Coronavirus In India: Ministry of Health Issues Guidelines On Use Of Masks And Home Quarantine

Most of the coronavirus cases reported in India so far have the travel history from affected countries. Coronavirus causes a minor illness in majority of patients with symptoms of fever and or cough. A small proportion of such persons may progress to severe disease with difficulty in breathing.

It is spread by an infected person with COVID coughing and the droplets from his cough infecting others in close vicinity (less than 1 metre).

Any such new disease invariably related to cough leads to suggestions from various quarters, especially in social media, to use mask by general public to prevent the disease.

In this backdrop, the Union Health Ministry has issues guidelines on use of masks and home quarantine so that you can protect yourself as much as possible.

Use of Masks by General Public

Persons having no symptoms are not to use mask

Medical masks should not be used by healthy persons who are not having any symptoms because it creates a false sense of security that can lead to neglecting other essential measures such as washing of hands.

Further, there is no scientific evidence to show health benefit of using masks for non-sick persons in the community. In fact, erroneous use of masks or continuous use of a disposable mask for longer than 6 hours or repeated use of same mask may actually increase risk of getting an infection. It also incurs unnecessary cost.

In such situation, more effective steps are:

  • Wash hands frequently with soap and water for 40 seconds. An alcohol-based hand sanitizer with 70% alcohol must be used for 20 seconds. If hands are dirty or soiled, do not use alcohol-based hand sanitizer, but wash hands preferably with soap and water.
  • While coughing or sneezing cover nose and mouth with handkerchief, paper tissue. If handkerchief or tissue paper is not available cough into the flexed elbow. Dispose of tissue immediately after use and wash hands.
  • Refrain from touching face, mouth, nose and eyes.
  • Stay at least a metre away from those coughing or sneezing.
  • Monitor your body temperature.

When and who should use medical masks (apart from health care worker):

  • When a person develops cough or fever.
  • Use of medical three-layer masks when ill, will prevent your infection from spreading to others. However, you also need to wash your hands frequently to avoid spreading infection to others.
  • While visiting a healthcare facility.
  • When you are caring for an ill person.
  • Close family contacts of such suspect/confirmed cases undergoing home care should also use Triple layer medical mask.

Duration for which a medical mask will remain effective

A medical mask, if properly worn, will be effective for 8 hours. If it gets wet in between, it needs to be changed immediately.

Correct procedure of wearing triple layer mask

While wearing a medical mask, the steps given below needs to be followed.  If you do not follow them, you may get infected from the mask itself. These steps are:

  • Unfold the pleats; make sure that they are facing
  • Place over nose, mouth and
  • Fit flexible nose piece (a metallic strip that can easily be located) over nose-
  • Secure with tie strings (upper string to be tied on top of head above the ears –lower string at the back of the )
  • Ensure there are no gaps on either side of the mask, adjust to
  • While in use, avoid touching the mask.
  • Do not let the mask hanging from the
  • Change the mask after six hours or as soon as they become
  • Disposable masks are never to be reused and should be disposed
  • While removing the mask great care must be taken not to touch the potentially contaminated outer surface of the mask
  • To remove mask first untie the string below and then the string above and handle the mask using the upper

Disposal of used masks

Used mask should be considered as potentially infected. Masks used by patients / care givers/ close contacts during home care should be disinfected using ordinary bleach solution (5%) or sodium hypochlorite solution (1%) and then disposed of either by burning or deep burial.

Guidelines for Home Quarantine

Scope

Detection of a travel related/unrelated suspect case of novel Coronavirus Disease (COVID-19) will be followed by rapid isolation of such cases in designated health facilities and line listing of all contacts of such cases. Home quarantine is applicable to all such contacts of a suspect or confirmed case of COVID-19.

This intervention will be limited to the initial phase of India reporting only (i) travel related cases and (ii) focal clusters arising from a travel related/unrelated case where cluster containment strategy is adopted (iii) Persons coming from COVID-19 affected areas where local and community transmission is evident.

Definition of contact

A contact is defined as a healthy person that has been in such association with an infected person or a contaminated environment as to have exposed and is therefore at a higher risk of developing disease.

A contact in the context of COVID-19 is:

  • A person living in the same household as a COVID-19 case;
  • A person having had direct physical contact with a COVID-19 case or his/her infectious secretions without recommended personal protective equipment (PPE) or with a possible breach of PPE
  • A person who was in a closed environment or had face to face contact with a COVID-19 case at a distance of within1 metre including air travel;

The epidemiological link may have occurred within a 14‐day period before the onset of illness in the case under consideration.

Instructions for contacts being home quarantined

The home quarantined person should:

Stay in a well-ventilated single-room preferably with an attached / separate toilet.  If another family member needs to stay in the same room, it’s advisable to maintain a distance of at least 1 meter between the two.

  • Needs to stay away from elderly people, pregnant women, children and persons with co-morbidities within the household.
  • Restrict his/her movement within the house.
  • Under no circumstances attend any social/religious gathering e.g. wedding, condolences, etc.

He should also follow the under mentioned public health measures at all times:

  • Wash hand as often thoroughly with soap and water or with alcohol-based hand sanitizer
  • Avoid sharing household items e.g. dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items with other people at home.
  • Wear a surgical mask at all the time. The mask should be changed every 6-8 hours and disposed off. Disposable masks are never to be reused.
  • Masks used by patients / care givers/ close contacts during home care should be disinfected using ordinary bleach solution (5%) or sodium hypochlorite solution (1%) and then disposed of either by burning or deep burial.
  • Used mask should be considered as potentially infected.
  • If symptoms appear (cough/fever/difficulty in breathing), he/she should immediately inform the nearest health centre or call 011-23978046.

Instructions for the family members of persons being home quarantined

  • Only an assigned family member should be tasked with taking care of the such person
  • Avoid shaking the soiled linen or direct contact with skin
  • Use disposable gloves when cleaning the surfaces or handling soiled linen
  • Wash hands after removing gloves
  • Visitors should not be allowed
  • In case the person being quarantined becomes symptomatic, all his close contacts will be home quarantined (for 14 days) and followed up for an additional 14 days or till the report of such case turns out negative on lab testing

Environmental Sanitation 

  • Clean and disinfect frequently touched surfaces in the quarantined person’s room (e.g. bed frames, tables etc.) daily with 1% Sodium Hypochlorite Solution.
  • Clean and disinfect toilet surfaces daily with regular household bleach solution/phenolic disinfectants
  • Clean the clothes and other linen used by the person separately using common household detergent and dry.

Duration of home quarantine

The home quarantine period is for 14 days from contact with a confirmed case or earlier if a suspect case (of whom the index person is a contact) turns out negative on laboratory testing

 

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