Nagaland Covid-19: Standard operating procedure for home isolation

Surveillance

• Digital surveillance: It is mandatory for the patient in home isolation to download the nCOVID Nagaland App and select 'Mark Yourself in Quarantine'. Self monitoring of symptoms and entering into the app twice daily will be done until discharge from home isolation. For any assistance on the app or on development of any symptom, the patient should call the Toll Free State Helpline 1800 345 0019. Aarogya Setu App should also be downloaded and kept activated at all times.
• Community Surveillance: The village council/ town council/ municipal council will immediately report any violation of home isolation to the district task force. On receiving such report, the medical surveillance team and district task force will be alerted for appropriate contact tracing, isolation/quarantine, testing, and containment measures.
• Medical surveillance: Each patient in home isolation will be linked to a designated Covid hospital. Ambulance service and relevant mobile numbers should be made available to the patient at the start of home isolation. Telephonic monitoring of symptoms by the medical team will continue in addition to the digital surveillance.

Penalty:

The violator(s) of this SOP will be penalised as per the relevant section of the Disaster Management Act 2005, and the Nagaland Epidemic Disease (Covid-19) Regulations 2020.
Safety precautions

1. The patient should not move out of the isolation room during the entire duration of isolation except in circumstances where the bathroom is located away from the room.
2. The dedicated caregiver should be a young and healthy person without any other chronic diseases. The care giver will avoid physical contact and maintain physical distancing when providing care. The patient and the caregiver will wear mask, maintain social distancing, and wash hands frequently.
3. Food may be served in disposable containers preferably made of biodegradable material. All essential items should be delivered at the door without entering the room.
4. Only on medical recommendation, Hydroxychloroquine prophylaxis will be taken by the care giver and close contacts.
5. If bathroom is shared, it should be disinfected after each use with appropriate disinfectant: sodium hypochlorite, phenyl, detergent / soap.
6. Elderly/pregnant women or family members with other co-morbid conditions should stay away from the isolation room and not share the bathroom.
7. Frequently touched surfaces will be disinfected regularly with I% sodium hypochlorite solution or other available disinfectants.
8. Clothes and linen used by the person should be washed separately using common household detergent and dried.
9. Used masks can be disinfected using ordinary bleach solution (5%) or sodium hypochlorite solution (1%) or appropriate concentration of household disinfectant (e.g. dettol, detergent) and then disposed off either by burning or deep burial.
10. The cleaning works such as washing of utensils, used linen / clothes, disinfection of frequently touched surfaces etc should be done by the patient in isolation to avoid contact with caregivers.

Duration of home isolation

1. The total duration of home isolation will be for 14 days. If there is no symptom throughout the period; which will be followed by 14 days home quarantine.
2. If symptoms develop during the isolation period, patient will be shifted to Covid hospital. But if the symptom is very mild and medical officer advises continued home isolation, the patient will continue isolation for 10 more days from the onset of symptom and the patient should not have had fever at least for the last 3 days. This will be follow by 14 days home quarantine.
3. After home isolation, testing is not recommended by GOI. But the state testing policy for discharge of confirmed cases will be followed, as revised from time to time.