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Expert answers COVID-19 queries on self-isolation and more

DT Pakistan
Dr Muattar Hanif

Dr Muattar Hanif

Fri. 19 June 2020

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As the pandemic continues to affect the world, many people have turned to Google to answer their queries about coronavirus. The most burning topic these days have been self-isolation. While reliable sources are working hard to communicate correct information, but at times the messages are not reached to people. This could be attributed to fake reports and videos circulating on Facebook and WhatsApp, to create chaos and confusion among the general public.  Infectious Disease Expert, Dr Farheen Ali, Diplomate American Board of Internal Medicine and Infectious Diseases; Head, Department of Infectious Diseases, NICVD and Consultant, Infectious Diseases, South City Hospital finally answered most common questions related to self-isolation in COVID-19 pandemic and debunked popular myths circulated within virtual platforms. 

What is the difference between home-isolation and quarantine; are they the same thing?

“People are interchangeably using the term quarantine and home/self-isolation, but these words are not same,” said Dr Farheen. 

“The word 'quarantine' is used when non-infected people decide to stay at home, just to protect and minimize the chances to contract the virus.”

“Self-isolation is done when a patient develops mild symptoms, and instead of isolating them at the hospital, it is suggested that they keep themselves isolated at home and monitor their symptoms and conditions. This is an effective way to stop the spread of COVID virus further.”

Which is more preferable: Isolation at Home or Hospital?

The place of isolation depends on the condition of the patient and whether there is an availability of separate room in the house of the patient, where they can be adequately isolated,” said Dr Farheen Ali.

“Usually, patients are advised to get themselves isolated at hospital wards when their symptoms are severe. But if the patient is showing mild to moderate level of symptoms and his condition is not critical, then we advised them to get home isolated, only if they have sources to manage that properly.”

What is the total period of isolation recommended? 

“As an expert, I recommend that a minimum of 14 days are required for quarantine. During this period, one should monitor those symptoms are not developed. Because the incubation period is 14 days for the virus, hence it takes two weeks at least to show physical symptoms, after the contraction of the disease,” said Dr Farheen. 

“Whereas for self-isolated people, especially those who have low immunity or are on a high dosed steroids, at least ten days from the start of symptoms and 3 to 4 days after they have started recovering.”

“For patients who are tested as positive but haven’t shown any symptoms, should be isolated for ten days.”

What are the do’s and don’ts that one should follow during self-isolation?

“There are various precautions and dos and don’ts that should be considered to prevent the spread of the virus among the community and especially among your loved ones,” told Dr Farheen.

“The most important thing to consider is to make sure that not only room but bathrooms are also separated. One should try to keep themselves isolated as much as possible. The caretaker should be just one person who should make sure to cover themselves with gloves and mask when interacting with the patient. Once done, then don’t forget to dispose of the masks and gloves properly.”

Hand hygiene should be the utmost priority, and washing of hands should be done not less than 20 seconds,Dr Farheen Ali

"Make sure to have pulse oximeter in the house to monitor oxygen levels of the patients, especially for high-risk patient or old age patients, smokers.”

Is it one size fits all, or do we have different protocols for healthy patients, pregnant women, children and medically compromised/elderly patients? 

“Standard Operating Procedures (SOPs) and guidelines of isolations are the same for everyone,” said Dr Farheen.

“However, for small children, if they can’t be isolated alone, especially the ones who are on breastfeed. They should be considered isolating with mother or any other caregiver.”

“If multiple family members are positive, then all of them can be isolated together.” 

Which symptoms require medical attention right away?

“There is a range of symptoms from mild to serious conditions, but proper infection control is highly important,” said Dr Farheen.

“If anyone is suffering from fever, body aches, severe fatigue, sore throats and loss of taste, they should be tested right away.” 

Should one go to ER/OPD during self-isolation, or is getting consultation through Online is good enough?

“In my experience, there is no need to visit the hospital unnecessary. You can get yourself tested from other hospitals collection units and government recognized laboratories if you experience previously mentioned symptoms,” said Dr Farheen.

“In case anyone develops COVID-19 symptoms, they should contact the hospital or doctor for consultancy, rather than visiting a hospital in person.”

“You can use telehealth kind of services to talk and consult a doctor on the phone regarding your condition. You can even update them about your symptoms so that they can monitor your health and recovery status.”

Are there any medicines to be taken during self-isolation 

“To be honest, there is no proper treatment or any medicine to cure COVID-19,” said Dr Farheen Ali.

“Only symptomatic treatment is advised. If you are suffering from fever, then any fever relievers can be used.”

“However, those who are at home isolation must take control of their other diseases, like diabetes or asthma, and make sure to take their medicines on time.

Please share some info about the myths floating around; taking steam reduces your chances of contracting Covid-19, Kalonji (black seed) is useful to prevent Covid-19, Meetings a Covid-19 person for less than 30 minutes is risk-free.

“There is no such data available for or against of any home remedies,” said Dr Farheen.

“So, without any evidence, it cannot be recommended. But then there is no data to prove against them. There is no concrete evidence for home remedies. If something makes you feel better, it is completely up to you. You can take it or not, as per your will.”  

“As far as a meeting patient of COVID-19 is concerned, then regardless of duration, one can get affected if they are close to the patient without any protective equipment.” 

Is it necessary to wear PPE at home for the patient in self-isolation

“Ideally, in-home isolation, one is already separated from the rest of the people. Hence there is no need to wear protective equipment,” said Dr Farheen. 

“However, caregivers should wear mask & gloves and ensure a safe distance from the patient.”

A lot of discussion about the inaccuracy of tests? Please comment. 

“PCR is the test that is widely and currently available. The process is done by taking sample through swab,” said Dr Farheen Ali.

“Serological test/blood test should not be used to diagnose COVID-19.”

“Having said that it is a fact that no test can be 100% accurate. There is always 70% to 80% sensitivity in PCR depending on how well the test is being done. You can get 20 per cent false results. Therefore, you should consult the doctor and let them decide if you are facing the right symptoms, even if the test comes negative.”

How to handle food items and groceries when bringing them home?

“We don’t have sufficient evidence to say that food items and groceries are a very high or efficient way to transmit the virus,” said Dr Farheen.

“However, one should make sure to wash their hands and get rid of the external packaging of the food and grocery items.”

“Moreover, eating food from outside does not cause COVID so one can deliver food, with precautionary measures.”

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