COVID19 Guidelines for patients at home

Assalaamu Alaikum Warahmatullaahie Wabarakaatuh / Good day / Hello

We have found ourselves in a difficult time. None would have imagined living in these unprecedented times. Whilst there is fear that surrounds this pandemic, we have to begin to live life under new norms and standards for the time being. Remember, do not fear. As much as we know the disease is highly transmissible, Allah / the Creator is the Giver and Healer of all diseases. We need to take our precautions and leave the rest to the Almighty
without making our lives too difficult and being paranoid. Now that you have either tested for Covid-19 or you are a direct contact of a Covid-19
positive patient, below are a few guidelines that can help you during this time.

• You should go into isolation IMMEDIATELY.
• If you are symptomatic and the other household members are asymptomatic (no symptoms) then you should isolate separately.
• You should choose a separate room and bathroom from the other household members.
• Please do not move out of this space for 14 days.
• Do not go outside of the house unless you follow the guidelines below.
• There should be minimal interaction with the rest of your household members.
• If this is difficult, all people in the house should wear masks for 14 days and you should keep a 2m distance from the other household members.

If there is one bathroom in the house, then when you need to use the bathroom:
• The family members should be away from the bathroom.
• You should wear a mask and a shield.
• The toilet seat and basin should be sanitised by you with soap and water, a 70% alcohol-based sanitiser or a Jik solution before and after using the toilet and basin.
• The Jik solution can be made as follows: Add 1 part of the 3.5% Jik to 6 parts of water. This can be used to sanitise the surfaces.
• Toilet seat should be closed prior to flushing.
• Wash your hands with soap and water for 20 seconds.
• All toiletries should be in a closed cupboard.
If all household members are symptomatic, then all the household members can isolate together within the same house. No visitors should be allowed to the house.

• High risk patients such as the elderly and those with chronic conditions should not nurse the Covid-19 positive patient.
• Ensure that you are wearing a mask and visor.
• Deliver the food to the door as mentioned below.
• Ensure the patient hydrates sufficiently.
• Please adhere to guidelines regarding laundry and meals below.
• Ensure that you maintain the social distance of greater than 2m.

• Practice good hygiene by washing your hands frequently with soap and water for 20 seconds or with a minimum 70% alcohol-based sanitiser.
• When sneezing and coughing, cough / sneeze into a tissue which should immediately be discarded in a dedicated bin bag. All high touch surfaces should be cleaned with an alcohol- based sanitiser or the Jik solution.

Handling of meals:
• Food should be left at the door of the isolation room, preferably in polystyrene / paper plates and cups, which can be discarded. A packet should be left outside of your room to discard this.
• You can wear a mask and dispose of these items in the opened bin packet left outside your room, being careful not to touch the outside of the packet. If this cannot be done, the utensils should be thoroughly washed with soap and hot water. A bucket can be kept outside the room with boiling water of more than 61°C. You can gently place your utensils in this bucket and let it soak for 24 hours before it can be taken to be cleaned with soap and water.
• Diet: Your diet should comprise of healthy foods such as green leafy vegetables, fruits such as citrus fruits and apples and protein from meat, chicken or fish.
• Hydration: Drink a minimum of 6 to 8 glasses of water a day. The elderly tends to drink less. Make a one litre rehidrat® solution. They should drink small amounts of the solution throughout the day.

• Laundry should be washed at a minimum temperature of 61°C. A separate bucket can be left outside the room. You should gently place your clothes in the bucket ensuring not to touch the outside of the bucket with your hands or your clothes. Boiling water should be gently poured inside the bucket, so the virus does not splash. Your clothes can be soaked for 24 hours before cleaning separately from the other clothes.
• The person picking up the dishes and laundry must wipe both buckets outside and inside with a 70% alcohol-based sanitiser. They should disinfect their hands before and after attending to the laundry or dishes. The person should sanitise before and after tying the bin packet. The bin packet should preferably be left outside for 4 days before discarding into main bin.

• It is advisable to buy a pulse oximeter from any pharmacy.
• Remember, send a family member who is not isolating to the pharmacy or let thepharmacy deliver to your house.
• The coronavirus is usually self-limiting, and the treatment is aimed at building yourimmune system to fight the virus and to help manage your symptoms.
• Take the vitamins as your doctor prescribed.
• Steaming with boiling water and a vapourub helps with your tight chest. Drinkingwarm water with lemon and honey may relieve the coughing.
• Follow the other symptomatic treatment that your medical practitioner prescribed.
• Please call your GP, if your symptoms are worsening and they will advise you onfurther management.

The following symptoms should be closely monitored:
• Increased shortness of breath
• Increased tiredness, increased body pain/chest painIncreased temperature
• Increased heart rate
• The oxygen reading on the oximeter shows in percentage. If it is ≤92%, call your medical practitioner.
• If your heart rate is greater than 100.
• The oxygen reading and heart rate values may differ for different individuals, therefore consult with your medical practitioner.
Your medical practitioner will give you a symptom log. Please fill it in diligently, it will help with quick and effective management.

All household members are considered close contacts and should isolate for 14 days. Should household members develop symptoms, they should call their GP. If the symptoms are mild the same steps can be taken, and the household member should isolate for 14 days from the first day of their symptoms. f children develop symptoms and were in contact with you, they do not need to test. They are most likely Covid-19 positive and will have mild symptoms. Please contact your medical professional for further management.

• Initially you may feel weak and tired. Try to get as much rest as possible. To prevent being immobile, try to walk around slowly in the place you are isolating or do calf exercises in the bed until you feel stronger.
• As you start to feel stronger, you can start with low intensity exercises such as walking around the area that you are isolating.
• If you live in a block of flats or apartments, you cannot walk outside.

• Do not smoke.
• When you lie down, lie on your stomach. This improves oxygenation in your lungs.
• If you are unable to lie on your stomach, then sit or stand up straight for 30 minutes after every one or two hours.
• Blowing balloons or blowing water through a straw: Test this exercise first. If your saturation / oxygenation improves after the test, then please continue with this for a minimum of 10 to 12 times per day. If your saturation does not improve during the test, then do not continue with this exercise.

• This may be a difficult time in your life.
• The body pains and headaches may be excruciating and may affect your mental health, take your painkillers that the doctor prescribed to alleviate these symptoms.
• If you have a mental illness, do not forget to take your medication on time.
• Video call family and friends.
• Read books.
• Restrict media and social coverage to prevent it from becoming overwhelming.
• Download a game on your phone to keep you occupied.
• If safe to do so and without placing others at risk, try and get some fresh air.
• If you feel you need to help yourself, you can always call SADAG 24-hour mental health helpline on 0800 456 789 or whatsapp 076 882 2775.

• You will need to isolate for 14 days from the onset of your symptoms.
• If members in your family are asymptomatic, they should isolate for 14 days. If they get symptoms in these 14 days, they should isolate for 14 days from the first day of the symptoms.
• If you were on oxygen, you will be required to isolate 14 days from the time you were off the oxygen.
• The family members who are still in isolation should isolate from the other members of the family, thereby enabling members of the family who have completed their isolation period, to de-isolate back into the community.
• You do not have to test after 14 days. The test may be positive; however, you will not be infectious if you have isolated for the required time.
• Continue with the standard precautions as we are still unsure about immunity.

• If you live in a separate house from the covid-19 positive patient and you the only one who was in contact with this patient. You will have to isolate from your family in your own house and follow the guidelines as above.
• You should isolate until you get symptoms. If you get symptoms, please contact your GP.
• If you remain asymptomatic you can isolate for 7 days and test on day 7. Please isolate until you have received your test results.

Compiled by:
Dr Fatimah Lambat [Specialist Anaesthesiologist and Fellow in intensive care] And the Islamic Medical Association of South Africa COVID19 Working Committee

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