FAQs for

Delhi COVID Positive Helpline

Clinical queries

What is the protocol followed by the DSO during the visit to the patient’s home?


The DSO will inspect the home conditions and advise the patient on the best
practices.

S/he will also assess if anyone else in the household needs testing, medicines or
other help, home lockdown, home quarantine for all members.

The DSO may facilitate medical check-up of the patient and her/his family members,
and advise next steps for treatment of the patient.




What is the treatment protocol for patients in Home Isolation that can I advise for thecvarious symptoms?


Please remember, Doctors on StepOne can only advise OTC medicines and home
remedies.

1. Vitamin C (1000 milligrams per day), Vitamin B complex tablets, Zinc (50
milligrams per day), Vitamin D 60,000 units once a week can be suggested to
patients.

2. For fever, can suggest Paracetamol SOS.

3. For severe cough, can suggest Syrup Honitus, Vicks/Halls lozenges or home
remedies like gargles, Honey, Turmeric, Lemon Ginger Tea etc.

4. For headache, can suggest Paracetamol, Aspirin, Ibuprofen, Naproxen.

5. For loose motions, can suggest Probiotics, Econorm Sachet, Loperamide,
Pepto-Bismol or home remedies like Bananas, Potatoes, ORS etc..

6. For loss of smell/taste, can suggest steam inhalation, Jal Naiti etc.

7. For sore throat, can suggest gargles, lozenges.

8. For severe weakness, can suggest healthy food, lots of fluids, paracetamol, B
Complex.

9. For difficulty in breathing, please select *Hospital* or *Emergency* as
applicable in the field ‘Recommendation by Doctor’ on the Freshdesk App.
Update/Save Changes (iOS or Android respectively). Please be very diligent
while selecting ’Emergency’ as it immediately dispatches an ambulance to the
patient. Please confirm with the patient and ask them to be ready to board
the ambulance as soon as it arrives.




If a patient wants to get the COVID-19 test done for her/his family members, who can he approach?


If a patient’s family members exhibit symptoms, they can approach any government dispensary or private physician, and they will get the prescription from these physicians for testing.




Will the Delhi Government provide medicines to the patients?


Yes, patients in Government hospitals and CCC are provided with medicines, food, water and oxygen if required.




To which authorities can we refer the patient if s/he enquires about sanitization of local areas/residences of COVID-19 positive cases?


While this is not in the scope of activities expected from a StepOne volunteer doctor,
the doctor, if s/he so wishes, may direct the patient to contact officers of the
Municipal Corporation of Delhi. (Annexure III: MCD numbers for sanitization)

The DSO may also advise next steps on sanitation requirements during her/his visits
to the patient’s house.




When will the DSO visit the patient?


The DSO will call the patient within 24 hours and arrange for their visit to the CCC for
a physical assessment or will visit the patient within 48-72 hours from the doctor’s
call.




Do the family members of a COVID-19 positive patient require testing?


Testing for family members should be advised if they are displaying symptoms of COVID-19, else they should be advised to follow the Home Isolation Guidelines provided by the Delhi Government. A relevant instructional video can be found on this link on the Delhi Fights Corona website.

Also, the DSO will make the final decision whether testing is required or not, in case the patients require free testing. If the patients can afford to pay, they can get the test done at any private lab after getting a prescription from a doctor.

1. To get this prescription, they can either approach their family physician or book an online consultation through any app like Practo, 1mg etc. StepOne doctors cannot give them any prescriptions.




How can the patient see the report?


The patient will have to follow up with the lab where s/he got the test done. The lab will share the report.




How should I respond to a patient who informs that s/he has received a negative result from the lab but our system indicates her/him to be COVID-19 positive?


The patient can be advised that, “Till the time you do not get the physical report, please self isolate at home. If you have received the physical copy of the report and it is indicating negative status, the same is to be relied on.”




What are the Helpline numbers which can be shared with the patient?


The following Helpline numbers can be shared with the patient:

1. Delhi COVID-19 Positive Helpline Number: 1800111747, 011 6119 3786
(COVID-19 Positive patients only) on which patients can call if
a) symptoms worsen, then we will arrange for a doctor callback
b) any emergency support needed

2. Delhi CATS Ambulance Helpline Number: 102 or 1099

3. Delhi Helpline number for general queries: 1031, 011-22307145




In case the DSO advises testing, is the patient required to visit a Testing Centre or is Home Collection of sample by Government testing centre facilitated?


There is no home collection facility offered by the government. Patient has to go to the facility advised by the DSO.




Are doctors volunteering for StepOne allowed to prescribe testing basis the teleconsultation?


Government guidelines do not permit such prescriptions based on telemedicine consultation.




What can I advise a patient who has a family member with high-risk comorbidity and wants to get her/him tested for COVID-19, but no doctor is prescribing tests because the family is not showing any symptoms?


The DSO will make the final decision whether testing is required or not, in case the
patients require free testing.

If the patients can afford to pay, they can get the test done at any private lab after
getting a prescription from a doctor.

1. To get this prescription, they can either approach their family physician or
book an online consultation through any app like Practo, 1mg etc. Doctors
volunteering with StepOne cannot give them any prescriptions.




How can I respond to a patient who is calling back to enquire after a doctor has spoken to the patient but the response from DSO is pending?


We can answer his queries and try to help him to the maximum. We can mark on the
doctor notes that a DSO visit is required.




Can I follow up with a patient or call a patient back if the ticket is resolved?


We do not advise call-backs or follow-ups on calls that are already resolved.




What should I do if the patient needs immediate medical intervention?


On the Freshdesk App, please select *High Risk* in the field *Clinical Status* and *Emergency* in the field *Recommendation by Doctor*. Update/Save Changes (iOS orAndroid respectively).

Please use this option with extreme caution and restraint as it means anambulance will immediately be dispatched to the address. Ambulances areprecious resources and should be used only in very deserving cases.




How can I help a patient who is showing mild symptoms and wants to get a chest X-Ray done since a family member has recently passed away due to COVID-19?


On the Freshdesk App, please select *Mildly Symptomatic* in the field Clinical Status
and *'Home Isolation* in the field Recommendation by Doctor.

Capture the specific details in the field *Doctor Notes*. Update/Save Changes (iOS or
Android respectively).

Further tests will be arranged by DSO when he visits.




What shall I recommend in case of a patient with comorbidities, who is asymptomatic and has not shared status with concerned authorities?


On the Freshdesk App, please select *High Risk* in the field Clinical Status & *Home
Isolation* in the field Recommendation by Doctor. Update/Save Changes (iOS or
Android respectively).

Share helpline numbers with the patient and advise them to call immediately in case
symptoms develop. Tell them to monitor their Oxygen levels and to immediately call
helpline if they drop below 92%.




How can I respond to a patient enquiring about HCQ as a treatment option for himself and as a prophylactic for family members?


It's not advised as there is no clinical data for it yet.




What guidance can I provide to a patient on Home Isolation measures?


The patient should be advised to follow the Home Isolation Guidelines provided by
the Delhi Government.

A relevant instructional video can be found on this link on the Delhi Fights Corona
website.




What can I advise a patient who has tested positive but has already self-isolated for 10 days?


Advise the patient to observe Home Isolation till 17 days from the date of the test and
that s/he should call on the Helpline No. if develops symptoms (please share Helpline
No.s with the patient).

On the Freshdesk App, please select the relevant option in the field ‘Clinical Status’
as applicable and select *Home Isolation* in the field ‘Recommendation by Doctor’.
Update/Save Changes (iOS or Android respectively).




What can I advise a patient who has completed Home Isolation and is showing no symptoms now?


If the patient has completed Home Isolation for 17 days and is afebrile since the last
10 days, then the patient need not follow any further isolation requirement. In case
symptoms re-appear, the patient should call on the Helpline No.s (please share
Helpline No.s with the patient).

On the Freshdesk App, please select *Asymptomatic* in the field ‘Clinical Status’ and
*Home Isolation* in the field ‘Recommendation by Doctor’. Update/Save Changes
(iOS or Android respectively).




What can I advise the patient if her/his entire family has tested positive, completed home isolation for 2 weeks and is showing no more symptoms?


Home isolation recommended for 17 days from the day of testing.

On the Freshdesk App, please select *Asymptomatic* in the field ‘Clinical Status’ and
*Home Isolation* in the field ‘Recommendation by Doctor’. Update/Save Changes
(iOS or Android respectively).




If a patient has only a fever and no other symptom, should I recommend home isolation or hospital?


If fever is the only symptom, even the temperature is higher than 101 degrees
Fahrenheit for more than 3 days, then on the Freshdesk App, please select *home
isolation* in the field ‘Recommendation by Doctor’. Update/Save Changes (iOS or
Android respectively).




If a patient has completed the 17 days Home Isolation period, does s/he require a retest after the isolation period?


If the patient has exhibited no symptoms for the last 10 days, then no retest is
required.




What can I advise a patient who is testing positive after 17 days isolation period but is completely asymptomatic for the last 10 days?


Since they have tested, they will have to undergo home isolation for 17 days from the
date of test.




What can I recommend in case of a patient who exhibited symptoms a few days back but is asymptomatic now?


On the Freshdesk App, please select *Asymptomatic* in the field ‘Clinical Status’ and
*Home Isolation* in the field ‘Recommendation by Doctor’. Update/Save Changes
(iOS or Android respectively).




What are the options available to patients who want to get the COVID-19 test done for their family members?


If a patient wants to get family members tested, the following options are available:

1. The family member can visit one of the government testing centres to provide sample for testing. (Annexure-I: List of Government Testing Centres in Delhi). They will need to carry a government dispensary prescription and their Aadhar Card.

2. The family member can register with a private service provider who will arrange for home collection of sample. (Annexure-II: List of Private Service Providers offering testing facility)

3. If DSO visits the family and observes the need for testing of patient’s family members, DSO will advise testing.




What can I recommend in case of an Asthma patient who has been recovering (normal temperature, minor cough) over the last few days?


On the Freshdesk App, please select *Mildly symptomatic* in the field ‘Clinical Status’
and *Home Isolation* in the field ‘Recommendation by Doctor’. Update/Save
Changes (iOS or Android respectively).

Please share Helpline No.s with the patient and ask her/him to call immediately in
case of respiratory distress.




If the patient is sharing a common bathroom with non-infected family members, can they continue with home isolation if following sanitation measures?


No, as per the Home Isolation Guidelines provided by the Delhi Government (A
relevant instructional video can be found on this link on the Delhi Fights Corona
website), the patient and family members need to have separate bathrooms for
Home Isolation of the patient.

On the Freshdesk App, please select the relevant option in the field ‘Clinical Status’
as applicable and select *COVID Care Centre* in the field ‘Recommendation by
Doctor’. Update/Save Changes (iOS or Android respectively).




What is the protocol followed once a patient is admitted to a COVID Care Centre?


The patient is kept for 12 days from the date of the test and sent home after that for
further five days of home isolation.




Is isolation recommended for a patient who is currently asymptomatic and got herself/himself retested to know the status, which again came back positive after 14 days?


The patient has to follow 17 days period of isolation from the day of re-test.

On the Freshdesk App, please select *Asymptomatic* in the field ‘Clinical Status’ and
*Home Isolation* in the field ‘Recommendation by Doctor’. Update/Save Changes (iOS
or Android respectively).









Breastfeeding and new-born related queries

Can COVID-19 be passed from a woman to her unborn or new-born baby?


Active COVID-19 has not been detected in the breastmilk of any woman with
confirmed/suspected COVID-19 and there is no evidence so far that the virus is
transmitted through breastfeeding.




Should a COVID-19 positive mother discontinue breastfeeding?


No. There is no evidence yet that mother can transmit the virus through the breast milk.
A mother's milk essentially provides the baby with the antibodies or immunity s/he needs. This should not be discontinued as it can be detrimental to the development of the child’s own immunity.

If the mother isn’t breastfeeding the baby, then she should make sure that she washes her hands properly with soap before touching any utensils etc. being used for preparing the feed. It’s mandatory that all the utensils being used for feed preparation be washed properly before and after the feed.

Mother should take care to wear a mask at all times, reduce unnecessary contact with the child and wash hands with soap before handling the baby.




What are key messages for a mother who wants to breastfeed but is scared about passing COVID-19 to her infant?


As part of counselling, a mother’s or family’s anxiety about COVID-19 should be acknowledged and responded to with the following messages:
1. Breastfeeding and skin-to-skin contact significantly reduce the risk of death in newborns and young infants and provide immediate and lifelong health and development advantages. Breastfeeding also reduces the risk of breast and ovarian cancer for the mother.

2. Newborns and infants are at low risk of COVID-19 infection. Among the few cases of confirmed COVID-19 infection in young children, most have experienced only mild or asymptomatic illness.

3. The numerous benefits of breastfeeding substantially outweigh the potential risks of transmission and illness associated with COVID-19.

4. Active COVID-19 has not been detected in the breastmilk of any mother with confirmed/suspected COVID-19 and there is no evidence so far that the virus is transmitted through breastfeeding.

5. If a mother confirmed/suspected to have COVID-19 was unable to breastfeed because she was too ill or because of another illness, she can start to breastfeed when she feels well enough to do so. a) There is no fixed time interval to wait after confirmed/suspected COVID-19. There is no evidence that breastfeeding changes the clinical course of COVID-19 in a mother.
b) She should be supported in her general health and nutrition to ensure full recovery. She should also be supported to initiate breastfeeding or relactate.
6. While handling the baby, the mother should take care to wear a mask at all times, reduce unnecessary contact with the child and wash hands with soap before handling the baby.




If a mother is confirmed/suspected to have COVID-19, is infant formula milk safer for infants?


No. There are always risks associated with giving infant formula milk to newborns and infants in all settings.
1. The risks associated with giving infant formula milk are increased whenever home and community conditions are compromised e.g. reduced access to health services if a baby becomes unwell / reduced access to clean water / access to supplies of infant formula milk are difficult or not guaranteed, not affordable and not sustainable.

2. The numerous benefits of breastfeeding substantially outweigh the potential risks of transmission and illness associated with COVID-19.

3. Mother should take care to wear a mask at all times, reduce unnecessary contact with the child and wash hands with soap before handling the baby.




Can a COVID-19 positive woman touch and hold her new-born baby?


Yes. Close contact and early, exclusive breastfeeding helps a baby to thrive. The mother should be supported to
1. Breastfeed safely, with good respiratory hygiene

2. Hold the newborn skin-to-skin
3. Share a room with the baby

4. Mother should wash her hands before and after touching the baby, and keep all surfaces clean. She should always wear a mask while handling the baby. The numerous benefits of skin-to-skin contact and breastfeeding substantially outweigh the potential risks of transmission and illness associated with COVID-19.




What to do for mother and newborn if she has recently delivered a baby and mother is found to be COVID 19 positive?


If a mother is confirmed/suspected to have COVID-19, there is no recommendation to separate the mother and baby. Mother should:

1. Wash hands frequently with soap and water or use alcohol-based hand rub, especially before touching the baby.

2. Wear a medical mask while feeding. It is important to:
a) Replace masks as soon as they become damp
b) Dispose off masks immediately
c) Not re-use a mask
d) Not touch the front of the mask but untie it from behind

3. Sneeze or cough into a tissue, immediately dispose of it and use alcohol-based hand rub or wash hands again with soap and clean water

4. Regularly clean and disinfect surfaces.

5. If the mother has just coughed over her exposed breast or chest, then she should gently wash the breast with soap and warm water for at least 20 seconds prior to feeding.
a) It is not necessary to wash the breast before every breastfeed or prior to expressing milk.




What to do if a child is tested COVID positive?


It's very likely that if a child is tested positive but asymptomatic, the child would not need any admission to hospital and would need to be quarantined.
1. Mother and father would be considered as primary contact and need to be quarantined.

2. If the child is an infant, breastfeeding is to be continued and maintain safety precautions.

3. If old enough to be alone, the child can be quarantined, otherwise needs to stay with the mother with adequate precautions.




What is the kind of care needed when the infant or child is positive? And how is it different from adults?


A. In such cases, an independent room is given to the mother and children, where beds will be at two different corners. The attendee or caregiver should take all precautions in such a situation.
1. Make sure masks are worn by the mother when handling the child.

2. Maintain cleanliness in the room and the clothes and linen of the mother and the child should be changed everyday.

3. Their clothing should be washed separately. Their utensils should also be separated from the other patients.

B. An infant being breastfed by a mother who is suspected or confirmed to have COVID-19 should be considered as having suspected COVID-19—when the infant’s testing results are not available—for the duration of the mother’s recommended period of home isolation and 14 days thereafter.
1. The same approach should be taken with respect to an infant who has any other ongoing, close contact with another person who has suspected or confirmed COVID-19.

2. Mothers should be counseled to inform their child’s healthcare provider that their child has had high-risk contact with a person suspected or confirmed to have COVID-19.




What to do if both parents are tested positive?


If both parents are tested positive and not symptomatic, then they would be home isolated and the child being considered as primary contact, also needs to be quarantined with them.
1. It's not advisable that the child be taken care of by grandparents (living at another place hence not primary contacts) since they would be a high risk population and also the child might be a carrier. So the child stays with the parents.

2. If any other caretaker is available and the child is old enough to stay away, can stay away but the caretaker here must take adequate precautions with the child since the child here is a primary contact.




What to do if both parents and child also tested positive?


If all are tested positive, all are isolated, and the child stays with the mother if too young to stay alone. All should maintain minimum contact since there is a chance of increasing the viral load in each other. So all should stay as separate as much as possible having minimum contact with adequate precautions.




Please Note: All the above situations are that of people when asymptomatic and not developed symptoms. If they develop symptoms, they will be in hospital, in which case the child would be with the parent at home or with another caretaker if both parents are hospitalised, provided the caretaker takes all safety precautions while taking care of the child.






Freshdesk queries

How shall I respond in case the patient informs that s/he has already received calls from multiple doctors?


This could be due to a common contact no. being shared for multiple COVID-19 positive members of a family. We are working on a technical solution to club the tickets of multiple family members in order to merge calls and prevent duplication of efforts. B. Also the patient may be confusing the screener call for a doctor call. Reassure them that the earlier call was to confirm address, phone number etc. This call is to offer medical help.




Why was the ticket lost before I filled in the parameters? How can I fill out those details now?


The ticket gets reassigned if it is kept unresolved for more than two hours. Please try and resolve your tickets in time.




Why am I not receiving tickets though availability is ON?


Please reconfirm that your availability is ON.

If you still do not get tickets, please highlight the same to the StepOne admins in the WhatsApp group and they will resolve the issue.




What should I do if the patient is not responding to multiple calls?


In case a patient does not respond to 3 calls over a 15 minutes period, please select ‘Patient Not Reachable’ in the field 'Recommendation by Doctor' on the Freshdesk App. Update/Save Changes (iOS or Android respectively).




Why is a ticket not resolved even though I have consulted the patient?


This could happen if you have not filled in the field ‘Recommendation by Doctor’ followed by Update/Save Changes (iOS or Android respectively). In such a case the ticket remains unresolved and gets re-allocated to another doctor.




Why have I got the ticket for a patient who already knows her test results and is practising isolation already?


It could have happened due to some human error during data upload. Please feel free to flag such cases in the WhatsApp group for the StepOne team to be able to sort the issue.




What shall I recommend in case a patient is already in the hospital?


On the Freshdesk App, please select *Patient already in Hospital* in the field ‘Recommendation by Doctor’. Update/Save Changes (iOS or Android respectively).




What shall I do if a resolved ticket is still showing as pending?



Please share ticket ID with the StepOne Admin team in the WhatsApp group for resolution




The person I spoke with was annoyed about receiving multiple calls since he is a friend of the patient. How can I update the phone no. on the app to reflect the patient’s phone no. from the existing no. being displayed in the app?


It is not possible to update the phone no. in the current system. On the Freshdesk App, in the field ‘Doctor Notes’, please leave a comment that the no. is wrong, and mention the correct no. In the field ‘'Recommendation by Doctor' section, select *Wrong Number*. Update/Save Changes (iOS or Android respectively). This will resolve the ticket.




If the patient has other symptomatic people in the family, where should this detail be logged?


This detail can be logged in the field ‘Doctor Notes’.




Should I change the Priority Status for patients who have nearly completed 14 days isolation, are not showing high risk symptoms but are still marked as high priority?


The priority field should be left unchanged. On the Freshdesk App, please select *‘Mildly Symptomatic* in the field ‘Clinical Status’. Select *Home Isolation* under *Recommendation by Doctor*. Update/Save Changes (iOS or Android respectively).




What shall I do in case of a ticket which has a note but no report?


These are incoming calls to the helpline from COVID-19 patients who want to talk to a doctor. Please call them and try to solve their issues. You can triage them just like you are triaging other cases.




How are the tickets marked Delhi Covid Incoming Tickets different from the others?


You will see several tickets which have the title “Delhi Covid Incoming Tickets” - please note that these are patients who have called the helpline and requested to speak to a doctor. These patients are typically in Home Isolation or rarely at a Covid Care Center. They are calling if they have a change in their symptoms or may have some other medical issue for which they need to consult a doctor. The process for addressing the issue is the same as new cases - consult with them and mark the usual recommendations.




What has to be filled in the Doctor Notes?


Patient's condition; whether DSO visit is urgent; any other important information.




Which are the fields which I have to fill in the app and which are the ones to be left unchanged?


The following fields need to be filled by the Doctor: Fields till (including) Doctor Notes.

The following fields should be ignored in the app: Product, Status, Priority, Type.




When should I mark a patient as Emergency?


Mark the patient as *Emergency* in the field *Recommendation by Doctor* only if you think an ambulance team needs to reach the patient immediately. Do not mark patients as Emergency if the situation is not suitable for an ambulance visit. This is usually a situation when the patient is extremely breathless, having multiple uncontrollable loose motions, has had a fall or fallen unconscious. Or a high risk comorbidity that needs immediate medical attention. Any other situation should be marked emergency only after great deliberation.





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