With more cases of the 2019 novel Coronavirus (COVID-19) being reported in the Africa region and world over, various screening and preventive measures are being implemented by countries to control the spread of the virus.
However, at the household level, there is undeniable panic. For how would one handle a patient who is isolation at home, or has mild symptoms of the virus?
Against this background, the World Health Organization (WHO) has developed interim guidelines for home care for patients with suspected COVID-19 infection presenting with mild symptoms, as well as public health measures of those in contact with the patients.
The guidelines were adapted from the interim guidance that addressed Middle East respiratory syndrome coronavirus (MERS-CoV) infection that was published in June 2018 and is informed by evidence-based guidelines published by the WHO, and current information regarding COVID-19 infection. However, WHO strongly warns that home-care should be restricted to patients without an underlying chronic illness − such as lung or heart disease, renal failure or immune compromising conditions that place the patient at increased risk of developing complications. The decision of home-care requires careful clinical judgment, the WHO stresses.
Recommendations for patients and families
. • Place the patient in a well-ventilated single room (i.e., with open windows and an open door).
• Limit the movement of the patient in the house and minimize shared space.
- Ensure that shared spaces (e.g., kitchen, bathroom) are well ventilated (e.g., keep windows open).
- Household members should stay in a different room or, if that is not possible, maintain a distance of at least 1 m from the ill person (e.g., sleep in a separate bed).
- Limit the number of caregivers. Ideally, assign one person who is in a good health and has no underlying chronic conditions
- Visitors should not be allowed until the patient has completely recovered and has no signs and symptoms.
- Perform hand hygiene after any type of contact with patients or their immediate environment
Hand hygiene should also be performed before and after preparing food, before eating, after using the toilet and whenever hands look dirty. If hands are not visibly dirty, an alcohol-based hand rub can be used. For visibly dirty hands, use soap and water.
• When washing hands with soap and water, it is preferable to use disposable paper towels to dry hands. If these are not available, use clean cloth towels and replace them when they become wet.
• To contain respiratory secretions, patients and caregivers should wear a tightly fitted medical mask that covers their mouth and nose when in the same room as the patient. If the mask gets wet or dirty from secretions, it must be replaced immediately with a new clean, dry mask. Remove the mask using the appropriate technique – that is, do not touch the front, but instead untie it. Discard the mask immediately after use and perform hand hygiene.
• Avoid direct contact with body fluids, particularly oral or respiratory secretions, and stool. Use disposable gloves and a mask. Perform hand hygiene before and after removing gloves and the mask.
• Do not reuse masks or gloves.
• Use dedicated linen and eating utensils for the patient; these items should be cleaned with soap and water after use and may be re-used instead of being discarded.
• Clean and disinfect daily surfaces that are frequently touched in the room where the patient is being cared for, such as bedside tables, bedframes and other bedroom furniture, bathrooms and toilets. Regular household soap or detergent should be used first for cleaning, and then, after rinsing, regular household disinfectant containing 0.5% sodium hypochlorite (i.e., equivalent to 5000 pm or 1part bleach5 to 9 parts water) should be applied.
- Clean the patient’s clothes, bed linen, and bath and hand towels using regular laundry soap and water or machine wash at 60–90 °C with common household detergent, and dry thoroughly. Avoid contaminated materials coming into contact with skin and clothes.
- Avoid other types of exposure to contaminated items from the patient’s immediate environment (e.g., do not share toothbrushes, cigarettes, eating utensils, dishes, drinks, towels, washcloths or bed linen).
Recommendations for contacts and health care workers
Persons (including caregivers and health care workers (HCW) who have been exposed to individuals with suspected COVID-19disease are considered contacts and are advised to monitor their health for 14 days from the last possible day of contact. A contact may also be a person who has been visiting patients or staying in the same environment as a patient with COVID-19 disease; an exposure through working together in close proximity to or sharing the same classroom with a patient with COVID-19 disease; an exposure through traveling with a patient who has COVID-19 disease in any kind of vehicle; an exposure through living in the same household as a patient with COVID-19 disease within 14 days after the onset of symptoms in the patient..
MITIGATION STRATEGIES FOR A COMMUNITY, SCHOOL, AND WORKPLACE
While each community is unique and appropriate mitigation strategies may vary depending on characteristics of the community and their populations, the US Center for Disease Control (CDC) has also developed a framework that can help check the transmission of COVID-19. This includes encouraging individuals to be keen on following the trends of COVID-19 cases, knowing the signs and symptoms and what to do if symptomatic; staying home when sick, calling the emergence healthcare helplines before the physical visit; ensuring hand hygiene and limiting visitors among others.
Compiled by Carol Natukunda