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What to consider when treating COVID-19 at home in Japan?

A pulse oximeter for coronavirus patients recuperating at home to borrow and use is seen in Kitakyushu, Fukuoka Prefecture, on Jan. 28, 2021. (Mainichi/Shotaro Asano)

TOKYO -- With the rapid spread of coronavirus infections, more patients are recuperating at home in Japan. What should we be careful about in these kinds of situations?

    Most COVID-19 patients with mild symptoms will recover, but some may experience a sudden change in their health. The Delta variant, which was first found in India and is the primary driver of the current outbreak in Japan, is believed to be more likely to cause severe illness in young people than the conventional strain. Amid the "fourth wave" of infections, a number of people staying at home have died without receiving treatment in Osaka and other areas.

    At least once a day, local government officials check the temperature of these patients by phone or smartphone application, and also check the status of their breathing and if they have symptoms including a cough, general malaise, nausea or diarrhea.

    Symptoms to watch out for as signs of a worsening situation include purple lips, increased breathing rate, sudden difficulty breathing, chest pains, an inability to breathe without sitting down, clouding of consciousness, and an abnormal pulse. If the patients themselves or those living with them, such as family members, notice any of these signs, they should immediately contact their local government office.

    Coronavirus patients sometimes do not feel like they are suffocating even when their blood oxygen levels drop as symptoms progress. For this reason, the central government will improve the distribution of pulse oximeters, which measure oxygen saturation levels. Infectious disease experts call for caution when there is a sudden drop in blood oxygen levels, such as when they fall below 95% in home care patients.

    If a patient has someone living with them, it is advisable to limit the number of people caring for them to one person to prevent infections within the household. According to the Tokyo Metropolitan Government's handbook for people recovering at home, both the patient and people living with them should wear a mask when people enter their room or take care of them.

    When wiping the patient's body or touching their waste, it is advisable to wear disposable aprons and gloves to prevent the virus from sticking to the caregiver's body. Disposable aprons can be substituted by wearing a large garbage bag over one's head. The handbook also recommends using disposable tableware for patients if possible.

    In addition, the handbook warns not to share towels and bedsheets between patients and those living with them. If there is a possibility that clothes, bedding, or pillowcases are contaminated with bodily fluids from the patient's diarrhea or vomit, disinfect them by soaking them in boiling water at a temperature of 80 degrees Celsius for at least 10 minutes before washing.

    Tissues used by patients to blow their noses and other trash may contain the virus, so dispose of them in a garbage can reserved for patients. Tie up the bag tightly when throwing out the waste. To ensure a tight seal, it is also effective to use a double layer of garbage bags. It is preferable for the person living with the patient to dispose of the trash, but if the patient lives alone, they may do it themselves after washing their hands and putting on a mask.

    It is also important to separate the rooms for patients and those living with them. If this is not possible due to housing conditions, they should be separated by at least two meters, and the space should be divided by a partition or curtain. The Architectural Institute of Japan describes on its website a method of using plastic sheets as partitions to prevent air from the patient's room flowing into other rooms.

    (Japanese original by Yuki Ogawa, Lifestyle and Medical News Department)

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