COVID-19: Home isolation guidelines for mild, asymptomatic cases revised; Details here

As Omicron cases surge across India, the Union Health Ministry on Wednesday issued revised guidelines for asymptomatic COVID-19 patients who are under home isolation or showing mild symptoms.

As per the new rules, patients under home isolation will stand discharged and can end isolation after at least 7 days have passed from testing positive and have no fever for 3 successive days. There is no need for re-testing after the home isolation period is over, the health ministry said. 

The present guidelines are applicable to COVID-19 patients who have been clinically assessed and assigned as mild /asymptomatic cases of COVID-19.

What are asymptomatic cases and mild cases of COVID-19?

The asymptomatic cases are laboratory-confirmed cases who are not experiencing any symptoms and have oxygen saturation at room air of more than 93%.

Clinically assigned mild cases are patients with upper respiratory tract symptoms with or without fever, without shortness of breath and having oxygen saturation at room air of more than 93%,

COVID-19 patients who are eligible for home isolation

• The patient should be clinically assigned as a mild/ asymptomatic case by the treating Medical Officer. Further, a designated control room contact number at the district /sub-district level will be provided to the family to get suitable guidance for testing, clinical management-related guidance, assignment of a hospital bed, if warranted.
• Such cases should have the required facility at their residence for self-isolation and for ‘quarantining the family contacts.'
• A caregiver (ideally someone who is fully vaccinated) should be available to provide care on a 24 x7 basis. A communication link between the ‘caregiver and a Medical Officer is a prerequisite during home Isolation.
• Elderly patients aged more than 60 years and those with co-morbid conditions such as Hypertension, Diabetes, Heart disease, Chronic lung/liver/ kidney disease, Cerebrovascular disease etc will only be allowed home isolation after proper evaluation by the treating medical officer.
• Patients suffering from immune-compromised status (HIV, Transplant recipients, Cancer therapy etc.) are not recommended for home isolation and shall only be allowed home isolation after proper evaluation by the treating Medical Officer.

Treatment for patients with mild /asymptomatic disease in home isolation

• Patients must be in communication with a treating Medical Officer and promptly report in case of any deterioration.
• The patient must continue medications for other co-morbidities/illnesses only after consulting the treating Medical Officer.
• Patient can use the teleconsultation platform made available by the district/state administration including the e-Sanjeevani tele-consultation platform.
• Patients must follow symptomatic management for fever, running nose and cough, as warranted.
• Patients may perform warm water gargles or take steam inhalation thrice a day.
• If fever is not controlled with a maximum dose of Tab. Paracetamol 650 mg four times a day, consult the treating doctor.
• Information floating through social media mentioning non-authentic and non-evidence-based treatment protocols can harm patients. Misinformation leads to the creation of panic and in turn undertaking tests and treatment which are not required has to be avoided.
• Do not rush for self-medication, blood investigation or radiological imaging Ike chest X-ray or chest CT scan without consultation of your treating Medical Officer.
• Steroids are not indicated in mild disease and shall not be self-administered. Overuse & Inappropriate use of steroids may lead to additional complications.
• Treatment for every patient needs to be monitored individually as per the specific condition of the patient concerned and hence generic sharing of prescriptions should be avoided.
• In case of falling oxygen saturation or shortness of breath, the person may require hospital admission and shall seek immediate consultation of their treating Medical Officer/surveillance team /Control room.

When to seek medical attention?

Patient / Caregiver will keep monitoring their health. Immediate medical attention must be sought if serious signs or symptoms develop. These could include-

• Unresolved High-grade fever (more than 100° F for more than 3 days)
• Difficulty in breathing
• Dip in oxygen saturation (Sp02 < 93% on room air at least 3 readings within 1 hour) or respiratory rate >24/ min
• Persistent pain/pressure in the chest, ‘Mental confusion or inability to arouse,
• Severe fatigue and myalgia