild symptomatic Covid-19 patients, including those in Bengaluru, to be in home isolation. The decision was taken after Chief Minister BS Yediyurappa met medical experts in Bengaluru who suggested the measure in a bid to lessen the burden on hospitals.
Who are asymptomatic and mild symptomatic Covid-19 patients?
Patients who test positive for Covid-19 but have no symptoms of the infection— like chills, cough, shortness of breath or difficulty in breathing, fatigue, muscle or body aches, headache, new loss of taste or smell and sore throat — are termed asymptomatic patients
However, asymptomatic patients could turn out to be the ones who may spread the infection to others. While it is likely that they may be less contagious than someone who is actively coughing, there is no evidence to suggest that the asymptomatic patients do not spread the virus. They, however, need no treatment.
At the same time, mild symptomatic patients will develop and exhibit one or a combination of the Covid-19 symptoms. Medical experts usually suggest medications to them to manage fever, cough and body aches would be suggested to them, along with some home remedies.
What are the conditions stipulated by the government to permit home isolation?
While only patients who are asymptomatic or mild symptomatic shall be permitted for home isolation, they will be oriented to the protocol of home isolation by a health team from the district health authority.
The team, during their visit to the house, will also assess its suitability for self-isolation and will check if the requisite facility is available at the residence for quarantining family contacts.
At home, a caregiver should be available to provide care on a 24 x7 basis. A regular communication link between the caregiver and hospital is a pre-requisite for the entire duration of home isolation.
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What are the medical conditions required for patients to get permission for home isolation?
The Department of Health and Family Welfare Services has directed that each Covid-19 patient in home isolation should always have an oxygen saturation of not less than 95 per cent. The patient shall have a pulse oximeter, digital thermometer and personal protective equipment (facemasks, gloves) to be used during home isolation.
The patient should be aged 50 or below. Home isolation shall not be applicable to pregnant women. However, lactating mothers are allowed home isolation after assessment and instructions.
Further, the patient will have to agree to monitor his/her health and regularly inform their health status to the physician and District Surveillance Officer (DSO) for further follow-up by the surveillance teams. A signed undertaking on self-isolation and that all guidelines of home isolation will be followed will also be sought.
Patients who fail to fit into the criteria mentioned above will be recommended to be shifted to a Covid Care Centre (CCC), Dedicated Covid Health Centre (DCHC), or Dedicated Covid Hospital.
Are patients with comorbid conditions allowed home isolation?
If the patient has comorbidities such as hypertension, diabetes, obesity, and thyroid disease, they have to be well-managed and under good clinical control as assessed by a medical officer/physician.
Patients with comorbid conditions like kidney diseases including patients on dialysis, heart diseases, stroke, tuberculosis, cancer, people living with HIV, immune-compromised, on steroids and immune-suppressants will not be allowed home isolation.
What are the guidelines patients in home isolation need to follow?
According to government guidelines, while in home isolation, Covid-19 positive patients should wear an N-95/medical facemask at all times. The mask should be discarded after 8 hours of use or earlier if they become wet or visibly soiled. While disinfecting the mask, 1% Sodium Hypo-chlorite solution should be used.
The patient must stay in the identified room only and maintain a physical distance of 2 meters/ 6 feet from other people in the home, especially elderly and those with comorbid conditions like hypertension, cardiovascular disease, and renal disease among others.
Further, cough etiquettes should be followed at all times and hands should be washed often with soap and water for at least 40 seconds or clean with an alcohol-based sanitizer.
Personal items like utensils, towels, should not be shared with other family members.
Smoking, chewing tobacco and alcohol intake should be strictly avoided and the patient should receive counselling services whenever necessary. Downloading Aarogya Setu App on the mobile phone is mandatory and it should remain active at all times — through Bluetooth and Wi-Fi.
What should the caretaker keep in mind while nursing the Covid-19 patient at home?
Similar to the guidelines stipulated for the Covid-19 patient, the caretaker should wear an N-95/medical facemask at all times. He/She should avoid touching eyes, nose or mouth.
Hand hygiene should be ensured at all times after having any contact with the patient. The caretaker should wash hands thoroughly before and after preparing food, before eating, after using the toilet, and whenever hands look dirty. Use soap and water for handwashing at least for 40 seconds. Alcohol-based hand rub can be used if hands are not visibly soiled.
All kinds of direct contact with body fluids of the patient, particularly oral or respiratory secretions should be avoided. Disposal gloves should be used while handling the patient.
The caretaker should not in any way avoid sharing food, utensils, dishes, drinks, used towels or bed linen with the patient. Food should be provided to the patient in his/her room.
Further, the caretaker is responsible for the patient following the prescribed treatment, ensuring counselling services whenever necessary, and to self-monitor his/her health with daily temperature monitoring.
In case the caretaker develops any symptom, it should be reported to the medical authorities immediately.
How can other family members help the person in home isolation?
Family members should be responsible to keep the patient cheerful and boost their morale at all times. Visitors should not be allowed until the patient has completely recovered and has no signs or symptoms of COVID-19.
Further, family members and neighbours are directed not to panic and to stigmatise the infection. “Remember, the fight is against the disease and not the person,” the government advisory mentions.
What can neighbours do to assist the person in home isolation?
Neighbours can support the person/family of a person who has tested positive for Covid-19 by providing essential items like medicines, rations and vegetables until they get cured.
Meanwhile, they should also keep a vigil on the patient and the family (residing with the patient/s) to ensure strict home isolation. Violations can be reported by calls to 080-45451111 or on Whatsapp at 9777777684.
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