COVID: WHY HOME ISO­LA­TION IS A CRIT­I­CAL PIL­LAR

Hindustan Times (Jalandhar) - - SUNDAYCOMM­ENT - ATISHI AK­SHAY MARATHE Atishi is a se­nior leader and MLA, AAP Ak­shay Marathe is spokesper­son, AAP (They are both Covid-19-positive pa­tients, cur­rently un­der home iso­la­tion) The views ex­pressed are per­sonal

As mildly symp­to­matic Covid-19 pa­tients un­der home iso­la­tion, the Bharatiya Janata Party (BJP)-led cen­tral gov­ern­ment’s ini­tial de­ci­sion to end home iso­la­tion on Fri­day was puz­zling, and its roll back of the or­der on Saturday is wel­come. A manda­tory five-day in­sti­tu­tional quar­an­tine for all new Covid19 pa­tients, as orig­i­nally or­dered, would have been un­prece­dented. Nowhere in the world do gov­ern­ments force ev­ery coro­n­avirus pa­tient into pub­lic iso­la­tion fa­cil­i­ties. Even the In­dian Coun­cil of Med­i­cal Re­search guidelines rec­om­mend home iso­la­tion for most cases, given that 80% of the pa­tients are ei­ther asymp­to­matic or mildly symp­to­matic.

It is im­por­tant to un­der­stand the sys­tem in place now. Our ex­pe­ri­ence of home iso­la­tion has been ben­e­fi­cial for our health and well-be­ing. Our sam­ples were col­lected on Tues­day and we tested positive for coro­n­avirus on Wed­nes­day. For­tu­nately, we had no se­vere symp­toms and did not need hos­pi­tal­i­sa­tion. That same day we re­ceived a phone call from a gov­ern­ment telemedici­ne ser­vice that of­fered med­i­cal ad­vice. An ASHA worker vis­ited our homes, con­firmed we were mildly symp­to­matic pa­tients and pasted a sticker next to our main doors, giv­ing neigh­bours fair warn­ing.

From the sec­ond day on­wards, our health and symp­toms were be­ing mon­i­tored daily through the Delhi gov­ern­ment’s tele-mon­i­tor­ing ser­vice that also pro­vided guid­ance on the iso­la­tion process. An emer­gency phone num­ber was also given to us to be called if our symp­toms were to es­ca­late. An am­bu­lance would take us to a hos­pi­tal if we were to re­port any es­ca­la­tion in symp­toms.

In one go, on Fri­day, the Cen­tre shut down the most smoothly func­tion­ing piece of the coro­n­avirus puz­zle that is home iso­la­tion. One of the lessons of gov­er­nance the Aam Aadmi Party (AAP) has learnt is — do not fix some­thing that is not bro­ken. The roll back of the or­der is good be­cause it would have other­wise cre­ated new prob­lems for the city and its gov­ern­ment, deal­ing a deadly blow to con­tain­ment ef­forts in Delhi.

The thought of be­ing dragged into a rail­way coach parked at the Anand Vi­har sta­tion upon test­ing positive would have driven away peo­ple from vol­un­tar­ily com­ing for­ward to test them­selves. And if asymp­to­matic and mildly symp­to­matic pa­tients refuse test­ing and carry on with their lives, they would have ended up in­fect­ing oth­ers.

Com­pul­sory quar­an­tine would have also needed ad­di­tional re­sources, di­vert­ing med­i­cal staff, am­bu­lances, and per­sonal pro­tec­tive equip­ment kits away from hos­pi­tals that are treat­ing crit­i­cal pa­tients.

An al­ready stretched med­i­cal sys­tem would have been forced to look af­ter thou­sands of pa­tients who may have never needed med­i­cal at­ten­tion. The cost of pro­vid­ing hy­gienic quar­an­tine fa­cil­i­ties, food, wa­ter and san­i­ta­tion to thou­sands of pa­tients would have proved de­bil­i­tat­ing to the cash­strapped state gov­ern­ment. Delhi is ex­pected to have hun­dreds of thou­sands of cases over the next few weeks. The state should fo­cus its ef­forts and re­sources on treat­ing the sick, not pro­vid­ing shel­ter and food to asymp­to­matic and mildly symp­to­matic pa­tients.

The data on Delhi’s home iso­la­tion pro­gramme shows why it is highly rec­om­mended around the world. Only 6% of all positive pa­tients un­der home iso­la­tion have been re­quired to be shifted to a hos­pi­tal or quar­an­tine fa­cil­ity dur­ing their home iso­la­tion pe­riod. Of more than 27,000 pa­tients who have been un­der home iso­la­tion thus far, only 1,618 re­ported a de­te­ri­o­ra­tion in their symp­toms and had to be shifted to hos­pi­tals. This is 6% of all home iso­la­tion pa­tients. We are happy with the roll back of the or­der be­cause bet­ter sense has pre­vailed. Other­wise, Del­hi­ites would have paid a huge cost.

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