The way of acting for family members of the Covid-19 patients

01.04.2020.  |   Print

Family members and persons, living in one apartment or house (household) with a patient with confirmed Covid-19 infection are considered as contact persons with high risk of infection. Regardless of the fact, whether the person with a confirmed Covid-19 infection, is in hospital or at home, the home quarantine or self-isolation is determined for persons, living together with the patient.

Other persons, who had a close contact (the distance is less than 2 m and the contact lasts for longer than 15 min) with the patient of the infection (for example, friends, work colleagues) are also subject to home quarantine. Contact persons shall be identified by epidemiologists of the Centre for Disease Prevention and Control through epidemiological examination, as well as they provide additional guidance on anti-epidemic and preventive measures, including: inform family doctors on the need for medical monitoring of contact persons.

Depending on the course of the infection disease, the prognosis of the disease, the risk of complications, the risk of infection to others as well as other conditions, the patient infected with Covid-19 infection may be isolated in a hospital or at home for as long as he or she is infectious (spreads the agents of the infection disease).

COVID-19 infectious agent spreads through direct contact with tiny droplets that occur when the infected person speaks, sneezes or coughs, as well as indirect contact, when touching surfaces and objects contaminated with respiratory secretions. For example, infection with COVID-19 infection may happen:

  • When being in the distance of less than 2 metres from an infected person, who speaks, coughs or sneezes;
  • When touching the body of an infected person, for example, when kissing, hugging;
  • When greeting and afterwards failing to wash hands, touching the facial area (mouth, eyes or nose);
  • When touching surfaces or objects, such as door handles, which have been touched by an infected person and afterwards failing to wash hands;
  • When touching objects, being previously touched by a person with unwashed hands, for example, a mobile phone.

Recommendations for measures at the place of residence after a person with a confirmed COVID-19 infection has been transferred to a hospital:

1. To perform a wet cleaning of the premises with a household cleaning agent and then disinfection.

2. Household disinfectants can be used or 0.5% sodium hypochlorite solution can be prepared for disinfection. Most of the household whitening agents contain 5% sodium hypochlorite (bleach 1:9).

3. Particular careful cleaning should be taken for objects and surfaces that have been touched by an infected patient. 70% ethanol solution can be used for small surface treatments.

4. Wash patient's clothes, linen and bedding in a washing machine with detergent in the temperature regime of +60 - + 90oC (recommended + 90oC).

5. Carefully wash dishes of the patient with dish washing liquid or wash in the dish washing machine in the high temperature conditions.

6. Ventilate the room.

When cleaning the premises, collecting dirty clothing, waste, a mask, gloves and disposable apron should be used!

Recommendations, if a person with confirmed COVID-19 infection is being treated in the home isolation conditions:

Delimit or isolate the patient.

It is recommended to allocate a separate room for a patient. It should be a well-ventilated single room (i.e., with openable window and doors). It is recommended for family members to stay in other rooms. If it is not possible, have at least the distance of 2 m from the sick person. Do not sleep in the same bed with the sick person.

It is necessary to provide the patient with all necessary hygiene items in the room, such as hand sanitizer, face masks, towels, disposable wipes, wet wipes, waste bin (for disposal of used napkins and other waste). The patient should be provided with individual eating items (cups, plates, spoons etc.) and bed-clothes. It is recommended to carefully wash the dishes of the patient and treat with hot water - +70OC. If possible, it is better to wash dishes in the dish washing machine in the high temperature conditions.

To minimise movement of the patient at the place of residence and public rooms (toilet, bathroom, kitchen). If possible, provide the patient with an individual toilet facility and feeding in a separate room. It that is not possible, often ventilate and clean the public rooms.

In order to reduce distribution of droplets from the respiratory tract, the patient should use a disposable medical mask. If the mask is not put on, carefully cover the mouth and nose with a disposable napkin, when coughing or sneezing. It should be immediately disposed and hands should be washed and disinfected.

Limit the number of visitors. It is recommended that only one relative is involved in the care of the patient. It is preferred that the person, who cares for the patient, has good health and does not have any chronic diseases.

Not to permit visits of other persons. It is important to prevent contacts with persons, who are older than 60 years.

Carefully wash and disinfect hands after any touching of the patient or objects around the patient (such as bed, dishes, clothing). Hands should be washed also before and after cooking, before eating, after the toilet and in every situation, when hands are dirty. If hands are visually clean, you may use alcohol-based hand disinfectant. If any dirt is visible on hands, they should be washed with soaps and water. Do not touch the facial area with unwashed hands (mouth, eyes or nose).

The person, who cares for the patient, should carefully put the surgical mask. During the use the mask should well fit to the face and it should not be touched. If the mask becomes wet or dirty, it should be replaced with a new one and the used one used should be disposed. The mask should be taken off from back to front, without touching the front of the mask. After removal of the mask it should be disposed and hand hygiene should be performed. You may see video instruction and information about placing and use of the mask here.

During care you should avoid contact with body fluids of the patient, in particular respiratory excretions (such as sputum) and faeces (excrements). If that is not possible, use the disposable gloves and mask, for example, when wiping the patient's nose, collecting urine, sputum, excrements or other waste. After removing the gloves do the hand hygiene (washing or disinfection).

Disposable gloves or masks cannot be used repeatedly! Dispose them as waste of the patient.

Regularly perform wet cleaning and disinfection in the room, where the patient stays. Use household cleaning agents for cleaning and afterwards perform disinfection of the room. It is possible to use products with combined effect (cleaning and disinfection). Additional attention should be paid to objects and surfaces that the infected patient has touched (handles, table surfaces, edges of the bed). Small surface treatment may be performed with 70% ethanol solution. Public rooms (such as toilet, bathroom) should be cleaned and disinfected at least once per day.

Dirty laundry and bed-clothing of the patient should be carefully collected, without shaking it and pressed against clothing. Wash in a washing machine with detergent at 60 - 90oC (preferably at 90oC or the hottest temperature that the fabric type allows) temperature conditions. Dry thoroughly. Wash the laundry separately from laundry of other family members.

When cleaning the premises, collecting dirty laundry, waste, use a mask, gloves and disposable apron!

Often ventilate the rooms.

A family doctor should be consulted via phone on the progress of the treatment of the patient, but in the event of a sudden deterioration of the patient's health status, a call to the phone 113 should be made immediately.