DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20211218

Eligibility for home care of asymptomatic COVID-19 patients: challenges from a low resource setting in Central Kerala, South India

Divyamol N., Sreedevi C.

Abstract


Background: As a large spectrum of COVID-19 disease is asymptomatic, there came a need for home based management of asymptomatic cases, which can ensure efficient utilisation of resources for care of severe cases. On 7th August 2020, Kerala government came up with advisory for home care of asymptomatic cases. The study was done to assess eligibility for home care among patients then admitted to COVID First Line Treatment Centres in Palakkad and to identify the challenges, to aid in further planning and decision making about home care.

Methods: A cross sectional study was conducted among 133 laboratory confirmed COVID-19 cases admitted to CFLTCs during 08 August 2020 to 12 August 2020. Semi-structured questionnaire was administered over telephone, after getting oral informed consent from patients. Analysis was done using Statistical package for social sciences (SPSS) 20.

Results: 28.31% of asymptomatic cases were eligible for home care. The challenges were. lack of separate room with attached bathroom and ventilation (29%), absence of facility to separate vulnerable persons at home (18.5%), lack of healthy caretaker (15.9%) and being unaware about co-morbidity status (27%). Significant associations were found between socioeconomic status and availability of separate room with attached bathroom as well as separate facility to accommodate vulnerable persons.

Conclusions: Major factors limiting eligibility for home care were lack of facility to self isolate and to separate vulnerable persons away from home. Both factors were common among patients from BPL families. 27.4% of asymptomatic patients were unaware of co-morbidity status. This reinforces importance of screening for non communicable diseases in the community.


Keywords


Eligibility, Home care, COVID 19, Kerala

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References


GoK Dashbord | Official Kerala COVID 19 statistics. Last accessed on 7th March, 2021.

COVID-19 (nCorona) Virus Outbreak Control and Prevention State Cell. Health & Family Welfare Department Government of Kerala. Reference Guide for Converting Hospitals into Dedicated COVID Hospitals, March 2020. https://dhs.kerala.gov.in/wp-content/uploads/2020/03/How-to-convert-Hospital-into-COVID-Hospital.final-pdf.pdf. Last accessed on 7 March, 2021.

COVID-19 (nCorona) Virus Outbreak Control and Prevention State Cell. Health & Family Welfare Department Government of Kerala. Advisory on home care of asymptomatic COVID 19 positive patients. No.31/F2/2020 Health. 2020. https://dhs.kerala.gov.in/wp-content/uploads/2020/08/Advisory-Home-care-Asymptomatic-COVID19-Postive-patient.pdf. Last accessed on 7th March, 2020.

Baggett TP, Keyes H, Sporn N, Gaeta JM. Prevalence of SARS-CoV-2 Infection in Residents of a Large Homeless Shelter in Boston. JAMA. 2020;323(21):2191-2192.

Dora AV, Winnett A, Jatt LP, Davar K, Watanabe M, Sohn L, et al. Universal and serial laboratory testing for SARS-CoV-2 at a long-term care skilled nursing facility for veterans—Los Angeles, California, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(21):651-5.

Ing AJ, Cocks C, Green JP. COVID-19: in the footsteps of Ernest Shackleton. Thorax. 2020;75(8):693-4.

Kumar N, Shahul Hameed SK, Babu GR, Venkataswamy MM, Dinesh P, Kumar Bg P et al. Descriptive epidemiology of SARS-CoV-2 infection in Karnataka state, South India: Transmission dynamics of symptomatic vs. asymptomatic infections. EClinicalMedicine. 2021;32:100717.

Coronavirus disease (COVID-19): Similarities and differences with influenza.WHO.Newsroom Q&A detail,17 March 2020 available from https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/q-a-similarities-and-differences-covid-19-and-influenza. Last accessed on 7th March, 2020.

Balsari S, Sange M, Udwadia Z. COVID-19 care in India: the course to self-reliance. Lancet Glob Health. 2020;8(11):e1359-e1360.

Golechha M. COVID-19 Containment in Asia’s Largest Urban Slum Dharavi-Mumbai, India: Lessons for Policymakers Globally. J. Urban Health. 2020;97: 796-801.

Sanyaolu A, Okorie C, Marinkovic A, Patidar R, Younis K, Desai P et al. Comorbidity and its Impact on Patients with COVID-19. SN Compr Clin Med. 2020;1-8.