Ask HN: How to help people that shut themselves in?

We are about to start a study to identify what causes flares and remission in a chronic condition. The problem is that about half of people with this condition can't differentiate between good and bad days in terms of symptoms. A trusted buddy (in real world) could to do it for them, but they often shut themselves in, and all of their interactions are online not in the physical world.

The condition is idiopathic malodor - when body loses ability to "deodorize" digested food in the blood and malodor episodically emits from all the skin pores at seemingly unpredictable times.

My questionnaire asks questions like how many people interacted with them in the last 24 hrs, how many of these interactions were positive, if they felt well-rested, depressed, miserable, had any physical symptoms (based on quality of life questionnaires).

Any other suggestions on how to differentiate their flareups from remissions?