Delhi govt notifies home isolation guidelines for ‘mild’ cases of Covid-19
A Covid-19 patient living at home will have his/her left hand stamped stating “committed to home isolation” and will have to remain in the designated room for at least 16 days, the Delhi government’s home isolation guidelines, released on Thursday, said.
This comes two days after the Centre allowed home isolation of positive patients, keeping in mind the rising number of cases and the strain they put on hospital infrastructure.
A consultative meeting of Delhi health minister Satyendar Jain, health secretary Padmini Singla, director general of health services Dr Nutan Mundeja and medical director of Lok Nayak hospital Dr JC Passey, among others, was held Wednesday to finalise the standard operating procedures (SOPs) for home isolation.
So far, 3,515 cases and 59 deaths have been reported in the city.
Data shows that around 43% of all active Covid-19 cases – those still with the infection – are admitted to the Covid-19 care centre with mild symptoms. These people will be eligible for home isolation if they have adequate facility – a separate bedroom and bathroom at home.
Once a person tests positive, the new SOPs state that the surveillance team will call to check if (s)he has mild or moderate symptoms. Anyone with moderate symptoms such as high fever or breathing difficulty, and those with comorbid conditions such as diabetes or hypertension will be moved to a Covid health centre or hospital.
If symptoms are mild and the person has no comorbid conditions, then a health team will visit the house to check the person and the house to see if it can be used for isolation. If yes, then the team will get an undertaking from the patient that (s)he will remain in isolation and call them in case symptoms worsen. The patient will be stamped on the left hand and made to download Arogya Setu app, which will track the person’s movements. A home isolation sticker will also be put up outside the residence.
The person will be allowed to come out of isolation only after two of his/her tests come negative for Covid-19. If not, the isolation can be extended and the right hand of the person will be stamped, the guidelines stated. The patient’s condition will be checked every day over phone by the district health teams and treatment has to be sought if there is difficulty breathing, persistent pain or pressure in the chest, mental confusion, or bluish discolourations on the body.
“It is impossible to assess someone’s condition over phone; a physical check is necessary at least twice a day. We simply do not have the manpower to let a doctor check every patient twice a day, even if we have just 50 such cases in a district. Also, the progression of the disease is sudden and might require immediate medical attention. In such cases, we cannot wait for the person to call us and then wait for an ambulance to bring her to a hospital,” a district health official said.
During the isolation, the patients must wear a triple-layer mask at all times and discard it after eight hours of use or when visibly dirty or moist. The mask has to be disinfected using 1% hypochlorite solution. The caregiver also has to wear a triple-layer mask when in the same room as the patient and use disposable gloves when handling the patient.
They must avoid contact with contaminated items such as cigarettes, eating utensils, dishes, drinks, used towel and bed linen, the guidelines say.
The caregiver also have to take the antimalarial drug hydroxychloroquine – 400 mg twice a day on Day 1 followed by one tablet every week for three weeks. The drug is not recommended for anyone under the age of 15, anyone with retinopathy, cardiac conditions, or know hypersensitivity to hydroxychloroquine and aminoquinoline. In case there are side effects, the caregiver has to report to pharma covigilance.
Once home isolation ends, the person will still be under surveillance for another 14 days, and they are not to attend any gathering, according to the guidelines.