Member news | Protect Yourself – Home Care Advice from the WHO and Chinese CDC

Due to the rapid increase in incidence of coronavirus (2019-nCoV) infections, the World Health Organization (WHO) has developed a rapid advice notice to give recommendations on safety measures for persons with suspected 2019-nCoV infection and asymptomatic contacts. What can you do if you or someone you know has a suspected coronavirus infection or has been in close contact with a suspected person? Read on as we have gathered the current advice from the WHO and Chinese Centers for Disease Control and Prevention.

This article is adapted from the WHO “Home care for patients with suspected novelcoronavirus (nCoV) infection presenting with mild symptoms and management of contacts – interim guidance (1) and translated from the Chinese CDC’s advice on how to avoid spreading the virus at home (2).

In view of the currently limited knowledge of the disease caused by the 2019-nCoV infection and its transmission patterns, the WHO recommends that suspected cases of 2019-nCoV infection be isolated and monitored in a hospital setting. However, WHO acknowledges that “for several possible reasons, including situations when inpatient care is unavailable or unsafe (i.e. limited capacity and resources unable to meet demand for health care services), or in a case of informed refusal of hospitalization, alternative settings (including home settings) for healthcare provision may need to be considered.”

WHO suggests that the following types of patients may be cared for at home

• Patients with mild symptoms,* without existing chronic conditions such as lung or heart disease, renal failure, and immuno-compromising conditions that place him/her at increased risk of developing complications.
• Asymptomatic patients no longer requiring hospitalization. 

*Mild symptoms include low-grade fever, cough, malaise, rhinorrhoea (running nose), sore throat without any warning signs, shortness of breath or difficulty in breathing, sputum or coughing of blood, gastro-intestinal symptoms such as nausea, vomiting, and/or diarrhoea, and those without changes in their mental status (i.e. confusion, lethargy).

This decision to be cared for at home requires careful clinical judgment and should be informed by assessing the safety of the patient’s home environment. Open communication between the health care provider and the patient should be established for the full duration of the home care period until the patient fully recovers. The patients and the household members should be educated on personal hygiene, basic infection prevention and control measures, on how to care for the suspected infected family member as safely as possible, and to prevent the spread of infection to household contacts [1].

For those who may be cared for at home, the WHO recommends the following:

• Place the patient in a well ventilated room. Limit the movement of the patient and minimize shared space. Avoid visitors.
• Ensure that shared spaces (e.g. kitchen, bathroom) are well ventilated.
• Sleep in a separate room from the patient. If conditions are limited, maintain a distance of at least 1 meter from the ill person (sleep in a separate bed). A mother can continue to breastfeed. 
• The caregiver should wear a medical mask fitted tightly to the face when in the same room with the ill person. Properly dispose of it after use, and wash your hands. Don’t reuse the mask if it gets wet or dirty with secretions.
• Hand hygiene should be performed before and after preparing food, before eating, after using the toilet, and whenever your hands look dirty. Use soap and running water, or an alcohol based hand rub (if hands are not visibly soiled). Avoid accidental ingestion and stay away from sources of fire when using alcohol-based hand rubs. 
• When using soap and water, use disposable paper towels to dry hands if possible. If not available, use a dedicated cloth towel and replace them when they become wet.
• Discard materials used to cover the mouth or nose, or clean them properly after use.
• Avoid sharing toothbrushes, cigarettes, utensils, dishes, drinks, towels, wash cloths, or bed linen. Utensils and dishes should be cleaned with either soap or detergent and water after use. 
• Clean and disinfect frequently touched surfaces, such as bedside tables, bed frames, and other bedroom furniture, and bathroom and toilet surfaces daily. To creat a diluted bleach solution, use one part bleach to 99 parts water. 
• Clean clothes, bedding, and bath and hand towels belonging to those who are ill, using regular laundry soap and water, or machine wash at 60-90 degrees with common household detergent, and dry thoroughly. 
• Wear protected clothing before cleaning or touching surfaces with a person’s secretions, clothes, or bed linens. Use disposable gloves to provide oral and respiratory care. Wash hands before putting on and after taking off gloves.