The Union health ministry on Wednesday said home isolation of COVID-19 patients will end after at least seven days from testing positive and no fever for three successive days, in revised guidelines for home isolation of mild or asymptomatic cases.
Also, there is no need for re-testing after the home isolation period is over.Earlier, the duration of home isolation ended after 10 days of onset of symptoms.It also advised people not to rush for self-medication, blood investigation or radiological imaging like chest X-ray or CT scan without consultation of a medical officer. Underlining that steroids are not indicated in mild disease and should not be self-administered, the ministry said overuse and inappropriate use of steroids may lead to additional complications.
reatment for every patient needs to be monitored individually as per the specific condition of the patient concerned and hence generic sharing of prescriptions should be avoided, the revised guidelines stated.According to the guidelines, patients under home isolation will stand discharged and end isolation after at least seven days from testing positive and no fever for three successive days, but they shall continue wearing masks.Asymptomatic contacts of infected individuals need not undergo Covid test and monitor health in home quarantine, the guidelines stated.
“Information floating through social media mentioning non-authentic and non-evidence-based treatment protocols can harm patients. Misinformation, leading to the creation of panic and in turn undertaking tests and treatment that are not required, has to be avoided. “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,” the guidelines read. The revised guidelines also specified that the district administration under the overall supervision of the State Health Authority shall be responsible for monitoring patients under home isolation.
Listing responsibilities of grass root level surveillance teams, the ministry said the teams (ANM, sanitary inspector, MPHW etc) shall be responsible for initial assessment of the patient and whether the requisite facilities are there for home isolation.The health worker should contact the patient daily, preferably in-person or over telephone/ mobile, and obtain the details of temperature, pulse, oxygen saturation, patient’s overall wellness and worsening of signs/symptoms.The teams may also provide home isolation kits to the patient/caregiver as per the policy of the state government. The kit may contain masks, hand sanitisers, paracetamol along with a detailed leaflet to educate patients and family members in local language.
The surveillance teams shall also undertake patient education on the disease, its symptoms, warning signs, COVID-19 appropriate behaviour and need for vaccination for all eligible members. Listing the responsibilities of district/sub-district control room, the guidelines stated that they will be made operational and their telephone numbers well publicised so that people under home-isolation may contact the control rooms for seamless transfer of patients through ambulance from home to the dedicated hospital.
“These Control Rooms shall also make outbound calls to the patients under home isolation to monitor their status and the district administration should monitor all cases under home isolation on a daily basis,” the guidelines stated.According to the guidelines, asymptomatic cases are laboratory-confirmed cases who are not experiencing any symptoms and have oxygen saturation at room air of more than 93 percent. Clinically assigned mild cases are patients with upper respiratory tract symptoms with or without fever, without shortness of breath and having oxygen saturation at room air of more than 93 percent.
The patient should be clinically assigned as mild/ asymptomatic case by the treating Medical Officer to be eligible for home isolation.Further, a designated control room contact number at the district/sub district level shall be provided to the family to get suitable guidance for undertaking testing, clinical management related guidance, assignment of a hospital bed, if warranted. “Such cases should have the requisite facility at their residence for self-isolation and for quarantining the family contacts,” the guidelines said.
Elderly patients aged more than 60 years and those with co-morbid conditions such as hypertension, diabetes, heart disease, chronic lung/liver/ kidney disease and cerebrovascular disease shall only be allowed home isolation after proper evaluation by the treating medical officer, the guidelines said.Patients suffering from immune-compromised status (HIV, transplant recipients, cancer therapy) are not recommended for home isolation and shall only be allowed home isolation after proper evaluation by the treating medical officer, they added.The guidelines said the patient should stay in a well-ventilated room with cross ventilation and windows should be kept open to allow fresh air to come in.
The patient may self-monitor breathing rate/respiratory rate in sitting position, breathe normally and count the number of breaths taken in 1 full minute, the guideline said. 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. The status shall be shared with the treating Medical Officer as well as surveillance teams/Control room. The caregiver should wear a triple layer medical mask and N-95 mask may be considered when in the same room with the ill person and maintain hand hygiene among others.
