Isolation of mild, asymptomatic and elderly patients: Centre issues revised guidelines

Centre issues revised isolation guidelines

New Delhi: The Centre on Wednesday issued revised guidelines for home isolation of mild and asymptomatic patients amid the surge in Covid-19 cases nationwide.

As per the new guidelines, the patient under home isolation will stand discharged and end isolation after at least 7 days have passed from testing positive and no fever for 3 successive days and they shall continue wearing masks. There is no need for re-testing after the home isolation period is over.

Asymptomatic contacts of infected individuals need not undergo Covid test and monitor health in-home quarantine as per the new guidelines.

"Patient should at all times use a triple-layer medical mask. They should discard the mask after 8 hours of use or earlier if the mask becomes wet or is visibly soiled. In the event of the Caregiver entering the room, both Caregiver and the patient may preferably consider using the N-95 mask", said the new guidelines. The mask should be discarded after cutting them to pieces and putting in a paper bag for a minimum of 72 hours.

Isolating himself from others and especially with elderly people with comorbidities, 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 patients have been advised to self-monitor the blood oxygen saturation with a pulse oximeter. The patient may self-monitor breathing rate, the respiratory rate in sitting position, breathe normally and count the number of breaths taken in 1 full minute and report promptly if any deterioration of symptom is noticed, says the new guidelines.

Elderly patients aged more than 60 years with co-morbid conditions will only be allowed home isolation after proper evaluation by the treating medical officer. The patients suffering from immune-compromised status (HIV, Transplant recipients, Cancer therapy, etc.) are not recommended for home isolation and shall only be allowed home isolation after proper evaluation by the treating Medical Officer, said the guidelines.

For the treatment for patients with mild, asymptomatic disease in home isolation, the ministry has advised that patients may utilize the teleconsultation platform made available by the district, state administration. If fever is not controlled with a maximum dose of Paracetamol 650 mg four times a day, consult the treating doctor, said the new guidelines.

The patients have been advised to perform warm water gargles or take steam inhalation thrice a day. The guidelines prohibit to rush for self-medication, blood investigation or radiological imaging like chest X-ray or chest CT scan without consultation from treating Medical Officer. Steroids are not indicated in mild disease and shall not be self-administered. Overuse and inappropriate use of steroids may lead to additional complications, the new guidelines said.

Immediate medical attention must be sought if serious signs or symptoms develop which may include unresolved high-grade fever of more than 100 degrees F for more than 3 days. Difficulty in breathing and dip in oxygen saturation (SpO2 93 per cent on room air at least 3 readings within 1 hour) or respiratory rate @24/minute. If the patient feels persistent pain or pressure in the chest or any mental confusion or inability to arouse along with severe fatigue and myalgia, immediate medical advice should be sought as per the new home isolation guidelines.

The concerned district administration under the overall supervision of the State Health Authority shall be responsible for monitoring the patient under home isolation.

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