Publication title: Clinical management of suspected or confirmed COVID-19 disease (Version 4)
Author(s): National Department of Health and National Institute for Communicable Diseases.
Publication date: 18 May 2020
What the guidelines are about:
These are updated guidelines on the care and management of COVID-19 cases in and outside of healthcare facilities. A previous version of the guidelines was issued on March 27. This latest edition includes a new section on the care and management of COVID-19 cases in children, pregnant and breastfeeding women, and people living with HIV.
Key take-aways from the guidelines:
- Acute cases of COVID-19 should be tested by polymerase chain reaction (PCR). These tests can produce false negatives, the guidelines warn. Repeat tests are thus recommended for suspected cases of COVID-19 infection despite a prior negative test. Repeat confirmatory tests aren’t necessary, however.
- Serological, or antibody, tests are currently not recommended to diagnose acute cases of COVID-19 as these are considered “insufficiently sensitive”.
- People with suspected cases of COVID-19 waiting for their test results can self-isolate at home if they are medically well. Individuals who have been diagnosed with a mild case of COVID-19 and are medically well can also self-isolate at home. If the condition of suspected or diagnosed patients deteriorates while self-isolating at home, they should return to a healthcare facility immediately.
- Individuals with suspected or confirmed cases will be admitted into an isolation facility if they are unable to self-isolate themselves safely. This includes individuals who are unable to “stay in a separate room, maintain physical distancing, maintain good hand hygiene, and return timeously to a healthcare facility in case of deterioration”.
- Patients with mild COVID-19 and who are potentially at risk of developing a more severe case needn’t necessarily be hospitalised. These patients can be managed from home if they are able to safely self-isolate. Home-managed patients should be given the contact details of their doctor or healthcare facility in case of deterioration.
- Asymptomatic COVID-19 patients can come out of isolation 14 days after their positive test. Patients with mild cases of COVID-19 can de-isolate 14 days after their symptoms begin. Those with severe cases of the disease can come out of isolation 14 days after they are in a stable condition.
- Paracetamol is recommended as the first option for fever and pain relief.
- Patients with low oxygen saturation levels should immediately receive supplemental oxygen therapy.
You can find and download the guidelines here.
[Please note: Information on the new coronavirus is rapidly changing. Please refer to the National Institute for Communicable Diseases’ website for the latest information. Visit www.sacoronavirus.co.za for updates on South Africa’s coronavirus response]