How to care for people with Covid at home
With roughly one in 30 Londoners testing positive for coronavirus, and other areas of the country experiencing rapid rises in cases, there’s a fair chance that someone in your household may become infected at some point.
The growing burden on hospitals may also mean more patients being discharged early, leaving other household members to pick up their care.
According to a newly released Sage document, reducing the spread of Covid within households – with support and an information campaign – could help cut hospitalisations and deaths. “We estimate that if all the [precautionary] measures outlined in this paper were followed and an overall 25% reduction in within-household transmission risk were achieved, this could lead to a prevalence of 10-15% lower after three weeks, with associated beneficial impacts for hospitalisation,” the experts write.
So what should carers expect, and how can they keep themselves safe during this time?
Keep your distance inside – wear a mask
Coronavirus spreads easily in household settings because of the length of time people tend to spend together in close proximity, but transmission isn’t inevitable. People are most infectious from the first day of developing symptoms through to day five, although they may continue to shed virus after this. However, a recent study found no live virus in any patient sample collected beyond nine days, so if someone is being discharged from hospital after severe Covid, they are extremely unlikely to remain infectious.
The virus is predominantly transmitted through respiratory droplets produced when people cough, talk or sneeze. These can be breathed in, but quickly fall to the floor, so during the early days of infection it pays to keep your distance – ideally 2 metres or more. If possible, the infected person should wear a face covering, as should other household members. Used face coverings should be placed straight into the washing machine, where they can be washed with other items on a hot setting. Disposable masks should be double-bagged and stored for 72 hours, before being thrown away with other household rubbish.
Make your home Covid safe: clean surfaces and close the lid when you flush
Coronavirus can get on to people’s hands and faces, and subsequently contaminate other surfaces, including towels, bedding, plates, cups and cutlery. Hand washing and disinfecting frequently touched surfaces should therefore be a priority.
Ventilation is critical because the virus can linger in smaller airborne particles, so try to keep windows ajar – including windows in different rooms, to promote airflow. Because the virus can also be shed in faeces, remember to close the toilet lid during flushing, and keep ventilation fans running for longer. Ideally, the infected person should use a separate bathroom.
When to book a test and self-isolate
Anyone who develops symptoms of Covid-19, or tests positive, should selfisolate from that day plus a further 10 full days. The same goes for other household members. If someone else in the household develops symptoms, they should also book a test, and if they test positive they must stay at home for a further 10 days. Other household members who do not develop symp
toms can go out after the original 10day period is over.
Expect unexpected symptoms
Most people are aware of the core symptoms of Covid-19: a fever, continuous cough, and loss of smell or taste. Other common symptoms include headache, fatigue, sore throat, loss of appetite and shortness of breath, while rashes are reported in around 8% of adults. Older people may experience disorientation and confusion.
During the recovery period, other symptoms could arise. Fatigue, muscle weakness, brain fog, and anxiety or depression are common ongoing symptoms, but many others have been reported – and these may change over time, and last for weeks or months in some cases. Contact a GP if you are concerned.
When to call an ambulance
If the person’s symptoms get worse and you are unsure what to do, you first should check the NHS 111 online coronavirus service, then call 111 if you can’t find help online. “You should call an ambulance if someone is unable to complete a short sentence because they’re so breathless, or if they suddenly get more breathless within an hour,” said Dr James Dodd, a consultant senior lecturer in respiratory medicine at the University of Bristol. Other more general signs of illness that could warrant a 999 call include coughing up blood, developing a mottled rash that doesn’t fade under glass, or becoming agitated or confused, he said.
Oxygen monitors
Pulse oximeters are devices that attach to the fingertip and measure oxygen saturation levels in the blood. They can be a useful indicator that someone’s blood oxygen has dropped to dangerously low levels. NHS England is distributing 200,000 oximeters to GP surgeries for monitoring high-risk Covid patients remotely at home (those over the age of 65, and under-65s who are clinically extremely vulnerable). So if you are in this category and short of breath, speak to your doctor. An ambulance should be called if oxygen saturation hits 92% or less.
Eating and drinking
Although those recovering from Covid may feel less like eating, losing too much weight may slow their recovery, so encourage them to eat little and often, and to drink plenty of fluids to stay hydrated. Milk-based drinks can provide additional protein, and if someone does not feel like eating, encourage them to try smaller amounts of protein-rich foods such as meat, fish, eggs, cheese, beans and lentils.
Managing fatigue
Although everyone’s recovery is unique, there are some straightforward things that people can do to support it – particularly regarding fatigue management. Often people try to cram in as many activities as they can when they are feeling good, which then wipes them out for days, according to Lauren Walker, professional adviser to the Royal College of Occupational Therapists. “One of the best ways to avoid that is through planning, pacing and prioritising,” she said. She advises patients to keep a diary and note what they’re doing each day, and how it makes them feel, breaking it down into individual activities, such as taking a shower or washing their hair. From here, they can start to prioritise activities, and plan how they’re going to achieve them – including asking for help where necessary.
Although carers can offer to help, they should avoid trying to do everything for the patient unless absolutely necessary, to avoid muscle wastage.
Mental recovery
Being seriously ill with Covid is a frightening experience, and patients may also worry about their recovery. “It’s really important for family and carers to listen to the person who is feeling unwell, and acknowledge that what they’re going through is real,” Walker said. The NHS’s Your Covid Recovery website has more tips for managing people’s psychological health.