Punjab govt releases guidelines for home isolation of positive patients

Pakistan is experiencing a deteriorating coronavirus situation, with almost 30,000 positive cases of the infection and upwards of 600 deaths.

In this worrisome situation, the Punjab government's Primary and Secondary Healthcare Department has released a list of guidelines for authorities to follow in case a person tests positive for the coronavirus and is allowed to be home isolated.

Guidelines for government designated isolation facilities:

• Any residential quarter like hotel, school building, mosque, hostel, community center or other suitable building with adequate facilities -under the supervision of concerned District Health Authority (DHA).
• Each laboratory confirmed COVID-19 patient should be kept in a single room with attached bathroom (where feasible or grouped together for positive patients).
• General premises of the isolation facility, rooms, corridors and washrooms etc. be disinfected on daily basis.
• There will be a system of record keeping to maintain data of admission/discharge of COVID-19 patients.
• Solid Waste Management in the isolation facilities will be carried out as per the guidelines issued by the Primary and Secondary Healthcare Department
• The isolation facilities should not be established in building with centralised HVACs (Heating, Ventilation and Cooling) as it may spread the virus.
• Only cooked food in disposable utensils be supplied to the patients

Guidelines for allowing home isolation and home isolated patients:

• Home isolation will be allowed on the recommendations of the 'Home Isolation Committee' with informed consent of the patient. The committee will be notified by the district deputy commissioner and will include the assistant commissioner (through his designated officer), deputy district health officer, chief officer of Tehsil or Town Municipal Administrations or Municipal Committees (MCs).
• A Punjab government issued detailed check list/score sheet must be filled for assessment of home isolation.
• A checklist for doctors for assessment of patients and primary caregiver for home isolation must also be filled.
• The committee will have to asses if there are sufficient number of single rooms (proportionate to family size) available to accommodate a COVID-19 patient.
• The committee has also been asked to consider the level of education of family, general understanding of COVID-19 self-isolation requirements and maturity to comply with the instructions of the department.
• It will be mandatory for home-isolated COVID-19 patient to monitor their health condition and report to the Primaryand Secondary Healthcare Department on a daily basis.
• It will be mandatory for home-isolated COVID-19 patients to comply with the instructions of the department.
• It will be mandatory for home-isolated COVID-19 patients to comply with requirements of testing protocols (as and when) required by the caregivers/P&SHC Department.

Protocol for re-test of a patient and end of isolation:

The government has stated that confirmed cases, who are home isolated their repeat testing should be done at Day 10 of isolation period. To end isolation, PCR should be negative twice and at least 24 hours apart.

• For the positive test result at Day 10 (2nd positive), repeat test is to be conducted at Day 05 after the 2nd positive test.
• Where testing is not possible, WHO recommends that confirmed patients remain isolated for an additional two weeks after symptoms resolved.