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5 reasons why removing home insulation from asymptomatic patients with Covid-19 in Delhi may not be a good idea – analysis


The Delhi Disaster Management Authority (DDMA) ordered a mandatory five-day institutional quarantine for all Covid-19 cases, including asymptomatic patients and those with mild signs of infection. The measure could strain the capital’s health infrastructure, which is already widespread; result in a shortage of health workers; He militates against the people who take the test; hamper detection rate; and scrap Delhi’s long-term plan at a time when infections continue to rise. We discuss five main reasons why it may not be a good idea:

1) Overflowing healthcare infrastructure

Adding thousands of people to institutional quarantine (10,490 people were quarantined as of Friday night) will require a sudden and abrupt increase in the Capital’s healthcare infrastructure, increasing the risk that the system will be overwhelmed by admitted. According to the June 19 government bulletin, 5,078 of its 10,961 Covid-19 beds were empty, and 5,036 beds were available (of 6,318) at Covid health and care facilities. A senior Delhi government official, speaking on condition of anonymity, said this availability of resources was mainly due to the success of the home quarantine scheme.

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Home isolation of asymptomatic and mildly symptomatic patients is considered by experts to be a crucial strategy in the fight against highly infectious disease. “Why unnecessarily burden the health infrastructure that is overwhelmed anyway when there is an increase in cases? Medical beds must be maintained for critically ill patients who need specialized care, otherwise where will you keep your critically ill patients whose lives we have to save? The home may be the best isolation facility as long as all protocols are followed, ”said T Jacob John, former CMC chief virologist Vellore.

2) cause severe staff shortages

If all cases are to be admitted to institutional facilities in the Capital, the authorities must find additional doctors, nurses and health workers. HT reported Wednesday that the plan to add 23,800 beds this month for Covid-19 patients will require approximately 2,000 doctors and 3,000 nurses, resources that it has so far been unable to secure. To increase the deficit, several health workers with positive results are quarantined by coming into direct contact with patients with Covid-19. The government will also find it difficult to attract doctors, nurses, and staff from its smaller non-Covid-19 hospitals.

The challenge of insuring more people has been heightened by the fact that some health workers fear becoming infected. “Most of our nurses left their papers when they asked us to assign beds for Covid-19. Several others demanded higher wages, it is not possible in this economy, “said a doctor in a private hospital, asking not to be identified. In a statement, the Delhi government said:” The entire workforce of the Delhi government is already is widespread. Now, it would take large quarantine centers to house thousands of asymptomatic people. “

Also Read: Delhi Health Minister Satyendra Jain Administered Plasma Therapy, Stable Health Condition

3) People can stop getting tested

The move is also likely to discourage asymptomatic and mildly symptomatic individuals from testing. Some believe that moving to institutional quarantine amid a shortage of beds and support staff will mean that the facilities are not up to scratch; They fear this will lead people to avoid getting tested. Atishi, a Kalkaji constituency legislator and spokesperson for the Aam Aadmi Party (AAP) who tested positive for Covid-19 two days ago and is currently in solitary confinement at home, said it has emotional and psychological benefits. “There is a lot of comfort in home isolation compared to institutional quarantine because you have your own room and most importantly, your own bathrooms … In home isolation, you have your family taking care of you.” He added that if institutional quarantine becomes mandatory, fewer people will opt for the Covid-19 test. “The police, along with medical personnel, will come to collect even asymptomatic people and take them to quarantine centers. People will be scared by all this and many will fear not being tested, “he said.

4) Cases can go unnoticed

If fewer people are willing to be tested, it is likely that the undetected spread of such patients will grow in the Capital. With the detection rate decreasing, more people are likely to arrive at hospitals after their infection has progressed, which could possibly also affect the recovery rate. Experts also point out the risks of infections from crowded quarantine facilities.

Home patient quarantine has been approved by the Union government as an effective way to preserve the healthcare infrastructure for future challenges, under certain guidelines. However, DDMA said in its order on Friday that it fears that “isolation at home without physical contact to monitor patients may be one reason for the increase in the spread of Covid-19 infections in Delhi.”

Also read: Kejriwal opposes L-G’s mandatory 5-day institutional quarantine order, says “will lead to evasions”

5) Long-term strategy takes a hit

To meet the need for around 150,000 beds by the end of July, the Delhi government has planned to use stadiums as makeshift hospitals. It has also identified neighborhood facilities to meet the need for beds, according to its prediction of the peak of infection in the Capital. This strategy, however, was devised in the model that included mild cases quarantined in the home. With the latest guidelines, this plan is compromised. A member of a committee set up to investigate the rise of Delhi’s health infrastructure previously told HT that the panel’s calculations, based on the Capital’s population and the current model, may have to be reworked and a new one Strategy may have to be devised. Experts insist that if the guidelines are changed regularly, the projections and modeling of the scenarios will need to be revised repeatedly, creating a challenge for the long-term strategy. They also say that most countries in the world recommend home insulation for mild cases and that the latest DDMA move should be rethought.

Hindustan Times