How to treat Covid from home

Mr Alex Esagala, a photojournalist at Daily Monitor,  tested positive for Covid-19 on December 6, but was advised by the doctor to take home-based care until he recovers.

Mr Esagala said his sickness started three days after he returned from covering the political campaigns of FDC presidential candidate Patrick Oboi Amuriat in Acholi, Lango and West Nile sub-regions last month.

“I was feeling well when I returned to Kampala and spent two days resting at home. On the third day, which was a Friday, I went to office,” he narrates.

However on a Saturday morning when Esagala was at work, he developed a strange body weakness and thought it was a malaria attack. He went to a pharmacy and bought a drug.

“But that night, I couldn’t sleep. I started getting high fever, muscle pain, too much headache and even diarrhoea,” he recalls.
By day break, his condition had worsened. He called his sister for help. “She took me to hospital,” he says. 
But the medics were treating malaria since he had tested positive for the disease. 
 “After four days, they tested and found that malaria was out but the intensity of fever had almost doubled,”  Mr Esagala recounts.
He developed breathing complications. His sister took him to hospital and doctors suspected Covid-19 infection.

“Doctors advised that I must go for Covid-19 testing. I went to Test and Fly, a private medical facility in Kampala, on December 5,”  Mr Esagala says.

The next day, the results came out positive for Covid-19.  “Doctors asked me to go home. I talked to my friends at the Ministry of Health and others who helped me. I was told the type of medicine I should use,” he recalls. He started taking a concoction of ginger, lemon, onions, mixed with other fruits. I was given azithromycin, zinc, vitamin C and Panadol,” he adds.  His sister took him to her home and gave him an isolation room.

Mr Esagala says being in isolation is like being in a prison only that one can talk to a family member at some point.

“They were just giving me food to eat [in the room] and when I am leaving for the hospital, they made sure I wore a face mask and had sanitisers,” he narrates.

He has been in isolation at home for more than 14 days but he is feeling better now. He is still taking the concoction and steamed mango leaves and menthoplus. 

 “I boil the leaves, pour in the bucket and apply mentho plus. Then I cover my head with a blanket over the bucket and steam for 30 minutes,” he says.

He also does shadow boxing in the isolation room to relieve the lungs and symptoms such as cough.  “I have defeated it, prayers from people and the love I was given helped me recover fast. I have taken another test and I am waiting results for results” he says.  With the fast-growing number of coronavirus infections that has overwhelmed hospitals with patients, home-based care for people such as Mr Esagala has emerged as a viable alternative.

Covid-19 cases
As of yesterday, the country had registered 29,361 Covid-19 cases,  228 deaths and 10,172 recoveries.

The Health ministry introduced home-based care in October to relieve the constrained health system. 

However, the large size of most Ugandan families which require more space for isolation, survival that depends on daily earning and strong drive to socialise continue to hinder implementation of the Covid-19 treatment.

Dr Jackson Amone, the commissioner of clinical services at the Health Ministry,  said home-based care is specifically for Covid-19 patients who are asymptomatic or having mild sickness.

Patients who are symptomatic and may progress to severe conditions, those presenting with severe or critical symptoms and the elderly patients aged above 60 are not eligible for home-care, according to the ministry’s guidelines.

Also patients with other underlying complications and risk factors such as diabetes, obesity, HIV/Aids, cancer, high blood pressure, kidney diseases, chronic lung diseases and those without proper isolation facilities are not eligible.

Dr Amone, however,  says a person who will be managed from home should have a separate room.  “Being in isolation doesn’t mean the patient cannot come out. They can come out and sit under a tree. But when they are moving out of the room, they should ensure that they don’t mix with other people,” he said.

He, however, says there is specific shift in diet when someone tests positive for Covid-19, for example, taking fruits and foods that are rich in vitamin and zinc. Such foods include mangoes, oranges, lemons, ginger, potatoes, beans, and chicken.

According to the guidelines for home care treatmeant, there are essential medicines that patients should have such as azithromycin, hydroxychloroquine, panadol, vitamin C, and zinc tablets.

The guidelines also indicate that the patient must agree to admission in case symptoms worsen and warrant hospital admission.

  The patient should also be confined at home until he is fit for discharge. 
Dr Amone didn’t clarify how someone can be declared free from the virus while under home-based care. 

However, Dr Stephen Obbo, the director of Lira Regional Referral Hospital, who also involved in Covid-19 case management, said the patients in home care are discharged after 10 days when they are not showing symptoms. 

The standard is to do Covid-19 test to determine whether the virus is no longer in the body.  “There should be one family member who will dedicate to give care. The care taker just needs to observe all Covid-19 measures,” Dr Amone said.

“Caregiver should monitor the patient’s well-being and ask the patient daily whether they  are developing new or worsening symptoms including fever, cough, runny nose or flu-like illness, sore throat, shortness of breath and headache,” he adds.

A health worker from the nearest health facility should also monitor the patient. A large number of them, however, have low level of education and may not be competent. Dr Amone said they training on Covid-19 home care.

11 precautions for successful home care

• Prepare a separate room for isolation with adequate ventilation.
• Provide clean water for hand washing.
• Avail soap or other any other hand-hygiene products.
• There should be a designated adult caregiver who regularly monitors the patient.
• If possible, presence of a separate toilet or pit latrine. 
• If possible, presence of immediate access to a functioning telephone for communication. 
• A guaranteed source of food. 
• Patient should be readily accepted at home by the family. 
• There should be a health facility within reach of the home. 
• Availability of Village Health Teams (VHTs) linked to the home of the patient. 
• Reliable transport to rush to health facility in case the condition worsens.

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