Ministry of Health

Lao PDR

Guide for Home and Community Care

for Asymptomatic or mild Covid-19
patient

Department of Health Care and Rehabilitation,

November 2021

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 Foreword
Currently, the Novel coronavirus (COVID-19) pandemic has continued to widely spread leading to the
dramatic increase in infection and mortality rate.
The Lao People’s Democratic Republic is one of many countries has been facing this COVID-19
pandemic situation causing negative impacts on health and livelihood of population leading to the
severe effects on the national socio-economic development. Toward this problem, the Party and
government have identified and set the measures to handle for prevention, control and address the
disease pandemic for public health and social measures. However, based on the development of
disease and severity of its spreading causing severely increased numbers of imported and locally
transmitted cases. Thus, to handle the pandemic situation, it is crucial need for not only the technical
responsibility but also the ownership of all stakeholders, local authorities at different levels in
monitoring, supervision and close coordination and with timeliness.
While the government continues to develop the capacity to accommodate COVID-19 cases in
hospitals and isolation facilities to monitor and provide treatment, if the number of cases continues
to increase, these facilities could face challenges and will need to consider monitoring of patients’
health at home based on the health status of patient and a certain criteria to monitor and care at
home appropriately.
This guideline on home and community care for asymptomatic or mild symptom COVID-19 cases is
developed to supportprovinces and districts in case the COVID-19 case load reaches the maximum
capacity to accommodate in those facilities. This guideline is intended to be useful for health
providers, other professionals, volunteers, local authorities and family members who need to take
care of a COVID-19 positive person at home
It provides clear instructions on: (1) who could be cared at home versus who should be prioritized
for monitoring and care in hospitals and isolation facilities; (2) how to monitor and take care of the
patient’s physical and mental welling; (3) how to protect other family members from further
infection; and (4) when to contact health facilities for referral to prevent delay in necessary medical
support.
We believe that having correct information about infection will contribute to preventing stigma
against those who are infected. We also hope that this guideline will prompt the community to
provide psychosocial support to the patient and the family through correct knowledge and no stigma
on each other in the society.
The Ministry of Health would like to note the great thanks and gratitude to the Department of
Health Care and Rehabilitation, Department of Hygiene and Health Promotion, Department of
Disease Control, Department of Planning and Cooperation, the National Laboratory and
Epidemiology Center, Sethathirath hospital, WHO and stakeholders for physical and intellectual
efforts and dedication toward formulating this guideline.
Vientiane Capital, 8th November,2021
Minister of Health
PhD. Dr Bounfeng Phoummalaysith

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Objectives
1. To Prioritize who could perform home self-monitoring;
2. To know how to monitor physical and mental health of infected people;
3. To know how to protect family members in not having more infection;
4. To know when to contact health facility for referral of infected cases to avoid delay in assistance

1. Who may use this guidance?

The intended audience of this guide includes: health providers, other professionals,
volunteers, local authorities who support COVID-19 patients and their family members
at home and in community.

2. When to use this guide?

This guideline will be used only when the government as the central Ad-hoc
Committee announced the needs of home care.This guide can be used to learn how to
provide messages to patients and their family members who need home or community
care. Some of the messages here can be used for general public for those who might
not access health providers but need information on home or community care.

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 3. Guide for home care
1) Criteria for safe home isolation and care

Well enough to stay at homebased on below criteria:

1. SpO2 ≥ 95% on air (in case the patient has access to pulse oximeter)
2. Respiratory rate < 25 / minute
3. No difficulty in breathing
4. Received complete doses of vaccine as recommended
5. Mild symptoms: not sever upper respiratory infection: sore throat, watery nose,
nosal congestion.
6. No risk factors of deterioration: age not more than 60 yearsand NCDs such as
cardiovascular disease, diabetes mellitus, chronic lung disease, renal disease, cancer
and cerebrovascular disease
7. Not pregnant

* If the symtopm is not well improved, should call hotline 164

Criteria on safely self-isolate:

1. There is a household member who is healthy (with no risk factors) to provide care
2. The infected person must be completely separated from family members(with
availability of separate area for self isolation for 14 days)

(refer to below 4.3)

Table on self-home care monitoring

Date Body Heart rate (based SpO2 Feeling Better

Time temperature on oximeter) better/same/worse breathing/same/worse

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2) Home care for COVID – 19 patient and referral to health facility
a. How to monitor and take care of the patient at home
Till now,there is no specific treatment for Covid-19, so there is only general
health care (such as sufficient drinking water (at least 2 litters/day) and nutrient
food consumption, providing medicine for high fever,andetc.) Prepare some
basic medicine such as Paracetamol, Berberine, ORS, Multivitamine.
Not recommended to use antibiotics and steroids to cure asymptomatic and
mild symptom COVID-19 cases

b. When to refer to health facility

If the infected person starts to have difficulty breathing or other

symptoms that the infected person or the family members feels the
needs for medical attentions:
Call hotline: 164

c. How to transport the patient to health facility

- If no ambulance is available, transport the patient in a well-ventilated
vehicle (such as pickup car )
- The patient needs to wear a mask prior to leaving the home and conduct
proper etiquette for sneezing and coughing
- The patient should not unnecessarily touch the vehicle
- Accompanying person needs to wear a mask
Everyone needs to perform proper hand hygiene during the
transportation.Upon arrival to the hospital, accompanying person should
inform the staff before letting the patient and family go into the hospital
building. Clean and disinfect the vehicle (thoroughly inside, item and seat
touch by the patient) after the transport
3) Infection prevention and control for COVID-19 cases at home
a. Care Place and shared areas at home
- Keep the patient as separate as possible from everyone else in
the house.
- Isolate the patient especially from family members who are at
high risk such as: age over 60 years, pregnant women, who
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 have heart, lung, kidney or liver disease, diabetes and cancer
The patient should be isolated in a well-ventilated single
room,windows and doors open as much as possible to improve
airflow in the patient’s room
- If possible, the patient should use a separate toilet from the
rest of the household. If not possible, spray the disinfectant
after use every time.
- All shared spaces should be well-ventilated and routinely
disinfected .
- If a household has more than one confirmed cases, all patients
should be placed in the same house (should immediately
inform local authorities ).

b. Caregiver
- Avoid as much as possible to go into the same room as the
patient
- Limit the number of people who have face-to-face contact with
the patient. Only one person should look after the patient
- Caregiver should be healthy and not at high risk factors
- Wear a mask whenever the caregiver needs to be close to the
patient and remove immediately after completing tasks
- Often wash hands with soap or alcohol 70-90

- Should avoid physical contact (e.g. hug, hand shaking etc.) with
the patient.
- No visitors should be admitted to the house
c. Person Protective Equipment (PPE) and hand hygiene
- The patient should wear a mask as much as possible when
being outside their room.
- Do not touch the mask during use and do not reuse masks
- Everyone in the house should frequently wash their hands with
soap or an alcohol70-90, especially before preparing food,
before eating, after going to toilet/ bathroom, after sneezing
or coughing

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 d. Daily activities
- Give the patient his/her own separate cup, plate and spoon /
chopsticks. Wash all items with washing liquid after use.
- Make sure the patient uses his/her own separate bed sheets,
towel and wash cloth….
- The patient is not allowed to go outside the house and the
caregiver should also avoid close contact with other members
in the community. In case they need to go out such as shopping,
ask other family members to go.

e. Monitoring patient’s health

The care giver should regularly monitor health of patient. If patient has
difficulty breathing ot other symptoms, patient or family members feel
that they should get medical care from health provider: call to hotline
164

4) Criteria for isolation at home

Isolate the patient until the patient meets the criteria below

Time period for isolation at home

✓ At least 14 days have passed since COVID PRC test was positive

✓ If mild symptom, quarantine for 3 more days

After fully completion of isolation, individual could practice new
normal living

4. Mental health and psychosocial considerations

Mental and psychological wellbeing is crucial during the home or community
care. The patients with COVID-19 and their caregivers would be under stressful
situation, and might feel isolated, anxious,and scared.

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 Whenever health care providers see people affected by COVID-19, health care
providers need to:
➢ Share simple facts about what is going on and give clear information about
how to reduce risk of infection
➢ Know how to provide support to the people affected by COVID-19 and how to
link them with available resources

Key messages listed below should be provided to the isolated patients with
COVID-19 and their caregivers:

Key Messages for people in isolation

1. Stay connected and maintain social connections (via telephone, text, or video
call, but NOT physical contact)
2. Keep regular routines or create new routines such as singing, paintingand
exercise inside the isolation area
3. Engage in healthy activities
• Exercise regularly (inside area of isolation)
• Keep regular and sufficient sleep routines
• Eat healthy food
• Avoid alcohol consumption
• Avoid tobacco and drugs
4. Seek information updates from reliable sources such as Ministry of Health and
WHO
5. If the patient needs to go to hospital for non- COVID related reasons
including appointment already made (Eg. antenatal care, follow up for
hypertension or diabetes etc.), contact the nearest health facility

5. For lactating mothers and babies

Infants born to mothers with confirmed COVID-19 should follow standard infant
feeding guidance for Lao PDR. This means that breastfeeding should be initiated within
1 hour of birth and exclusive breastfeeding should continue for 6 months. Mothers
with confirmed COVID-19 should wear a mask while breastfeeding. They should also
wash hands before and after touching the baby and routinely clean and disinfect
surfaces.
Mothers and infants should be encouraged to practice skin-to-skin contact and to
remain together throughout the day and night, especially immediately after birth
during establishment of breastfeeding

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6. In case the infected patient immediately died at home
Call to Hotline 164 and Do not move the deceased person

7. Cleaning and disinfecting home

Need to clean the room daily basis:
- Clean with use of detergent and disinfect with disinfectant liquid with 0.1%
concentration or bleach in the proportions specified in the product.
- Use 70%-90% alcohol or disinfectant for small area or corner of the room.
- Do not use high-pressure spray directly on the floor to avoid the spread of virus .
- Hygiene and disinfect all equipment or areas that are frequently touched, such
as reception areas, tables, chairs, elevator push button,, doorknobs, door
handles, toilets, etc.
- Cover all remote control with plastic cover of television and air conditioner to
easily disinfect.
- Need to wash fabrics used in the bedroom with detergent and hot water at 100
degrees Celsius or higher. When using cold water for washing, use bleach liquid
diluted with clean water (in case of general disinfection).
- Cleaner must put on gloves and mask, boots, goggles, apron, gown when
cleaning every time..

8. Management of household waste

- Put all kinds of waste in a double-layer plastic bag and spray it with disinfectant
with a concentration of 0.5 - 1% before tie the plastic bag tightly.
- Excretion and other contaminants from the body of the patient such as mucus,
saliva, vomit, blood, stool, urine, and mucous membranes must be put in two
layers of plastic bags, tied the bag and sprayed with disinfectantcontaining 0.5%
-1% chlorine or 70% alcohol and leave it for 30 minutes, put it in the infectious
waste garbage with a lid before putting it at the waste collection point.
- Waste disposal: to ensure animals will not distract, the waste disposal should
be easy to move. Each bag must be labeled as hazardous and should not be more
than 3/4, tie the bag tightly, bring it to the waste collection point within 24 hours.

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- Waste collection point: identify the waste collection point, should not be mixed
with general waste, for garbage bins at the collection point must have a
wheelbarrow with a lid.
- Always wash your hands after handling or touching waste bags.

9. Roles and responsibilities of the local authorities and volunteers in

community

(1) District EoC has to clarify roles and responsibilities of village chief, village
police, village health volunteer, woman’s union and other people who can
help the patient and the family.
(2) Ensure the villagers support the patient and the family; for example make
sure they have enough water and food while they are isolated; make sure
they receive psychosocial support.
(3) Ensure this guide is disseminated to every village and family so that the
families know: when to allow home care, how to take care of the patient
at home; how to protect other family members from infection; when to
send the patient to a hospital; Time period of home isolation
(4) Protect family members and others from further infection
(5) Ensure there is a means of transport in case anyone needs referral
(6)Ensure infected patients and the families are protected from stigma and
they have access to essential needs
(7)Village authorities facilitate and support funerals for diseased persons
following the measures.

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References
WHO COVID-19 interim guidance: Home care for patients with suspected or confirmed COVID-19 and
management of their contacts, https://www.who.int/publications/i/item/home-care-for-patients-with-
suspected-novel-coronavirus-(ncov)-infection-presenting-with-mild-symptoms-and-management-of-
contacts [Access 3rd October 2021]

WHO COVID-19 technical guidance: Home care for patients with suspected novel coronavirus (nCoV)
infection presenting with mild symptoms and management of contacts, https://www.who.int/publications-
detail/home-care-for-patients-with-suspected-novel-coronavirus-(ncov)-infection-presenting-with-mild-
symptoms-and-management-of-contacts [Access 1st April 2020]

WHO COVID-19 technical guidance: Operational considerations for case management of COVID-19 in health
facility and community, https://www.who.int/publications-detail/operational-considerations-for-case-
management-of-covid-19-in-health-facility-and-community, [Access 1st April 2020]

WHO COVID-19 technical guidance: Severe Acute Respiratory Infections Treatment Centre,
https://www.who.int/publications-detail/severe-acute-respiratory-infections-treatment-centre, [Access 1st
April 2020]

WHO COVID-19 technical guidance: Clinical management of severe acute respiratory infection when COVID-
19 is suspected, https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-
infection-when-novel-coronavirus-(ncov)-infection-is-suspected, [Access 1st April 2020]

WHO COVID-19 technical guidance: Infection Prevention and Control for the safe management of a dead
body in the context of COVID-19, https://apps.who.int/iris/bitstream/handle/10665/331538/WHO-COVID-
19-lPC_DBMgmt-2020.1-eng.pdf, [Access 1st April 2020]

WHO COVID-19 technical guidance: Infection prevention and control during health care when novel
coronavirus (nCoV) infection is suspected, https://www.who.int/publications-detail/infection-prevention-
and-control-during-health-care-when-novel-coronavirus-(ncov)-infection-is-suspected-20200125, [Access 1st
April 2020]

WHO COVID-19 technical guidance: Water, sanitation, hygiene and waste management for COVID-19,
https://www.who.int/publications-detail/water-sanitation-hygiene-and-waste-management-for-covid-19,
[Access 1st April 2020]

WHO COVID-19 technical guidance: Infection prevention during transfer and transport of patients with
suspected COVID-19 requiring hospital care

WHO COVID-19 technical guidance: Mental health and psychosocial considerations during the COVID-19
outbreak, https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdf,
[Access 1st April 2020]

WHO COVID-19 technical guidance: Algorithm for COVID-19 triage and referral

Technical report: Novel coronavirus (SARS-CoV-2) Discharge criteria for confirmed COVID-19 cases -When is
it safe to discharge COVID-19 cases from the hospital or end home isolation?,
https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-Discharge-criteria.pdf, [Access 1st
April 2020]

USCDC, Discontinuation of Transmission-Based Precautions and Disposition of Patients with COVID-19 in

Healthcare Settings (Interim Guidance), https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-
hospitalized-patients.html, [Access 1st April 2020]

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