A resurgent coronavirus is starting to overwhelm hospitals with patients queueing up for admission. For asymptomatic and mild cases, home care is an option, as prescribed by the World Health Organization, as long as it is coordinated with health professionals, experts said.
Before home care is considered, three things must be considered: Does the patient qualify? Is the home setup appropriate? Can the caregiver assess the patient properly?
"The current surge in cases has severely challenged the health care system in NCR and many areas in the country. Many of the expected COVID cases are expected to be mild," said Dr. Anna Ong-Lim, co-convenor of the Healthcare Professional Alliance Against COVID-19.
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Who qualifies for COVID home care?
Lim cited guidelines from the World Health Organization:
- Asymptomatic, mild or moderate cases without risk factors
- Those with no shortness of breath, with a respiratory rate that is less than 30 breaths per minute, can speak in full sentences and if measurable, with 94% oxygen saturation
- Those who are not considered at risk: those above 60, smokers, those with heart, kidney or lung disease, cancer patients, those who are immunosuppressed
What is the appropriate setup for COVID home care?
- The patient must have a separate room for isolation with good air flow, a door that closes and is positioned in such a way that they have minimal contact with the rest of the household
- The caregiver must wear a face mask and face shield when delivering supplies to the patient. A PPE will help if available.
- The patient must wear only medical grade face masks
- As much as possible, supplies should be left by the patient's door.
- Medical grade masks and gloves must be disposed after use. Heavy duty gloves and cloth masks must be washed with soap and water.
- Ideally, there should be just one caregiver.
- The patient must have dedicated utensils and linens that must be washed properly.
- The patient, ideally, should have their own bathroom.
What should be in a COVID home care kit?
- A stash of face masks, face shields, gloves, alcohol, soap and water.
- Disinfection solution of 45 ml of bleach per liter of water. Ideally, this should be used within the day to ensure its effectivity. Avoid storing it.
- Monitoring equipment for temperature, blood pressure.
- Cough and cold medicine, maintenance medicine.
Can families who are all positive isolate together?
Yes, according to Ong-Lim, as long as they are mild or asymptomatic.
In case one or more is not positive, they should quarantine for 14 days from their last contact with an infected person. The quarantine for negative contacts is actually longer. COVID patients are no longer contagious after 10 days, she said.
How should COVID patients be monitored?
- The assigned caregiver should be reliable, should not be sick and should not have co-morbidities or risk factors.
- The caregiver should have an open line with a trained health worker or public health professional.
- The caregiver should watch out for danger signs: troubled breathing, difficulty in speaking, pain or pressure in the chest, feeling of confusion or being disoriented, difficulty to stay awake, bluish or gray complexion.