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PEOPLE’S COMMITTEE
OF HO CHI MINH CITY
DEPARTMENT OF HEALTH
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SOCIALIST REPUBLIC OF VIETNAM
Independence – Freedom – Happiness
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No. 6065/SYT-NVY
On updating “Guidelines on healthcare
package for F0 at home” (version 1.5)
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Ho Chi Minh City,
August 27, 2021
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To:
- Public and non-public
hospitals;
- Hospitals receiving COVID-19 patients for treatment;
- Medical centers of Thu Duc City and districts;
- F0 concentrated quarantine facilities in Thu Duc City and districts;
- Medical stations and mobile medical stations of wards, communes, and
towns.
On August 25, 2021, Department of Health
promulgates Official Dispatch No. 6002/SYT-NVY on updating “Guidelines on
healthcare package for F0 at home” (version 1.4).
Pursuant to Decision No. 4109/QD-BYT dated August
26, 2021 of Minister of Health on issuance of provisional guidelines on “List
of medicine for outpatient treatment at home for persons infected with
COVID-19”;
The Department of Health updates “Guidelines on
healthcare package for F0 at home” version 1.5 which adds “Community-based
COVID groups” (as per direction of Minister of Health) and revises list of oral
anticoagulant from 3 types down to 2 types.
The Department of Health hereby requests hospitals,
medical centers of Thu Duc City, districts medical stations of wards, communes,
and towns to organize implementation in order to ensure safety and
effectiveness for COVID-19 patients.
Difficulties that arise during implementation
should be reported to Department of Health (Department of Medical Profession -
Phone number: 028.3930.9981).
Version 1.5 of the “Guidelines on healthcare
package for F0 at home” is attached hereto./.
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PP. DIRECTOR
VICE DIRECTOR
Tang Chi Thuong
GUIDELINES ON
HEALTHCARE PACKAGE FOR F0 AT HOME
(Version 1.5)
(Attached to
Official Dispatch No. 6005/SYT-NVY dated August 27, 2021 of Department of
Health)
1. Regulated
entities: new COVID-19 patients (F0) who are tested positive by the RT-PCR
test or quick antigen test, detected within the community, and eligible for
quarantine at home as per the law.
2. Conditions
for quarantining F0 at home
- F0 who satisfy all
requirements below:
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(2) Range from 1 to 50 years of age, have no
underlying medical condition, are not pregnant, and are not overweight. If
these requirements are not satisfied, ensure that F0 have received 2 shots of
COVD-19 vaccination or passed 14 days from their first shot of COVID-19
vaccination.
- F0 is capable of taking care
of themselves: Can take care of themselves (such as eating, cleaning, washing,
sanitizing, etc.); can contact medical personnel to be supervised and monitor,
and when facing medical emergency. In case F0 are children or people who are incapable
of taking care of themselves, assistants are required.
- Facility requirements: Have
separate rooms for F0 where windows, separate bathrooms, and phones are
installed with phone number of medical facilities and phone number of rapid
response teams of districts available for contact when necessary. Have
individual table or chair positioned in front of quarantine rooms to receive
food and necessary personal items; have personal garbage bins with cover and
bags. Have hand sanitizer, surface sanitizer, mouthwash or 0.9% saline
solution, medical facemasks, and thermometer.
3. Healthcare
activities for F0 under quarantine at home
Activity 1: Identify and prepare list of local
F0 under quarantine at home
- Trace and manage list of F0
under quarantine at home within districts, wards, communes via the function
“người cách ly” (quarantined individuals) on the software “Hệ thống Quản lý
người cách ly và người bệnh COVID-19” (System for managing quarantined
individuals and COVID-19 patients).
- Manage individuals who
declare to be F0 (via the application for “electronic medical declaration”,
phone calls to medical facilities, etc.) after conducting the test themselves
and individuals who display suspected symptoms but have not been screened and
tested via reports of community COVID-19 teams.
Activity 2: Instruct F0 on how to take care at
home
- Wear masks regularly, except
for when eating and personal hygiene. Replace face masks twice per day or when
necessary, sanitize hands with alcohol prior to removing face masks.
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- Measure body temperature,
SpO2 (if possible) at least twice per day or when feeling signs of
fever and/or dyspnea. Perform medical declaration at least once per day or when
displaying irregular symptoms via the application for “Electronic medical
declaration” or via health monitor check form (breathing rate, body
temperature, SpO2).
- Rest, perform mild physical
exercises (depending on health conditions); perform breathing exercises at
least 15 minutes per day; drink water regularly instead of waiting for the
thirst; do not skip meals; increase nutrient consumption; consume fruits, fruit
juice, etc. think positively, and maintain comfortable mindset.
- Prepare phone number of
medical personnel to contact when requiring advice and/or assistance (hotline
“1022”, phone number of medical stations, mobile medical stations, or rapid
response teams of wards, communes, towns, Thu Duc City).
- All members staying in the
same house with F0 must perform health declaration via the software for
“electronic medical declaration” at least once per day or when necessary.
Activity 3: Conduct medical examination and
monitor health
- “Mobile medical stations”
and “Community-based COVID groups” shall manage list of F0 under quarantine at
home that they are assigned to oversee (medical centers of districts shall rely
on number of new F0 to assign local mobile medical stations).
- “Mobile medical stations”
and “Community-based COVID groups” shall organize physical examination, immediate
distribution of medicine package for COVID-19 treatment at home for F0,
monitor health at home, and promptly detect F0 exhibiting worsening symptoms
and F0 with high risks (the elderly who live alone, individuals suffering from
metal conditions, etc.) to promptly transfer to quarantine and treatment
facilities.
- Instruct F0 to declare
health conditions on a daily basis via the application for electronic medical
declaration, produce health monitor check list, promptly detect cases of severe
symptoms to cooperate with rapid response teams of communes, wards, districts
to transfer patients to district hospitals for treatment.
- Instruct F0 to call the
hotline “1022”, press number “3” or press number “4” to receive advice and
instruction on how to perform healthcare at home (if necessary).
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Activity 4: Provide guidelines on using COVID-19
medicine at home
- Medicine for treatment at
home includes: antipyretic, vitality boosters (vitamins, micro-nutrients,
traditional medicine), antiviral drugs, corticoid anti-flammatory drugs, and
oral anticoagulant for certain recommended situations.
- Oral antiviral drug
(Molnupiravir) is recommended for F0 who displays mild symptoms and provided by
Ministry of Health under Controlled community intervention program.
- Corticoid anti-flammatory
and oral anticoagulant are recommended when patients display early symptoms of
respiratory failure (dyspnea, breathing rate > 20 breaths/minute, SpO2 <
95%) but have not been able to contact medical personnel for assistance. F0
must not take medicine on their own for more than 3 days, during which period,
patients must contact physicians and/or doctors to receive support and,
depending on patients' conditions, physicians and/or doctors will advise patients
to continue with said medicine until 7-day mark.
Activity 5: Test F0 under quarantine at home
- Collect specimen at home
(for quick test or RT-PCR) for F0 on the 14th day to prepare for finishing the
quarantine.
- Test caretakers and/or
individuals staying in the same house with infected individuals when showing
suspected signs of COVID-19.
Activity 6: Provide emergency medical aid for F0
under quarantine at home
Instruct F0 to dial “115” or call phone number of “Mobile
medical stations”, “Community-based COVID groups”, rapid response teams of
communes, wards, districts upon showing signs of worsening namely dyspnea
(short breath, rapid breath more than 30 breaths/minutes), lethargy, pale lips
and/or extremities, SpO2 < 95% to receive emergency medical aid
and be transported to hospitals on a timely manner.
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GUIDELINES ON
USING COVID-19 MEDICINE AT HOME
(FOR INDIVIDUALS
ABOVE 18 YEARS OF AGE)
Medicine for COVID-19 treatment at home consists of
3 packs (A, B, and C): Pack A consists of common medicine, including antipyretic
and vitality boosters; Pack B consists of anti-flammatory medicines and
anticoagulant recommended for specific circumstances; Pack C consists of
antiviral drugs used under Controlled community intervention program of
Ministry of Health.
PACK A (for use in 7 days)
1. Paracetamol 500 mg
Administer 1 tablet when body temperature exceeding
38.5 oC, may re-administer every 4 to 6 hours if the fever persists.
2. Vitamins (mixed vitamins
or vitamin C)
Administer twice per day: 1 tablet in the morning,
1 tablet in the afternoon/evening.
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Instruct patients to immediately contact
physicians/doctors for immediate assistance when feeling dyspnea (short breath,
difficulty breathing increases by activities, resting breathing rate exceeds 20
times/minute or SpO2 drops below 95%). If physicians and/or doctors
cannot be reached, patients may administer anti-flammatory drugs (the 3rd
medicine) and anticoagulant (the 4th medicine) for NO MORE THAN 3
DAYS. During this period, patients must continue to attempt to contact
physicians and/or doctors to receive assistance and, depending on patients’
health, physicians and/or doctors shall decide to continue with these medicine.
3. Dexamethasone 0.5 mg
Administer once per day: 12 tablets in the morning
after meal (equivalent to 6 mg/day).
OR
Methylprednisolone 16 mg
Administer twice per day: 1 tablet in the morning,
1 tablet in the evening after meal (equivalent to 32 mg/day).
OR
Prednisolone 5 mg
Administer once per day: 8 tablets in the morning
after meal (equivalent to 40 mg/day).
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Administer once per day: 1 tablet in the morning.
OR
Apixaban 2.5 mg
Administer twice per day: 1 tablet in the morning,
1 tablet in the afternoon/evening.
Note: The 3rd and 4th
medicines ARE NOT used for: Pregnant women, breast-feeding women, and
individuals suffering from any of the following conditions: gastric ulcer,
liver failure, kidney failure, conditions that can cause bleeding within
gastrointestinal tract, urinary tract, and other conditions that can cause
bleeding.
PACK C (for use in 5 days)
This is antiviral drug recommended for F0 who
displays mild symptoms and provided by Ministry of Health under Controlled
community intervention program. Medical facilities must instruct F0 to sign
“Notice of approval for participation in Program for controlled Molnupiravir
use in community for mild COVID-19 cases” prior to distribution and use.
5. Molnupiravir 200 mg
tablet or 400 mg tablet
Administer twice per day: 800 mg in the morning and
800 mg in the afternoon/evening for 5 consecutive days.
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- The 5th
medicine MUST NOT be taken by: Pregnant women, breast-feeding women,
people suffering from liver failure, acute hepatitis, kidney failure, acute or
chronic pancreas failure.
- As per recommendations of
Ministry of Health, if patients who are using Molnupiravir must administer
anti-flammatory drugs and anticoagulant as per guidelines above, the patients
must STOP USING Molnupiravir.