At home with a little help, patients fight Covid-19
Rohini resident Richa Gupta’s husband woke up with a mild fever on May 24 and the family decided to isolate him in one of the rooms of their two-bedroom flat. Two days later, they got themselves tested by a government-run mobile sample collection unit. Her husband and four-year-old son tested positive for coronavirus disease (Covid-19).
The family of Richa Gupta, 40, was concerned about her well-being because she suffers from hypertension and severe diabetes that can only be controlled with insulin shots. She is also obese.
“I live with my husband, son, sister-in-law, and a full-time help and we have only one bathroom. Initially, we thought of getting admitted to the government facilities but then chose to stay at home as it was more comfortable,” said Gupta. Her husband lives in one of the rooms, she is in another room with her son, and her sister-in-law and the help stay in the living room.
Her husband, Pankaj Kumar, 40, had mild fever, sore throat, and headaches. Her son, Vardhan, did not have any symptoms other than some ulcers in his mouth. And she had extreme body ache for a day.
One in three of every Covid-19 positive patient in Delhi is currently isolated at home. According to data released by the Delhi government, 13,012 people are under home isolation across the city currently. Home isolation becomes all the more important as the Delhi government works towards scaling up of hospitals beds in preparation for up to 550,000 lcases of Covid-19 it expects in the city by July-end.
Only those with mild symptoms – low grade fever, sore throat, headache — and no comorbid conditions like diabetes, hypertension, heart and kidney disease will be allowed to remain in home isolation. Comorbid conditions are known to increase the risk of a person developing severe symptoms of Covid-19.
Nobody from the government’s health department visited Richa Gupta’s family to check their condition or their situation. Someone from the district office just put up the Home Isolation sticker on their home and left. But her husband receives a call from the government every other day checking in on his symptoms and psychological well-being.
“Not only do they ask him about his fever and other symptoms, they also check how his mood is. We have also been given the number of a doctor who prescribes medicines when necessary,” she said.
The family has not been given or prescribed any hydroxychloroquine, which the government’s home isolation guidelines say should be given to the caregivers as prophylaxis to prevent the infection. Their home isolation will end on Saturday.
The family learnt how to make 1% hypochlorite solution — a chemical used to disinfect surfaces — on their own and have been using it to sanitise all the surface in each of the rooms twice a day and cleaning the bathroom after a visit by any of the family members.
“My husband keeps all his toiletries and clothes with him. He calls out when he needs to use the bathroom, we open the door and switch on the light so that he does not touch the surfaces. After he is done, we spray the hypochlorite solution on all the surfaces and wipe it down with tissues an hour later. We spray the pot after anyone goes,” she said.
With everyone in home quarantine, the family also faced problems in getting groceries. “I have subscription with an online grocery store, but they refused to deliver. Even the local grocery stores refused. Initially many of the people in my society also did not help. So, I could not get anything for two days. Now, my neighbours understand my situation and they help me out. They get me everything I need and drop it outside my door,” she said.
The civic body collects her garbage every other day. “I sanitise my garbage with the hypochlorite solution and pack it in multiple layers of garbage bags,” she said.
With increasing number of Covid-19 patients in home isolation, waste collection is a challenge. “The corporation has been given a list of households where Covid-19 patients live, they collect their garbage separately in a yellow bio-medical waste disposal bag and take it to the proper facilities to be discarded as bio-medical waste,” said one of the district officials on condition of anonymity.
The district teams and a private home-care company hired by the Delhi government regularly monitors the condition of the patients.
“Only about 7% of those who have been put under home isolation need to be moved to a hospital. The rest can recover on their own at home,” Meena Ganesh, chief executive officer of Portea, the company that has been hired by the Delhi government, told HT in a report published last week.
In case they have to be transferred, the district teams are on the ready.
“In case the condition of anyone in home isolation deteriorates, we get a distress call immediately and our team rushes an ambulance to the house. However, because of the regular followup we also come to know before-hand whether someone is likely to deteriorate. In addition, in our district, we have created a WhatsApp group of all the people in home isolation and some of our doctors are also on it to answer any query the people might have,” said BM Mishra, district magistrate of south Delhi.
Arvind Sehgal, 56, decided to get tested for Covid-19 after feeling breathless. He did not have any fever or other symptoms of Covid-19, but tested positive for the infection on May 29. He has hypertension. Instead of waiting for the government, he hired one of the home-care services – HDU Healthcare.
“Once I tested positive, I started looking for such home care services. They have provided me with a nurse and even an oxygen machine. I got better within two days of using oxygen,” he said. He is staying alone in one of the six rooms of his house.
He uses utensils that are not used by other members of his family. “We assess every patient who calls us – some of them just need regular teleconsultation, others might need to be hospitalised. We refer them accordingly. However, some people who are not very sick and can recover at home with just oxygen support, we provide them with oxygen concentrator or oxygen cylinder as per their need,” said Dr Dixit Kumar Thakur, consultant of pulmonary critical care with HDU Healthcare.
Several Delhi-National Capital Region hospitals such as Max Healthcare, Fortis and Medanta provide such home care to Covid-19 patients with mild to moderate disease.