Bench Marks Guidelines for people who may get seriously ill if infected by the Coronavirus

28 July 2020

Some people will unfortunately become very ill if infected by the Coronavirus, or even not survive. It is vitally important that such people take special precautions and are protected from infection.

These guidelines explain how to know who are especially vulnerable, what special precautions to take to avoid infection and what to urgently do if infected. It may not be possible to implement all the suggestions, but it is important to do our best and to also assist each other when having difficulties.

Please first read the attached Bench Marks Coronavirus Guidelines of April 2020 for general information on the virus.  

Who is especially vulnerable to serious illness if infected?

According to the experience of the virus so far, you are at greatest risk to severe illness and need more careful monitoring if you:

• Are older than 60 years.
• Are overweight and unfit.
• Have medical conditions like hypertension; diabetes; chronic kidney, heart or lung disease; cancer; HIV or TB.
• Live in areas with high air pollution and have respiratory diseases.

What special precautions should be taken to avoid infection?

In addition to washing your hands, wearing a mask and physically distancing, there are two main ways to take extra precautions in avoiding infection:

• Firstly, keeping your bodily defenses against infection as high as possible; and secondly
• taking additional care to physically distance.

How do I keep my bodily defenses against infection as high as possible?

Your body has defenses that fight against infection of all kinds. This is your immune system. It is important that you keep this system functioning as well as possible. Medical specialists recommend that:

• Keep yourself as fit and healthy as possible.
• Eat healthy foods which include eating fruit and vegetables regularly.
• Drink plenty of water.
• If you smoke, stop or at least reduce smoking.
• Vitamins are necessary, including vitamin C, D and zinc. Fruit and vegetables are an important source of vitamins and sunlight also provides vitamin D. Also buy vitamin tablets if you can afford.
• Gargle and rinse your nose with warm salt water every day.  This helps to prevent infection.
• Make sure your underlying medical conditions are well controlled. Take your hypertension, diabetes and other medicines correctly and on time.
• Monitor your blood pressure and sugar if possible. Some chemist shops provide free tests for diabetes and hypertension, but be careful of infection.
• Keep as relaxed as possible and get plenty of rest but also remember to stay active.

Another step to take if possible is to monitor the oxygen levels in your blood. This can be done through an APP that can be bought for your cellphone quite cheaply or through a device called a pulse oximeter, which is more expensive. By measuring your oxygen levels in your blood it helps to warn you early on when you are in need of medical attention. Your oxygen levels should always be greater than 92%. Please note that these readings only give a rough idea of your oxygen levels.

How do I physically avoid infection in addition to the basic steps?

• Carefully read the attached Bench Marks Coronavirus Guidelines of April 2020 on avoiding infection.
• Because of your vulnerability, it is important to be even more careful.
• This means, if at all possible, never going inside any enclosed place other than your own home. This includes taxis, shops, malls, churches and other people’s homes. It also means never going into any open space with crowds of people.  
• If you need medical care, be very careful if you go to a clinic or hospital as they are sites of infection. In some areas it is possible to carry out consultations by telephone.
• These steps might sound as if they are expecting too much of you, but they are very important. The virus is extremely infectious and especially in any enclosed space where there are other people or open space where there are lots of other people.
• Ask other less vulnerable people to perform the tasks that would endanger you.
• Please remember, just one careless moment can result in infection and serious illness or even death for a vulnerable person.   

What can families and communities do to protect vulnerable people from infection?

• It is important that every family must know who is especially vulnerable within their family group.
• Every family needs to support and ensure vulnerable members are protected as much as is possible from infection. This means, for example, advising them and carrying out tasks for them that would involve exposure to possible infection, such as shopping.
• Each community needs to discuss having a plan to support their community members who are especially vulnerable to infection.  

Urgent steps to take if I am infected with the virus?

The following is the advice given by medical specialists based on the experience of the virus so far:

• If you test positive or show the symptoms of the virus, it is important to act immediately.
• Get advice from a help line, health worker, doctor, clinic or hospital.   

• You should immediately self-isolate. Separate yourself from other people in your home in a well-ventilated bedroom. Your family should not stay or sleep in the same room as you.
• Use a separate bathroom if possible. If you have to share a bathroom, clean after every use.
• Avoid sharing items and the same spaces with other people in the home and clean surfaces often.
• If self-isolation is not possible, try to contact your local church, community centre or government help line to arrange to self-isolate outside your home.

• Keep your viral load down. Your viral load is the amount of virus in your body.  Do this by gargling and rinsing your nose with warm salt water at least twice a day.
• *Carry out breathing exercises to clear your lungs and improve flow of oxygen. This is very important.  
• *Use the usual cold and flu remedies to relieve your symptoms, such as Panado for fever and pain, warm honey and lemon water or lozenges for a sore throat and steam with eucalyptus oil or Vicks for your lungs.
• *All people who have been in close contact with you should quarantine for 14 days from the day of your positive test.

If you feel a little short of breath

• *Sleep on your stomach for as much as possible with your head turned to the side (prone position).
• *It helps to prop a pillow lengthwise underneath your head and chest for this.
• *You can also cycle between laying on your belly, on your side and sitting up.  

When should I seek medical help?

• If your symptoms are worsening.
• If your symptoms have not improved after 7 days.
• If you become confused or have difficulty concentrating.
• If you develop a new fever or your fever returns.
• If you develop chest pain.
• If your breathing becomes difficult, and the number of breaths you take in one minute (respiratory rate) is more than 25.
• *If you are able to measure your oxygen level, it is lower than 92%.

If you have any of these symptoms seek medical help immediately.

Government Covid-19 Data free WhatsApp number: Whatsapp ‘’Hi’’ to 0600 123 456

COVID-19 National Crisis Helpline 0800 029 999

*For more information please see the Department of Employment and Labour presentation ‘’Stay Safe and Stay Positive – A guide to managing mild COVID-19 disease at home’’ July 2020

Issued by Bench Marks Foundation, 11th Floor Khotso House, 62 Marshall Street, Marshalltown, 2001  P O Box 62538, Marshalltown, 2107 Tel: 011 832-1743/2 ● E-mail: info@bench-marks.org.za