COVID-19: How to take care of COVID-19 patient at home.

What is Coronavirus Pandemic?

A disease named as COVID-19 or Coronavirus disease 2019 was declared as a global pandemic by world health organization (WHO). It was initially reported in December 2019 that a new virus of corona family has started infecting humans being in Wuhan city of China. It was also stated that the reported Coronavirus causes illness like Severe Acute Respiratory Syndrome Coronavirus-2 abbreviated as SARS-Cov-2.

Covid-19 Pandemic and HealthCare System of Modern World.

Since December 2019 Coronavirus has wrapped the whole world in his curse and has infected more than 8 million peoples and approximately 0.5 million peoples have lost hope of life due to SARS-Cov-2. Such a huge flow of SARS-Cov-2 patients crashed the health systems of even advanced countries like Italy, Spain, and America, etc. It was difficult to take care of each patient in the hospital for which an alternate proposal was proposed to take care of patients at home and was adopted across the whole world. The focus of this article is also on the home care of Coronavirus patients. In this article, we are going to explain that for which patient and in which case the home care should be considered. It will also explain how the patient should care at home.

When home care should be considered for coronavirus patient?

Home care for SARS-Cov-2 patients should only be considered in the following cases

• When the illness is mild.
• When the patient is symptomatic but no longer require hospitalization.
•  An informed decision has been made to refuse hospitalization.
• When inpatient care is unavailable or unsafe.
• When capacity is limited or resources are unable to meet the demands.

In any of these situations, patients with mild symptoms and without underlying chronic conditions such as lung or heart disease, renal failure, or other immune compromising conditions that place patients at increased risk of developing complications may be cared for at home.

How the COVID-19 patient should be cared at home?

Caring COVID-19 patients at home, a communication link with a doctor or healthcare provider, or public health personal or both should be established for the duration of the home care period that is until the patient’s symptoms have completely resolved.

Further care of Coronavirus patients at home is categorized in the following section.

1. Isolation of COVID-19 Patients

The coronavirus patient should be isolated from the other household member as much as possible. The place (room and attached section of home such bathroom etc.) in which the patient is isolated must be well ventilated.
Minimize the numbers of caregivers as much as possible, if possible assign a single person who has no chronic or immune compromising conditions and is in good health. No visitors should be allowed to the patient until the patient has completely recovered.

2. Hygiene and Disinfection

Perfect hand and body hygiene should be performed after any type of contact with the patient or his immediate environment. The hygiene should be performed by using soap and standard sanitizers. Use disposable towels for drying hands and body if this is not possible use a cloth towel and then replace it when becoming wet.
The patient and caregiver should use mask or cover the mouth and nose as much as possible. If you cannot tolerate wearing a medical mask then you should do rigorous respiratory hygiene to avoid contamination of the environment by respiratory secretions.

The mask and material used to cover the mouth and nose should be discarded if not possible cleaned them appropriately after use.

Do not touch directly the oral or respiratory secretion and stools of COVID-19 patients. Use disposable gloves and mask to perform proper hygiene before and after removing masks and gloves.

Clean and disinfect daily surfaces that are frequently touched in the room where the patient is being cared for such as bed, side tables, bed frames, bedroom furniture, bathroom, and toilet surfaces at least once daily with soap, detergent, and water and then with 0.5% sodium hydrochloride.

Also, clean the wearing and underuse utensils of Coronavirus patients in the same way and avoid exposure to the contaminated things of patients.

3.  Medication for Covid-19 Patient.

Since the beginning of this pandemic, the researchers are in a race to discover treatment and vaccines for this disease named as SARS-Cov-2. But until this current date of 17/06/2020, no proven treatment and vaccine is discovered. However, healthcare professionals are prioritizing different medicines in different categories based on their clinical trial experience which are discussed below.

3.1. Anti-Viral

For treating primary infection caused by Coronavirus different anti-viral drugs have been used in clinical trials across the world. Among which hope of success has been shown by an anti-viral drug remdesivir in clinical trials in the United States.

The result of clinical trials shows that remdesivir reduce the span of recovery of COVID-19 patients from 15 days to 11 days based on these results the remdesivir got approval from the Food and Drug Administration (FDA) of the United States. Still, some other medicines are under trials.

3.2. Antibiotics

The infection caused by Coronavirus weak the immune system of the patient that makes the patient vulnerable to secondary infection. As there is no empirical therapy for treating this condition but different antibiotics are used for this purpose which includes azithromycin 250 mg two times a day. If this causes diarrhea, do not stop diarrhea use ORS to recover if not possible then replace azithromycin by levofloxacin 500mg.

In addition to azithromycin or levofloxacin also use ceftriaxone 1gm intravenous and Vibramycin in tablets form.

3.3. Other Medicines

If the patient has no stomach ulcer use low dose Disprin because blood starts to clot in vessels especially in young people when infiltrates and inflammation occurs in the lungs. Use low dose Disprin to ensure proper blood circulation in the body.

Use anti-histamine fexit 60mg daily once for irritation of throat.

Use hydro chloroquine 2 tablets 2 times a day for seven days.

If fever spikes occur the patient should both immediately and take 2 Panadol tablets to avoid the use of Ibuprofen.

In a recent study, published by the Oxford University of United Kingdom, it is claimed that the use of dexamethasone in seriously ill patients of COVID-19, that are either on a ventilator or taking other respiratory support, can reduce the death ratio remarkably. Dexamethasone is an immune compressor so the decision to use dexamethasone should be taken by the Doctors.    

Note- All these medicines are suggested for normal patients of Coronavirus if the patient has other issues like diabetes, liver, kidney, and heart chronic disease then please consult with the doctor.

4. Routine Examination of COVID-19 Patients.

COVID-19 patients should be under proper monitoring for which the following tests will be performed on a regular basis.

• Complete Blood Count-CBC
• C- Reactive Protein-CRP
• D-Dimer Test

If there is an elevation in the test values, then immediately contact a doctor.

5. Techniques Used to Help Coronavirus patient.

There are some techniques that are in use from 1970 in vibrant pneumonia patients which are also adopted for the relief of current SARS-Cov-2 patients across the world and gives better result these techniques include the following steps.

4.1. Taking Long and Deep Breath

In SARS-Cov-2 the oxygen concentration decreases in the blood to meet the demands of oxygen the breathing rate increases and the stress on the lung increases and stress on the lung increases. To get relief the patient should take a long deep breath for 5 seconds at least five times in each iteration.

4.2. Gently Walk or Move Body Parts

The patient should not lie still on the bed. He should walk gently or move his body parts that will help him to circulate blood in the body.

4.3. Lie on Chest (Prone Position)

The patient should not lie down on his back instead lie on the chest that is in Prone Position by doing this more oxygen enter in his lungs. Basically lungs in the body are towards the rear side (close to back) not towards the front side. So when you lie on back the organs in the chest put pressure on the lungs. And hence patient feel difficulty in breathing. This is the most critical condition in about 19-20 % seen ARDS vibrant Pneumonia in which lungs fail. The patient should go on a ventilator that damaged the lungs by pushing oxygen with pressure.

4.4. Drinking More Water

Drink plenty of water with more water in the body immune system work properly.

Covid-19: When to end Home Isolation?

According to the updated CDC guidelines, the Covid-19 patients should end their home isolation based on the Test based information or on the basis of the time span from illness to recovery.

On the Test based information, the guidelines are clear, the patient should not end its isolation until the test result comes negative.

On the basis of the time span, the Covid-19 patient should note time from the first appearance of symptoms to the disappearance of symptoms. And should end isolation in the following situation.

• At least when the time span is 14 days from illness to recovery.
• Or at least after three days of disappearance of symptoms (disappearance of fever without medication).