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MINISTRY OF
HEALTH
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SOCIALIST
REPUBLIC OF VIETNAM
Independence - Freedom – Happiness
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No. 604/QD-BYT
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Hanoi, March 14,
2022
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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
Chief author/editor
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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.