The Union Health Ministry has updated its guidelines for home isolation of mild and asymptomatic COVID-19 cases last released in April 2021.

The new guidelines have reduced the duration of home isolation from the earlier recommended “at least 10 days” to 7 days.

Patients under home isolation can now discontinue with self-isolation after at least seven days of testing positive and if they have had no fever for three consecutive days. But they still need to continue wearing masks. Re-testing is not mandatory once the home isolation ends.

Their contacts, who do not exhibit any symptoms, are not required to undergo Covid test now unlike the previous guideline under which all family members and close contacts of the patient were required to be “monitored and tested” as per protocol. Now they should monitor their health while in home quarantine.

According to the guideline, clinically mild cases are “patients with upper respiratory tract symptoms with or without fever, without shortness of breath and having oxygen saturation at room air of more than 93%”. While asymptomatic patients are laboratory confirmed cases who do not have any symptoms and have oxygen saturation of over 93%.

Patients older than 60 years and those with comorbidities can opt for home isolation only after thorough assessment by the treating doctor. The revised guideline does not recommend home isolation for immunocompromised patients such as those undergoing chemotherapy for cancer, transplant patients or patients with HIV infection.

A caregiver should be available 24 x7 for patients in home isolation. The guideline specifies that the caregiver should ideally be fully vaccinated and highlights the need for a communication between the caregiver/patient and the treating doctor as a prerequisite for home isolation.

The guideline reiterates the need to follow Covid-appropriate behavior at all times by the patient as well as the caregiver. The patient should remain in a well-ventilated room with cross ventilation, constantly wear a triple layer medical mask, follow respiratory hygiene and frequently hand wash with soap and water for at least 40 seconds or clean hands with alcohol-based sanitizer. All frequently touched surfaces in the patient’s room should be regularly cleaned and disinfected.

Safe and proper disposal of biomedical waste generated at home is essential to prevent spread of infection. The used masks, gloves, tissues or swabs contaminated with blood / body fluids of the patients including used syringes, medicines, etc., should be collected in a yellow bag and handed over to the waste collector separately.

The guideline has cautioned against self-medication, particularly steroids.

Patients must immediately consult their doctor if they develop high fever (>100° F x ≥ 3 days), dyspnea, hypoxia (SpO2 ≤ 93% at least 3 readings within 1 hour), continuous chest pain, severe fatigue or mental confusion.

Source: Revised guidelines for home isolation of mild /asymptomatic COVID-19 cases, Government of India Ministry of Health & Family Welfare, Jan. 5, 2022