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Friday, July 10, 2020

All Covid cases to now be put in institutional quarantine in Delhi

The Delhi government termed the order as “arbitrary”, and said it will “seriously harm” people. It said the new policy would discourage people from getting tested and further strain the city’s already overstretched medical infrastructure and health workers.

Written by Sourav Roy Barman , Shivam Patel | New Delhi | Updated: June 20, 2020 7:26:01 am
A health worker takes a sample for rapid antigen test at a health centre in New Delhi Friday. (Express Photo: Praveen Khanna)

Delhi Lt Governor Anil Baijal Friday issued an order making five days of institutional quarantine “mandatory” for “each case under home quarantine”, while striking down a Delhi government contract with a private home healthcare company for remote monitoring of patients under home isolation.

Till late night, there was no clarity from Baijal’s office on whether only new individuals testing positive will be covered under the order or existing patients under home isolation as well. Besides, the order said, instead of remote monitoring, patients under home isolation should be monitored physically.

The shift in policy, cleared by Baijal in his capacity as the chairman of the Delhi Disaster Management Authority, was attributed to “lapses” in monitoring of patients under home isolation which, the Union Home Ministry observed, “may be a reason for increase” in cases in the Capital, assuming a “threatening proportion”.

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The Delhi government termed the order as “arbitrary”, and said it will “seriously harm” people. It said the new policy would discourage people from getting tested and further strain the city’s already overstretched medical infrastructure and health workers.

“After this order, we would immediately need thousands of beds in quarantine centres. We have been completely supportive of the Central government in our collective fight against corona, but this arbitrary decision will seriously harm Delhi. They should re-consider,” a Delhi government spokesperson said.

Baijal also struck down the contract that the Delhi government had signed with a Bangalore-based private home healthcare firm, Portea Medical, to remotely monitor the health status of every patient under home isolation.

The order by the LG said, “Mandatory physical verification of each case under home isolation is to be carried out by the surveillance teams of the District Surveillance Officers under overall supervision of the District Magistrate. Five days institutional quarantine of each case under home quarantine is to be made mandatory and thereafter they will be sent for home isolation except in cases where symptoms require further hospitalisation.”

As on June 19, there were 10,490 cases under home isolation in Delhi. Chief Minister Arvind Kejriwal has repeatedly advocated home quarantine for those with mild or no symptoms.

So far, Delhi has four categories of patient management — hospitals, Covid health centres, Covid care centres and home isolation. The care centres are for those clinically assigned as patients with very mild/mild symptoms; health centres for those with moderate symptoms and hospitals for those with severe symptoms. There are currently 5,974 patients at care centres, 344 at health centres and 10,961 at hospitals.

There are 4,819 vacancies in care centres and 204 at health centres.

“In addition to the 80,000 beds being planned for serious patients in July, we will have to add thousands of quarantine rooms now. ICMR guidelines are still applicable to the rest of India, then why are there different parameters for Delhi? There is already a serious shortage of doctors and nurses to treat serious patients, where would medical manpower come for taking care of these quarantine centres?” the Delhi government spokesperson added.

Earlier on Friday, the Centre wrote to the Delhi government saying home isolation for patients with Covid-19, especially in densely populated areas, may result in the spread of the virus among family members and neighbours.

In a letter, Joint Secretary in the Union Ministry of Health and Family Affairs Lav Aggarwal drew the state’s attention to the Centre’s guidelines for patients under home isolation and stressed the need to implement them strictly, while observing that the norms were being flouted in “certain states”.

Baijal said in his order that the matter had come up in the course of review meetings at the Home Ministry. “It was observed that home isolation without physical contact to monitor the patients may be a reason for increase in spread of Covid-19 infections in Delhi,” his said.

Aam Aadmi Party Kalkaji MLA Atishi, who is among those under home isolation after testing positive for coronavirus, said the new norms would be psychologically detrimental. “Being in the comfort of your home surrounded by people you know, even though you can’t see them, is helpful. The directive would scare a lot of people into not testing,” she said.

She said this step was justified only when people do not have the required facilities to isolate themselves at home.

Delhi government advisor Abhinandita Mathur, who is also positive and under home isolation, said patients get constant medical support even if they are at home through messaging or phone calls with doctors. “After the initial scare with neighbours, the stigma associated with virus is removed,” she said.

The Centre also wrote to other states urging them to follow the guidelines for effective home isolation of patients. “As per the Guidelines, very mild and pre-symptomatic COVID-19 patients can opt for home isolation provided the patient has a room to himself/herself with toilet facility and has an adult attendant/caregiver. Also, the patient shall agree to monitor his/her health and regularly inform the health status to the District Surveillance Officer for further follow up by the surveillance teams,” the centre wrote.

The Centre has also underlined that an “important clause” of the revised guidelines is that “the treating doctor is satisfied about the patient opting for home isolation based on medical assessment and assessment of his/her residential accommodation”.

-with ENS inputs

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