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 Table of Contents  
REVIEW ARTICLE
Year : 2021  |  Volume : 16  |  Issue : 2  |  Page : 404-406

Quarantine for COVID-19: Is it enough?


Department of Prosthodontics, Sharad Pawar Dental College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (M), Wardha, Maharashtra, India

Date of Submission14-Apr-2020
Date of Decision21-Nov-2020
Date of Acceptance08-Feb-2021
Date of Web Publication18-Oct-2021

Correspondence Address:
Dr. Tanvi Jaiswal
Department of Prosthodontics, SPDC, DMIMS (DU), Sawangi (M), Wardha - 442 001, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_117_20

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  Abstract 


The 2019-2020 coronavirus is a progressing pandemic disease spreading worldwide. The outbreak was first identified in Wuhan, Hubei Province, China, in December 2019. The World Health Organization (WHO) declared the occurrence to be a Public Health Emergency of International Concern on January 30, 2020, and recognized it as a pandemic on March 11, 2020. This review article describes and suggests the various tips and precautionary measures urged by the WHO and other health-care centers so that one ought to follow and help the nation to break its chain and reduce it spread in future.

Keywords: COVID 19, pandemic, quarantine


How to cite this article:
Jaiswal T, Kambala SS. Quarantine for COVID-19: Is it enough?. J Datta Meghe Inst Med Sci Univ 2021;16:404-6

How to cite this URL:
Jaiswal T, Kambala SS. Quarantine for COVID-19: Is it enough?. J Datta Meghe Inst Med Sci Univ [serial online] 2021 [cited 2021 Nov 28];16:404-6. Available from: http://www.journaldmims.com/text.asp?2021/16/2/404/328444




  Introduction Top


Coronavirus disease 2019 (COVID-19) is a respiratory ill health that can transmit from one to one. A novel coronavirus termed as SARS-CoV-2 is the source of COVID-19 and the uprising first identified in China in December 2019. The scientific spectrum of COVID-19 ranges from the bland condition with indifferent signs and symptoms of acute respiratory disease to severe pneumonia with respiratory failure and septic shock. The delirium course among patients with COVID-19 is unsaid; it may be prolonged and periodic. Sore throat has also been noted in some patients initially in the clinical course. Uncommonly reported problems encompass sputum production, headache, hemoptysis, and diarrhea. The incubation time is predicted at approximately 5 days (95% confidence interval, 4–7 days). Few researched have estimated a wider range for the incubation duration. Records for human infection with other coronaviruses (e.g., Middle East respiratory syndrome [MERS]-CoV, SARS-CoV) advocates that the incubation period may range from 2 to 14 days.[1]

On January 30, 2020, the World Health Organization (WHO) Director-General concludes that the outbreak of COVID-19 constitutes a Public Health Emergency of International Concern.[2] As the outbreak progresses to expand, State responsible persons are considering as preferential to limit the introduction of the illness to nonaffected areas or to minimize one to one transmission in areas where COVID-19 virus is as of now circulating.

Community health precautionary steps to accomplish these results may comprise of quarantine to observe symptoms and the initial detection of cases.[3]


  Quarantine of Persons Top


According to the WHO, quarantine is the control of movement or segregation of individuals who are not ill but may be exposed to a contagious virus or illness, to observe symptoms and early disclosure of cases. Quarantine and isolation are two distinct terminologies, Quarantine is the separation of ill or infected persons from others to prevent the transmission of infection or contamination and isolation is the instance of isolating affected one from the unaffected.


  When to Use Quarantine Measures Top


The WHO proposed that familiarizing quarantine procedures initially in an outburst may postpone the initiation of the disease to a nation or zone and/or may delay the spike of a widespread in a zone where the local spread is ongoing. However, if not executed properly, quarantine may also form a supplementary sources of infection and dissemination of the disease.

In the situation of the existing COVID-19 outburst, the global containment policy includes the rapid identification of laboratory-confirmed cases, and their isolation and management in either a medical facility or at home.[4],[5],[6]

General principles of infection prevention and control to prevent or limit transmission of COVID-19:[7]

  1. Early recognition and containment of disease
  2. Application of standard precautions at all times for all residents
  3. Implement Transmission Based Precautions:


    • Contact and droplet precautions (except for aerosol-generating procedures or critically ill residents with high volume/high frequency, prolonged care)
    • Airborne safety measures for aerosol-generating procedures (AGPs) such as positive pressure ventilation (BiPAP and CPAP), endotracheal intubation, airway suction, high-frequency oscillatory ventilation, tracheostomy, chest physiotherapy, nebulizer treatment, and sputum induction and while providing care for critically ill residents with high volume/high frequency of care (increased health worker contact or prolonged care).


    NB: In a RAFC AGPs should be avoided wherever possible.

  4. Hand hygiene (5 movements)


    • Hands to be maintained in hygienic conditions using an alcohol-based hand rub or water and fluid soap solution
    • All health workers must perform hand hygiene beforehand and after contact with a resident, even when hands are visibly clean
    • After being in association with soiled surfaces
    • Whether or not gloves are worn.


    Essentials of contact and droplet precautions are:

    • Appropriate personal protective equipment (gown, eye protection, mask, and gloves)
    • Hand hygiene
    • Maintain a >1 m distance
    • Inspire good cough etiquette and respiratory hygiene
    • Use resident reusable, dedicated gear
    • Allocate ill residents to single rooms or cohort (put in a shared room) those with confirmed COVID-19.


  5. Environmental cleaning


  6. Cleaning and disinfection are advised to disinfect the environment:

    • Resident room/zone should be disinfected daily
    • Cleaners should observe contact and droplet precautions
    • Ensure adherence to the cleaning product manufacturer's recommended contact time
    • Use therapeutic goods administration approved products with demonstrated efficacy against enveloped viruses (as the easiest class of microorganisms to kill) (10)
    • Terminal clean on discharge from room/zone.
    • Minimize equipment and items in the resident areas


    NB: If unsure of the properties of your disinfectant use a chlorine-based product such as sodium hypochlorite, this is the recommended solution for disinfection).

  7. Cleaning of shared equipment
  8. Alternative modes of visiting for families of residents, for example, virtual visiting
  9. Respiratory hygiene, cough etiquette, social distancing
  10. Annual influenza vaccination of residents, health-care workers, and visitors



  Residential Cleaning Top


CDC has to disclose provisional direction for restricting the blowout of COVID-19 in family unit and built-up societies[8]

  • Maintain hand hygiene frequently. Rinse hands with soap and water for a minimum of 20 s or use an alcohol-based hand disinfectant with 60%–95% alcohol
  • Respiratory etiquette: Mask coughs and sneezes with a tissue, then throw into a lined waste carton
  • Avoid sharing personal home items, dishes, drinking glasses, cups, eating utensils, towels or bedding with people or pets in your home. After using these things, wash thoroughly with soap and water
  • Wash laundry thoroughly: Wear one-use gloves while managing soiled items. Read and follow the directions on the labels of bedding, clothing, detergent and/or washing machines. Dry thoroughly using the warmest temperatures recommended on the clothing label
  • Disinfect all “high-touch” surfaces every day, such as counters, tabletops, doorknobs, fixtures, toilets, and phones. Also, clean any surfaces which will have blood, stool, or body fluids on them. Use a daily household cleaning spray or wipe consistent with the label instructions, which include precautions you ought to take when applying the merchandise, like wearing gloves and ensuring to possess good ventilation during use of the merchandise
  • When removing personal protective equipment (PPE), first remove and dispose of gloves. Then immediately clean your hands with soap and water or alcohol-based hand sanitizer. Next, remove and dispose of facemask, and immediately clean your hands again with soap and water or alcohol-based hand sanitizer
  • Place used gloves, facemasks, and other contaminated items in a lined container before disposing of them with other household waste.
  • Clean your hands (with soap and water or alcohol-based hand sanitizer) immediately after handling these items.[8]



  Sanitation and Plumbing Top


The WHO advocates the use of standard, well-maintained plumbing, like sealed bathroom drains, and backflow valves on sprayers and taps to stop aerosolized fecal matter from entering the plumbing or ventilation, alongside standard wastewater treatment. Imperfect plumbing and a poorly construct air ventilation system were implicated as add-on factors to the spread of the aerosolized SARS coronavirus in a high-rise apartment building in Hong Kong in the year 2003. Alike concerns have been raised about the blowout of the COVID-19 virus from defective toilets in high-rise apartment buildings. If health-care facilities are associated to sewers, a risk valuation should be directed to confirm that wastewater is contained within the system (i.e., the system does not leak) before it arrives at a working action or dumping site, or both. Hazards about the adequacy of the collection system or to treatment and disposal methods should be measured following a safety planning approach, with serious control ideas prioritized for mitigation.[9]


  Safely Removal of Graywater or Water from Washing Personal Protective Equipment, Surfaces and Floors Top


The current WHO recommendations are to clean utility gloves or heavy-duty, reusable plastic aprons with soap and water then disinfect them with 0.5% hypochlorite solution after every single use. Disposable gloves and gowns should be disposed after every single use and not be reused; hand sanitation should be achieved after PPE is removed. If graywater comprises disinfectant utilized in previous cleaning, it does not get to be chlorinated or treated another time. However, such water must be disposed of in drains connected to a septic system or sewer or in a soak-away pit. If graywater is disposed of in a soakaway pit, the pit should be fenced off within the health facility grounds to prevent tampering and to avoid possible exposure in the case of overflow.


  Safe Management of Health Care Waste Top


The greatest method for safely handling health care waste should be followed, including passing on responsibility and sufficient human and material resources to eliminate such waste safely. There is no evidence that direct, unprotected human contact during the handling of health care waste has resulted within the transmission of the COVID-19 virus. All health-care waste produced during the care of COVID-19 patients should be collected safely in designated containers and bags, treated, then safely disposed of or treated, or both, preferably on-site. If waste is moved off-site, it is critical to know where and the way it'll be treated and destroyed. All who handle health-care waste should wear appropriate PPE and perform hand hygiene after removing it.[10]


  Conclusion Top


The COVID-19 is characterized as an epidemic, WHO, ACHA, and everyone other health-care centers assessed its depth and administered various guidelines and generates precautionary measures to reduce its chain, preassessment of this outburst round the clock and intensely concerned by the alarming levels of blowout and severity, and alarming level of inaction. Much has been done to mobilize resources and expertise to guard the general public health during the COVID-19 outbreak. As the WHO suggests, if nations detect, test, segregate, trace, and mobilize their people in response, those with a couple of cases can prevent those cases becoming clusters, and people clusters becoming community spread. Hence, it is better to be a quarantine, but it is not enough alone to interrupt its chain, alongside it, it is necessary to follow all other precautionary measures suggested by all the authorized organizations and health-care centers in the world to reduce its further spread and to save lots of the state.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
ACHA Guidelines, Preparing for COVID-19; 2020. p. 1-10.  Back to cited text no. 1
    
2.
World Health Organization. Statement on the Second Meeting of the International Health Regulations. Emergency Committee Regarding the Outbreak of Novel Coronavirus (2019-nCoV). Geneva, Switzerland: World Health Organization; 2005.  Back to cited text no. 2
    
3.
World Health Organization. International Health Regulations. Geneva, Switzerland: World Health Organization; 2005.  Back to cited text no. 3
    
4.
World Health Organization. Clinical Management of Severe Acute Respiratory Infection when Novel Coronavirus (nCoV) Infection is Suspected. Geneva, Switzerland: World Health Organization; 2020.  Back to cited text no. 4
    
5.
World Health Organization. Home Care for Patients with Suspected Novel Coronavirus (nCoV) Infection Presenting with Mild Symptoms and Management of Contacts. Geneva, Switzerland: World Health Organization; 2020.  Back to cited text no. 5
    
6.
World Health Organization. Considerations for Quarantine of Individuals in the Context of Containment for Coronavirus Disease (COVID-19). Interim Guidance. Geneva, Switzerland: World Health Organization; 2020.  Back to cited text no. 6
    
7.
Infection Prevention and Control Guidance for Residential and Aged care Facilities -Version 1; 2020.  Back to cited text no. 7
    
8.
Sonia Y Angell Coronavirus Disease 2019 (COVID-19): Cleaning and Waste Management Considerations for Residences. California Department of Public Health; 2020.  Back to cited text no. 8
    
9.
World Health Organization. Water Sanitation, Hygiene and Waste Management for the COVID-19 Virus, Technical Brief. Geneva, Switzerland: World Health Organization; 2020.  Back to cited text no. 9
    
10.
Safe Management of Wastes from Health-Care Activities: A Summary. Geneva: World Health Organization; 2017. Available from: https://apps.who.int/iris/handle/10665/259491. [Last accessed on 2020 Mar 03].  Back to cited text no. 10
    




 

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  In this article
Abstract
Introduction
Quarantine of Pe...
When to Use Quar...
Residential Cleaning
Sanitation and P...
Safely Removal o...
Safe Management ...
Conclusion
References

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