How to treat Omicron at home

Health experts have recommended a raft of medicines and dietary adjustments for effective management of Covid-19 at home as Omicron drives a third wave of the pandemic in the country.

“Those who are infected should drink hot tea, something warm,” Dr Celestine Barigye, the Mbarara Regional Referral Hospital director, advises, warning that home-based care is only for people with mild to moderate disease.

Dr Barigye adds: “They should also make sure they don’t expose themselves in the cold because it can exacerbate the condition.”

Dr Jackson Amone, the commissioner of clinical services at the Health Ministry, advises patients to eat fresh fruits and foods that are rich in Vitamin and zinc. These include mangoes, oranges, lemons, ginger, garlic, potatoes, beans, and chicken.

Health experts say these foods increase the body’s immunity to fight Omicron or other variants of the coronavirus.

Like Dr Amone, Dr Emmanuel Tugainayo, the Mbale Regional Referral Hospital director says in addition to a balanced diet, infected people can also buy vitamin and zinc supplements from pharmacies.

The Ministry of Health introduced home-based care during the first wave of Covid-19 in 2020 as one of the ways to ensure decongestion of hospitals.

In the Ministry’s revised guidelines for home-based care, Covid-19 patients are encouraged to take “plenty of oral fluids; at least 10 glasses of water, fruit juice and tea daily.”

The patients are also encouraged to take “high energy giving foods like posho, rice, millet, potatoes and cassava.” They should also eat fish such as Nile Perch, mushroom soup as sources of vitamin D for the body, and sunbathe, especially in the morning.

Other home remedies include a “cocktail made of warm tea with honey, garlic. Fresh juice from ginger/citrus fruits (lemon, oranges, tangerines, passion fruits.”  This should be taken as frequently as possible according to the Ministry.

Dr Henry Kyobe, the National Incident Commander for Covid-19, says they are still using the earlier recommended drugs to manage Covid-19 at home.

The drugs were announced by the Ministry of Health before Omicron but according to doctors, the medicines are just as effective against Omicron.

Dr Barigye says Covid-19 cure is not yet there “but there is supportive treatment using azithromycin.”

However, in the new Ministry of Health guidelines for home-based care which was released on January 8, drugs such as azithromycin can only be used by a patient after an assessment and recommendation from the doctor.

Previously, the Ministry had listed the antibiotics among the freely accessible medicines for those undergoing home-based care.

This adjustment also follows past criticisms from the Pharmaceutical Society of Uganda that allowing Covid-19 patients to buy antibiotics over the counter without a prescription by a qualified health practitioner will worsen the problem of drug resistance in the country. Self-medication is also associated with drug misuse.

Dr Tugainayo suggests that patients also stock painkillers such as Panadol. Covid-19 infection with Omicron presents with headache, fever, joint pain, body weakness and flu, according to health experts.

The Ministry of Health, in the revised guidelines for home-based care, calls for supportive treatment for adults and children older than 12 years. If fever is more than 37 degrees Centigrade, they should be given 1gram of Paracetamol tablet every after six or eight hours for three days.

The person should also be given 20 milligram of the zinc tablet once daily for 14 days, in addition to cough syrup/expectorant for cough when the patient is not having “danger signs.”

Danger signs include body temperature raise to more than 39 degrees Centigrade, change in mental state, increased heart rate and very fast breathing, according to information from the Ministry.

Dr Tugainayo adds that the patient should also have devices for monitoring the progress of the disease.

“When your condition worsens you should run to the hospital. Another important thing you should have is pulse oximeter. It measures oxygen circulation when you put it on your finger...It is not very expensive, it is less than Shs200,000,” he says.

A normal level of oxygen is usually 95 percent or higher, according to available scientific information. But some people with chronic lung disease or sleep apnea can have normal levels around 90 percent but a health worker in a health facility should be able to advise the patient on what they should consider as normal.

The guidelines state that for infected children aged six to11 years, when their body temperature hits more 37.5 degrees centigrade, they should also be given Paracetamol 10-15miligrams per kilogramme of their body weight every after six to eight hours for three days. Zinc tablet is given at the same rate and quantity as in adults.

But for a child with nasal congestion, they should be managed using “normal saline two drops in each nostril three times a day for three days.”

Normal saline is a salty water solution prepared by health specialists. They should also be given cough syrup/expectorant if they don’t have danger signs.

Dr Barigye says they are registering abnormally high rates of Covid-19 infections among children below 10 years.

“Infections which are in children are very hard to control; they can infect their parents,” he says. “We have seen that if the virus attacks one child, you find that 80 percent of their family is also attacked.”

Since the outbreak of Covid-19 in Uganda in 2020, a total of 162,049 people have been infected with 3,543 succumbing to the disease, where 99,357 have recovered, according to February 1 statistics from the Ministry of Health.

The ministry says in the revised guidelines that for infected children who are under five years but more than two months, when the body temperature rises to more than 37.5 degrees centigrade, they should be given paracetamol 10-15miligrams per kilogramme of their body weight every four to six hours for three days.

They should also be given normal saline treatment and cough syrup at the same rate and quantity as for the children between six and11 years.

But the ministry warned that Covid-19 infected children who are less than two months “should be managed in the healthcare facility by a skilled health worker.”

President Museveni in December last year said experts have advised that the solution to Covid-19 is vaccination, but he said the experts are also recommending herbal remedies such as Covidex.

Dr Barigye says: “We have seen that people recover in a week’s time.” Previously, with delta variant, many infected people were reported to have taken around two weeks to recover.

Omicron is considered by Ministry of Health to be highly transmissible but its risk of causing serious illness is low compared to delta.

The Mbale hospital director also advises that patients should be responsible enough not to infect others.

“Even when you go out into the community, don’t imagine that people who are outside your home are not part of you and you don’t care what happens to them,” he says.

Dr Barigye says it has been discovered that even most people who are vaccinated are getting infected.

Dr Tugainayo says the two deaths they have registered at their hospital were among two old people who had shunned Covid-19 vaccines.

 “Covid-19 vaccination is very important as it reduces the risk of developing severe disease and death,” he says.

Experts recommendation

• Take warm tea with honey, garlic
• Eat fruits or drink fresh juice made out of mangoes, oranges, lemons, ginger, garlic
• Eat foods like potatoes, posho, beans, fish like Nile perch and chicken
• Drink at least 10 glasses of water per day
• Use painkillers like panadol
• Take vitamin and zinc supplements
• Have devices like a pulse oximeter to monitor oxygen level
• Wear facemask and adhere to all SOPs when at home
• Stay in a separate room when possible.
• Stay in touch with family members and a health worker
• Alert the health worker when your condition worsens
• Infected children who are less than 2 months shouldn’t be managed at home
• Use Covidex for managing symptoms

New restriction

• Take drugs (antibiotics) like azithromycin only after assessment and recommendation from a health practitioner.

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