Chronicle Editor
Tatenda Simango
I hope I find you well and in good spirits.
We are going through unusual and uncertain times. There has been an increase in Covid-19 cases being detected in the past few weeks. Most of the cases are being managed at home under self-quarantine.
Most people who get sick with Covid-19 have mild illness and have been able to recover at home. This article is going to highlight World Health Organisation guidelines on how to manage such cases in a manner that will ensure safe recovery while curbing further transmission to other family members they live with.
The patient should be placed in a well-ventilated single room (open windows and door). Other family members should stay in different rooms. If not possible, a distance of at least one meter should be maintained from the patient; sleep in separate beds, limit the number of caregivers, ideally one person who is in good health with no underlying medical conditions and strictly no visitors policy should be abided to until the patient has completely recovered.
Hand hygiene after any type of contact should be practised. Hand hygiene when preparing food, before and after eating, after using the toilet and when hands are dirty. An alcohol-based sanitiser may also be used. Disposable paper towels may be used to dry hands and if you choose to use cloth towels, you will need to wash them frequently.
A medical mask or simple cloth face coverings — these can be fashioned from household items or made at home at low cost — should be provided to the patient and to be worn as much as possible. If the patient cannot tolerate a mask, they should use rigorous respiratory hygiene, covering mouth and nose with paper tissue when coughing and disposing after.
The caregiver should wear a mask that covers their mouth and nose when in the same room. Masks should not be touched or handled during use and cloth face covering should be routinely washed.
Procedures for putting on surgical masks:
Position the mask to cover both nose and mouth.
Tie the two top ties first, firmly at the back of the head. Tie the two bottom ties at the back of the neck. Bend the flexible metal tab above the bridge of the nose to help secure the mask. The mask should conform to the shape of the face to minimise venting at the sides.
When using the mask with elastic bands, position the mask to cover both the nose and mouth with the bands looped behind each ear. Adjust the flexible metal tab as described above. Once in position, handling of the mask and talking should be minimised.
A surgical mask becomes an ineffective barrier if the integrity is damaged or if it becomes wet (from perspiration, or if splashed with blood or other potentially infectious material). If this occurs, remove the mask and replace with another.
The mask should be removed after the gown and gloves.
Untie the bottom ties then untie the top ties, being careful not to let go of the mask with both hands. Masks with elastic bands should be removed by unlooping the bands from behind each ear, being careful not to drop the mask. Used masks must not be crushed or squeezed before discarding into a waste receptacle or washing basket — hold the mask by the string or rubber band.
Discard used masks into an infectious waste container. Clean hands with sanitiser or soap under running water. Avoid direct contact with body fluids, particularly oral and respiratory secretions and stools. Use disposable gloves when handling urine, stool, sputum pots and other waste. If gloves are available, make sure to thoroughly wash your hands with soap for at least 20 seconds after handling the infectious waste. Do not reuse disposable masks and gloves.
Procedures for putting on and removing gloves:
Donning (putting on) of gloves — always check gloves for damage before using them. Use the correct size, that is, gloves that fit the hands.
Doffing (removing) — remove gloves and discard after single use or after handling specimens. To remove gloves, grasp the cuffed end of one glove with the other gloved hand and carefully pull off the held glove in a motion directed away from the body. Then either dispose of this glove or hold it in the remaining gloved hand. Remove the second glove by placing a finger from the un-gloved hand between the cuff of the remaining glove and the skin of the wrist to form a hook. Remove the second glove with a peeling motion, pulling it inside out and enclosing the other glove, if it is being held by that hand during the process.
Take care not to splash other people or surfaces. Discard used gloves into the appropriate waste receptacle for infectious waste. Wash hands after removal of gloves.
Use dedicated linen and eating utensils for the patient; these items should be cleaned with soap and water after use and may be re-used instead of being discarded. Daily, clean and disinfect surfaces that are frequently touched in the room where the patient is being cared for, such as bedside tables, bedframes, and other bedroom furniture.
Regular household soap or detergent should be used first for cleaning. After rinsing, use regular household disinfectant containing 0,1 percent sodium hypochlorite, for example bleach solution. Clean and disinfect bathroom and toilet surfaces at least once daily using bleach solutions. Place contaminated linen into a laundry bag.
Do not shake soiled laundry and avoid contaminated materials coming into contact with skin and clothes.
Avoid other types of exposure to contaminated items from the patient’s immediate environment (for example do not share toothbrushes, cigarettes, eating utensils, dishes, drinks, towels, washcloths or bed linen).
Persons (including caregivers) who have been exposed to individuals with suspected Covid-19 are considered contacts and should be advised to monitor their health for 14 days from the last day of possible contact.
This article is a summary of the article released on March 17, 2020 by WHO on Home care for patients with Covid-19 presenting with mild symptoms and management of their contacts
Online Reporter