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G.O.Rt.No.226, Date: 01-04-2020- Guidelines for Home isolation.

G.O.Rt.No.226, Date: 01-04-2020- Guidelines for Home isolation.

    World Health Organization  (WHO) has declared  recent Novel Corona Virus  Disease (COVID-19)  affecting  all  the regions  of  the world  as  Pandemic. In this  context,  Government of  Andhra  Pradesh has taken  several measures to  strengthen  the  surveillance  for  Containment,  Control  and  Prevention  of COVID-19  including  declaring  a “Lock down”.

2.   Where Government  is  satisfied that, any  foreign returnee or his/her contact or symptomatic  person showing  COVID-19  symptoms like  fever,  dry cough, sore  throat  and/or  breathlessness should follow  home  isolation  to prevent  spread  of  COVID-19 in  community or as advised by a Medical Officer.

3.   The  following  guidelines  are  issued  for  home  isolation  to  be  followed by all  foreign returnees or his/her contact or any  symptomatic person  showing COVID-19 symptoms:

I.   Guidelines  for Home Isolation: Home  Isolation  is applicable  to  all  foreign returnees  or  their  contacts or symptomatic showing COVID-19  symptoms  like fever,  dry  cough,  sore throat and/or breathlessness.

II. Definition  of  foreign  returnee: Any persons coming  from  outside India on  or after 10th  Feb.  2020  or any  COVID-19 affected  areas  where local and  community  transmission  is evident  or a person  coming  from  focal  clusters arising  from  a travel related/unrelated  case  where cluster containment  strategy  is  adopted. 

III.  Definition  of  a Contact: 
       1.  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 the disease.

       2.  A  person  living  in  the same  household  where a COVID-19 positive        person  is  living. 2.  A person  having  had direct physical  contact with  a  COVID-19 positive  person.

        3.  A person  having  had direct physical  contact with  a  COVID-19 positive  person’s  infectious  secretion without recommended personal protective  equipment  (PPE)  or  a person  with a possible breach of  PPE.

        4.  A person who was in  a closed  environment or has had face  to face contact with  a COVID-19 positive person at a distance of within 1 metre  including air  travel,  train,  bus  or  any form  of  travel. The epidemiological  link may have  occurred  within  a 14‐day period before  the  onset of  illness  in the  case  under  consideration.

 IV.  Definition  of  Symptomatic:  A  Person  who is  showing  symptoms  of COVID-19 like fever,  dry cough, sore  throat  and/or breathlessness.

V. Instructions for home isolation: Any  person(s)  suggestive of  2019-nCoV,  should  for at least  14 days:
   1.  Stay  home, preferably  isolate himself  / herself  in  a separate & wellventilated room  preferably with an  attached/separate  toilet.  If there is a single  toilet to  use,  it should be  cleaned with 1%  hypochlorite or  lysol solution  after  every use.
   2.  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.
   3.  Needs  to  stay  away  from  elderly  people,  pregnant  women,  children and persons with  co-morbidities  within  the  household.
   4.  Avoid  common  areas  frequented  by  other members  of  the family.
   5.  Avoid close  contact  with others. If inevitable, always maintain atleast two  metres  distance. 
   6.  Avoid meeting visitors.
   7.  Under no circumstances attend any  social/religious gathering e.g. wedding,  condolences, etc.
   8.  He/She  should also  follow the  under  mentioned public  health measures at all  times.
       a.  Avoid frequent  touching of  face 
       b.  Avoid hand shaking  and wash hands frequently with  soap and water. In case  of  non-availability  of soap and water, commercially  available  hand  rubs can be  used. 
       c.  Take  plenty of  fluids. 
       d.  Follow  cough  etiquettes.
       e.  Cover  mouth and  nose  with a  tissue/ handkerchief  when coughing  or sneezing;  In case  tissue/handkerchief  is  not available  cough/  sneeze onto  your upper  arm flex  or shoulder; coughing/ sneezing  directly  onto hands  should  not be  done.
       f.  Turn away from others when  coughing  or  sneezing.
       g.  Do  not spit/blow  nose  here  and there,  use  a water  filled receptacle  for collecting sputum, thereby minimizing aerosol generation.
       h.  Avoid sharing household items e.g. dishes, drinking glasses, cups, eating utensils, towels, bedding,  or  other items with other people  at  home.
       i.  Wear a surgical mask at all the  times. The  mask should  be changed  every  6-8  hours  and  disposed-off.  Disposable  masks are  never  to  be  reused.
       j.  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 or  pack in double bag sprinkle  bleaching powder  and seal  bag and handover  to waste  disposal  agency for safe  disposal.
       k.  If symptoms  appear  (cough/fever/difficulty in  breathing), he/she  should  immediately  call  “104”.

VI. Instructions for  the family members of  persons under  home isolation:
   1.  Only  an  assigned  family  member  should  be  tasked  with  taking  care of the  such  person.
   2.  Avoid shaking the  soiled linen or  direct  contact with skin.
   3.  Use disposable  gloves  when  cleaning  the surfaces  or handling  soiled linen.
   4.  Wash hands with  soap water for minimum 20  seconds after removing  gloves.
   5.  In case  the  person  being  quarantined  becomes symptomatic, all his close  contacts will  be  home  isolated  (for  14  days) and followed  up for  an  additional  14  days  or  till  the  report  of  such  case  turns  out negative  on  lab testing.

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

VIII.  Duration  of  home  isolation: The  home  isolation  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.

4. All the  District Collectors, Joint Collectors, Police  Commissioners, Superintendents of  Police,  District  Medical & Health Officers, Municipal Commissioners, Sub-Collectors, RDOs,  Tahsildars and  MPDOs are hereby instructed  to  implement  these guidelines.

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