Home-isolation of mild cases to begin in Delhi this week

Of the 2,182 active cases — those still with the infection — 788 are admitted to Covid Care Centres, with such mild symptoms.

Starting this week, the Delhi government is planning to allow patients with mild symptoms of coronavirus (Covid-19) to home-quarantine themselves as the number of cases continues to rise in the Capital.

On Tuesday, the number of cases in Delhi spiked by 206, with 3,314 cases recorded in total. (Ajay Aggarwal /HT PHOTO)

On Tuesday, the number of cases in Delhi spiked by 206, with 3,314 cases recorded in total.

According to Central government guidelines, a person with mild symptoms will be allowed home quarantine only if he/she has proper facilities to allow for self-isolation, if a caregiver is available throughout, who will keep in touch with the nearby Covid-19 hospital, and the patient agrees to monitor the health condition and report to the district surveillance officer. “What we have seen is that a major chunk of the Covid-19 cases are asymptomatic or have very mild symptoms. The Central government has now issued guidelines for allowing such people to remain at home. Delhi will also start implementing this in the next couple of days,” a senior official of Delhi’s health department said.

Of the 2,182 active cases — those still with the infection — 788 are admitted to Covid Care Centres, with such mild symptoms.

The home quarantine will not be allowed for patients who have co-morbid conditions like diabetes, hypertension, heart or kidney diseases. “This will not be allowed for the low-income group as well, those who might be living with several family members and will not be able to maintain isolation effectively,” the official said.

However, healthcare workers and district officers working on the ground said this will be a massive challenge.

“It is impossible to assess someone’s condition on the phone; a physical check is necessary at least two times a day. We simply do not have the manpower to let a doctor check on every patient twice a day, even if we have just 50 such cases in a district. Also, the progression of the disease is sudden and might require immediate medical attention. In such cases, we cannot wait for the person to call us and then wait for an ambulance to reach a hospital,” a district health official said.

A senior district official said that the biggest challenge will be keeping a check on positive cases and ensuring they don’t violate the home-quarantine norms. Another issue, officials say, is that this can be done largely in middle-class and upper-middle-class neighbourhoods.

While the district authorities were informed about the decision on Tuesday, officials said it will take a day or two to implement the new guidelines, as necessary surveillance measures, guidelines for patients and other protocols have to put in place.

Most districts are currently using the Home Quarantine mobile application, which was first used in south Delhi, to keep a check on suspected Covid cases. “We are going to use the same mobile application to track Covid positive cases now. 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,” a senior official said.

The app has been in use for around 15 days now.

Another issue with the new scheme is the management of waste generated at the residences of positive cases. Delhi government officials say that it has to be treated as biomedical waste.

The three civic agencies have deployed dedicated teams in each municipal zone to collect and dispose of waste from home of suspected patients and dispose of it at designated centres.

Residents’ welfare associations in the city say that it will be a huge risk and many will oppose it. “The government’s decision is likely to meet RWA resistance, but the ground reality is such that it is inevitable. Those who can afford to pay would like to be in a setup that has a basic minimum standard, which is woefully lacking in centres like Narela and Bakkarwala, as per the reports, and private hospitals charging a bomb in the absence of any government diktat on standardisation of treatment cost,” said Rajiv Kakria, convener of Save Our City campaign.

Current protocol

At present, if a person tests positive, they are sent to designated Covid hospitals, care centres and health centres, depending on the severity of symptoms.

Currently, a Covid-19 positive patient with no or mild flu-like symptoms is sent to one of eight the Covid Care Centres in the city, depending on the patient’s location and availability at the centre. Those with moderate symptoms are sent to the two Covid Health Centres. A decision is taken by the district’s medical team after a home visit to check on the patient.

“If a patient wants to go for a private facility, then they are referred to the three designated Covid hospitals — Ganga Ram, Indraprastha Apollo and Max Hospital in Saket. They will have to pay directly to the hospital,” said a senior Delhi government official, who is a part of the medical team that visits positive cases and decides on the severity.

Although the Delhi government has tied-up with private hospitals for paid quarantine in some districts, these are not operational.

Residents said that the Delhi government should come out with a list of low-cost paid facilities. “Not everyone has a big house and has rooms with attached bathrooms. People wouldn’t like to put their family members at risk and would like to shift to a quarantine facility, but not the government-run ones. The Delhi government should tie-up with guest houses where one could avail of the facilities by paying ₹500- ₹1,000 per day,” said BS Vohra, president of East Delhi RWAs joint front.