The Union Health Ministry on Thursday issued fresh set of guidelines for home isolation of mild/asymptomatic Covid-19 patients. The government has strictly advised not to procure or administer Remdesivir injections at home. AIIMS Director Randeep Guleria has reiterated at several occasions that “Remdesivir is not a magic bullet” and should be administered only in a hospital setting.
India saw a record single day rise of3,79,257 new coronavirus infections pushing the total tally of Covid-19 cases to 1,83,76,524, while active cases crossed the 30-lakh mark, according to the Union Health Ministry data. The death toll increased to 2,04,832 with a record 3,645 daily new fatalities, the data updated at 8 am on Thursday showed.
Here’s a look at the recent SOPs and quarantine details:
Home QUARANTINE FOR ELDERLY PEOPLE
Elderly patients aged more than 60 years and those with co-morbid conditions such as hypertension, diabetes, heart disease, chronic lung or liver or kidney disease, cerebrovascular disease etc. shall only be allowed home isolation after a proper evaluation by the treating medical officer, the health ministry said. In case of falling oxygen saturation levels or shortness of breath, the person should require hospital admission and seek immediate consultation with the treating physician or surveillance team.
WHERE TO ISOLATE
The patients must isolate themselves from the other family members, stay in the identified room and away from others, especially elderly people and those with co-morbid conditions like hypertension, cardiovascular disease, renal disease etc. The patients should be kept in well-ventilated rooms with cross-ventilation, the windows should be kept open to allow fresh air to come in and should at all times use a triple-layer medical mask, the guidelines read.
"The mask should be discarded after eight hours of use or earlier if they become wet or visibly soiled. In the event of the caregiver entering the room, both the caregiver and the patient may consider using the N95 mask. "The masks should be discarded only after disinfecting it with one per cent sodium hypochlorite,” the guidelines stated.
According to the health ministry’s revised guidelines, “If fever is not controlled with a maximum dose of tab. Paracetamol 650 mg four times a day, consult the treating doctor, who may consider advising other drugs like non-steroidal anti-inflammatory drug (NSAID) (ex: tab. Naproxen 250 mg twice a day). "Tab. Ivermectin (200 mcg/kg once a day, to be taken on empty stomach) for 3 to 5 days should be considered.”
The patients may perform warm-water gargles or take steam inhalation twice a day.
Inhalational Budesonide (given via inhalers with spacer at a dose of 800 mcg twice daily for five to seven days) to be given if the symptoms (fever and/or cough) persist beyond five days, they added. The decision to administer Remdesivir or any other investigational therapy must be taken by a medical professional and it should be administered only in a hospital setting, the ministry said.
"Do not attempt to procure or administer Remdesivir at home. Systemic oral steroids are not indicated in mild disease. If symptoms persist beyond seven days (persistent fever, worsening cough etc.), consult the treating doctor for treatment with low-dose oral steroids,” the guidelines said. The revised guidelines stated that the asymptomatic cases are laboratory-confirmed cases that are not experiencing any symptoms and having oxygen saturation at room air of more than 94 per cent, while the mild cases are patients with upper respiratory tract symptoms (and/or fever) without shortness of breath and having oxygen saturation at room air of more than 94 per cent.
According to the guidelines, the patients must be in communication with a treating physician and promptly report to the latter in case of any deterioration. They should continue the medications for other comorbidities after consulting the treating physician.
GUIDELINES FOR CAREGIVERS
A caregiver should be available to provide care on a 24×7 basis. A communication link between the caregiver and the hospital is a prerequisite for the entire duration of home isolation. Patients suffering from an immune compromised status (HIV positive, transplant recipients, cancer therapy etc.) are not recommended for home isolation and shall only be allowed home isolation after a proper evaluation, the guidelines read.
The caregiver and all close contacts of mild or asymptomatic cases should take Hydroxychloroquine prophylaxis in accordance with the protocol and as prescribed.
WHAT TO EAT/DRINK AND HOW TO MAINTAIN HYGIENE
The ministry has advised the patients to take rest and drink lot of fluids to maintain adequate hydration, follow respiratory etiquettes at all times, not share personal items with others. "Ensure cleaning of surfaces in the room that are touched often (tabletops, doorknobs, handles etc.) with a one-per cent hypochlorite solution. Self-monitoring of blood oxygen saturation with a pulse oximeter is strongly advised,” the guidelines stated.
WHEN TO END HOME ISOLATION
Patients under home isolation will stand discharged after at least 10 days have passed from the onset of the symptoms (or from the date of sampling for asymptomatic cases) and no fever for three days. There is no need for testing after the home isolation period is over, the document stated.
(with inputs from PTI)