SINGAPORE - Home recovery is now the default care management model for people infected with Covid-19 who have mild or no symptoms.
While those on the Home Recovery Programme (HRP) must isolate themselves in a room and refrain from interacting with anyone, there is a higher risk of other people living in the same home becoming infected with the virus. Hence, there is a need to take more thorough precautions.
Experts share tips on how people can maintain hygiene and cleanliness during HRP.
Ventilating the room
Covid-19 patients should avoid switching on the air-conditioner and open the windows to keep the isolation room well ventilated.
Dr Tan Teck Jack, chief executive of the Northeast Medical Group clinic chain, says switching on the air-con with the windows closed may result in viral particles escaping from under the door, potentially spreading the virus.
Instead, it is better to switch on the fan and point it away from the room door towards the windows.
If patients switch on the air-con in the room, they should get an air-con specialist to wash it after the isolation period, says a cleaning expert. "This is because the Covid-19 virus is airborne and particles may be trapped in the coil," says Mr Bryan Wong, a cleaning specialist at cleaning firm Hiremop.
Serving food and washing utensils
The patient's family members should wear masks and ensure meals are left just outside the patient's room door, says Dr Tan. They should move away before the patient opens the door to ensure safe distancing and to minimise contact with the patient.
Use dedicated utensils and cutlery set aside for the patient if disposable ones are unavailable, he adds.
After the meal, patients should wash the utensils and cutlery themselves before placing them outside the room, says Mr Johnson Zhuo, founder and managing director of cleaning company Dream Sparkle.
However, if the utensils cannot be washed in the room, the family member tasked with collecting the finished meal should wear gloves before carrying out the task.
Wash the utensils and cutlery with soap and water immediately. Dry them thoroughly using a separate tea towel, or in the sun, and ensure other household members do not use them, says Mr Zhuo.
The family member should double-bag all waste securely and dispose them into the rubbish chute. Finally, wash hands thoroughly with soap after handling any contaminated item.
Washing the bedding and clothes
Dr Tan says studies have shown that Covid-19 viruses can possibly survive on clothes and linen for between two hours and two days.
Hence, clean the patient's bedsheets, towels and clothes separately from items belonging to other members of the household if possible, he stresses.
"Avoid shaking dirty laundry to minimise the possibility of spread of the virus in the air," he adds.
Wash the items with soap and detergent using the warmest setting on the washing machine. Drying the items under the sun also helps kill the virus, adds Dr Tan. Finally, remember to wash or disinfect the laundry bag or use disposable bags.
Keeping the room clean during recovery
As most Covid-19 infections are mild, the patient should clean his own room, where possible, to minimise the risk to others.
The surfaces in the room should be cleaned and disinfected with household detergent at least once a day, says Mr Zhuo. This includes high-touch areas such as light switches, door knobs, TV remote controls, bedside tables, bed frames and furniture.
To clean surfaces effectively, use regular household soap or detergent first, rinse and then use a disinfectant containing at least 0.1 per cent bleach or a disinfectant with an active ingredient such as accelerated hydrogen peroxide, chloroxylenol or ethanol, listed on the National Environment Agency website.
Disposing of waste from the room during recovery
The patient should have a separate waste bin with a lid in his room for items such as tissues and masks and antigen rapid test (ART) kits, says Mr Zhuo.
Those who need to enter the isolation room to take care of the patient should dispose of his waste, along with any cleaning cloths and personal protective equipment (PPE) he has used in disposable rubbish bags.
These bags should be placed into another bag, tied securely and put aside for at least 72 hours before being put in your external household waste bin, advises Mr Zhuo. Make sure all household waste is stored in a strong and securely closed garbage bag before removing it from the home. Then, wash hands thoroughly with soap and water for at least 40 seconds after removing the mask, gloves, and after handling the waste.
Cleaning the mattress after recovery
There is no need to throw away the mattress, says Dr Tan. He suggests using common household cleaning agents such as those that contain diluted bleach solution or 70 per cent alcohol to wipe down the mattress.
Consider exposing the mattress to a UV-C sterilising lamp or the sun to further disinfect it. "People may also wish to change and wash the bedsheets more often to reduce remnant viral particles," he adds.
Disinfectant sprays containing 70 per cent alcohol or diluted bleach may also be used on mattresses.
Cleaning and disinfecting a room after home recovery
With many Covid-19 patients going through the Home Recovery Programme, there are concerns over how to disinfect a room occupied by someone who had recovered from the virus. Mr Johnson Zhuo, founder and managing director of cleaning firm Dream Sparkle, details the steps to cleaning and disinfecting a room.
Items to prepare for cleaning:
1. Personal protective equipment (PPE) or at least gloves and a surgical mask.
2. Cleaning solution, made up of household disinfectant, or bleach (sodium hypochlorite) solution.
3. A change of clothes, plastic or trash bags, disposable cloths or rags, a pail and a mop.
1. The area to be cleaned should be well ventilated, with the windows opened for at least three hours before cleaning. Ensure the room is also left undisturbed during this time.
2. Put on the PPE or gloves and a surgical mask before cleaning. Avoid touching your face and eyes during the cleaning process.
3. Keep the room well ventilated during cleaning.
4. Mop the floor with the prepared cleaning solution, going from one end of the room to another. Do not move from an area that has not been cleaned to an area that has been cleaned, to avoid dirtying the cleaned area.
5. Soak the cloths with the prepared cleaning solution and use them to wipe all the frequently touched areas in the room, such as doorknobs, armrests, tables, keyboards, mouse, switches, window grille and walls.
To prevent cross-contamination, rinse and soak the cloths with the prepared cleaning solution before cleaning the next surface, or use another cloth.
6. Wash all linen as the virus can stay on surfaces such as curtains, carpets, mattresses, pillows or cushions for two to three days.
7. Laundry and linen should be put directly into the washing machine or a pail of water, and washed with laundry detergent.
8. Set aside items that you are unable to wash or disinfect and do not use them for three days.
9. Finally, mop towards the exit of the room. If using disinfectant from a spray bottle, spray the disinfectant onto the cloth instead of directly onto the surface, to avoid creating splashes which can further spread the virus.
Cleaning the bathroom
1. First, disinfect the sink pipes and toilet floor trap to reduce the risk of Covid-19 aerosol transmission from wastewater.
Do this by adding one cup of the prepared cleaning solution (about 250ml) into the sink, and pouring two cups of the solution (about 500ml) down the floor trap.
2. Clean all surfaces such as sinks, taps, soap dispensers, toilet roll dispensers, doors, handles and flush buttons with the solution.
3. Clean the toilet bowl with a brush, pour the cleaning solution into it and leave it for a minute before flushing with the lid closed.
The brush and cloths used for the toilet bowl and seat cover should not be used for other surfaces. Use a separate cloth for the toilet seat cover.
4. To further minimise the risk of aerosol transmission, it is recommended that a toilet disinfectant tablet or leave-in disinfectant be added into the toilet tank to sustain the disinfection effect.
5. Clean the toilet floor with the prepared cleaning solution from the exit inwards.
Disposing of waste and change of clothes
1. Disinfect the mop head and pails used for cleaning by soaking in disinfectant or mild bleach solution.
2. After cleaning and disinfection is done, remove the PPE or gloves and mask, and wash your hands with soap and water.
3. Throw the PPE, gloves and mask into a double-lined plastic or trash bag.
4. Finally, shower and change your clothes immediately after the clean-up. Wash these clothes you cleaned in as soon as possible.