Assam issues new guidelines for home isolation of COVID-19 patients

The government of Assam has issued a fresh set of guidelines for home or institutional isolation of COVID-19 patients starting Monday, May 17.

The Health department said it has been taking all possible steps for the management and treatment of COVID-19 positive patients in the wake of the second wave of the pandemic in the state.

The capacity of beds in hospitals has been ramped up and COVID Care Centres are being set up to accommodate asymptomatic and mildly symptomatic patients.

“Many individuals who tested positive have been insisting on undergoing isolation at home, and have been allowed to do so, but with certain conditions,” the Assam government’s notification says.

Home isolation of COVID-19 patients comes at a risk of transmitting the virus to other residents in the house and the neighbourhood. Home isolation also leads to complications in some cases, especially among those above the age of 50 and those with co-morbidities, the Health department said.

“It has been seen that a large number of patients who opted for home isolation are falling seriously ill as a result of not following home isolation guidelines and medications carefully,” the notification says.

According to the Assam government, the Health & Family Welfare Department has deployed all available medical personnel to take care of the patients in Government facilities, and hence, it is not possible to spare medical staff to monitor the condition of each COVID-19 patient under home isolation. “The ambulances of the Health department are also fully engaged in the transfer of patients. Hence, it may be difficult to provide an ambulance for a patient who has opted for home isolation, if their condition rapidly deteriorates while at home.”

To deal with the situation, the Health department has modified the guidelines for home isolation:

1. COVID-19 patients, who are aged 50 years and above or with co-morbidities shall be strictly advised to undergo institutional isolation as per COVID treatment protocol applicable.
2. They shall undergo 7 days of Institutional isolation under medical supervision and shall be eligible for all supports including refreshment etc. as notified Iron, from time to time. After discharge, following the discharge protocol, they shall complete another 7 days of home isolation.
3. Those above 50 years and above or with co-morbidities will be allowed home isolation only if they fulfil the other criteria of home isolation as follows:

• The patient is asymptomatic, and that he/she is, prima facie, in good clinical condition without serious co-morbid conditions certified by a medical practitioner.
• There is a separate well-ventilated room with a separate toilet for the person in isolation. If there is no such arrangement for a separate toilet and well-ventilated room, then Home Isolation will not be permitted.
• No person is living in the house along with the patient, who is above 60 years of age with co-morbidities/ a pregnant lady/ and others in the high-risk category in respect of COVID- 19.
• The entire residence shall be converted to a containment zone for 14 days. All persons living in the house along with the patient shall voluntarily get themselves tested for COVID-19 on the 4th day after the beginning of the home isolation period. In case, any of these persons develop symptoms they will riot wait for the 4th day and shall get tested immediately in the nearest testing centre.
• In case of the residence of the patient being located in an apartment or densely packed neighbourhood, and the neighbours object to the home Isolation on reasonable and good grounds, then the patient will have to be shifted to a hospital.
• The patient has to isolate himself at home and all the family members including the patient have to wear a mask all the time.
• A caregiver should be available to provide care on a 24 x7 basis. The caregiver should follow all protocols strictly so as not to spread infection. The caregiver should also take prophylaxis treatment as per protocol.
• The patient/guardian shall arrange for a private medical practitioner to regularly monitor the patient’s condition in a person or through tele/video-link. Without a private medical practitioner engaged, Home Isolation will not be granted.
• During the period of home isolation, the patient shall strictly adhere to the medical advice given by the medical practitioner and also strictly follow hygiene and social distancing norms in the residence.
• The patient shall keep a fingertip pulse oximeter and thermometer at hand, and keep a proper record of the oxygen saturation level, pulse rate, and temperature readings at regular intervals. In case, the oxygen saturation level falls below 95% or there are any life-threatening symptoms and signs, the patient shall be shifted to a hospital by the guardian/caregiver immediately.
• As the Government ambulances are fully engaged in ferrying patients to Government facilities at all hours, the patient/guardian must make arrangements for a private vehicle to be available at all hours, in case the need arises to shift the patient to a private hospital, which is treating COVID patients or to Government COVID hospital. This should be intimated to 104 immediately. However, 108 assistances shall be provided wherever possible.
• The patient/guardian shall make arrangements for treatment in a private sector hospital if the need arises. However, the said patient will be allowed to be treated in a Government facility, if he/she so desires.
• The 104 team is regularly calling patients who have opted for home isolation in the Kamrup Metro district. The patients in Home isolation are to cooperate with the 104 callers and give correct information as asked for.
• Each District will set up telemedicine service for the patients in Home isolation.
• One ADC rank officer shall be designated as nodal officer for issues relating to home isolation in the district. Another officer not below the rank of Assistant Commissioner shall be similarly designated to look after telemedicine /call centre services.
• The Sampark team, stationed at NHM headquarters, consisting of a dedicated team of Doctors and counsellors, are calling all Covid Home isolation positive patients. Patients in Home Isolation may call the Sampark team in case of emergencies or for medical advice through the eSanjeevani OPO app and call directly in the number from which calls were made to the patient between 10 AM to 10 PM.
• A patient who has completed 14 days of home isolation without any complications shall be deemed to be discharged, in consultation with State Dis-charge Board. 104 and Sampark team will advise accordingly.
• All patients in Home isolation are to cooperate with the District Administration, the 104 and SAMPARK team. Anyone not cooperating will be mandatorily shifted to Health facilities run by Government.
• An undertaking is to be furnished by the COVID-19 patient seeking Home Isolation, in the format at ANNEXURE-I mandatorily to the district administration
• Correct information and phone number are to be given in the undertaking. In case false information is provided then Health & Family Welfare department reserves the right to revoke permission for Home Isolation and impose a penalty. It is mandatory for Home Isolation patients to respond to follow-up calls.

District Administration of KamrupMetro took to Twitter to announce the fresh guidelines for home isolation in the state.

Originally tweeted by Kamrup Metro District Administration (@DCKamrupMetro) on May 18, 2021.

Also read: 270 doctors have died of COVID-19 in second wave: IMA