The Centre on Thursday made it clear to those in the home isolation not to hanker for anti-viral drug Remdesivir or any other investigational therapy meant to be administered only in a hospital setting.
The advice comes amid huge demand for Remdesivir among others which has led to its shortage as well as hoarding with blackmarketeers making huge profits.
The “Revised guidelines for home isolation of mild/asymptomatic Covid-19 cases”, also stated that systemic oral steroids are not indicated in mild cases and if the symptoms (persistent fever, worsening cough etc.) persist beyond seven days, the treating doctor should be consulted for treatment with low-dose oral steroids.
It also advised the patients to be kept in well-ventilated rooms with cross-ventilation while the windows should be kept open to allow fresh air to come in and should at all times use a triple-layer medical mask.
“The mask should be discarded after eight hours of use or earlier if they become wet or visibly soiled. In the event of the caregiver entering the room, both the caregiver and the patient may consider using the N95 mask,” it said.
Elderly patients aged more than 60 years and those with co-morbid conditions such as hypertension, diabetes, heart disease, chronic lung or liver or kidney disease, cerebrovascular disease etc. Shall only be allowed home isolation after a proper evaluation by the treating medical officer, it added.
At the same time, patients suffering from an immune compromised status (HIV positive, transplant recipients, cancer therapy etc.) are not recommended for home isolation and shall only be allowed home isolation after a proper evaluation, the guidelines read.
In case of falling oxygen saturation levels or shortness of breath, the person should require hospital admission and seek immediate consultation with the treating physician or surveillance team.
According to the revised guidelines, the patients may perform warm-water gargles or take steam inhalation twice a day. “If fever is not controlled with a maximum dose of tab. Paracetamol 650 mg four times a day, consult the treating doctor, who may consider advising other drugs like non-steroidal anti-inflammatory drug (NSAID) (ex: tab. Naproxen 250 mg twice a day).
“Tab. Ivermectin (200 mcg/kg once a day, to be taken on empty stomach) for 3 to 5 days should be considered,” the guidelines said adding that inhalational Budesonide (given via inhalers with spacer at a dose of 800 mcg twice daily for five to seven days) to be given if the symptoms (fever and/or cough) persist beyond five days.
“Do not attempt to procure or administer Remdesivir at home. Systemic oral steroids are not indicated in mild disease. If symptoms persist beyond seven days (persistent fever, worsening cough etc.), consult the treating doctor for treatment with low-dose oral steroids,” the guidelines said.
It further said that the asymptomatic cases are laboratory-confirmed cases that are not experiencing any symptoms and having oxygen saturation at room air of more than 94 per cent, while the mild cases are patients with upper respiratory tract symptoms (and/or fever) without shortness of breath and having oxygen saturation at room air of more than 94 per cent.
The caregiver and all close contacts of such cases should take Hydroxychloroquine prophylaxis in accordance with the protocol and as prescribed. “Ensure cleaning of surfaces in the room that are touched often (tabletops, doorknobs, handles etc.) with a one-per cent hypochlorite solution. Self-monitoring of blood oxygen saturation with a pulse oximeter is strongly advised.”
Patients under home isolation will stand discharged after at least 10 days have passed from the onset of the symptoms (or from the date of sampling for asymptomatic cases) and no fever for three days. There is no need for testing after the home isolation period is over, the document said.
