What you need to know about home-based care for Covid-19

Rwanda is set to roll out home-based care for Covid-19 patients, a move that follows a spike in daily cases registered by Rwanda Biomedical Centre (RBC). In anticipation that cases may in the immediate short run continue to increase and the medical facilities may get overwhelmed. The system, which was rolled out Friday, will therefore ensure patients with mild cases and are out of the high risk population, are isolated at home until they test negative to the virus. Currently, Rwanda has over 3,672 confirmed cases; and RBC says new cases may rise due to the reopening of airports for commercial flights and the resumption of domestic and international tourism in the country. RBC has been piloting the initiative, and they are now ready to roll it out on large scale. Rwanda’s home-based care system is only the second kind of initiative in the region, after Kenya embarked on such earlier this year. Here are 7 things you should know about Rwanda’s home-based care for Covid-19 patients: 1. It comes to ease possible pressure on health centres and other facilities The Covid-19 pandemic found Rwanda unprepared, just like almost every country on the globe. To deal with the rising number of patients, the country repurposed some health centers and schools into special treatment centers for the pandemic. According to RBC, by July 21, there were 18 treatment centers: 9 health centers and 7 schools with a total capacity of 1986 beds. Turning health centres into Covid-19 treatment facilities creates a barrier in accessing health services, according to RBC. “This is detrimental to achieving the goal of ensuring continuity of health services during this pandemic with associated indirect morbidity and mortality due to other health related conditions. As the country progressively reopens the economy; schools, hotels, private and government services need to be fully operational and will therefore not be available for use as treatment centers,” read a document from RBC. 2. It is only for asymptomatic patients, and those with mild symptoms RBC says that this kind of care is for patients who are asymptomatic and those with mild symptoms, and they should not be above 65 years of age. Current available data in Rwanda shows that approximately 70% of cases are mild/asymptomatic and requiring only isolation and supportive management to recover, “and this can be done from the home set up. 3. Suitability of the home is pre-requisite Selecting a patient for home-based Covid-19 care will be informed by an assessment of the suitability of the patient’s home environment. Such home should not have people that are at high risk of complications from the pandemic for example those above 65 years of age; immunocompromised people; those who have chronic heart, lung, or kidney conditions. It must also have adequate toilets and bathrooms facilities on the premises or in the compound; and a separate well-ventilated bedroom or isolation space where the patient can recover without sharing immediate space with others. There should also be another responsible adult in the household. 4. Patients monitored on daily basis Patients will be followed up on a daily basis through phone calls. Patients will take their own temperatures daily and report the daily temperatures during the call; in addition to reporting other symptoms that may occur. Community Health Workers (CHWs) will be responsible for educating the affected household on home-based isolation, care and infection prevention and control. 5. In case of progression of symptoms, the patient will be referred to treatment facilities In case of worsening symptoms, patients or caregivers can report this, and the medics may react by organising the patient’s referral to a facility that can provide care for critically ill patients. 6. Other members of the household will be on self-quarantine, and the home will observe strict social distancing measures and hygiene All the other household members are high-risk contacts and will be on self-quarantine, according to RBC. These will also be followed up on phone until the home-based care and isolation for the confirmed case ends. Household members must limit movements in the house and shared spaces; should always wear facemasks; always maintain a 2 metre distance from each other; the care giver of the patient must wear a medical mask (other household members may wear a cloth mask). Basic personal protective equipment (mainly gloves) should be used when cleaning surfaces. After cleaning, the protective equipment that has been used should be cleaned with soap and water and decontaminated with 0.5% chlorine solution. 7. Patients will be on home-based care for a minimum of 14 days. Regardless how fast they improve, patients on home-based care must in isolation at home for at least 14 days. After that period, then medics will look to find out whether these patients have recovered. The recovery is confirmed by two negative results of COVID-19 RT-PCR, 24 hours apart.

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What you need to know about home-based care for Covid-19