From

Additional Chief Secretary, to Govt. of l{aryana

Health Department.
To

l. All the Deputy Commissioners in the Haryana State

2. All Deputy Commissioner of Police/Senior Superintendent of Police/
Superintendent of Police.
3. All Civil Surgeons, Haryana
No. 32l3/IDSPl2020t 3? 25 - 66 Dated: l1-o 6-2.24
Subject: Regarding SOPs issued by the Health Department (Haryana) for Home
Isolation of mild/very mild/Asymptomatic/Pre-symptomatic COVID
Positive Cases.

In view of evolving situation of COVID-19 in the State and In continuation of

Revised Guideline issued by the Health department regarding Home Isolation of mild/very
mild/Pre-symptomatic COVID Positive Cases issued vide letter no. 3213-1D5p1202012738-91
dated l3-05-2020, following StandardOperating Procedure (SOP) are framed for effective
implementation of guidelines and to provide clarification regarding the various issues being
faced by the districts:-

I. ELIGIBILITY CRITERIA
' Mild Symptomatic / Very Mild Symptomatic / asymptomatic I Pre-Symptomatic
COVOD-19 confirmed cases who fulfill the pre-requisite conditions.
Pre-requisite Conditions: -
o Patients have to submit
"IINDERTAKING' for self-isolation as per Annexure-I.
o He / She should be assigned as Mild Symptomatic /Very Mild Symptomatic/
Asymptomatic /Pre-Symptomatic COVOD-19 confirmed casesby the treating
Medical Officer / doctor.
. Such cases should have separate room facility with attached toilet/washroom at their
home.
o A care giver should be available to provide care on24 X 7 basis.
o d communication link between the caregiver and hospital is a prerequisite for the
entire duration of l{ome Isolation.
o l'he care giver and all close contacts of such cases should take Hydroxychloroquine
prophylaxis as per protocol and as prescribed by the treating medical officer.
o Download Arogya Setu App on mobile and it should remain active at all times
(through Bluetooth and Wi-Fi) available at: https://www,mygo_v,in/AA-fogya:setu;app/
o The patient shall agree to monitor his health and regularly inform his health status to
the District Surveillance Officer for further follow up by the surveillance teams.

2. PERIOD OF HOME ISOLATION

o Such patients shall be kept under Home Isolation fbr a total period of 17 days(Ig
days under regular observation by surveillance team and an additional period of 7
days "Sel f-Monitoring").
o In case of such patients if admitted for some reason to any dedicated COVID care
facility for few days and then shifted to Home Isolation or vice-versa. the total
period of isolation shall remain the same as mentioned above.

3. WHEN TO SEEK MEDICAL ATTENTION

Patient I Care giver will keep monitoring their health regularly on daily basis and
immediate medical attention must be sought if serious signs or symptoms develop like:
 a Difficulty in breathing
a Persistent pain/pressure in the chest
a Mental confusion or inability to arouse
o Developing bluish discolorations of lips/face or as advised by treating medical
officer.

4. WHEN TO DISCONTINUE HOME ISOI,ATION

o Patient under Home Isolation will end Home lsolation after 17 days of onset of
symptoms (or date of sampling, for pre-symptomatic cases) and no fever for l0 days.
There is no need for testing after the Home Isolation period is over.

5. CONTAINMENT ZONE
o Containment zone for positive patients under Flome Isolation shall be delineated by
District Administration in coordination with concerned Civil Surgeon considering
the number of patients under Ilome Isolation and spread of positive cases in a
particular geographical area / Iocality.

6. INSTRUCTIONS FOR CAREGIVER

. Masks: The caregiver should wear a triple layer medical mask appropriately when
in the same room with the ill person.If the mask gets wet or dirty with secretions, it
must be changed immediately.Discard the mask after 8 hours as per Bio-medical
waste guidelines and perfbrm hand hygiene afier disposal of the mask.
o Hand Hygiene: Frequent Hand washing using soap and water for at least for 40
seconds or use alcohol-based hand sanitizer.
o Avoid direct contact with body fluids of the patient, particularly oral or respiratory
secretions and use disposable gloves while handling the patient. Perform hand
hygiene before and afier removing gloves.
o Avoid exposure to potentially contarninated items in his immediate environment
(e.g. avoid sharing cigarettes, eating utensils, dishes, drinks, used towels or bed
linen).
o Food must be provided to the patient in his room.
' Utensils and dishes used by the patient should be cleaned with soap/detergent and
water wearing gloves. The utensils and dishes may be re-used.
. Clean hands after taking off gloves or handling used items.
o Use triple layer medical mask and disposable gloves while cleaning or handling
surfaces, clothing or linen used by the patient.
o Perform hand hygiene before and after removing gloves.
o The care giver will make sure that the patient follows the prescribed treatment.

' The care giver and all close contact will self-monitor their health with daily
temperature monitoring and report promptly if they develop any symptom suggestive
of COVID- 1 9 (fever/cough/diffi culty in brearhing).
. Caregiver shall maintain a daily temperature log book provided by health team.

7. INSTRUCTIONS FOR PATIENT

o Patient should at all times use triple layer medical mask and discard mask after 8
hours of use or earlier if they become wet or visibly soiled.
. Mask should be discarded only afier disinfecting it with l%o Sodium Hypo-chlorite
Solution* or it should be kept in a paper bag / newspaper for at least 72 hours &then
disposed it ofT.
o Patient must stay in the identified separate room and away from other people in
home, especially elderlies and those with co-morbid conditions like:Hypertension,
Cardiovascular Disease, Renal Disease orPregnant Women and Children etc.
o Patient must take rest and drink lot of fluids to maintain adequate hydration
. Follow respiratory etiquettes all the time.
 Hands must be washed often with soap and water for at least 40 seconds or clean
with alcohol-based sanitizer.
o Don't share personal items with other people.
a Clean surfaces in the room that are touched often (tabletops. door knobs, handles,
etc.) with 1% hypochlorite solution.
a The patient must strictly follow the physician's instructions and medication advice.
a The patient will self-monitor his/her health with daily temperature monitoring and
report promptly if develops any deterioration of symptom as detailed below.

8. ROLE OF HEAI,TH TEAMS

o District Surveillance Officer/Medical Officer In-charge of concerned area will
designate a team of Health Workers (ASHA, ANM/MPHW(M)&UniI Committee
Member)to visit the house of patient and to verify whether patient meet the pre-
requisite for Home Isolation or not.
If Y€S, Health Team will explain the total duration of Home Isolation,
medicines/drug prophylaxis to be taken, do's & don'ts, Helpline Call
Centre/Ambulance numbers to the patient, caregiver and their tamily members.
Health team will also provide logistics for infection prevention control e.g. Masks,
Gloves, Bleaching Powder, Yellow Rag for disposal of waste as per Bio Medical
Waste protocol and demonstrate preparation of lYo Hypochlorite solution* and
waste disposal process.
Home Isolation guideline booklet (attached herewith)containing instructions for
patients & care giver and a log chart to keep the record of daily Health Status of
patient for l7 daysto be printed by the Districts for further distribution by the
Health teams on flrst dav of visit.

*How to make l% Hypochlorite solution;

Guidelines for Preparation of I %o sodium hypochlorite solution

Product Available Chlorine I Percent

Sodium hypochlorite - liquid 3.5% I -part bleach to 2.5 parts water

bleach
Sodium hypochlorite - liquid 5% I -part bleach to 4 parts water

NaDCC (sodium 60% 17 grams to I litre water

dichloroisocyanurate) powder
NaDCC (1.5 gl tablet) - tablets 60% I I tablets to I litre water
Chloramine * powder 2s% 80 g to I litre water
Bleaching powder 70% 79 to I litre water

Use freshly prepared Solution.

Ifno, Health team will coordinate to shift the patient to designated COVID Care
Centre (CCC) with the help of District Surveillance Officer.
Health Team will also visit the house of 'Home Isolated Patient' every third day to
check the health status of patient and to check whether patient is following the
guidelines or not.

9. BIO-MEDICAL WASTE (BMW) MANAGEMENT

o URBAN AREA: The Bio Medical Waste generated by the COVID Positive
patients who are kept under Home Isolation in urban area to be collected daily by
Municipal Corporation/lVlunicipal Committees and dispose off as per Bio Medical
waste guidelines issued by Haryana state pollution control Board.
 o Rural Area: The Bio Medical Waste generated by the COVID Positive patients
kept under Home Isolation in rural area to be collected daily by Development &
Panchayat Departmenland dispose off as per Bio Medical Waste guidelines issued
by Haryana State Pollution Control Board.

NOTE: In this regard, District administration shoukJ include Urban Local Bodies
&Developmenl &
Pctnchayat department lo prepare micro plan with clesignated teams, route
maps, de'signated vehicle and.fbllow all infection control prevention measures.
District HealthAuthorities to provide detailed line list of' positive cases kept under home
isolation with their address on dailv basis

10. DEDICATED CALL CENTRE / CONTROL ROOM

o A robust & dedicated COVID Control Room with to be set up with sufficient
number of lines. A Control Room Nodal Officer to be designatedfor
Training,Supervision, Monitoring& Evaluation and Analysis of call data.
o Control Room Nodal Officer shall ensurethat person kept under Home Isolation to
be contacted telephonically atleast once in five daysto enquire about 'Questionnaire
based Health Status'of all the positive patients. The 'Health Status Report,of such
patients besubmitted to Chief Medical Officer/District Surveillance Officer.
o Control Room Nodal Officershall promptly arrange Dedicated COVID
Ambulance for shifting the patients to appropriate COVID facility on receiving the
call / information of worsening the symptoms of any Home Isolated Patient.

This is for necessary action.

Enclosure:
a Undertaking Form for self-isolation.
a Home Isolation guideline booklet.
o Algorithm.
a Frequently Asked Questionnaire for call centre (FAe)

A
For Directo,ffi*.rvices (rDSp)
Health Department.

No. 32l3-ID SP /2020t 3%? - 68 Dated: 11-96-2oZo

A copy is forwarded to the following for information please:
l. Mission Director, National Health Mission, Haryana.
2. Director General Health Services, Haryana.

For Director Health Services (IDSP)

Health Department
 Annexure 1

Annexure I
Undertaking on self-isolation
I ………………………… S/W of ……………………, resident of ……………………………………
being diagnosed as a confirmed/suspect case of COVID-19, do hereby voluntarily undertake to
maintain strict self-isolation at all times for the prescribed period. During this period I shall monitor
my health and those around me and interact with the assigned surveillance team/with the call center
(1075), in case I suffer from any deteriorating symptoms or any of my close family contacts develops
any symptoms consistent with COVID-19.
I have been explained in detail about the precautions that I need to follow while I am under self-
isolation.
I am liable to be acted on under the prescribed law for any non-adherence to self-isolation protocol.

Signature____________________
Date________________________
Contact Number ______________
 Home Isolation Guideline Booklet

Home Isolation
Guidelines
Health Department,
Haryana
 Eligibility For Home Isolation
• Clinically assigned very mild case/ pre-symptomatic
case by the treating physician provided that patient have
the requisite facility at their residence for self-isolation
and also for quarantining the family contacts.

• Availability of 24 X 7 basis care giver and a communica-

tion link between the caregiver and hospital

• Care giver and all close contacts should take Hy-

droxychloroquine prophylaxis as per protocol and as pre-
scribed by the treating Physician.

• Patient and family members should download Arogya Setu

App on mobile : https://www.mygov.in/aarogya-
setuapp/.

• The patient shall monitor his/her health and regularly in-

form his/her health status to the District Surveillance
Team for further follow up . In addition to this health au-
thorities will monitor health of the home isolated patients
regularly.

The patient will fill in an undertaking on self-

isolation and shall follow home isolation guidelines
Process For Home Isolation
 When to Seek Medical Attention
•Difficulty in breathing,

•Persistent pain/pressure in the chest,

•Mental confusion or inability to arouse,

• Developing bluish discolorations of

lips/face

•As advised by treating medical officer

Call Health Facility / Help Line –

1075 /108 /8558893911
Immediately
 Instructions for the Patient
• Patient should use triple layer medical
mask. Mask should be discarded only af-
ter disinfecting it with 1% Sodium Hypo
-chlorite or after keeping it in paperbag
for 72 hrs

• Patient must stay in the identified room

and away from other people in home.
Follow respiratory etiquettes all the
time.

• Hands must be washed often with soap

and water for at least 40 seconds or
clean with alcohol-based sanitizer.

• Don’t share personal items with other

people.
 Steps for the Hand Washing
Seedha Ulta

Muthi Anghotha

Kalai
Nakhoon

SUMAN-K METHOD
Hands must be washed often with soap and water for at
least 40 seconds or clean with alcohol-based sanitizer.
 Respiratory and Cough
Etiquette

Follow respiratory etiquettes all the time.

 Dietary Advice for the Patient
• Ensure intake of plenty amount of fluids;
like water, soup, tea, juice etc to main-
tain adequate hydration .

• Increase the number of times you eat as

there is need for more calories.
• Food should include a variety of foods
like milk, eggs, legumes, pulses , fruits
and vegetables.

• Avoid intake of alcohol and tobacco

products.

• Honey, Ginger, Pineapple, Vegetable

Soups, Green Tea , Hot Turmeric Milk
can help in soothing sore throat and
cough.
 Advice for the Patient

• You can stay Connected

with Friends , family rela-
tives over phone , video
call , social media .
• Spend time watching your
favourite TV Shows , mov-
ies , read books , listen to
music or play games in
your mobile phones .
 Instructions for Care-Givers
• Wear a triple layer medical mask .

• Hand hygiene must be ensured following contact with

ill person or his immediate environment. Use soap and
water for hand washing at least for 40 seconds. Alcohol-
based hand rub can be used, if hands are not visibly
soiled.

• Avoid direct contact with body fluids of the patient,

particularly oral or respiratory secretions. Use disposa-
ble gloves while handling the patient.

• Bed sheets/ linen of patient to be disinfected with

1% sodium hypochlorite solution before washing.

• Frequently touched surfaces (tabletops, door knobs,

handles, etc.) in the room should be cleaned with 1%
sodium hypochlorite solution.

The care giver will make sure that the patient

follows the prescribed treatment.
 Preparation of 1% Sodium
Hypochlorite Solution from
Bleaching Powder for
Disinfection f

Product Available 1 Percent

Chlorine
Sodium Hypochlorite– 3.5% 1 part bleach to
liquid bleach 2.5 parts water
Sodium Hypochlorite – 5% 1 part bleach to
liquid 4 parts water
NaDCC(Sodium di- 60% 17 grams to 1
chloroisocynaurate) litre water
Powder
NaDCC(1.5 g/tablet)- 60% 11 tablets to 1
tablets litre water
Chloramine Powder 25% 80 g to 1 litre
water
Bleaching Powder 70% 7 g to 1 litre
water

Always use freshly prepared 1% Sodium

Hypochlorite.
 Where to Use 1% Sodium
Hypochlorite for Disinfection
• Bed sheets/ linen to be disinfected with 1% sodium
hypochlorite solution before washing for 30 minutes.

• Used Mask, Gloves should be disinfected with 1%

sodium hypochlorite solution for 30 minutes before
discarding.

• Frequently touched surfaces (tabletops, door knobs,

handles, etc.) in the room should be cleaned with
1% hypochlorite solution 4 times a day.

• Surfaces like Ceilings, Floor, Walls, Mirrors etc. at

should be cleaned at least once daily with 1% hy-
pochlorite solution .

The care giver will make sure that the patient

follows the prescribed treatment.
 Points to Remember
• The patient must strictly follow the physi-
cian’s instructions and medication advice.

• The patient will self-monitor his/her health

with daily temperature monitoring and report
promptly if develops any deterioration of
symptom.

• The care giver and all close contact will self-

monitor their health with daily temperature
monitoring and report promptly if they devel-
op any symptom suggestive of COVID-19
(fever/cough/difficulty in breathing).

• Maintain Log chart and write down body

temperature, pulse rate and any other symp-
toms twice a daily. These readings should be
shared with health team .
 Log Chart for Home Isolation
Day Date Temperature Pulse Runny Sore Cough Remarks
Nose Throat

Morning Evening Morning Evening

10

Care Giver/ Patient will monitor condition twice

a daily in log chart and inform Health
Department .
 Log Chart for Self Monitoring
Day Date Temperature Pulse Runny Sore Cough Remarks
Nose Throat

Morning Evening Morning Evening

•Patient under home isolation will end

home isolation after 17 days of onset
of symptoms (or date of sampling, for
pre-symptomatic cases) and no fever
for 10 days.
 Home Isolation
Guidelines

Integrated Disease Surveillance Programme,

Haryana
 Screening and Sample Collection
(Govt. & Pvt. Hospital / Dispensaries / Flu Clinic / ILI Survey)

COVID-19 PATIENT

On the basis of
Mild / Pre Symptomatic Clinical Symptoms by Moderate / Sever Patient
• Clinician will take undertaking Clinician
for self isolation
• Provide prescription
• Intimate DSO)

Home Isolation If Symptom deteriorates Facility Isolation

Medical Officer/
Mild patient will have
Clinician should Patients at
the option for Home
intimate DSO for these facilities
Isolation. Subject to
further surveillance should be
eligibility (As per GOI
activity as per treated as per
guidelines)
protocol GOI guidelines.

An oversight review committee consisting of one Dy. CS, concerned MO & BEE will review all home
isolation patients.

Care giver should On first day of isolation Health workers like ASHA, ANM/MPHW (M) will On every third day
be available for visit the house of patient and carryout following:
these Health Workers
1. Availability of care giver on 24*7 bases and check for pregnant
24*7 basis and women, children and elderly person and comorbid conditions.
will visit the Patient’s
House for any
should follow 2. Care giver to be instructed to monitor daily health status and deterioration of
these points. temperature of the patient and intimate to Health Authorities. symptoms and will
3. Ensure the availability of separate room, bathroom/washroom. ensure Home Isolation
1. Drug 4. Ensure separate clothes, bed sheets/linen (to be disinfected with protocol being
sodium hypochlorite solution before washing). followed. These
prophylaxis. 5. Patient to be instructed, not to share personal items with family
workers should share
2. Use of Mask. members.
their contact.

3. Hand Hygiene. 6. Make aware the patient & family members for hand washing for at
4. Disposal of Bio least 40 seconds or clean with alcohol based sanitizer.
Medical Waste as 7. Ensure Arogya Setu App be downloaded by the patient.
8. Provide Home Isolation Guidelines Booklet and logistics for infection
per attached prevention control e.g. masks, gloves, bleaching powder, yellow bag for
When to
Guidelines. disposal of waste as per BMW protocol and demonstrate
discontinue
preparation of 1% Hypochlorite solution and waste disposal process.
home isolation:
9. Ensure to clean surfaces in the room that are touched often Patient under
(tabletops, door knobs, handles, etc.) with 1% hypochlorite solution. home isolation
10. Stamping on the Patient’s Hand. will end home
11. Pamphlets distribution. isolation after 17
12. Display of Red Poster outside of Patient’s House. days of onset of
13. Health Workers shall share contact numbers of concerned Health symptoms
authority with Patients /family members.
 Frequently Asked Questions
HEALTH DEPARTMENT
GOVERNMENT OF HARYANA
INTEGRATED DISEASE SURVEILLANCE PROGRAMME
Website: haryanahealth.nic.in Email: dhs.idspdatam@hry.nic.in

FAQs for COVID-19 Cases put under Home Isolation

Q 1: Is Health Team visiting you on every third day to check your health status?

Q2: Is a care giver available with you 24x7?

Q 3: Are you providing information regarding your health status (temperature
reading etc.) daily to the health team over phone?

Q 4: Are you wearing a triple layer medical mask appropriately at all times and
discarding the mask after 8 hours or before if become wet?

Q 5: Is your care giver wearing a triple layer medical mask when entering your
room?

Q 6: Do you know the proper way of discarding the used mask i.e. discarding after
disinfecting it with 1% Sodium Hypo-chlorite solution?
Q 7: Are you, your care giver and other family members are washing their hands
frequently for at least 40 seconds and often using alcohol based hand
sanitizer?

Q 8: Are you, your care giver and other family members following social distancing
norms (2 Gaj Ki Duri) at home and following respiratory etiquettes
(coughing, sneezing etc.)?

Q 9: Are you staying in a separate room?

➢ Home isolated person should only stay in the identified separate room
away from other people in home, especially elderly and those with co-
morbidity conditions like diabetes, Asthma, hypertension,
cardiovascular disease, renal disease etc.

Q 10: Are you sharing your personal items like towel, eating utensils and especially
mobile phone with your care givers and other family members?

➢ COVID-19 patient should not share their personal items with other
persons.

Q 11: Are you taking proper medicines as advised by the treating physician and
drinking plenty of fluids?

Q 12: Are your care giver and members taking Tab. Hydroxychloroquine
prophylaxis as advised by the treating physician?
Q 13: Have you, your care giver and other family members downloaded the Arogya
Setu App in their personal smart phone?