New Delhi, The Health Ministry has issued guidelines for home isolation of very mild and pre-symptomatic Covid-19 cases under which a patient can stay at home but will have to be in touch constantly with the District Surveillance Officer, and a hospital and will have to sign an undertaking.

The present guidelines are in addition to guidelines on appropriate management of suspect/confirmed cases of Covid-19 issued by the Health Ministry on April 7.

All suspected (awaiting test results) and confirmed cases of Covid-19 disease are currently being isolated and managed in a hospital setting with the intent to break the chain of transmission. As per existing guidelines, during the containment phase, the patients should be clinically assigned as very mild/mild, moderate or severe and accordingly admitted to (i) Covid Care Centre, (ii) Dedicated Covid Health Centre or (iii) Dedicated Covid Hospital respectively.

"However, very mild/presymptomatic patients having the requisite facility at his/her residence for self-isolation will have the option for home isolation," the guidelines said.

The eligibility for home isolation is that the person should be clinically assigned as a very mild case/pre-symptomatic case by the treating medical officer. Such cases should have the requisite facility at their residence for self-isolation and also for quarantining the family contacts.

A caregiver should be available to provide care on a 24 x7 basis. A communication link between the caregiver and hospital is a prerequisite for the entire duration of home isolation. The caregiver and all close contacts of such cases should take Hydroxychloroquine prophylaxis as per protocol and as prescribed by the treating medical officer.

As per the guidelines, the patient shall agree to monitor his health and regularly inform his/her health status to the District Surveillance Officer for further follow up by the surveillance teams.

The patient will also fill in an undertaking on self-isolation and shall follow home quarantine guidelines.

The guidelines said that the patient or caregiver will keep monitoring their health and immediate medical attention must be sought if serious signs or symptoms develop. These could include difficulty in breathing, persistent pain/pressure in the chest, mental confusion or inability to arouse, developing bluish discolorations of lips/face and as advised by treating medical officers.

On when to discontinue home isolation, the guidelines said that patients under home isolation will end home isolation if symptoms are clinically resolved and the surveillance medical officer certifies him/her to be free of infection after laboratory testing.

Instructions for care-givers are to wear a triple layer medical mask appropriately when in the same room with the ill person. Hand hygiene must be ensured following contact with an ill person or their immediate environment, as well as before and after preparing food, before eating, after using the toilet, and whenever hands look dirty.

Caregivers have been asked to avoid direct contact with body fluids of the patient, particularly oral or respiratory secretions. Disposable gloves are to be used while handling the patient, and hand hygiene done before and after removing gloves.

They also must avoid exposure to potentially contaminated items in the patient's immediate environment (e.g. avoid·sharing cigarettes, eating utensils, dishes, drinks, used towels or bed linen).

The patient should at all times use a triple layer medical mask and discard mask after 8 hours of use or earlier if they become wet or visibly soiled.

The patient must stay in the identified room and away from other people in home, especially the elderly, and those with co-morbid conditions like hypertension, cardiovascular disease, renal disease.

The patient must take rest and drink lots of fluids to maintain adequate hydration, and follow respiratory etiquette all the time.