Tiếng Việt- 1 Law No. 03/2007/QH12 of November 21, 2007, on prevention and control of infectious diseases.
- 2 Law No. 40/2009/QH12 of November 23, 2009, on medical examination and treatment
- 3 Decree No. 75/2017/ND-CP dated June 20, 2017, defining functions, tasks, powers and organizational structure of Ministry of Health
- 4 Decision No. 528/QD-BYT dated March 03, 2022 on Guidelines on home treatment of children with covid-19 infection
- 5 Decision No. 261/QD-BYT dated January 31, 2022 on the promulgation of the Guidelines on management of COVID-19 patients at home
| MINISTRY OF HEALTH | SOCIALIST REPUBLIC OF VIETNAM |
| No. 604/QD-BYT | Hanoi, March 14, 2022 |
DECISION
ON PROMULGATING “GUIDELINES ON HOME MANAGEMENT OF COVID-19 CASES”
THE MINISTER OF HEALTH
Pursuant to the Law on Prevention and Control of Infectious Diseases in 2007;
Pursuant to the Law on Medical Examination and Treatment in 2009;
Pursuant to Decree No. 75/2017/ND-CP dated June 20, 2017 of the Government on function, tasks, powers and organizational structures of the Ministry of Health;
According to the meeting minute dated March 08, 2022 of the Council on formulation of specialized documents and guidelines and regulations to ensure COVID-19 diagnosis and treatment according to the Decision No 4026/QD-BYT dated August 20, 2021 of the Minister of Health;.
At the request of the Director General of Department of Medical Service Administration of the Ministry of Health,
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Article 1. Dedicated document on "Guidelines on home management of COVID-19 cases” is promulgated herewith".
Article 2. Dedicated document on “Guidelines on home management of COVID-19 cases” is applied to home management facilities for COVID-19 cases, households and accomodation with COVID-19 cases.
Article 3. The Departments of Health of the provinces and central-affiliated cities are assigned to formulate and apply guidelines to their provinces/cities on the basis of the developments of the COVID-19 in their provinces/cities and "Guidelines on home management of COVID-19 cases" of the Ministry of Health.
Article 4. This Decision comes into force from the day on which it is signed and replaces the Decision of the Ministry of Health No. 261/QD-BYT on promulgating Guidelines for management of COVID-19 cases at home and No. 528/QD-BYT dated March 03, 2022 on promulgating Guidelines on home management of children with COVID-19 infection.
Article 5. Chief of the Ministry Office, Chief Inspector of the Ministry; Director Generals of Departments and Agencies and Departments under the Ministry of Health; Directors of the Departments of Health of provinces and central-affiliated cities; Directors of hospitals affiliated to the Ministry of Health, medical Chief Officers of industries are responsible for the implementation thereof./.
PP. MINISTER
DEPUTY MINISTER
Nguyen Truong Son
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HOME MANAGEMENT OF COVID-19 CASES
(Issued together with Decision No. 604/QD-BYT dated March 14, 2022 of the Ministry of Health)
List of compilers of
“guidelines on home management of COVID-19 cases”
Directors of compelation
Assoc.Prof.Ph.D. Nguyen Truong Son
The Deputy Minister of Health
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Director General of Department of Medical Service Administration of the Ministry of Health
Co-chief author/editor
Prof. Ph.D. Nguyen Gia Binh
President of Vietnam National Association of Emergency, Intensive Care Medicine and Clinical Toxicology
Prof. Ph.D. Nguyen Van Kinh
President of the Vietnam Society of Infectious Diseases (VSID), former Director of National Hospital for Tropical Diseases
Assoc.Prof.Ph.D.. Nguyen Lan Hieu
Director of Hanoi Medical University Hospital
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Assoc.Prof.Ph.D.. Nguyen Hoang Anh
Director of the National Center of Drug Information and Adverse Drug Reactions Monitoring (National DI & ADR Center) - Hanoi University of Pharmacy, Deputy Head of Pharmacy Department of Bach Mai Hospital
Specialist level II Doctor. Nguyen Trung Cap
Vice President of National Hospital of Tropical Diseases
Ph.D. Nguyen Van Vinh Chau
Deputy Director of Department of Health of Ho Chi Minh City
Ph.D. Vuong Anh Duong
Vice Director of the Vietnam Administration of Medical Services - Ministry of Health
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Director of Vietnam National Children's Hospital (VNCH)
Specialist level II Doctor. Nguyen Hong Ha
Vice - President of Vietnam Association for Infection Diseases, Former Vice Director of National Hospital of Tropical Diseases
Ph.D. Nguyen Thanh Ha
Deputy Director of Department of Health Environment Management
MD. Vu Quang Hieu
Specialist of the Office of World Health Organization in Vietnam
Assoc.Prof.Ph.D.. Nguyen Thanh Hung
Director of the Children's Hospital 1 of Ho Chi Minh city
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Head of Department of Tropical Diseases - Cho Ray Hospital
Ph.D. Nguyen Dinh Hung
Deputy Director of Department of Health of Hanoi
Dr. Truong Huu Khanh
Vice President of Ho Chi Minh Association for Infection Diseases, Adviser on Infection Diseases of the Children's Hospital 1 of Ho Chi Minh city
Ph.D. Nguyen Trong Khoa
Vice Director of the Vietnam Administration of Medical Services - Ministry of Health
Ph.D. Nguyen Phu Huong Lan
Head of Laboratory Department – Ho Chi Minh City Hospital of Tropical Diseases
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Specialist of the Professional Department - the Department of Health of Ho Chi Minh city
Specialist level II Doctor. Bui Nguyen Thanh Long
Head of the Professional Department - the Department of Health of Ho Chi Minh city
MD. Ngo Thi Huong Minh
Deputy Head of Deparment of Pharmacy Sales, Drug Administration of Vietnam
Assoc.Prof.Ph.D.. Phung Nguyen The Nguyen
Head of Department of Children of Ho Chi Minh City University of Medicine and Pharmacy, Head of COVID-19 Department - the Children's Hospital 1 of Ho Chi Minh city
MD. Nguyen Thi Thanh Ngoc
Person in charge of the Department of Professional Competence – Inspection – Protection of Health of Officers, Vietnam Administration of Medical Services - Ministry of Health
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Deputy Head of the Department of Professional Competence – Inspection – Protection of Health of Officers, Vietnam Administration of Medical Services - Ministry of Health
Ph.D. Vu Dinh Phu
Head of Intensive Care Unit – National Hospital of Tropical Diseases
MD. Cao Duc Phuong
Specialist of the Department of Professional Competence – Inspection – Protection of Health of Officers, Vietnam Administration of Medical Services – Ministry of Health
Assoc.Prof.Ph.D.. Pham Thi Ngoc Thao
Vice Director of Cho Ray Hospital
Specialist level II Doctor. Nguyen Minh Tien
Vice Director of the Department of Health of Ho Chi Minh city
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Head of Intensive Care Unit – Thu Duc Hospital of Ho Chi Minh City
Specialist level II Doctor. Nguyen Thanh Truong
Vice President of Hospital of Tropical Diseases of Ho Chi Minh City
Ph.D. Ta Anh Tuan
Head of ICU – Internal Medicine Ward – Central Children’s Hospital
MD. Nguyen Thanh Tuan
Head of Department of General Planing - the Children's Hospital 1 of Ho Chi Minh city
Ph.D. Cao Viet Tung
Vice Director of Vietnam National Children's Hospital (VNCH)
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Assoc.Prof.Ph.D.. Phung Nguyen The Nguyen
Head of Department of Children of Ho Chi Minh City University of Medicine and Pharmacy, Head of COVID-19 Department - the Children's Hospital 1 of Ho Chi Minh city
Ph.D. Ta Anh Tuan
Head of ICU – Internal Medicine Ward – Vietnam National Children’s Hospital
MD. Nguyen Quoc Thai
Center of Infection Deseases – Bach Mai Hospital
MD. Truong Le Van Ngoc
Deputy Head of the Department of Professional Competence – Inspection – Protection of Health of Officers, Vietnam Administration of Medical Services - Ministry of Health
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Specialist of the Vietnam Administration of Medical Services – Ministry of Health
Pharmacist. Do Thi Ngat
Specialist of the Vietnam Administration of Medical Services – Ministry of Health
TABLE OF CONTENTS
1. GENERAL INFORMATION
1.1. Objectives
1.2. Regulated entities
2. Criteria for home management of COVID-19 cases
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2.2. Criteria for caring and monitoring the health
3. Health declaration
4. Necessary preparation
4.1. Home essentials
4.2. Drugs for home management
5. GUIDELINES ON HOME MANAGEMENT
5.1. Monitoring of health of COVID-19 cases
5.2. Treatment
5.3. Diet and lifestyle
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6. Duties of home management facilities
APPENDIX 01
APPENDIX 02
guidelines on home management of COVID-19 cases
1. GENERAL INFORMATION
1.1. Objectives
“Guidelines on home management of COVID-19 cases” is formulated for the purpose of provision of instructions on management of people with SARS-CoV-2 infection and mild COVID-19 cases at home (hereinafter refered to as “COVID-19 cases”)
1.2. Regulated entities
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b) Health workers, people involved in home management of COVID-19 cases.
c) COVID-19 cases, caregivers of COVID-19 cases at home and COVID-19 cases' accommodation.
2. Criteria for identifying COVID-19 cases eligible for home management
2.1. Clinical criteria
a) COVID-19 cases confirmed to be infected with SARS-CoV-2 by realtime RT-PCR or antigen rapid test done by themselves or by health workers or health facilities:
- Do not have any symptoms or have mild clinical symptoms such as fever, dry cough, sore throat, stuffy nose, fatigue, headache, muscle aches, numbness of the tongue, diarrhea, runny nose, loss of smell, loss of taste; normal breathing rate by age, SpO2 ≥ 96% when breathing normally, no signs of shortness of breath, no respiratory failure;
- Do not have any underlying conditions or have underlying conditions which are under stable treatment.
b) COVID-19 cases are under treatment by examination and treatment facilities but they do not meet standards for COVID-19 recovery and meet standards for home management, they may be transferred home for further care.
2.2. Criteria for caring and monitoring the health
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b) COVID-19 cases are able to contact health workers and have communication means such as mobile phones, computers, etc. for instructions and settlement in case of emergency by health workers;
c) For COVID-19 cases who are unable to self-care, their families must have caregives who meet the criteria above-mentioned.
3. HEALTH DECLARATION
1. COVID-19 cases or caregivers or health workers or health facilities assess COVID-19 cases who are under home management as specified in section 2 above.
2. The COVID-19 cases or their caregivers shall notify the health stations of their communes or wards or facilities for home management of COVID-19 cases of personal information, dates of being identified to be COVID-19 cases and entities eligible for home management and the time of ending isolation or home management according to instructions of their communes or wards.
3. The health stations of their communes or wards or facilities for home management of COVID-19 cases shall collect their information and make lists of COVID-19 cases eligible for home management according to the form prescribed in Appendix 01.
4. Necessary preparation
4.1. Essential items
a) Thermometers;
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c) Medical face masks;
d) Hand sanitary equipment;
dd) Necessary personal belongings;
e) Containers for infectious waste with covers.
g) Means of communication: Telephones, phone numbers of health facilities (health stations, district-level health centers, emergency transportation centers, doctors, community counseling groups, rapid response teams, hospitals, etc.).
4.2. Drugs for home management
a) Paracetamol for adults: 500mg tablets, 3 to 5 days doses. Paracetamol for children (depending on body weight and age): 80mg, 100mg, 150mg or 250mg, 325mg, 500mg (oral suspension powder or granule packs or tablets), 3 to 5 days doses.
b) Electrolyte balancing solution: Oresol, rehydration packages or other electrolytes.
c) Cough suppressants (depending on symptoms): Herbal medicine or stand-alone cough suppressant or cough suppressant combined with antihistamine, etc. for about 5-7 days. The indications, contraindications and warnings while using the drugs must be noted.
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dd) Drugs for treatment of underlying conditions according to prescriptions (if any, for 01-02 week (s)).
4.3. Isolation
Isolation places must be separated. The isolation places must be well ventilated and not using central air conditioning; always open their windows.
5. GUIDELINES ON HOME MANAGEMENT
5.1. Monitoring of health of COVID-19 cases
5.1.1. Children aged under 5
a) Monitor mental signs, skin color, mucous membranes and digestive disorders, breastfeed/eating; measure body temperature at least 2 times per day; count breathing rate and pulse, measure SpO2 (if a pulse oximeter is available).
b) Abnormal signs: when detecting any one of the following signs, immediately notify home management facilities for COVID-19 cases including health stations of communes/wards; or mobile health stations, emergency transportation centers, etc. for timely health examination, emergency treatment and hospitalization or take children with COVID-19 to health facilities for health examination and treatment.
(1) Mental signs: the children are fussy, tired, refuse to play, do not take notices or convulse.
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(3) Abnormal rapid breathing rate:
- Children under 2 months old: ≥ 60 times/minute;
- Children from 2 months old to under 12 months old: ≥ 50 times per minute;
- Children from 1 to under 5 years old: ≥ 40 times per minute;
(4) Children with abnormal breathing: shortness of breath, nose flaring, intercostal retractions, abdominal external oblique muscles, etc.
(5) SpO2 < 96% (if if a pulse oximeter is available)
(6) Cyanosis
(7) Signs of dehydration: dry lips, sunken eyes, thirst, little or no urination, etc.
(8) Nausea
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(10) Children with underlying conditions: Dengue fever; Hand, foot and, mouth disease, etc.
(11) Other abnormal symptoms that are serious.
5.1.2. Children aged from 5 to 16
a) Monitor mental signs, breathing rate, pulse, skin color, mucous membranes, eating, cough, stomachache, chest pain, diarrhea, loss of smell and hearing; measure SpO2 (if a pulse oximeter is available) and body temperature at least 2 times/day.
b) Abnormal signs: Detect any one of the following signs, must immediately notify facilities for home management of COVID-19 cases including health stations of communes/wards; or mobile health stations, emergency transportation centers, etc. for timely health examination, emergency treatment and hospitalization or take children with COVID-19 to health facilities for health examination and treatment.
(1) Rapid breathing rate: children from 5 to under 12 years old: ≥ 30 times/minute; children above 12 years old: ≥ 20 times/minute
(2) Abnormal breathing: intercostal retractions, abdominal external oblique muscles, etc.
(3) SpO2 < 96% (if if a pulse oximeter is available)
(4) Shortness of breath
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(6) Chest pain
(7) Drinking/eating refusal
(8) Nausea
(9) Diarrhea
(10) Withdrawal from interaction
(11) High fever that does not go down or improve after 48 hours
(12) Other abnormal symptoms that are serious.
5.1.3. Adults (above 16 years old)
a) Monitor signs:
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- Symptoms: fatigue, cough, coughing up sputum, chills/splits, conjunctivitis (red eyes), loss of taste or smell, diarrhea (loose stools); coughing up blood, shortness of breath, persistent chest pain, lethargy; other symptoms such as sore throat, headache, dizziness, loss of appetite, nausea and vomiting, muscle aches, etc.
b) Abnormal signs: Detect any one of the following signs, must immediately notify facilities for management of COVID-19 cases at home or accomodation including health stations of communes/wards; or mobile health stations, emergency transportation centers, etc. for timely health examination, emergency treatment and hospitalization or take children with COVID-19 to health facilities for health examination and treatment.
(1) Shortness of breath
(2) Breathing rate ≥ 20 times/minute
(3) SpO2 ≤ 96%.
(4) Rapid pulse >120 beats/minute or 50 beats/minute.
(5) Low blood pressure: systolic blood pressure <90 mmHg, diastolic blood pressure < 60 mmHg (if measurable).
(6) Frequent chest pain, feeling of tightness in the chest and the pain increasing when taking a deep breath.
(7) Pale lips, fingernails, toenails, skin, cold fingers and toes.
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(9) Unavailability to eat or drink due to vomiting.
(10) Other abnormal symptoms that are serious of COVID-19 cases.
5.2. Treatment
a) Take Antipyretic when having temperature ≥ 38,50C or severe headache:
- Adults: take paracetamol, 01 pill of 500mg or 10-15 mg/kg /time with an internval of 4-6 hours. Note: The total dose should not exceed 4g (4000mg)/day.
- Children: take paracetamol at a dose of 10-15 mg/kg/time (oral or rectal), at least 4-6 hours if repeated (or use dose under age if the child's weight is not known, details in Appendix No. 02); Note: the total dose should not exceed 60 mg/kg/day.
b) Electrolyte balancing solution for dehydration (due to high fever, diarrhea, fatigue): COVID-19 cases are encouraged to drink plenty of water, may use juice or Oresol (mix and use in the right instructions). If the patient does not like Oresol, it cann be replaced with cooled boiled water or juice. Do not use soft drink (not produced from fruits) to rehydrate;
c) Increase nutrients, eat foods containing enough nutrients, eat more fresh fruits and vegetables.
d) Take symptom treatment drugs if necessary:
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- Nasal congestion, runny nose: use nasal spray, nasal drops with 0.9% sodium chloride solution.
- Diarrhea: take probiotics beneficial to the intestines, digestive enzymes.
dd) Drugs for treatment of underlying conditions according to outpatient prescription: continues to take drugs under instructions.
e) Other drugs: take prescription antiretroviral drugs, etc. according to current regulations.
g) Notes:
- Do not use antiviral drugs, antibiotics, anti-inflammatory drugs, etc. without any indication or prescription.
- Steam therapy is not recommended for children
5.3. Diet and lifestyle
a) Regularly drink water and do not wait until having thirst;
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c) Should take a rest. For adults, should do light physical activities (suitable for their health condition), practice breathing at least 15 minutes per day and have positive thinking and maintain a comfortable mental state.
5.4. Measures against COVID-19 infection
COVID-19 cases and caregivers or roommates of COVID-19 cases shall implement infection control and prevention measures, as follows:
a) COVID-19 cases should avoid leaving their isolation places. When they have to leave their isolation places, they must wear face masks and keep distance from others.
b) Caregivers or family members living in the same house have to always wear face masks and keep distance when they have to come into contact with COVID-19 cases.
c) The isolation places have to be kept well ventilated, limit the use of items that are difficult to clean (stuffed animals, paper, paperboard, etc.) in these places.
d) Frequently wash or disinfect their hands. Disinfect frequently touched items and surfaces such as countertops, doorknobs, hand-held devices, toilets, sinks, etc., daily and when dirty.
dd) Classify and collect infectious waste according to regulations.
6. Duties of home management facilities
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a) Assess COVID-19 cases who are eligible for home management according to the criteria specified in section 2.
b) Make lists of COVID-19 cases eligible for home management (according to form prescribed in Appendix 01).
6.2. Do testing or instruct COVID-19 cases to test themselves; instruct caregivers or roommates of COVID-19 cases with suspected COVID-19 symptoms to test them, in accordance with current regulations.
6.3. Provide guidance and advices for COVID-19 cases, caregivers on home management of COVID-19 cases.
6.4. Prescribe and dispense drugs for outpatient treatment: comply with the Guidelines for diagnosis and treatment of COVID-19 of the Ministry of Health and relevant guidelines.
6.5. Provide emergency treatment, instructions for COVID-19 cases, caregivers to transfer patients to health facilities when there are abnormal signs, need for emergency, medical examination and treatment or when there are emergency conditions for other diseases such as the risk of obstetric complications, trauma, stroke, etc. that are exceed the facilities’ capacity.
6.6. Perform duties of confirming recovery from COVID-19 and other duties according to the current regulations.