Covid-19: Do's And Don'ts During Home Quarantine
What conditions allow a Covid-19 patient to be quarantined at home in Malaysia? What precautions should family members take when a loved one in their household tests positive for Covid-19? Read on to learn what Ministry of Health (MoH) SOPs apply to Covid-19 patients under home quarantine in this detailed guide by Thomson Hospital Kota Damansara consultant emergency physician, Dr Mohamed Al-Hadi Mohamed Razhi.
Patient requirements for home quarantine
After testing positive, patients will be assessed by a medical doctor on whether they meet the criteria for home quarantine. Adults who are below 60 years of age with no comorbidities or with stable, controlled comorbidities may be allowed to quarantine at home; the same applies to suitable obstetric patients (expecting mothers or women who have just given birth). Covid-19 patients who are 18 and below may also be eligible for home quarantine if they have a suitable caregiver and no comorbidities.
Patients on home quarantine must be contactable at all times by phone. They must be able to maintain a one-meter distance from other household members, and use separate eating utensils, tableware, towels and bedding. Ideally, they should quarantine in a separate bedroom with an attached bathroom that's not shared with other household members.
Home patients are required to wear face masks around their family members and to wash their hands regularly with soap and water for at least two minutes (or use a hand sanitiser). Patients must not use public transport but instead arrange for ambulance to pick them up or use a personal vehicle for hospital visits. Importantly, patients must be responsible for their health status every day on their MySejahtera app and monitor their symptoms closely.
Requirements for caregivers
Parents or caregivers of a Covid-19 patient should be available to continually monitor the patient's symptoms, ensuring that the patient is well-nourished, hydrated and well-rested. The caregiver must also be ready to call the Covid Assessment Centre (CAC) or 999 if the patient starts displaying breathing difficulties, chest pains, loss of speech or mobility, or confusion.
"Identify one household member to be the contact person for the Covid-19 patient; someone who is not at high risk," says Al-Hadi, cautioning against designating that role to pregnant women, adults over 60, immuno-compromised individuals, and anyone with heart disease, kidney disease, diabetes, chronic respiratory disease or other diseases deemed high risk by health personnel. "The designated caregiver should wear the appropriate personal protective equipment (PPE), a face mask and gloves when handling Covid-19 patient."
When in the same room with the patient, the caregiver must wear a 3-ply medical mask. Caregivers should also take special care to clean touched surfaces like door knobs, water faucets and other appliances after they have been exposed to the patient. Bathrooms used by Covid-19 patients should be cleaned and disinfected at least once a day with regular washing powder and a disinfection solution containing 0.1 per cent sodium hypochlorite.
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Caring for loved ones with Covid-19
Families with limited living space at home can also take certain steps to keep a safe distance from the Covid-19 patient in home quarantine. Start by ensuring that the patient has a separate bed or area of the home to rest in, away from other members of the household. If sharing bathrooms or kitchens can't be avoided, set up a schedule for using these areas. For instance, a shower schedule can be incorporated with the sick person being the last to use it for the day. After visiting these areas, the patient should take care to wipe and clean any surfaces he or she touches with a household disinfectant. Other members of the household should also be sure to wear a mask when entering these shared areas, cleaning any surfaces again before each use.
The patient's room and any shared areas within the home should be well-ventilated, with windows opened. Installing an air purifier with a HEPA filter will also help improve the ventilation.
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Managing a patient's laundry
Precautions should be taken when handling the sick person's laundry. Used clothes and bed linens should not be mixed with that of other household members. They should be stored in a closed plastic bag till they can be washed separately.
When handling dirty clothes or bed linens, caregivers must use disposable face masks, gloves and a plastic apron. If you're using a temperature-controlled washing machine, set the temperature at 60 to 90°C (140 to 194°F) before washing. Alternatively, soak the clothes and linens in hot water before handwashing them. Be sure to wash your hands after handling laundry, eating utensils or any other items used by the Covid-19 patient.
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A guide for patients
"Covid-19 spreads between people who are in close contact (within about six feet) through respiratory droplets, created when someone talks, coughs and sneezes," says Al-Hadi. "Staying away from others helps stop the spread of Covid-19."
By avoiding contact with household members and pets, home quarantine patients can focus on recovering while in isolation, getting plenty of rest, staying hydrated and eating nutritious meals. When coughing or sneezing, they must cover their mouths and noses, disposing used tissues and face masks in a sealed package before throwing in a covered bin. Meals should be taken away from other members of the household to prevent the spread of infection.
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According to guidelines from the MoH, Covid-19 patients who receive their vaccination appointments while still in recovery should reschedule their appointment by cancelling it via the MySejahtera app. A new appointment date will be given within 30 days.
"Vaccination should be deferred until the patient has recovered from the acute illness (if symptomatic) and if they have met the criteria to discontinue isolation as set by MoH," adds Al-Hadi.
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