Home care for patients with suspected Covid-19

For those presenting with mild illness, hospitalisation may not be possible because of the burden on the health care system, or required unless there is concern about rapid deterioration.

World Health Organisation has provided some guidelines which household members should adhere to when caring for a suspected Covid-19 patient at home:

• Place the patient in a well-ventilated single room which has open windows and an open door.

• Limit the movement of the patient in the house and minimize shared space. Ensure that shared spaces such as kitchen and bathroom are well ventilated.

• Household members should stay in a different room or, if that is not possible, maintain a distance of at least 1 metre from the ill person.

• Limit the number of caregivers. Ideally, assign one person who is in good health and has no underlying chronic or immunocompromising conditions. Visitors should not be allowed until the patient has completely recovered and has no signs or symptoms of Covid-19.

• 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 frequently.

• To contain respiratory secretions, a medical mask should be provided to the patient and worn as much as possible, and changed daily. Individuals who cannot tolerate a medical mask should use rigorous respiratory hygiene; that is, the mouth and nose should be covered with a disposable paper tissue when coughing or sneezing. Materials used to cover the mouth and nose should be discarded or cleaned appropriately using regular soap or detergent and water.

• Caregivers should wear a medical mask that covers their mouth and nose when in the same room as the patient. Masks should not be touched or handled during use. If the mask gets wet or dirty from secretions, it must be replaced immediately with a new clean, dry mask. An exception may be made for breastfeeding mothers. Considering the benefits of breastfeeding and the insignificant role of breast milk in the transmission of other respiratory viruses, a mother could can continue breastfeeding. The mother should wear a medical mask when she is near her baby and perform hand hygiene before and after having close contact with the baby.

• Avoid direct contact with body fluids, particularly oral or respiratory secretions, and stool. Use disposable gloves and a mask when providing oral or respiratory care and when handling stool, urine, and other waste. 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.

• Daily clean and disinfect surfaces that are frequently touched in the room where the patient is being cared for, such as bedside tables, bedframes, and other bedroom furniture. Regular household soap or detergent should be used first for cleaning, and then, after rinsing, regular household disinfectant containing 0.1% sodium hypochlorite (i.e. equivalent to 1000 ppm) should be applied.

• Clean and disinfect bathroom and toilet surfaces at least once daily. Regular household soap or detergent should be used first for cleaning, and then, after rinsing, regular household disinfectant containing 0.1% sodium hypochlorite 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. Place contaminated linen into a laundry bag. Do not shake soiled laundry and avoid contaminated materials coming into contact with skin and clothes.

• Gloves and protective clothing should be used when cleaning surfaces or handling clothing or linen soiled with body fluids. Depending on the context, either utility or single-use gloves can be used. After use, utility gloves should be cleaned with soap and water and decontaminated with 0.1% sodium hypochlorite solution. Single-use gloves should be discarded after each use. Perform hand hygiene before putting on and after removing gloves.

• Gloves, masks, and other waste generated during home care should be placed into a waste bin with a lid in the patient's room before disposing of it as infectious waste.

• Avoid other types of exposure to contaminated items from the patient's immediate environment such as do not share toothbrushes, cigarettes, eating utensils, dishes, drinks, towels, washcloths, or bed linen.