by– Sama Resource Group for Women and Health
Disclaimer: The suggestions provided in this information handout are not in lieu of health interventions necessary for COVID-19 – it is important to consult a physician regarding diagnostics, medication, etc.
The suggestions here are only expected to facilitate home based care for persons who have mild symptoms and are not medically indicated or advised for facility-based care.
Needless to say, dealing with these symptoms is more challenging for those who do not have the necessary resources and systematic support. A large number of people, particularly from marginalised
communities, do not have access to basic amenities- food, housing, water nor adequate access to health care facilities. They may not be able to access basic diagnostic equipment to monitor oxygen saturation,or body temperature. There is an urgent need to develop strategies for community and home-based care for mitigation and prevention of escalation of infection. Such strategies only complement health system preparedness and services, which along with access to basic amenities, are critical and urgent. These
strategies can, to an extent, facilitate informed care and decisions to manage their health needs.
These suggestions have been compiled after referring to a range of available resources and advice/ guidance sought from public health and medical professionals and are in response to increasing requests from friends and families for guidance on credible information, tips for care, and for hope.
The Second Wave of COVID-19 in 2021 Coronavirus Disease 2019 (COVID-19) 1 (Covid-19 is an acute respiratory disease caused by a novel Coronavirus (SARS-CoV-2)– especially this new wave of 2021 – is infecting entire households, not just individuals, as well as people of all age groups. Innumerable friends, entire families, and relatives across different cities are battling the new COVID-19 wave and its variants.
In the hospitals too, we find entire families – across generations – admitted due to COVID-19. Patients and their families are struggling to get access to testing, proper care – beds, oxygen, medicines – and even for basic masks. Within households, it is very difficult to prevent members from infecting one another, and it is almost inevitable that people will fall sick in succession. In such a situation, one should try to buy some time and pace out the illness in terms of when people could be likely to fall sick and others begin to get better, so that caregiving responsibilities can be passed on to others as caregivers fall ill.
However, in order to prevent oneself and others from getting infected, it is important to discuss the protocols to be followed and involve all members of the family – from the youngest to the oldest – in making sure that these are respected.
The most simple, yet effective precautions Within households it may be difficult to prevent members infecting one another. However, it is important to continue taking preventive measures for your own well-being and that of the others in the family or community. It is true that the virus has assumed formidable proportions and has disrupted lives globally but some simple and uncomplicated preventive measures can, to a great extent, save
ourselves and others around us from contracting the infection. These include –
- Wear a well-fitted mask that covers your mouth, nostrils, and cheeks to prevent the virus from
entering your system as well as to prevent transmitting the virus to others. If possible, wear
two masks – a surgical mask beneath and a cloth mask on top.
- Wash your hands regularly with soap and water, especially after coming in contact with
potentially infective surfaces. Use hand sanitizers to maintain hand hygiene if water is not
readily available (but not as a replacement for hand-washing).
- Maintain physical distance while interacting with people.
- Unless there is an emergency, avoid stepping out. As much as possible, try to opt for delivery
services for supplies, or ask your friends to drop them at your door.
- Wash, sanitize, or disinfect any products that come from outside.
Care for mild symptoms of COVID-19
The majority of people who are infected with coronavirus experience a mild or asymptomatic disease,
which can be treated at home. These are some simple steps you can take to feel better. These are based on the experiences of those who have been COVID-19 positive and subsequently recovered.
- What are some of the typical symptoms to look out for?
• Fever (a temperature above 37.8°C/ 100°F or skin which feels hot to touch).
• A new, persistent cough, throat pain.
• Fatigue, body aches, and tiredness.
• A loss of or change to your sense of smell or taste.
• Shortness of breath and difficulty in breathing.
• Some people experience redness in eyes with fever.
• Nausea, loss of appetite, vomiting, loose stools.
• Remember, some people may show no symptoms at all and can still have COVID-19. Theyare said to be ‘asymptomatic’. Maintain distance/ isolate yourself if you have come in contact with anyone who has been diagnosed as COVID-19 positive.
What immediate steps can be taken if someone shows any symptoms?
If you experience fever, lose your sense of smell or taste, or develop a new continuous cough, you
should self-isolate immediately. You should get a test done and also consult your physician.
RT-PCR is a confirmatory test, but it takes longer to get the result. Especially, in the current surge of demand, it is taking much longer to get a RT-PCR test done. Rapid antigen tests may be useful for quicker results, but have high false negative rates. So, if rapid antigen test is negative in someone with symptoms, it is necessary for them to get a confirmation through a RT-PCR test.
Onset of symptoms also vary. In a family, for example, the oldest member got her first symptoms 20 days after an 18-year-old member got hers. Severity varies – from mild to moderate to severe and from 1 day fever to 5 days. A large number of COVID-19 infections are mild and manageable at home starting with self-isolation. A proportion of corona infected people would require hospital care.
Older people and those with underlying health conditions run the risk of severe or critical infections.
Medicines: Please check with your physician once you have developed symptoms. Take medical advice before you use any medicines. Taking paracetamol at 6-hour intervals is generally safe if you have fever or ibuprofen for headache. However, you should follow expert advice if symptoms get worse.
Testing for COVID-19
The general tests for determining if one has acquired the infection include:
1 Rapid Antigen Test – Antigen tests detect specific proteins—known as antigens—that are unique to the coronavirus. Nasopharyngeal secretions or secretions from the nose and throat are commonly used as the samples for antigen testing. Positive results indicate a current infection. Rapid antigen tests can generate results in just 15 minutes. However, this test has a
higher chance of missing an active infection. The usual guidelines suggest that if your antigen test is negative but you display some of the typical symptoms, you should follow it up with a RT-PCR test to be definite.
2 RT-PCR or “reverse transcription polymerase chain reaction” test determines if you have an active SARS-CoV-2 coronavirus infection. This is done by checking a sample of nasal
secretion (which may be collected with a nasopharyngeal swab) for the genetic material of the virus. The RT-PCR test is widely regarded as the “gold standard” for COVID-19 testing.
Remember, there is a false negative rate of 30%, even with the best tests. It means there is a 30% possibility that the test may show a negative result even if you are positive. But still it is important to get a test done if you have any of the symptoms.
Suggestions on Self-Isolation
Upon developing any of the symptoms, self-isolate and do not leave your house for any reason, unless advised medically. The same applies if you have been in close contact with someone with a confirmed case of COVID-19. According to the National Centre of Disease Control, a contact is a person who is
- involved in any of the following:
• Providing direct care without proper personal protective equipment (PPE) for COVID-19 patients.
• Staying in the same close environment of a COVID-19 patient (including workplace,classroom, household, gatherings).
• Traveling together in close proximity with a symptomatic person who later tested positive for COVID-19.
• Any other situation by which you could have got respiratory droplets on yourself through others talking, coughing, or sneezing.
What does self-isolation mean in practical terms?
Isolation should be for a minimum period of 14 days from the start of symptoms. If you live in a household with other people, everyone else must also isolate for 14 days. In case of any subsequent infection in the household, self-isolation for positive members and quarantine for the rest of the family must be maintained until everyone has recovered and reported negative on their test. If you don’t have the adequate facilities/ support at home, you should reach out to institutional isolation
centers like COVID-19 First Line Treatment (CFLT) Centres in your town/city. While self-isolating:
• Keep the elderly members safely away, within the household, or if possible, in a separate room or at some other location.
• Stay at home or maintain physical distance with each other if you have enough space in your room or house. Keep windows open for ventilation. If there is no space available, try and
maintain as much distance as possible from others and wear masks.
• Avoid physical contact and maintain physical distance with others, especially visitors or people you are not familiar with.
• Caregivers should wear masks and gloves while performing any task that involves direct contact with patient or contaminated surfaces, such as the bathroom, kitchen, utensils, clothes, beddings, etc.
• Discard gloves after every use. Reusing disposable gloves may increase the risk of infection.
• Wash hands with soap and water after taking off gloves.
• Have food, medicines, or other essentials delivered at home through family members, friends,or delivery services.
• Have the groceries or food delivered to be left outside your door to prevent face-to-face contact.
• Do not share utensils, bed linen, towels, or other household items with others whilst isolating.
• Try to use a separate bathroom, if available. If using shared bathroom, try to clean the toilet and bathroom every time you have finished using them. You can use bleaching solution/Sodium hypochlorite.
• Clean the surfaces first with water and soap/detergent first to remove dirt, then carry out disinfection.
• Cleaning should always start from the least soiled (cleanest) area to the most soiled (dirtiest) area in order to not spread the dirty to areas that are less soiled.
• High contact surfaces such telephone, printers/scanners, electrical switches should be cleaned
twice daily by mopping with a cloth soaked in 1% bleaching powder/sodium hypochlorite.
Frequently touched areas like table tops, chair handles, pens, diary files, keyboards, mouse, mouse pad, etc. should specially be cleaned.
• For metallic surfaces like door handles, security locks, keys etc., sanitizer with 70% alcohol can be used to wipe down surfaces where the use of bleach is not suitable.
• Train the patient on how to use thermometer and oximeter twice a day. If the patient is literate, ask them to record the readings in a notebook. Provide a pen and notebook.
• Wash hands with soap and water immediately after each piece of PPE (in case if you are using any at home) is removed, following completion of cleaning.
• The COVID-19 positive person should avoid using the kitchen.
• The patient should ideally avoid eating with others; they should eat in their designated space or in a separate room.
• They should ideally use separate utensils, plates, glasses, or cups and wash these with hot water on their own.
• Try and provide kettle, flask so that the caregiver can save time instead of heating water on stove many times in a day.
• Dispose all possibly contaminated material like dry waste and sanitary waste in yellow chlorinated bags that can be collected by your regular waste collectors. This is an important
step for controlling the spread of COVID-19 in the community and for protection of persons who take care of the waste.
Looking after yourself or someone you care about who has COVID-19
As with other viruses such as colds and flu, taking it easy and looking after yourself (for patients and caregivers) is crucial to recovery. COVID-19 care should include:
• Drinking plenty of fluids and water. Staying hydrated is critical. Hot water will help with the throat as well. Kadha, a concoction of ginger, honey, tulsi, turmeric and boiled in water is generally helpful for the wellness of the throat.
• Salt water gargling or Betadine Gargle 3-4 times a day helps in keeping the throat moist and helps in conditions of cough and sore throat.
• Some recommend high protein diet during this period which can include paneer, eggs,legumes, and varied meat products. Caregivers can provide a basket with biscuits, rusks, fruits
and nuts so that patients can eat something when they feel hungry.
• Avoid alcohol as this will cause dehydration and further compromises those with weak liver function.
• Avoid any strenuous activity when unwell.
• If your oxygen saturation is normal and if you do not have any other symptoms other than fever, all you need is paracetamol. However, it is always better to consult your physician first.
• Do not take any other medicine without medical advice. Do not self-medicate or follow any experiential advice from friends or well-wishers.
• Since COVID-19 affects the breathing and clogs the lungs with phlegm, we found that deep breathing exercises are extremely helpful. An exercise called ‘proning’ has been recommended by many friends. It can be done 4-5 times a day and can help to push up oxygen levels. A video at https://scroll.in/video/992771/watch-how-the-prone-position-helpsimprove-oxygen-flow-in-COVID-19-19-patients demonstrates the prone position.
• When sleeping, lie on stomach and on your sides. Avoid sleeping on your back.
• Keep walking and moving. Sitting up and taking deep breaths helps open up the lungs.
*Please note, these exercises are not substitutes for medical care.
• Avoid stress as much as possible. Try to engage yourself in reading, listening to music, or with hobbies which make you feel good. Try to be cheerful and get plenty of rest.
Equipment to be kept handy
Masks: Everyone in the family should start wearing masks when near each other. Make sure to wear
N95 masks when entering rooms of symptomatic patients. Doctors are recommending double masking now – a surgical mask beneath and a cloth mask on top of it. Masks are effective if worn according to instructions and properly fitted. Masks should be discarded and changed if they become physically
damaged or soaked. Used masks should be considered as potentially infected.
- Disposable gloves: Do not forget to use gloves when handling utensils, clothes and other items of a COVID-19 patient or while cleaning potentially infected surfaces. Discard gloves after use and wash hands with soap and water.
- Pulse oximeter is a critical tool to keep an eye for oxygen level and pulse; keep a stock of spare batteries as some of these oximeters run out of battery very fast.
Thermometer to keep an eye on the fever and decide when medication is required.
Sanitizer with 70% alcohol to be used at regular intervals along with regular handwashing.
There has been a major shortfall in oxygen availability (for example, in Delhi and in some other places). The oxygen shortage has been evident in hospitals as well as for home based care. Several patients who are in dire need of oxygen have not been able to access it. Oxygen concentrator is a useful medical device to manage breathing related problems including in cases of delays in hospitalization. Keep handy phone numbers / contacts of oxygen concentrator vendors; ensure that the
contacts are accurate. Support groups can also facilitate crowd sourcing and sharing of these contacts for particular locations to facilitate access.
- Despite the benefits of getting an oxygen concentrator, in
the current situation of immense shortfall and desperate demand, storing oxygen concentrators when not medically indicated by the physician nor immediately required, is unethical and should be avoided.
Advice for Families
• COVID-19 is not a stigma. Talk openly about COVID-19 if you are positive, with your family and friends. Do not shy away from disclosing when there is a COVID-19 positive patient in the household and informing others working at your home (your help, driver, others in your house) so that they too can isolate and take the necessary precautions. It is our responsibility towards our community to keep them safe as well. With people working at home, ensure an open and safe environment where they can disclose their / their family member’s status when the situation arises.
• Women often end up taking on more work and care giving responsibilities. So, it is important to make sure that tasks are delegated. If possible, try to minimize their work and exposure to the patient.
• Talking with friends, relatives, and family can be helpful for both the patient as well as the family. Creating occasions to laugh and be joyful amidst the gloom – a food treat, a movie
together, even with physical distance may help.
• De-stressing individually by taking up meditation, music, mild exercise, reading, engaging with hobbies, etc.
• Fear, anxiety, sadness, anger are natural responses to such a situation, especially for the patient and their family, and it is important to acknowledge them. If possible, let these feelings pass by you rather than trying to control them or get rid of them. There is no doubt that providing care is a huge responsibility but this is not the time to panic or stress. Yes, the pressure of work is likely to be overwhelming in the beginning, but an
organized approach and systematic delegation will make the process smoother.
• Lastly, but more importantly, the healing can only happen when the COVID-19 patient also responds to the treatment and adheres to protocols. It is imperative that the patient’s morale is built with love, care, and support throughout this healing process and the person never feels lonely and abandoned due to the isolation measures.
• After contracting the disease, it is likely that the patient will feel distressed and might suffer from anxiety, insomnia etc. So, even if patient is in isolation, they should feel that there is a
loved one to provide a lending hand, whenever needed. If the patient is not provided with adequate love and comfort during this crisis, the healing process might be traumatic for the
patient and can lead to poor mental health.
Do reach out to support systems for help if:
• You are facing domestic violence and your home is not a safe space • You do not have adequate space or facilities to isolate safely at home.
• You have elderly/ other vulnerable persons you cannot isolate sufficiently from.
• You cannot cope with your symptoms at home.
• Your condition gets worse.
• You still have fever, are feeling generally unwell or have other symptoms after a week.
• You are unable to do everyday tasks such as looking at your phone, reading or getting out of bed.
• You have someone at home who has tested positive/ is showing symptoms but not cooperating in terms of self-isolation and care, putting you or other family members at risk.
You need to seek medical help when the patient:
• Cannot cope with their symptoms at home.
• Their condition gets worse, especially if oxygen levels are less than 94 for more than 2-3 hours.
• If fever does not go down to 102 F, irrespective of multiple doses of paracetamol.
• They still have fever, are feeling generally unwell or have other symptoms even after a week.
• Also, as advised by their physician for any other symptoms and signs which require immediate medical help.
STAY SAFE & TAKE CARE
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• Coping when Covid Hits the Household: Jennifer Liang and Sunil Kaul
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Family Welfare: https://www.mohfw.gov.in/pdf/COVID-1919ProningforSelfcare3.pdf
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• How to dispose of COVID waste from your household (2020, September 1). Retrieved from
Citizen Matters, Bengaluru: https://bengaluru.citizenmatters.in/how-to-manage-dispose-ofCOVID-19-biomedical-waste-from-your-household-apartment-49824
Sama Resource Group for Women and Health April 2021
• ICMR. (2020, June 14). Advisory on Use of Rapid Antigen Detection Test for COVID-19.
• Knowing Covid-19 was at their door, family of 8 planned strategy to fight it (2020,
September 26). Retrieved from The Straits Times:
• The Tips for Home Management: Progressive Medicos and Scientists Forum(PMSF)
• Watch: How the ‘prone position’ helps improve oxygen flow in Covid-19 patients. (2021,April 20). Retrieved from Scroll.in: https://scroll.in/video/992771/watch-how-the-proneposition-helps-improve-oxygen-flow-in-COVID-19-patients
We acknowledge Dr. Sunil Kaul, Jennifer Liang and Dr.Vikas Bajpai allowing us to use their material and information. Dr. Subha Sri and Dr. Rakhal Gaitonde for providing information and support
despite their busy schedule. Ranjan De for inputs and editing
Research and Developed by Sarojini Nadimpally and Aakriti Pasricha with Neelanjana Das