Covid-19 vaccine arrival – not to relax now on important general protection measures & role of diagostic testing

Covid-19 – Their Vaccines are nearing completion & in some countries, are ready for getting rolled out for use too. This shall take a little more time in the Indian scenario however. Which means that we need to tighten up on some of the important protection measures even after the vaccine arrival, till the Virus is ERADICATED from India, like in the case of Polio.

Some Basic Food & Grocery Related Measures we need to take seriously with regards to our daily Grocery Shopping, Market Vegetables Procurement & Cooking, or Consuming Deliveries/Eating out, which we are now frequently indulging in regularly, are enumerated in the following paragraphs:

Before venturing out to the Market – Prepare a shopping list in advance. Buy just 1 to 2 weeks worth of groceries at a time. (Buying more than you need, can create unnecessary demand and temporary shortages). Wear a face covering or mask at all times while you are in the store.

Carry your own wipes or use one provided by the store, to wipe down the handles of the shopping cart/basket. If you are using reusable shopping bags, ensure they are cleaned/washed before each fresh use.

Practice social distancing while shopping – keep at least 6 feet between you & other shoppers and the store employees. Take care to keep your hands away from your face at all times.
Wash your hands with water and soap for at least 20 seconds on returning home, and again after you put away your groceries after cleaning and disinfecting the vegetables before storing in a Fridge.

There is no evidence of pre-packaged food being associated with transmission of COVID-19. However, you may wipe-down product packaging and allow it to air dry, as extra precaution. As always, it is important to follow food safety practices to help prevent food-borne illness:- Before eating, rinse fresh fruits and vegetables under running tap water, including those with skins and rinds that are not eaten. Scrub farm produce with a clean firm brush. For canned goods, remember to clean lids before storing/opening.

When home storing groceries, refrigerate or freeze meat, poultry, eggs, seafood, and other perishables. Consume early, within a reasonable time.

Regularly clean and sanitize kitchen counters using a commercially available disinfectant. A home-made sanitizing solution can be made with 5 tablespoons (75 mls) unscented liquid chlorine bleach to 4 ltrs of water, or 4 teaspoons (20 mls) of bleach per ltr of water. WARNING: Do not use this solution or other disinfecting products or food. If used at all, RINSE off thoroughly before consuming.

Always keep in mind the basic food safety steps—Clean, Store/Chill, Cook. Food is a source of comfort, as well as nourishment for you and your family – especially now – and it is hoped this advice will help you continue to buy groceries with care and confidence.

Imporatant- Can a patient spread the disease even after his Corona-virus symptoms disappear?
They can still infect others after they stop feeling sick, so preventive measures should continue for at least two weeks after symptoms disappear. Visitors should not be allowed until the end of this period. All confirmed cases, even mild cases, should be isolated, to prevent transmission and provide adequate care. Cases needs be cared for at home or hospitalised depending upon their medical severity.

Caring for infected people at home may put others in the same household at risk, so it’s critical that care-givers follow preventive measures to provide care as safely as possible. Both the patient and their care-giver should wear a medical mask when they are together in the same room. The patient should sleep in a separate bedroom to others, and use a different bathroom. Assign only one person to care for the patient, ideally someone who is in good health and has no underlying conditions. The care-givers should thoroughly wash hands after any contact with the patient or their immediate environment. Visitors should not be allowed until the end of a two week period.

Subsequent Re-exposure after a COVID-19 Infection: For persons recovered from Covid infection, a positive PCR without new symptoms during the 90 days after illness, onset more likely represents persistent shedding of viral RNA than re-infection. (a) If such a person remains asymptomatic during this 90-day period, then any re-testing is unlikely to yield useful information, even if the person had close contact with an infected person. (b) If such a person becomes symptomatic during this 90-day period and an evaluation fails to identify a diagnosis other than Covid infection (e.g., influenza), then the person may warrant evaluation for Covid reinfection in consultation with a Doctor. Isolation may be warranted during this evaluation, particularly if symptoms developed after contact with an infected person.

Duration of isolation and precautions: For most persons with COVID-19 illness, isolation and precautions can generally be discontinued 10-14 days after symptom onset and resolution of fever for at least 24 hours, without the use of fever-reducing medications, and with improvement of other symptoms. A limited number of persons with severe illness may produce replication-competent virus beyond 10 days that may warrant extending duration of isolation and precautions for up to 20 days after symptom onset; Consider consultation with medical experts.

For persons who never develop symptoms, isolation and other precautions can be discontinued 10 days after the date of their first positive RT-PCR test for COVID-19.

Role of viral diagnostic testing (PCR or antigen) to discontinue isolation or precautions: A test-based strategy alone is not recommended, except to discontinue isolation or precautions earlier than mandated.

Role of viral diagnostic testing (PCR or antigen) after discontinuation of isolation or precautions: For persons previously diagnosed with symptomatic COVID-19 who remain asymptomatic after recovery, retesting is not recommended within 3 months after the date of symptom onset for the initial COVID-19 infection.

For persons who develop new symptoms consistent with COVID-19 during the 3 months after the date of initial symptom onset, if an alternative aetiology cannot be identified by a provider, then the person may warrant retesting. Consultation with Doctor is recommended, especially in the event symptoms develop within 14 days after close contact with an infected person. (For persons who never developed symptoms, the date of first positive viral diagnostic test (PCR or antigen) should be used in place of the date of symptom onset).

Quarantine of Persons Recovered from diagnosed Infection with Subsequent Re-Exposure: Most recovered individuals have a degree of immunity for at least 3 months following initial diagnosis of COVID-19. If implemented with current safety measures to prevent transmission (Masking, stay 6 feet away from others whenever possible, and wash hands regularly), the risks of potential transmission from recovered persons are likely outweighed by the personal and societal benefits of avoiding unnecessary quarantine. If a person has a new exposure to someone with suspected or confirmed COVID-19 and meets all of the following criteria:

• Has recovered from laboratory-confirmed (PCR or antigen) infection and has already met criteria to end isolation;
• Is within the first 3 months following the onset of symptoms of their initial confirmed infection; and
• Has remained asymptomatic since the new exposure.

Then that person does not require quarantine or repeat testing in the context of this new exposure.

If a person has a new exposure to a person with suspected or confirmed COVID-19 and meets the first two above criteria, but develops new symptoms consistent with COVID-19 within 14 days of the new exposure, consultation with a Doctor is recommended. In the absence of clinical tests to rule out re-infection, this person should be isolated for the duration recommended – For most persons, this would be 10-14 days – after symptom onset and resolution of fever for at least 24 hours, without the use of fever-reducing medications, and with improvement of other symptoms.
WHO, Journal on Communicable Diseases, CDC.