Entering a home where someone is immunocompromised protocol

This protocol is under review, and has not been accepted.

We are currently gathering feedback and editing this protocol, and there may be errors or bad wording. Please only use this protocol with caution, and if other organisations have definitive protocol, use that instead.

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This page is specific to the COVID-19 pandemic. It will be updated rapidly.

This is a protocol for entering someone's home when they are self-isolating due to being immunocompromised or otherwise at risk from the virus. Usually this will not be necessary, but if it is, you must follow this protocol very carefully to minimise the chances of introducing the virus to their home.

Note that this protocol does not cover situations where you must be in close contact with the person in question. This protocol covers situations where you must enter the home (perhaps to take care of chores and such) but do not need to come into close contact (i.e. within 2m for more than a moment) with anyone inside.

For situations where you do not need to enter someone's home, you should follow Delivering items to someone who is immunocompromised protocol.

When to enter a home of someone in self-isolation

• You can enter the person's home if they need care that requires someone to do so.
• You must not enter the person's home if you can provide the care they need without doing so.
• You should not enter the person's home if you are likely to have been exposed to the virus at any point within the last 14 days, or if you have been symptomatic in that time. In situations where there is absolutely no alternative, you must disclose this to them beforehand.

What to do before entering someone's home

1. You must read and make sure you understand hand hygiene protocol, glove protocol and mask protocol.
2. You should discuss the risks and benefits of entering the person's home with them, to see if there is an alternative to doing so.
3. If there are any items you will be bringing into the person's home, you should clean and disinfect each item you’re going to deliver. See Disinfection protocol for how to disinfect each item. Then place these items in a bag which you have disinfected inside, or which is new.
   • You can double-bag as in Delivering items to someone who is immunocompromised protocol if you wish; this will make it quicker to bring the items safely into the home.
4. You must make sure you have adequate personal protective equipment (masks, and gloves if available).
   • If mask supplies are limited (and they likely will be), you can use another form of face covering, provided it covers your mouth and nose. Tightly woven cotton is best.
   • If using a mask/cloth face covering on public transport, bring a fresh one for use in the person's house.
5. You must bring either soap and disposable paper towels, or hand sanitiser containing at least 70% alcohol, if the person does not have these at home.
6. You should prepare a bleach solution to disinfect surfaces you touch in the house, if the person does not have this available. It must be prepared no more than 24 hours before your visit.
7. If your clothes may pick up infection from public transport on the journey, you should bring some form of outerwear which can be worn over your clothes while in the person's house (e.g. a gown, overall, or rain poncho).
   • If this is fabric, wash at 60C, if it has previously been used.
   • If this is plastic, disinfect it, if it has previously been used.
   • Place it in a bag which you have disinfected inside, or which is new.
8. If you will travel by bike or car, disinfect the handles, controls and any other surfaces you will touch on the journey.
9. Put on outer clothes which have been washed at 60C since the last time you handled them, or which have not been handled for at least 72 hours.
10. If you have long hair you should fasten it back, to reduce the temptation to touch your face.
11. Wash your hands immediately before leaving the house.

How to enter someone's home

Approaching the home

1. Travel to see the person, in a way which minimises your risk of exposure to the virus.
   • If possible, travel by pavement, a bike or private car whose surfaces you have disinfected, or a taxi.
   • If you must use public transport, try not to touch spaces with your hands, use hand sanitiser after travelling if available, or wear gloves which you will change.
   • If wearing gloves while travelling, remove these immediately after leaving the train/bus, without touching the exterior with your bare skin, so that they turn inside out to enclose the potentially-contaminated surface. (illustrated technique, video technique)
   • If wearing a mask or cloth face covering while travelling, remove this after leaving the train/bus, after you have removed any gloves. Handle it by the ties or earloops, without touching the face.
2. As you approach the person's house, call/text/etc them to open the door. Make sure to stay at least 2m from the door.
   • If they live in a block of flats or other building with a communal entrance accessed by a buzzer, call/text and ask them to buzz you in, rather than pressing the button.
3. Use hand sanitiser if you have any.
4. Wait for the person to open the door
5. Ask the person to back away from the door at least two meters

Entering the home

1. Remove your shoes leaving them either just outside the door or just inside. Do not let your shoeless feet touch the ground outside. If this is not possible, you can put new or disinfected plastic bags over the shoes.
2. If you are bringing items to the person's home, put the bag down just outside or just inside and open it. Do not touch the contents.
3. If you have brought clean outerwear, put down the bag just outside or just inside, and open it without touching the contents.
4. Wash your hands in the person's sink.
   • Make sure not to touch anything before you do so, and use a tissue/paper towel to turn the tap on.
   • If you have hand sanitiser containing 60% or more alcohol, you can wash your hands with sanitiser.
5. Remove your clean outerwear from its bag without touching the exterior, and put it on.
6. Put on your mask/face covering
7. Wash or sanitise your hands again.
8. Disinfect the taps and anything else you couldn't avoid touching before you washed your hands.
9. Put on fresh gloves if you have any, touching only the cuff with your bare skin. (illustrated technique)
10. If you are bringing items into the person's home, take the items out of the bag without touching the exterior and bring them into the home.

Inside the home

1. Perform the tasks you need to, as quickly as you can without making mistakes. Remain at least 2m from anyone else as much as is possible.
   • If any of these tasks require leaving the house, make sure to follow this same procedure each time you enter and leave.
   • Do not touch your face while doing this work.
   • Do not allow your hands/gloves to come into contact with anything you've brought in with you (including your clothes) that has not been disinfected. (It's okay for the cuffs of your gloves to touch your sleeves.)
   • If you do accidentally touch something that may be infected, you should wash your hands, and replace your gloves if you are wearing any.
   • If you are able to do these tasks without sitting down or leaning on anything, you should do so.
2. Once you are done, disinfect any surfaces you have touched. This includes anything that has come into contact with any part of your body or clothes.
   • If the person does not want you to use bleach in their home, you can scrub the surfaces with soapy water.

Leaving the home

1. Leave the person's home, putting on your shoes (or removing the covering) before you leave but without letting your shoes touch the inside of the person's home.
2. Take your gloves off, without touching the exterior with your bare skin. (illustrated technique, video technique).
3. Remove mask or face covering by unfastening the ties or unhooking the earloops, without touching the face.
4. Wash your hands as soon as possible after leaving.

If you placed anything inside the person's home that was not disinfected (i.e. bag or shoes), you should instruct the person to disinfect the areas where these items were as soon as possible.