Eligibility for home care of asymptomatic COVID-19 patients: challenges from a low resource setting in Central Kerala, South India

Abstract

Background: As a large spectrum of COVID 19 disease is asymptomatic, there came a need for home based management of asymptomatic cases, which can ensure efficient utilisation of resources for care of severe cases. On 7th August 2020, Kerala government came up with advisory for home care of asymptomatic cases. The study was done to assess eligibility for home care among patients then admitted in COVID First Line Treatment Centres in Palakkad and to identify the challenges to aid in further planning and decision making about home care.Methods: A cross sectional study was conducted among 133 laboratory confirmed COVID 19 cases admitted to CFLTCs during 08 August 2020 to 12 August 2020. Semi-structured questionnaire was administered over telephone, after getting oral informed consent from patients. Analysis was done using Statistical package for social sciences (SPSS) 20.Results: 28.31% of asymptomatic cases were eligible for home care. The challenges were lack of separate room with attached bathroom and ventilation (29%), absence of facility to separate vulnerable persons at home (18.5%), lack of healthy caretaker (15.9%) and being unaware about co-morbidity status (27%). Significant associations were found between socioeconomic status and availability of separate room with attached bathroom as well as separate facility to accommodate vulnerable persons.Conclusions: Major factors limiting eligibility for home care were lack of facility to self isolate and to separate vulnerable persons away from home. Both factors were common among patients from BPL families. 27.4% of asymptomatic patients were unaware of co-morbidity status. This reinforces importance of screening for non communicable diseases in the community.