COVID-19 - Home Isolation and Quarantine

The WHO (World Health Organization) declared the COVID-19 outbreak as a public health emergency of international concern. All countries are advised to detect COVID-19 cases early, isolate such cases, manage their symptoms, trace their contacts, and to prevent the spread of SARS-CoV-2, which is the virus that is responsible for this pandemic. According to the WHO, the best way to contain this virus is by isolation of infected patients and quarantine of their contacts.

Isolation and Quarantine:

Isolation and quarantine prevent the spread of the virus to the population from individuals who have or may have been infected by COVID-19.

1. Isolation - It is when a person who has been tested positive for the new coronavirus is separated from people who are not infected.

2. Quarantine - It is when a person, who is not sick yet but might have been exposed to the virus (contact), is separated to check if they become sick and produce symptoms.

When Is Home Isolation Needed?

According to WHO’s recommendations, all patients who have been tested positive for COVID-19 should be isolated and managed in a healthcare facility. If isolation in a healthcare facility is not possible for all cases, then the doctors are advised to hospitalize those who are most likely to have a bad prognosis. This includes patients with critical illness and those with comorbidities.

If the hospitals are overwhelmed with COVID-19 patients, then patients with mild illness and no risk factors can be isolated in temporary isolation facilities until they test negative for the virus. In some cases, patients with no or mild illness and no risk factors, the doctor might suggest home isolation.

An individual who is confirmed to have infected with the new coronavirus can be under home isolation if he or she:

• Is not showing severe symptoms, such as breathing problems.

• Has a separate room where they can stay alone and recover.

• Has access to personal items and food.

• Has a healthy caregiver at home.

• Has the necessary protective equipment like gloves and masks.

• Does not live with people who are at increased risk of complications from COVID-19, such as older adults (above 65 years of age, children, pregnant women, and people with chronic illnesses).

If you have to travel from the hospital or airport to your house for isolation, avoid using public transport. Use ambulance services or a car to avoid exposure to others. In case you have been advised to stay in home isolation, do not leave your house to go to work, school, or public gatherings. Do not let anyone apart from your caregiver visit you at home.

When Is Home Quarantine Needed?

Home quarantine is necessary for all contacts of confirmed or suspected COVID-19 cases. The following people should be home quarantined:

• People who traveled to countries that have a high number of COVID-19 patients.

• Doctors and other healthcare workers who treated a patient, who tested positive later, without personal protective equipment (PPE) or a possible breach of PPE.

• People living in the same house as COVID-19 patients.

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• Individuals who had direct physical contact with COVID-19 patients.

• People who were in a closed environment with a COVID-19 case (including air travel).

What Are the Precautions to Be Taken by the Caregiver During Home Isolation or Quarantine?

All caregivers of COVID-19 patients at home or in a quarantine facility should strictly adhere to these following advice.

It is important to limit the contact of the caregiver with the patient, as this virus spreads between people in close contact (about a meter) through respiratory droplets of the patient. To limit contact:

• Keep the patient in a well-ventilated and separate room. Open all the windows and turn on the fan to increase airflow.

• Do not let the patient move around the house.

• Other members in the house should stay in a different room and maintain at least 1-meter distance from the infected person.

• Only one caregiver, who is in good health and has no underlying conditions, should care for the patient.

• No visitors should be allowed until the patient tests negative for COVID-19.

Food:

• Make sure you eat in different rooms.

• Always wash the utensils used by the infected person with hot water and soap while wearing gloves and a mask.

• Wash your hands properly after handling cups and dishes used by the patient.

Personal Items:

• Never share your cups, spoon, plate, towels, bedsheets, or mobile phones with the infected person.

Mask and Gloves:

Always wear a mask and gloves when you:

• Enter the infected person’s room.

• Touch the person’s blood, urine, vomit, mucus, or saliva.

• Are washing personal items used by the patient.

Once you finish caring for the patient, throw away the mask and gloves immediately, and wash your hands with soap and warm water. Do not touch your eyes, face, our mouth without washing your hands. Avoid touching and adjusting your masks.

Wash Your Hands:

The best way to prevent getting infected is to wash your hands. Wash your hands with warm water and soap for at least 20 seconds, or use an alcohol-based hand sanitizer. The alcohol content in the sanitizer should be at least 60 %. Make sure you properly clean the back of your hands, wrist, and nails also.

Cleaning Patient’s Items:

The patient’s clothes, towels, bed linen, etc., should be washed using hot water and soap or detergent. This includes cloth masks or bandana used by you. If you are washing it by hand, then do not forget to wear gloves and masks. You can also machine wash them using regular laundry soap at 60 to 90 °C. Dry the clothes at least for 5 hours under the sun.

Keep the following things in mind:

• Avoid shaking dirty or wet laundry.

• Use disposable gloves while touching the dirty items.

• Make sure you use the hottest setting in the washing machine.

• If sun drying is not possible, then dry laundry using the dryer.

• Do not forget to clean and disinfect the laundry bag and then wash your hands.

Disinfect the House:

Disinfect high-contact surfaces, such as tabletops, doorknobs, light switches, toilets, faucets, and electronics daily. You can use soap and water to clean the dirty surface and then use a disinfectant. You can use 0.1 % sodium hypochlorite or an EPA-registered disinfectant. Mobile phones should be cleaned using alcohol-based (70 % alcohol) wipes or spray.

In case you share a bathroom with the patient, the toilet should be disinfected after every time he or she uses it.

Disposing Gloves and Masks:

Gloves, masks, and other disposable protective wear should be discarded in a closed bin. The waste should then be carefully disposed of as infectious waste.

Utility or reusable gloves and aprons should be cleaned with water and soap and then disinfected with 0.1 % sodium hypochlorite solution. It is best to use disposable gloves.

Check Yourself Regularly:

Take your temperature readings every day. As you come in close contact with the infected person on a regular basis, contact a doctor immediately if you develop fever, cough, breathing difficulty, or any other symptoms.

How to Care for a COVID-19 Patient?

Keeping the above precautionary measures in mind, care for the patient. You can:

• Help him or her follow the doctor’s instructions and medicines.

• Make them drink plenty of water and fluids to prevent dehydration.

• Get groceries, medicines, and other things he or she needs.

• Keep the doctor informed about the patient’s progress.

• Call the ambulance or get help immediately if the patient has:

  • Breathing difficulty.

  • Chest pain or pressure.

  • Bluish lips.

How Can the Quarantined or Isolated Person Help?

If you are in home quarantine or isolation for suspected or confirmed COVID-19, you should:

• Wear a surgical mask at all times, especially when your caregiver is close. This will limit the spread of the virus.

• Change your mask every 6 to 8 hours and throw it in a covered bin.

• Never reuse a disposable mask.

• Stay away from older adults, children, pregnant women, and people with chronic illnesses.

• Avoid moving around the house.

• Never attend any social gathering.

• Wash your hand using soap and water as often and as thoroughly as possible.

• Do not share your glasses, cups, towels, etc., with others.

• In case you develop new symptoms or if your condition is worsening, immediately inform your doctor.

When and How to End Home Isolation or Quarantine?

If you had symptoms, tested positive, and are isolated at home, you can leave the house:

• After being tested negative twice in a row (at least 24 hours apart).

• No fever in the last 72 hours without medicine.

• Significant improvement in other symptoms such as cough or shortness of breath.

If you tested positive and did not have symptoms from the start, then you can leave the house:

• No development of symptoms in the last 10 days.

• After being tested negative twice in a row (at least 24 hours apart).

If you are in home quarantine, then you have to stay at home for at least 14 days, because that is the incubation period for SARS-COV-2. If you do not develop any symptoms during these 14 days, you can end your home quarantine after talking to your doctor.

Infected patients with a weak immune system can shed the virus even after recovery. So do not make the decision to end quarantine on your own.

These guidelines can vary depending on your country and government rules. Make sure you cover your nose and mouth, maintain social distancing, and wash your hands properly.