So you have a respiratory infection and feel crummy. You decide to isolate at home. What do you do? These are the guidelines from UpToDate:
Home care — Home management is appropriate for patients with mild infection who can be adequately isolated in the outpatient setting. Management of such patients should focus on prevention of transmission to others and monitoring for clinical deterioration, which should prompt hospitalization.
Outpatients with COVID-19 should stay at home and try to separate themselves from other people and animals in the household. They should wear a facemask when in the same room (or vehicle) as other people and when presenting to health care settings. Disinfection of frequently touched surfaces is also important.
Environmental disinfection — To help reduce the spread of COVID-19 virus, environmental infection control procedures should also be implemented. In United States health care settings, the CDC states routine cleaning and disinfection procedures are appropriate for COVID-19 virus.
Products approved by the Environmental Protection Agency (EPA) for emerging viral pathogens should be used; a list of EPA-registered products can be found here.
Specific guidance on environmental measures, including those used in the home setting, is available on the CDC and WHO websites.
The importance of environmental disinfection was illustrated in a study from Singapore, in which viral RNA was detected on nearly all surfaces tested (handles, light switches, bed and handrails, interior doors and windows, toilet bowl, sink basin) in the airborne infection isolation room of a patient with symptomatic mild COVID-19 prior to routine cleaning [1. Viral RNA was not detected on similar surfaces in the rooms of two other symptomatic patients following routine cleaning (with sodium dichloroisocyanurate). Of note, viral RNA detection does not necessarily indicate the presence of infectious virus.
It is unknown how long SARS-CoV-2 can persist on surfaces; other coronaviruses have been tested and may survive on inanimate surfaces for up to six to nine days without disinfection. In a study evaluating the survival of viruses dried on a plastic surface at room temperature, a specimen containing SARS-CoV (a virus closely related to SARS-CoV-2) had detectable infectivity at six but not nine days . However, in a systematic review of similar studies, various disinfectants (including ethanol at concentrations between 62 and 71 percent, THAT’S WHY TEQUILA AND VODKA WON’T WORK) inactivated a number of coronaviruses related to SARS-CoV-2 within one minute .
As mentioned yesterday, here are the guidelines for discontinuation of precautions. If you are sick, they are shorter than if you’ve been exposed and are worried that you might get sick or expose other people.
The United States Centers for Disease Control and Prevention (CDC) has issued recommendations on discontinuation of home isolation, which include both test-based and non-test-based strategies [72,73]. The choice of strategy depends upon the patient population (eg, immunocompromised versus nonimmunocompromised), the availability of testing supplies, and access to testing.
When a test-based strategy is used, patients may discontinue home isolation when there is:
- Resolution of fever without the use of fever-reducing medications ANDImprovement in respiratory symptoms (eg, cough, shortness of breath) ANDNegative results of a US Food and Drug Administration (FDA) Emergency Use Authorized molecular assay for COVID-19 from at least two consecutive nasopharyngeal swab specimens collected ≥24 hours apart (total of two negative specimens)
- When a non-test-based strategy is used, patients may discontinue home isolation when the following criteria are met:At least seven days have passed since symptoms first appeared ANDAt least three days (72 hours) have passed since recovery of symptoms (defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms [eg, cough, shortness of breath])
- In some cases, patients may have had laboratory-confirmed COVID-19, but they did not have any symptoms when they were tested. In such patients, home isolation may be discontinued when at least seven days have passed since the date of their first positive COVID-19 test so long as there was no evidence of subsequent illness.
I HAVE JOKED WITH THE FAMILIES OF PATIENTS IN THE PAST WHO ARE SELF ISOLATED FOR FLU OR OTHER ILLNESSES THAT THE IDEAL FOOD TO FEED YOU ISOLATEE IS PIZZA BECAUSE IT SLIDES UNDER THE DOOR.:)
