Dr Daniel Israel is a general practitioner working in Johannesburg. He is a member of GGPC (Gauteng General Practitioners Collaboration) which has created a platform for doctors to share resources during Covid-19. Look for  #voicesthatcare on the GGPC Facebook page. 

We each treat our family as the safe zone. What a blessing this is, that in today’s world fraught with risks, influences and unhealthy environments, there is a space that exists where we can de-mask, expose and let be. However, the surge of COVID-19 challenges the norm for many families.
How do you protect family members who are negative when a loved one is newly diagnosed with the coronavirus?

Your spouse tests positive for Covid-19: Now what?

Some common questions below will help you work around this new situation.

QUESTION: If my husband has COVID-19, and we’re all young and healthy, why don’t we all just quarantine at home and get it?

ANSWER: First things first,  if an elderly grandparent or a person with a co-morbidity lives in the family, this  is NOT a consideration.

How about a family that has no obvious ‘risk factors’? Once a member tests positive, can they all just cocoon together and take the knock? Unfortunately, international data has shown that 5% of deaths from coronavirus are in young healthy people with no risk factors. So, the challenge is set: how do you remain coronavirus negative while you live with someone who tests positive?

QUESTION: What precautions do I take with our home quarantine?

ANSWER: Members of the family who have been in contact with the positive patient should start social distancing. There is no need to test anyone else yet. In fact, tests before 7 days since the infected patient became symptomatic are likely to show false negatives. However, if new members of the family begin to experience symptoms, contact your GP.  Testing may be advised. 

Who should quarantine, and who should isolate?

Quarantine: Members of the household who have been in contact with the positive person must

  • practise social distancing 
  • quarantine for 2 weeks since their last close contact with the positive patient. This means they should stay home and have necessities delivered. (Note: the length of the isolation may be reviewed by the DIH soon)

Isolation:  The infected family member needs to be isolated from the rest of the family. This is the tough part. It means staying in a different living area and not sharing anything with the rest of the family. Easier said than done. 

Tips for isolating the Covid positive family member

The bedroom

Once a member tests positive he/she should sleep in a separate room to reduce close contact and transmission through surfaces.  Create a ‘sick room’ in your home:

  • This room should be cleaned daily by wiping surfaces with a bleach solution (1 part of 5% bleach to 9 parts of water.)
  • Whoever cleans the room must wear a mask and sanitize their hands after the cleaning.

The bathroom

A study in Wuhan showed significant positive swabs from bathrooms in a hospital. (April 2020, bioRxiv journal). Where possible:

  • the COVID positive patient in your home should have their own bathroom.
  • It is important to close the toilet seat before flushing.
  • The bathroom must be cleaned down daily with disinfectant (containing bleach as above).
  • If you need to share a bathroom, the surfaces need to be wiped down between each user.

The living room

Few homes have separate living rooms that can sustain pockets of isolation. Furthermore, families find it emotionally straining, having NO contact with an infected family member over this time. The WHO recommends sharing living space at a distance. If you are going to spend limited time with the member that tests positive:

  • do it in the garden or in a ventilated room, at a distance of more than 2 metres with all members of the family wearing masks.
  • Don’t be tempted to share food.

Meals

Families who eat together, get Corona together. Meals promote viral shed because we are used to sharing dishing up spoons and condiments and because masks cannot be worn 

  • Ideally, the infected patient should eat in his/her room.
  • If this is emotionally straining, the patient should at least eat on the other side of the room with no sharing of food or utensils.
  • Cutlery and crockery must be washed in hot soapy water or in a dishwasher on a hot setting.

Laundry

Laundry from the infected person must be handled carefully and washed in hot water. The person handling the laundry should:

  • wear gloves or
  • thoroughly sanitise their hands after touching it.

Hot water removes coronavirus from clothes, so clothes can be reintroduced into the family after washing.

Parenting

Young children may not be understanding of the rules of social distancing. We are encouraged by the evidence, thus far, that children don’t spread coronavirus. The important goal should be to at least treat the coronavirus patient as ‘sick’ to the young child and encourage keeping a distance ‘to stop germs.’  Explain to the child that this will just be for a while and once Mom or Dad has fought off the virus, they will be able to hug again.

QUESTION: So now that I know how to remain negative, how do I keep my mind positive?

ANSWER: This is all a little overwhelming…

Be Resilient

Remember, your loved one is probably more scared than you are. Scared of complications or death (even if they are unfounded). Scared of infecting you. It’s important that in the milieu of madness in your home, you are able to provide a framework of support. The patient’s focus is on resting and recovery. This is your opportunity to dig deep into your resources of resilience, and lead from the front. You may find this challenging, given your own concerns. Reach out to your GP or a mental health worker to help you process your own anxieties.

Talk openly to fight stigma

The societal fear of coronavirus has led to its stigma. You may be afraid that if you disclose that your family has been affected, your children may be stigmatised and you may be avoided for months. However, cases are rapidly rising, and hiding away from COVID is not sustainable. The best approach you can take is to be open and honest from the outset:

  • This builds empathy in the community.
  • It prevents spread by making contacts aware of their possible retroactive risk and helps others understand why you are in quarantine.
  • Most importantly here, it gives those who care for you, the opportunity to offer you support.

Look after yourself

For the next fourteen days, you are likely to be caring for a COVID patient, implementing measures to prevent spread and fielding electronic communication about your family’s well-being. Try to set limits on these. Remember:

  •  You may still have a parental role which is likely to now be largely alone.
  • You may still have a job, and you still need to exercise.
  • Make sure you get enough rest and make time for the activities that feed your soul.
  • If the children’s home schooling falls slightly behind, or your house turns into a tip, don’t be too hard on yourself.
  • Try to consider your family’s coronavirus ordeal as a project that will come and go – albeit a project you didn’t choose.

Human beings are resilient. The fourteen days ahead may seem endless as you enter them but think of how many past fourteen-day periods of the last year stick out in your mind. This time will pass and make you stronger. Contact your GP should you require guidance navigating this process. Go forward and conquer it.

Useful guidelines on quarantine and isolation

What to do if I:

  • think I have Covid…read more
  • test positive for Covid and I am asked to stay at home… read more
  • am told to quarantine: how and when to do it…read more

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