Don’t fix what’s not broken

Delhi must revert to its earlier home isolation system

In the middle of a long and arduous battle with Covid-19, meddling with successful and globally established health protocols on how to manage the pandemic is an ill-advised step. A case in point is the needless flip-flop in the national Capital in recent days over one practice that has clearly been working well, not just in the city but across nations — home isolation for mild and pre-symptomatic cases. While

Covid-19 is a deadly and life-threatening disease, it does not affect everyone in the same manner. A large number of patients develop no or mild symptoms, and can be treated at home with proper monitoring and care. The idea to keep them at home — given they have isolation space so as to not infect others, and a caregiver who can cater to their basic needs — is to keep the hospital beds, health centres and institutional isolation facilities free for people who really require them. This stops the health system from being overrun, particularly in a country such as India where resources are inadequate at the best of times.

In this universally acknowledged backdrop, on June 19, the Delhi Disaster Management Authority (DDMA), which is chaired by the lieutenant-governor with the chief minister as its vice-chairman, ordered that all patients, irrespective of their condition, must be kept in an institutional facility for at least five days. While DDMA said the idea was to stop the spread in densely populated communities, data till last week showed that of more than 27,000 patients who were in home isolation in Delhi, only 1,618 (or 6%) had to be shifted to hospitals, while the rest had either successfully recovered or were on the road to recovery. The order led to legitimate criticism. The Delhi government questioned the rationale behind it; the district administration said it would be unable to handle the extra flow of patients; and health officials complained of the lack of facilities and the additional load on care workers.

The order was corrected the next day and status quo was restored with one major change — a mandatory first-examination at a government care centre for all those who test positive. But this revised framework with mandatory examination has already added to the pressure on health infrastructure in the city (the patients, for instance, are to be ferried to the centres in ambulances), with the Delhi government now asking for a reversal to the old system in which a medical team visited homes. As Covid-19 cases rise, home isolation will be key in battling the crisis while keeping the health system robust. The government and DDMA must develop a consistent, coherent framework, work on strengthening protocols and monitoring, and go back to the old system. Don’t fix what’s not broken.