Covid-19: Why is home insulation a critical pillar? Analysis
As mildly symptomatic Covid-19 patients under home isolation, the initial decision by the central government of the Bharatiya Janata Party (BJP) to end home isolation on Friday was puzzling, and their revocation of the order on Saturday is welcome. A mandatory five-day institutional quarantine for all new Covid-19 patients, as originally ordered, would have been unprecedented. Nowhere in the world do governments compel all coronavirus patients to public isolation facilities. Even the guidelines of the Indian Council of Medical Research recommend home isolation for most cases, since 80% of patients are asymptomatic or mildly symptomatic.
It is important to understand the system in place now. Our home isolation experience has been beneficial to our health and well-being. Our samples were collected on Tuesday and on Wednesday we had positive results for coronavirus. Fortunately, we had no severe symptoms and we do not need hospitalization. That same day we received a phone call from a government telemedicine service that offered medical advice. An ASHA worker visited our homes, confirmed that we were mildly symptomatic patients, and affixed a sticker to the side of our front doors, giving neighbors a fair warning.
From the second day onwards, our health and symptoms were monitored daily through the Delhi government remote surveillance service which also provided guidance on the isolation process. They also gave us an emergency phone number to call us if our symptoms increased. An ambulance would take us to a hospital if we were to report an escalation of symptoms.
At once, on Friday, the Center closed the piece of the coronavirus puzzle that works best, which is home insulation. One of the governance lessons the Aam Aadmi Party (AAP) has learned is: do not fix something that is not broken. The revocation of the order is good because otherwise it would have created new problems for the city and its government, dealing a fatal blow to the containment efforts in Delhi.
The thought of being dragged into a railroad car parked at the Anand Vihar station after testing positive would have kept people from volunteering for the test. And if asymptomatic and mildly symptomatic patients reject the test and continue with their lives, they would have ended up infecting others.
The mandatory quarantine would also have required additional resources, diverting medical personnel, ambulances, and personal protective equipment out of hospitals treating critically ill patients.
An already extended medical system would have been forced to care for thousands of patients who may never have needed medical attention. The cost of providing hygienic quarantine facilities, food, water and sanitation to thousands of patients would have been debilitating for the state government with liquidity problems. Delhi is expected to have hundreds of thousands of cases in the coming weeks. The state must focus its efforts and resources on treating the sick, not providing shelter and food for asymptomatic and mildly symptomatic patients.
The data on Delhi’s home insulation program shows why it is highly recommended worldwide. Only 6% of all positive patients in home isolation have been transferred to a hospital or quarantine center during their period of home isolation. Of more than 27,000 patients who have been in isolation at home so far, only 1,618 reported deterioration in their symptoms and had to be transferred to hospitals. This is 6% of all patients with home insulation. We are happy with the reversal of the order because a better sense has prevailed. Otherwise Delhiites would have paid a huge cost.
Atishi is a senior leader and MLA, AAP. Akshay Marathe is spokesperson, AAP
(Both are positive for Covid19, currently under isolation at home)
The opinions expressed are personal.