Evaluation of the clinical characteristics of suspected or confirmed cases of COVID-19 during home care with isolation: A new retrospective analysis based on O2O

Hui Xu; Sufang Huang; Shangkun Liu; Juan Deng; Bo Jiao; Ling Ai; Yaru Xiao; Li Yan; Shusheng Li

The recent outbreak of the novel coronavirus in December 2019 (COVID-19) has activated top-level response nationwide and has been classified as a public health emergency of international concern (PHIEC) by the World Health Organization (WHO). 1 By 24:00 on February 16, 2020, 70,548 confirmed cases, 10,644 severe cases, 1,770 deaths, and 546,016 close contact cases have been identified in 31 provinces (autonomous regions and municipalities) and the Xinjiang Production and Construction Corps of China. 2 The SARS-CoV-2-induced pneumonia has rapidly spread from Wuhan to 21 other countries, including the United States, Japan, Italy and Germany 3, 4 , demonstrating high levels of infectivity and pathogenicity. [5] [6] [7] The fever clinic of Tongji hospital in Wuhan has been the center of this outbreak. During the early phase of this outbreak, a large number of patients poured into the fever clinic, which far exceeded the medical resources that the hospital could equip. The medical staff were obviously insufficient to cope with it, and were prone to a wide range of cross-infection between doctors and patients. Based on this situation many patients had to be quarantined at home due to objective reasons and could not receive effective medical guidance. Therefore, we developed a new treatment method based on the online-to-offline (O2O) business model 8 for close contact, suspected (currently known as clinical diagnosis) and confirmed patients that were under quarantine. We developed a medical observation scale according to the patients' first symptoms and new symptoms which can be filled out by the patients on their smartphones or computers. Our online multidisciplinary team (medicine, rehabilitation, psychology and nursing) can then provide guidance and advice for patients based on the subjective changes in their symptoms. This method ensures that the patients follow an orderly treatment-seeking strategy that begins from their home and extends to the community and finally to the hospital. Our strategy not only helps relief the problem of scarce medical resources and reduce unnecessary cross-infection in hospitals, but it also increases people's self-management ability and cooperation and encourages them to participate in health monitoring. In addition, in accordance with the guidelines of home care for isolation patients issued by WHO 9 , the infection of family members was not increased during the strict self-isolation at home in this study.