As Covid-19 cases mount in Delhi, more than 700 in home isolation

For the ease of the Covid-19 patients, the government has also set up a consultation app that allows the dispensing of prescriptions.

As many as 771 people, who have tested positive for coronavirus disease (Covid-19) in Delhi but are displaying only mild symptoms have been placed under home isolation within a week of the government issuing guidelines in this matter, according to Delhi government data. 

A Delhi Police personnel keeps guard as a bus with migrant workers crosses a barricade towards New Delhi Railway Station to board the first ‘Shramik Express’ train to their native state. (Biplov Bhuyan/HT PHOTO)

This comes on the heels of Delhi recording more than 200 cases of Covid-19 each day for the past week, and over 400 cases a day on three occasions.

For the ease of the patients, the government has also set up a consultation app that allows the dispensing of prescriptions. The government has designated 37 doctors for the service, which will be active between 8am and 8pm every day for Covid-19 patients to seek medical care.

The national capital has recorded 5,980 cases of Covid-19 and 66 deaths as of Thursday, which also had Delhi’s largest single-day case spike, with 448 new cases.

Of the 3,983 active cases till May 7, 1,358 were admitted with severe symptoms to the 10 designated Covid-19 hospitals.

Another 1,230 people were admitted to either Covid Care Centres or Covid Health Centres with mild to moderate symptoms. Some people who are asymptomatic and are showing mild symptoms such as low-grade fever, headache, throat pain and don’t require oxygen support but cannot ensure isolation at home are admitted in Covid Care Centres.

And 771 people have been placed under home isolation.

“This is an effective alternative for a scenario where the government is unable to cope up with the number of cases. Even if 30% to 40% of the population gets the infection, it is impossible for any government to manage the numbers. Also, when people know they can stay at home even if they test positive, more will come forward to report their symptoms and get tested,” said Dr Jugal Kishore, head of the department of community medicine at Safdarjung hospital.

To be sure, along with mild symptoms, only those with no comorbid conditions like diabetes, hypertension, heart and kidney disease, are allowed to stay in home isolation.

Comorbid conditions are known to increase the risk of developing severe symptoms of Covid-19.

Even then, home isolation is only allowed if the patients have adequate facilities, such as a separate room and bathroom, for the positive person, and if the others in the family do not have severe comorbidities.

According to the standard operating procedure for home isolation issued by the Delhi government, a two-member team of an accredited social health activist (ASHA) and auxiliary nurse midwife (ANM), or any other health care worker, visits the house of the patient on the first day of isolation to check symptoms and the isolation facility at home. The team carries a pulse-oxymeter to measure the oxygen saturation of the patient, a thermal scanner to measure the patient’s temperature, and 100gm bleaching powder for the family.

The families are taught how to make 1% hypochlorite solution to clean various surfaces in the patient’s room, and how to disinfect masks before disposing of them.

The patient also has to ensure that there is a family member who can provide 24x7 care, including food, cleaning of utensils, and other chores, without exposing others. The person has to wear mask and gloves when in the patient’s room.

They caregiver also has to monitor the condition of the patient regularly and keep in touch with the district authorities to let them know if the patient develops symptoms such as difficulty in breathing, persistent pressure or pain in the chest, confusion, or bluish discolouration of lips or face. A team of privately hired staff actively checks with the family over the telephone for symptoms every day.

The team visiting the Covid-19 patient -- they get ₹100 for every household visited, an additional ₹200 for refreshments, and free commute -- stamps the left hand of the person stating ‘Committed to Home Isolation’ and pastes a sticker outside the house informing others of home isolation.

The family and the teams all have to to download the Aarogya Setu app to monitoring that patients do not break isolation.

“In the app, we have a facility to track the movement of the patient. Our teams often ask them to send a selfie just to ensure that they are in their rooms,” said a senior official.

The patient is allowed to come out of isolation only after two of their tests are negative – for the first, the sample will be collected from home by private laboratories and, if negative, the person has to go to the nearest testing centre for the second sample collection.

The big challenge, experts said, is handling the biomedical waste generated.

“The waste generated from these households would be infected and cannot be disposed of as is with other general waste. The current guidelines do not talk of the biomedical waste management. The entire waste from the household will have to be treated as biomedical waste and can either be picked up by the bio-medical waste management agencies or provisions must be made for the waste to be dropped off at the nearest hospital or dispensary from where it can be collected,” said Dr Jugal Kishore.

Currently, waste is collected separately from these houses by municipality collectors based on the list provided by the government.