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Mar 4: Twenty-one Italian tourists and three Indian tour operators have been sent to an ITBP quarantine facility in Delhi on Tuesday for suspected coronavirus exposure, official sources said.

Health Ministry sources said these foreigners, 13 women and eight men, were in the same group of which an Italian and his wife have tested positive in Rajasthan capital Jaipur.

“His (Italian in Jaipur) condition is stable,” a source said.

Three Indians, who were accompanying this Italian group as tour operators, have also been sent to the ITBP facility in Chhawla area of south-west Delhi, they said.

All these people, staying at a five-star hotel in south Delhi, have been put in “preventive isolation” at the ITBP camp and their samples will be taken on Wednesday, sources said.

The centre already has 112 people, 76 Indians and 36 foreigners, since February 27 after they were evacuated by an IAF plane from Wuhan in China, the epicentre of the coronavirus.

The first samples of these 112 people had tested negative when reports came in last week.

The Ministry of Health and Family Welfare has prepared a draft for guidelines for home quarantine, as well as for the use of masks by public, in view of coronavirus.

What to do in Home Quarantine?

The government says, for those taking refuge to home quarantine should stay in a well-ventilated single-room preferably with an attached or separate toilet. It adds that if another family member needs to stay in the same room, it's advisable to maintain a distance of at least 1 metre between the two.

The government advised, coronavirus patients to stay away from elderly people, pregnant women, children and persons with co-morbidities within the household as their immune system may be low. The health minister also suggested to restrict the patient's movement within the house. "Under no circumstances attend any social/religious gathering e.g. wedding, condolences, etc, said the guideline.

It also instructed the corona virus infected person to avoid sharing household items like dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items with others at home. The guideline also demanded that even though home quarantine, the patient should wear a surgical mask at all times. "The mask should be changed every 6-8 hours and disposed off. Disposable masks are never to be reused, it added.

"Masks used by patients/ caregivers/ close contacts during home care should be disinfected using ordinary bleach solution (5 per cent) or sodium hypochlorite solution (1%) and then disposed of either by burning or deep burial," instructs the government.

Even for family members of a patient, the health ministry clearly instructs to use disposable gloves when cleaning the surfaces or handling soiled linen. No visitors, under any circumstances will be allowed, said the guideline.

"In case the person being quarantined becomes symptomatic, all his close contacts will be home quarantined (for 14 days) and followed up for an additional 14 days or till the report of such case turns out negative on lab testing," states the draft.

How to wear & dump masks?

There is a specific and elaborate do's and don'ts also released by the ministry. For those unsure in which mask to choose, it says, "Medical masks of different sizes and shapes are available in the market. The common ones are flat pleated masks of woven fabric which covers the nose and mouth and affixed behind the head with straps/ elastic fasteners. There are also conical or duck bill shaped masks with valves (or without valves) that fit in the contour of face over the nose and mouth, but are costlier."

However, the ministry warns, medical masks should not be used by healthy persons who are not having any symptoms "because it creates a false sense of security". Instead, it suggests to refrain from touching face, mouth, nose and eyes as well as washing hands regularly with soap for 20 seconds each time.

However, when a person develops a cough or fever, the suspected patient needs to switch to medical masks. "Use of medical three layer masks when ill, will prevent your infection from spreading to others. However you also need to wash your hands frequently to avoid spreading infection to others," read the guideline.

Even if one is not tested positive but showing symptoms, they are advised to wear masks while visiting a healthcare facility. "Close family contacts of such suspect/confirmed cases undergoing home care should also use Triple layer medical mask," it warns.

The ministry has also given point by point guideline on how to use a mask like to make sure that they are facing down while unfolding or for that matter to ensure there are no gaps on either side of the mask.

It even warns, "Fit flexible nose piece (a metallic strip that can easily be located) over nose-bridge" to ensure no one else are infected. The government also warns against simple dumping of the masks once used. Instead one should disinfect "using ordinary bleach solution (5 per cent) or sodium hypochlorite solution (1 per cent) and then disposed of either by burning or deep burial," says the Health Ministry.

COVID-19 emerged in early December 2019 in China's Wuhan province and has now spread to over 100 countries. As on March 9, 2020, India has reported 42 cases mostly among those who had travelled from affected countries.

However the government says, "It causes a minor illness in majority of patients with symptoms of fever and or cough. A small proportion of such persons may progress to severe disease with difficulty in breathing."