What should patients with mild novel coronavirus symptoms and asymptomatic people with a clear history of exposure do? 

The World Health Organization (WHO) provides some suggestions, and here are some recommendations based on the data.

Since the proportion of severe 2019-nCoV cases is not very high, the mortality rate is lower than SARS and no effective medicine has been identified. That means suspected patients with mild symptoms or those who are asymptomatic do not require hospitalization; self-quarantine and self-observation may be feasible.

In light of 2019-nCoV transmission patterns, the WHO recommends that suspected 2019-nCoV patients can be isolated and monitored in a hospital setting. 

However, for several possible reasons, including situations when inpatient care is unavailable or unsafe, for example, or health care capacity is limited, alternative settings provision may need to be considered.

Who needs to self-isolate? 

If you are in good health, have no cardiopulmonary disease, renal insufficiency, immunosuppression or tumors, or any other underlying disease, you don't need to worry too much if you have fever, and you can remain at home for self-observation. 

This is also applicable to patients no longer requiring hospitalization.

Most people who died from COVID-19 were elderly, so if you are over 65 years old, you should seek medical advice in a timely manner.

What are the requirements for self-quarantine?

It is better to have a medical worker to provide the patient with consultation and monitoring during their self-quarantine and self-observation. Telephone care is needed on a daily basis, in case the patients' symptoms worsen.

If a patient needs to remain at home for self-quarantine and self-observation, other household members need  personal sterility training to control the spread of infection, and to provide the patient with safe care.

What are sterility considerations for home isolation?

1. The patient should stay in a separate room with good ventilation.

2. No visitors.

3. Limit the number of caretakers; ideally assign one person who is in a good health to the patient.

4. Household members should stay in a different room or, if that is not possible, maintain a distance of at least a meter from the patient. Sleep in a separate bed.

5. Limit the movement of the patient and minimize shared space. Ensure that shared spaces (e.g. kitchen, bathroom) are well ventilated (e.g. keep windows open).

6. The caregiver should wear a mask fitted tightly to the face when in the same room with the patient. The patient should also wear a  mask.  If the mask gets wet or dirty, it must be changed immediately. Discard the mask after use and perform hand hygiene after removal of the mask.

7. When to perform hand hygiene?

Perform hand hygiene following all contact with the patient or after entering their room. Hand hygiene should also be performed before and after preparing food, before eating, after using the toilet, and whenever hands look dirty.

If hands are not visibly soiled, alcohol-based hand rub can be used.

Perform hand hygiene using soap and water when hands are visibly soiled.

Note: Keep away from fire when using alcohol-based disinfectants indoors.  When using soap and water, drying hands with disposable paper towels is desirable.

8. Respiratory hygiene should be practiced by all members. Cover the mouth and nose during coughing or sneezing using medical masks, face masks or tissues, followed by hand hygiene.

9. Discard materials used to cover the mouth or nose or clean them appropriately after use (e.g. wash handkerchiefs using regular soap).

10. Avoid direct contact with body fluids, particularly oral or respiratory secretions, and stool. Use disposable gloves to provide oral or respiratory care and when handling stool, urine and waste. Perform hand hygiene after removing gloves.

11. How to deal with polluted articles? Gloves, tissues, masks, and other wastes that have come in contact with the patient should be placed in a garbage bag dedicated to the patient's room and marked as polluted articles before being discarded.

12. What can share with the patient as household members? Do not share anything that may result in infection, including public toothbrushes, tobacco, food, drinks, towels, clothing, and bed linens. Eating utensils and dishes should not be reused until it has been soaped and disinfected.

13. How to disinfect rooms?

Dinning tables, bed tables, and bedroom furniture: Clean them with a diluted disinfectant (one percent disinfectant and 99 percent water) on a daily basis.

Washstand tables: Clean them with a diluted disinfectant at least once a day.

Wash the patient's sheets, quilt covers and clothing with water at 60-90 degrees celsius and then dry them thoroughly.

When to terminate the isolation?

If symptoms disappear in at least seven days (the longer, the safer) and/or the results of two RT-PCR (real-time reverse transcription polymerase chain reaction) tests at 24 hour intervals were negative.

Who should be considered as contacts?

All household members should be closely monitored.

Once household members have symptoms of acute respiratory infections, including fever, cough, sore throat, and dyspnea, the following recommendations must be followed.

What to do with contacts?

All contacts should monitor their health for 14 days from the last day of contacting the patient. And seek immediate medical attention if they develop any symptoms, particularly respiratory symptoms such as fever, coughing, pharyngalgia, shortness of breath, or diarrhea.

Keep in contact with medical staff throughout the process so that they can provide advice and monitoring.

How to get there if you need to go to the hospital for medical treatment? Avoid public transportation if possible; call an ambulance or drive a car. Keep the windows open to maintain the car well-ventilated.

Once a contact person becomes sick, please wear a mask and keep more than a meter away from other people (this is also applicable to vehicle or medical institutions).

Appropriate hand hygiene should be employed by all contacts and medical staff.

Any part of the vehicle that is contaminated with respiratory secretions or body fluids should be disinfected in time (one percent bleach + 99 percent water).

if any of the following conditions occur, immediately stop home isolation and seek medical attention:

Dyspnea (including chest distress, and shortness of breath after exercise)

Problems with consciousness (including lethargy, deliriousness, inability to distinguish between day and night)

Diarrhea

High fever of over 39 ℃

(The above suggestions are shared by Tencent Medpedia upon the authorization of a WeChat official account called PUMCH Pneumology)

Stories in this series were contributed from Tencent Medpedia medical team, which were written and reviewed by medical experts from China's top hospitals. They are intended for informational purposes only, not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on our website. If you think you may have a medical emergency, immediately call your doctor, or go to the hospital.