On December 31, 2019 the authorities of People's Republic of China reported to WHO about several cases of pneumonia of an unknown etiology, located in the Chinese province of Hubei. In a week they confirmed that it pneumonia was caused by a new coronavirus which received the name SARS-CoV-2. Now it is established that this virus, as well as others in family of coronaviruses, causes various clinical manifestations under term COVID-19, including respiratory symptoms which vary for cold to heavy pneumonia with respiratory a distress syndrome, septic shock and multiorgan insufficiency.
Easy manifestations of a disease therefore now in many countries it is considered that leaving (treatment) is preferable option at treatment of cases with easy symptoms at home, without any considerable associated diseases and with a stable clinical picture have the majority of cases of COVID-19 about which it was reported provided that the house situation in this case is adequate for delivery of health care and the minimum requirements of safety are observed. Besides, the considerable number of cases of this pathology does not receive confirmation by standard diagnostic aids for one reason or another, but are conducted by patients independently, under control of health workers at home. This article generalizes experience of physicians of the western countries in treatment of COVID-19, but demands adaptation to local conditions of a health care system.
Requirements for care of the patient who is at home
The decision on an opportunity to treat the patient has to be accepted only by the qualified health worker at home. It is not obligatory for patient to live with someone if the help with phone can be provided to him. Therefore the patient has to have phone which guarantees a continuous communication with medical personnel for elimination of symptoms. Though each case has to be estimated individually, as a rule, with the patient persons with risk factors should not live: advanced age, functional frustration, chronic diseases, immunosuppression, pregnancy and so on. The patient and his cohabitants have to understand and correctly and consistently apply the main measures of hygiene, prevention and to watch an infection. It is necessary that the qualified health worker exercised control of such patients by phone, and in necessary cases and internally.
Councils for the patient who is in isolation
Preferably the patient has to be in the individual room or the room. If it is impossible, the patient has to be in the place where the minimum distance (two meters) is guaranteed against other cohabitants. The door to the room has to be the isolation closed before the termination. In case the patient needs to use the general rooms of the house or the apartment, he should use a surgical mask and to observe hygiene of hands at an exit and before an entrance to the room.
The room or the room have to have sufficient ventilation and be reported with the street. There should not be any air heating systems or coolings. The general spaces also have to be aired well.
If there is an opportunity, the bathroom has to be available only for the patient. If it is impossible, the bathroom should be cleaned household bleach after each use by the patient.
It is recommended to have houses a way of communication, phone or a communicator (for example such which are used for observation of babies) to contact relatives, without leaving the room.
In the dwelling or the room it is necessary to put a bin with a cover and a pedal. For collecting garbage it is necessary to use the closed package.
It is necessary to have individual means of hygiene and also means for washing of hands (for example, soap or aqueous-alcoholic structure).
Personal clothes, bed linen, towels and other which have to change regularly are allocated to the patient.
The patient has to take measures of respiratory hygiene: to close a mouth and a nose at cough and sneezing by a bend of an elbow or disposable kerchiefs which are thrown out in a garbage can in its room right after use.
The patient has to wash often hands with soap. In the presence it is possible to use aqueous-alcoholic solutions.
It is forbidden to visit the patient during the isolation period.
It is recommended to keep the daily magazine of an entrance and exit of persons who enter the room of the patient.
Prevention measures for the persons living together with the diseased
The family members and persons living with them have to be in the separate room and minimize contacts with the diseased. To avoid contact with biological liquids, in particular, from a mouth or allocations from a nose, a stake. It is necessary to allocate everyone living separately objects of individual use: toothbrush, glass, plates, tableware, towels, clothes, etc.
Living in the house have to wash as often as possible hands with soap or water spirit solution after each contact with the patient or his environment.
The family members living in common the persons which are carrying out care of the patient have to monitor manifestations of symptoms of an acute respiratory disease daily: temperature, cough, a pharyngalgia, the complicated breath. At manifestation of symptoms it is necessary to ask for medical care immediately.