ROJOSON-PEP-TALK: Home Management of COVID19 Patient (May 22, 2021)

1. Underlying Principles of Patient Empowerment
• Every person has the right to make their own
choices with regards to their health care.
• They have the right to be the primary decision-
makers with regards to their medical conditions.

2. Patient Empowerment (WHO):
• It is a process through which people gain greater control over decisions
and actions affecting their health.
• It is a process in which patients understand their role, are given the
knowledge and skills by their health-care provider to perform a task in
an environment that recognizes community and cultural differences and
encourages patient participation.

3. Benefits of Patient Empowerment
• Improvement in quality in health care administered by
physicians and health care professionals because of patient-
centered care.
• Improvement in health outcomes because of patient
participation.

5. COVID19 patients are those infected with
COVID19.
They may be symptomatic or asymptomatic.
For the symptomatic patients,
they may be in mild, moderate, severe and
critical stages.

6. Management of COVID19 patients may be
done
• at home
• at a designated quarantine or isolation
facility
• at a hospital
depending on the stage and other situations.

7. As a general rule,
COVID19 patients with moderate, severe and
critical diseases should be managed in a
hospital.
Asymptomatic and mild COVID19 can be
managed at home or at a designated
quarantine or isolation facility.

8. My PEP Talk will focus on the home
management of COVID19 patients
who are asymptomatic and with
mild COVID19.

9. Mild COVID19 patients are those
symptomatic patients presenting with fever,
cough, fatigue, anorexia, myalgia; other non-
specific symptoms such as sore throat, nasal
congestion, headache, diarrhea, nausea and
vomiting, loss of smell or loss of taste, etc.
without symptoms and signs of pneumonia
and hypoxia (not enough oxygen).

10. Signs used to signify probable presence
of pneumonia and hypoxia include
breathing difficulty, a respiratory rate
of more than 30 per minute in an adult
and an oxygen saturation of less than
92% using a pulse oximeter.

11. Once a patient comes into close contact with a
patient with probable or confirmed COVID19,
meaning within 6 feet of an infected person for a
total of 15 minutes or more,
s/he should self-quarantine (meaning
stay home) right away for at least 14
days for monitoring of COVID19
symptom development.

12. If COVID19 symptoms develop,
s/he should do strict self-isolation right
away in a room with bathroom facility
and with good ventilation.

13. While at home in quarantine or in
isolation,
s/he will be managed with the best
supportive care possible with close
monitoring with the assistance of a
physician through telemedicine.

14. S/he should be closely monitored for
development of symptoms and signs of
pneumonia and hypoxia.
If these develop, s/he should be
admitted to a hospital for further
treatment.

15. Home management of COVID19
patients is essentially
family or household health
management
with the following processes:

16. Home management of COVID19 patients (family or
household health management):
• Identification and segregation of
suspected, probable and confirmed
COVID19 household members.
• Identification and segregation of
asymptomatic and symptomatic COVID19
household members.

17. Home management of COVID19 patients (family or
household health management):
• Identification and segregation of
household members with high risk for
severe diseases such as elderly age and
those with chronic medical diseases.

18. Home management of COVID19 patients (family or
household health management):
• Avoidance of cross infection among
household members through segregation
and isolation; use of face mask, face shield,
and personal protective equipment; physical
and social distancing; hygienic practice;
decontamination and disinfection; use of
properly ventilated room; etc.

19. Home management of COVID19 patients (family or
household health management):
• Extra protection of the household
members with high risk for severe
COVID19 disease.

20. Home management of COVID19 patients (family or
household health management):
• Caregiving for sick household members by
relatively well members until the former
get well and recover.
• Close monitoring of sick household
members and reporting regularly to a
physician through telemedicine.

21. In the medical management for
asymptomatic and symptomatic household
members,
the best supportive care is given through this
regimen:

22. • Build and maintain innate or natural
immunity against COVID19.
• Take medications to control intolerable
symptoms as well as the maintenance
medications for existing chronic medical
diseases, if present. (Ask the physician
supervising the home care management.)

23. The following are the specific measures to
build and maintain innate or natural
immunity against COVID19:
• STOPPING ANY KIND OF TASK AND
ACTIVITY AT FIRST SYMPTOM OF
COVID19, ISOLATE YOURSELF AND
GO TO BED RIGHT AWAY.

24. The following are the specific measures to
build and maintain innate or natural
immunity against COVID19:
• NUTRITION – eat HEALTHY NATURAL
DIET – adequate but moderate in
amount; balanced; varied (There is
no need for additional vitamins and
other supplements.)

25. The following are the specific measures to
build and maintain innate or natural
immunity against COVID19:
• HYDRATION – drink at least 8 glasses
of water per day

26. The following are the specific measures to
build and maintain innate or natural
immunity against COVID19:
• EXERCISE – at least one hour a day
(distributed over the day – walking and
stretching and flexing as abled, when
symptoms are subsiding or completely
subsided already)

27. The following are the specific measures to
build and maintain innate or natural
immunity against COVID19:
• HYGIENIC PRACTICE – frequent
handwashing and daily bath

28. The following are the specific measures to
build and maintain innate or natural
immunity against COVID19:
• STRESS MANAGEMENT – control anxiety with
attitude of acceptance of COVID19 infection but
coupled with optimism (positive thinking) [hope
for the best but ready to accept the worst]

29. The following are the specific measures to
build and maintain innate or natural
immunity against COVID19:
• STRESS MANAGEMENT –
• a good strategy for stress management is to
formulate an intentional living plan for the next
14 days (the average duration of quarantine and
isolation).

30. Home management of COVID19
patients includes close monitoring of
asymptomatic and symptomatic
household members and reporting
regularly to a physician through
telemedicine.

31. There must be close monitoring for and
of symptoms and vital signs.
There must be a diary of the
monitoring to be shown to the
physician supervising the home care
management through telemedicine.

32. The minimum vital signs that need to be
monitored daily (once to thrice a day) during
the entire period of quarantine and isolation
include the following (your physicians may
add more such as blood pressure and pulse
rate):

33. FEVER (there is fever if the oral or mouth
temperature is 38 C or higher or if the armpit
or forehead temperature is 37.5 C or higher)
Respiratory rate (which must be less than 30
/ minute)
Oxygen saturation on the pulse oximeter
(which must not be less than 92%).

34. Your physician will guide you on the red flags
(when s/he must be contacted on an
emergency basis).
S/he will advise accordingly if a household
member needs to be admitted to a hospital
or not.

35. As a general guideline,
the isolation period for symptomatic
household members with mild COVID19
disease ranges from 10 to 21 days with
additional requirements of no fever and with
progressive improvement of other symptoms
for at least 3 days toward the end of the
stipulated isolation period.

36. As a general guideline,
The usual quarantine period for
asymptomatic household members
with no COVID19 test is 14 days.

37. As a general guideline,
The usual isolation period for asymptomatic
household members with confirmed
COVID19 test is 10 days from the day of the
positive test.
Note: a physician will determine the end of
quarantine and isolation period.

38. Testing for COVID19 is done only as
indicated.
The following are some principles and
indications on COVID19 tests:

39. • Do COVID19 test if the management will
differ according to the test result.
• Example, if whether positive or negative, the
household members will be quarantined or
isolated anyway, there is no need for the test.
• Do the test if there is a need to shorten the
period of quarantine and isolation. Example: If
the test result is negative, the initial period of
quarantine and isolation can be shortened.

40. • There is no need to repeat the COVID19
test after the prescribed quarantine and
isolation period has been observed and the
household members are asymptomatic and
for the symptomatic members, have
improved or recovered already with no
fever and progressive improvement of
other symptoms for at least 3 days toward
the end of the stipulated isolation period.

41. Take away in this ROJoson PEP Talk – Home
Management of COVID19 Patients:
• Asymptomatic and mild COVID19 patients
can be managed at home with the
guidance of a physician through
telemedicine.

42. Take away in this ROJoson PEP Talk – Home
Management of COVID19 Patients:
• Home management of COVID19 patients
is essentially family or household health
management with the following
processes: isolation and segregation;
avoidance of cross-infection; protection of
high-risk members; caregiving; and close
monitoring.

43. Take away in this ROJoson PEP Talk – Home
Management of COVID19 Patients:
• Depending on the situations, the
quarantine and isolation period ranges
from a minimum of 10 days to 14
(average) to 21 days. A physician will
determine the end of quarantine and
isolation period.

44. Take away in this ROJoson PEP Talk – Home
Management of COVID19 Patients:
• Testing for COVID19 is done
judiciously and only as indicated.