COVID-19

In the wake of the Coronavirus outbreak which has wreaked havoc across the world with authorities of various countries undertaking a raft of measures to combat the situation. Awareness and safety measures are key to keep the virus at bay. Let’s know about different facets of quarantine which is a necessary step to tackle COVID-19.

Why is home quarantine required?

COVID-19 is said to spread mainly through contact with respiratory droplets. The droplets landing on objects and surfaces after a sneeze or cough by an infected person, when touched or breathed by a healthy individual cause the transmission of the infection. Along with multiple measures taken by central and state governments Home quarantine is one of the most cost effective public health intervention to break the chain of transmission in absence of any definite vaccine and treatment.

Significant number of total cases is attributed to the primary contacts of covid 19 positive cases. It is very essential for the contacts to follow the instructions of the government health authorities with respect to home isolation.

Who is a “contact” with respect to Covid-19? :-

A contact is defined as a healthy person that has been in such association with an infected person or a contaminated environment as to have exposed and is therefore at a higher risk of developing disease. A contact in the context of COVID-19 is a person living in the same household as a COVID-19 case or a person having had direct physical contact with a COVID-19 case or his/her infectious secretions without recommended personal protective equipment (PPE) or with a possible breach of PPE or a person who was in a closed environment or had face to face contact with a COVID-19 case at a distance of within 1 metre including air travel. The epidemiological link may have occurred within a 14‐day period before the onset of illness in the case under consideration. Home quarantine is for 14 days.

Responsibilities of a person who is home quarantined:-

· Should stay in a well-ventilated single-room preferably with an attached/separate toilet.

· If another family member needs to stay in the same room, it’s advisable to maintain a distance of at least 1 meter between the two.

· He/she needs to stay away from elderly people, pregnant women, children and persons with co-morbidities within the household and also to restrict his/her movement within the house.

· Under no circumstances he/she shall attend any social/religious gathering e.g. wedding, condolences, etc.

The public health measures to be followed by a home quarantined person are:

· He/she should wash hand as often thoroughly with soap and water or with alcohol-based hand sanitizer.

· Should avoid sharing household items e.g. dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items with other people at home.

· Should wear a surgical mask at all the time. The mask should be changed every 6-8 hours and disposed off. Disposable masks are never to be reused.

· Masks used by patients / care givers/ close contacts during home care should be disinfected using ordinary bleach solution (5%) or sodium hypochlorite solution (1%) and then disposed of either by burning or deep burial.

· Used mask should be considered as potentially infected.

· If symptoms appear (cough/fever/difficulty in breathing), he/she should immediately inform the nearest health centre or call 011-23978046.

Instructions to family members of a person being home quarantines are:

· Only an assigned family member should be tasked with taking care of such person.

· Avoid shaking the soiled linen or direct contact with skin.

· Use disposable gloves when cleaning the surfaces or handling soiled linen.

· Wash hands after removing gloves.

· Visitors should not be allowed.

· In case the person being quarantined becomes symptomatic, all his close contacts will be home quarantined (for 14 days) and followed up for an additional 14 days or till the report of such case turns out negative on lab testing.

Environmental sanitation

· Clean and disinfect frequently touched surfaces in the quarantined person’s room (e.g. bed frames, tables etc.) daily with 1%Sodium Hypochlorite Solution.

· Clean and disinfect toilet surfaces daily with regular household bleach solution/phenolic disinfectants

· Clean the clothes and other linen used by the person separately using common household detergent and dry.

District surveillance department is closely monitoring and ensuring the implementation of the protocol for home isolation.

Due to some unavoidable reasons if it is not possible for the individual to practice the protocol of home quarantine or it is brought to the notice of public health authorizes that it is not being followed the state will make necessary arrangement towards quarantine of these individuals.

Disclaimer: The article is based on the guidelines as on today i.e. 28th March 2020. As per the requirement the protocol regarding isolation of contacts may change. It has been written by Dr M Vijayakumar, Vice chancellor, Yenepoya (deemed to be University), Dr Abhay Nirgude, Associate Dean, Yenepoya medical College, Mangaluru, and Dr Pavithra Adarsh, Department of Community Medicine.

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