Home care for COVID-19 positive cases: suitability of the residential setting and ability of cases to adhere to the required preventive measures

Abstract

With the upsurge of COVID-19 cases, Lebanese hospitals were overburdened and hospital care was prioritized for COVID-19 patients with the highest probability of poor outcomes. This paper aimed to assess the suitability of residential settings for home isolation and to explore the patient’s ability to adhere to the required precautions measures. All COVID-19 cases reported between February, 21 and the end of June 2020 and who had mild or moderate symptoms, were contacted via phone calls by a healthcare professional to fill out a standardized questionnaire developed to assess the suitability of the residential setting for home care. Inpatient cases were required, before their discharge from the hospitals, to sign consent related to their adherence to the mandatory precautionary measures. They were also asked to complete, on daily basis, the symptoms monitoring log form. A referral system to health facilities was established to manage cases with worsening health status. A collaborative framework to address violations of home isolation rules was also put in place. Of the 600 cases assessed, 44.7% of them were isolated in a living building apartment (67.2%) with one entrance (85.5%) including four to eight rooms (71%). Around one-quarter of patients have children (< 5 years) and 75% of them were living with elderly people. Most of the patients confirmed the availability of a well-ventilated single room (96.2%) and a separate bathroom (80.17%). As for infrastructure, more than 90% of patients confirmed the availability of drinking and tank water, heating facilities, electricity, and safe trash elimination. Similarly, more than 90% of them had access to personal hygiene items, disinfectants, and personal protective equipment. The bulk of homes care were rated as easily reachable. As for awareness and ability to self-serving, 94.5% of patients were knowledgeable about the required preventive measures, able to serve themselves and to adhere to the isolation requirements as well. Only 51.8% of them had access to psychological support. Proper assessment of the residential setting for home care of COVID-19 cases combined with close monitoring of the adherence of patients to the required precaution measures are highly needed for limiting the spread of infection within the household and the community.