Government of Karnataka has introduced home isolation for COVID-19 positive persons since July 2020. The revised guidelines were issued on 10.08.2020 vide reference above. It is important to allow suitable COVID positive persons for home isolation following a triage. Triage is an important activity and when done meticulously will allow right persons in home isolation. These persons also need to be regularly monitored. When these activities are done correctly, deaths in home isolation do not occur. It is also important that an early recognition of warning signs and prompt referral to a hospital will be life-saving. In this context, districts are hereby instructed to strictly follow these guidelines:
Day 1
Person tested COVID-19 positive and opts for home isolation
- Telephonic triage/ physical triage should be done within 24 hours [Annexures 1 and 2]
- Triage form should be filled for every COVID-19 positive case reported
• Triage Activities:
- Enquire for symptoms and severity
- Enquire for any co-morbid conditions
- Measure temperature, pulse rate and oxygen saturation
- Clinical evaluation and recommended baseline investigations should be done for symptomatics and persons with co-morbid conditions
- Persons with co-morbidity shall be evaluated for good clinical control of the condition. If the co-morbidity is not under good clinical control, then the person is shifted to DCHC/COVID hospital.
- Blood: CBC, RBS, D-DIMER; Chest X-ray, etc.
- A technician in PPE kit collects blood sample from home / alternatively the patient is shifted to a nearby hospital/lab. for sample collection and chest x-ray
- Check whether the person has a room with toilet for oneself
- Verify suitability and acceptability of caregiver; mutually agreeable with COVID-19 positive person
- Clinical evaluation and recommended baseline investigations should be done for symptomatics and persons with co-morbid conditions
- Home care triage and follow-up: There shall be a mobile team (one doctor- MBBS/AYUSH and one staff nurse/ health-worker with a vehicle) for every 10- 20 persons in home isolation and depending on geographical
- The mobile team shall do initial triage and subsequently make house visits for all home isolated persons at least once in 3 davs. However, symptomatics and those with co-morbidity shall be visited every day to check for warning signs and symptoms. If any warning signs and symptoms are noticed, they shall be immediately transferred to the
- The mobile team shall carry necessary medical equipments like digital thermometer, fingertip pulse oximeter, essential and emergency drugs,
- If the person is found fit for home isolation, then:
- Obtain signed undertaking [Annexure-3]
- Downloads Arogyasetuapp
- Provide COVID-19 home care kit and train in use of digital thermometer and pulse oximeter. Provide instructions for use of other items in the kit
- Contents of COVID-19 Home care Kit
- Fingertip pulse oximeter with battery
- Digital thermometer
- Facemasks
- Hand sanitizer
- Gloves
- Tab. Zinc
- Tab Vitamin-C
- Tab Paracetamol
- Handout for person in home isolation/home care[Annexure-4]
- If the person is found not fit for home isolation, then:
- Shift the person to CCC/COVID hospital as appropriate in a dedicated ambulance
Day 2 to Day 10
- The mobile team shall make house visits for all home isolated persons at least once in 3 days. However, symptomatics and those with co-morbiditv shall be visited every dna to check for warning signs and If any warning signs and symptoms are noticed, they shall be immediately shifted to the hospital
- Telephonic monitoring shall be done once every day for all home isolated persons: o Temperature, pulse rate and oxygen saturation [Annexure-5]
- Enquire for symptoms and severity
- Enquire for warning signs and If any warning signs and symptoms are noticed, they shall be immediately shifted to the hospital
Day 11
- Tele-check the patient for temperature, pulse rate and oxygen saturation
- Enquire about recovery and absence of symptoms for last 3 days
- If no symptoms are reported during last 3 days:
- The person may be considered suitable for release/discharge from home isolation
- Advice one more week of strict self-isolation at home Day 12 to Day 17
- If the condition is good, instruct the person to stay indoors with face mask, physical distancing of over one meter from others and observing hand hygiene and respiratory etiquette
- The person shall self-report any symptoms during this period
Day 18
- The person shall be examined by a medical officer. If found fit,
- A “fitness certificate“ shall be issued by the treating medical officer/physician [Annexure-6]
- The person shall be allowed to resume his normal activities/duty
The data regarding triage done, persons allowed for home isolation, daily follow-up of persons in home isolation, number of home isolation patients referred to hospital admission shall be reviewed every day at PHC, Taluka and district level by Deputy Commissioner of the district/ Commissioner-BBMP. It is very important that if any deaths occur in home isolation, an audit shall be done immediately and followed by suitable action and a report sent.