Covid-19: Order on mandatory centre visits revoked
Thursday’s decision was welcomed by the Delhi government, district officials, health care workers, and resident welfare associations across the city.Updated: Jun 26, 2020, 01:56 IST
People who test positive for Covid-19 will not need to go to a government facility for a mandatory assessment, the Delhi Disaster Management Authority (DDMA) led by lieutenant governor Anil Baijal said on Thursday, walking back from a controversial rule for the second time in less than a week after persistent demands for a reversal.
Thursday’s decision was welcomed by the Delhi government, district officials, health care workers, and resident welfare associations across the city.Since Saturday, a large chunk of the 3,500-plus people testing positive through swab every day were required to visit a Covid Care Centre (CCC) to be assessed by a doctor for whether they can isolate themselves at home for the period of their recovery, or stay at a CCC, or be taken to a hospital. This protocol was widely seen as burdening stretched health care staff further, and adding to the risk of infection.
The issue was discussed at the meeting of DDMA, also known as state disaster management authority, where the LG is the chairperson. “Yes, the L-G has agreed to revert to the old system where a team led by the district surveillance officer (DSO) will visit the house of the Covid positive patient to decide whether home isolation can be recommended,” deputy chief minister Manish Sisodia said after the meeting.
In recent days, Sisodia and chief minister Arvind Kejriwal made strong appeals to Baijal and the Union home ministry, to which the LG reports, to abandon the protocol. “People were anxious over the rule that required every person who tested Covid positive to be taken to quarantine centre [for assessment of symptoms],” Sisodia said at a digital press briefing on Thursday.
Later in the evening, the directorate general of health services formalised the order in a revised standard operating procedures document.
According a spokesperson from the Union home ministry, Thursday’s decisions “have been taken in accordance with the guidance given by the Union home minister in the meeting held on June 21 to further review and strengthen the surveillance mechanism for Covid positive cases in Delhi to prevent the spread of the disease and to provide timely medical care”.
But the latest order means a return to the protocol “applicable till Friday (June 19), which required medical teams to visit the house of person testing Covid patient and do assessments there. The symptoms and condition of residence would decide if the person could be assigned home isolation or taken to a hospital or quarantine centre,” the deputy CM, who also heads the health department temporarily, pointed out.
“We requested central government to roll back that order. We are happy that they have agreed. The old system has been restored now,” he added.
The rule for mandatory facility assessment was announced on June 20 during what itself was a reversal of another controversial protocol announced by the DDMA on June 19: mandatory facility quarantine for all patients, including those with no or mild symptoms, for five days.
Experts welcomed the rethink. “It is a good decision. The rule that require patients to be mandatorily taken to Covid centres for clinical assessment had two issues. First, it was a logistical nightmare. Second, it increased chances of local transmission. The districts in the city can now focus on strengthening the health care system and stress on contact tracing and better surveillance,” said Jugal Kishore, head of community medicines department in Safdarjung hospital.
At least three of the 11 districts in the city were not able to switch to it, due to lack of human resources and adequate number of ambulances, the only mode of travel allowed for Covid positive patients under the now-scrapped protocol. The city has 163 dedicated Covid ambulances, and transporting 3,000 people daily would have required at least 18 trips over a 24-hour period by each on average.
“We did our best to implement the rule. We succeeded to some extent by managing to send a few people to CCCs for clinical diagnosis. But we were not sure for how long we could carry such a herculean task. Revocation of the order is a big relief,” said a district magistrate who wished to remain anonymous.
Delhi on Thursday added 3,390 new cases, taking the total tally of infections in the Capital to 73,780. The number of fatalities stood at 2,429, according to the Delhi government’s daily health bulletin.
In a statement on Thursday, the LG office also clarified about the process of assessment: Those testing through antigen kits “will be examined by the medical officer on duty at the testing site to assess the severity of illness... The assessment on site shall effectively constitute an assessment made at the COVID Care Centre”. This was in line with the existing position.
For those who have taken a swab test (RT-PCR), a home Isolation team will be sent by the District Surveillance Officer (DSO) which will check for symptoms and assess the residence to see whether home isolation will be possible. Home isolation will be allowed “if the patient is mild/pre-symptomatic/asymptomatic and has a residence of two rooms or a separate room and a separate toilet for the patient. He/she will be provided a contact number for any consultation required by him along with details of CATS ambulance call number for transfer to hospital in case symptoms develop,” according to the statement.
For those with moderate or severe symptoms and underlying health conditions that are known to exacerbate Covid-19, the officials will arrange for transport to a CCC, Covid Health Centre or a hospital.
Resident welfare groups in the city also welcomed Thursday’s move, saying it would ease concerns and encourage people to get tested.
“We welcome the move. People feared the idea of being sent to Covid centres, even if it was for some clinical assessment. But the government must ensure that their health officials visit each patient’s house in time without fail. We have come across a lot of complaints and the government should take note of that,” said BS Vohra, president of the federation of resident welfare associations in east Delhi.
(With inputs from Abhishek Dey in New Delhi)