COVID-19 and Home Treatment: For General Awareness

The government has issued new guidelines on COVID-19 treatment — Asymptomatic /Mildly symptomatic patients can be treated at home isolation.

What will be in this article?

1. A) Why this guideline?
2. B) Who are asymptomatic and mildly symptomatic patients?
3. C) What to do in home isolation?
4. D) When to go to the hospital?
5. E) Who is eligible for home treatment and who is not?
6. F) How to prepare for home isolation in advance?

A) Why this guideline?

1) Latest data says, in COVID-19

• 80% patients are asymptomatic / mildly symptomatic
• 15% are symptomatic, who need oxygen,
• 5% are critical-who need a ventilator.

These 80% patients recover completely without any treatment or with very basic conservative treatment.  At the rate the COVID-19cases are increasing day by day, the infrastructure to treat these huge number of patients in hospitals is not possible, as our hospitals are not so well equipped in terms of beds, doctors, staff and equipments. Admitting all COVID19 patients will mean filling up all hospital beds, overburdening the limited doctors, staff, health workers and equipment facilities thereby depriving the symptomatic and critical patients who actually deserve treatment under close watch in hospitals .

2) In maximum cases, COVID-19 disease is similar to other common flu. Since there is no specific treatment and patients are treated based on their symptoms, so in maximum cases that can be undertaken at home with observation and with minimum medicines.

Asymptomatic or mildly symptomatic patients require a 14 days Home isolation and self monitoring with periodic doctor consultation if so advised. People have been recovering completely in this way.

B) Who are Asymptomatic, Mildly symptomatic?

Asymptomatic:

• Corona test positive, but did not develop any symptoms in 3weeks- 4weeks period, are called asymptomatic,
• Some of them develop symptoms after a few days, and then they are categorized as pre-symptomatic.

It is impossible to predict who will develop symptoms or who will not, because it depends entirely on patient’s own immune system.

What is the Incubation period (how long does it take to develop symptoms)?  Roughly 5days- 6days, sometimes 14days.

Mildly Symptomatic:

Patients with mild fever, runny nose, cough,sore throat, weakness and test report positive.

• Symptoms vary from person to person.
• Usual symptoms are Fever, Cough, Sorethroat, Anosmia, Respiratory distress, Fatigue, Bodyache, Headache etc.
• Unusual symptoms: Gastro-intestinal [GI] upset, Diarrhea, Vomiting etc.

C) What to do in Home Isolation?

1. Isolate yourself from the rest of the family first, especially aged (> 60yrs), keep the kids away.
2. Choose a separate room for yourself.
3. Separate all things of your own use.
4. Mask: positive patients should use triple layered medical mask. After 8 (eight) hours of use discard it. Before discarding disinfect, cut / tear off the mask, put it in a paper bag and throw it away. (1% hypochlorite solution should be used to disinfect. This solution can be easily made at home with bleaching powder.
5. Drink adequate amount of water– it is important to stay hydrated.
6. Take proper rest.
7. Note your daily symptoms in a diary.
8. Keep a Pulse oxymeter. This is a small device with which the pulse rate and oxygen saturation level in the blood can be easily monitored. Check for oxygen saturation in your blood every 4 hours.
9. Disinfect the high touch areas with 1% hypochlorite solution.
10. Take care of your mental health. Don’t get panicky. Read good books, listen to music, watch movies, talk /video call with friends.
11. If necessary, talk to a familiar doctor.
12. Even if you feel healthy, you must follow these 14 days’ isolation.
13. When to come out of Home isolation?

• There is no fever for 10 days.
• 17 days have passed since the start of the symptoms/sample collection.

NO NEED OF TESTING AFTER HOME ISOLATION PERIOD IS OVER.

D) When to get admitted to a hospital?

1. Fever not subsiding, instead increasing.
2. Feeling pressure/ discomfort in the chest,
3. Feeling shortness of breath,
4. Mental confusion,
5. Feeling very tired/weak.
6. Pulse oxymeter—oxygen saturationis 95% or less.

E) Who are eligible for Home isolation and who are not?

There are some criteria to stay in Home isolation.  Basically this guideline is for urban areas.

Who are eligible?

1. Patient must be mildly symptomatic or pre-symptomatic, must be determined by a doctor.
2. Self isolation facility should be there in patient’s home– such as separate room, separate washroom
3. Must have a 24 × 7 caregiver / helping hand.

Who are not eligible?

1. Those who do not have the facilities for home in isolation. (For them there areCOVID care centers Safe home)
2. Asymptomatic positive, but age> 60yrs,
3. Asymptomatic positive, with co-morbid conditions, such as high blood pressure, diabetes, heart diseases, kidney diseases, Immuno-suppression, cancer, etc.

F) What can you do in advance?

This is from a very practical point of view.-

If you can, from now on –

• Just select the room of isolation with attached washroom.
• Keep things separate for your daily use
• Keep emergency contact numbers- doctor, ambulance, hospital help line number and close friends or relatives.
• Keep Thermometer, Pulse oxymeter and adequate sanitizing /disinfecting materials indoor.
• Keep good books, movie collection, songs, etc for self entertainment

Finally remember, this is not the first pandemic in the world.  Science says that like other pandemics, Corona will leave the earth some day.

#Stay protected, Stay Alert, Stay Well and Stay Healthy.

(Disclaimer: The contents of this article  should be treated as an additional awareness material  and should be read accordingly.  Home isolation or official quarantine can best be prescribed by the treating doctor, so follow your doctor’s advice.)

First published in Rational Drug Bulletin, Volume 29, Issue 3, July-September, 2020