DIMAPUR, MAY 11: An overwhelmed Health system in Dimapur is not being able to ensure daily monitoring of COVID-19 positive persons in home quarantine/isolation, despite clear instructions in the guidelines issued by the Union Ministry of Health and Family Welfare.
According to the State Health Department’s latest weekly data, there were 991 weekly COVID positive cases in Dimapur, out of which only 124 were admitted to hospitals.
Thus, in a week alone, 867 COVID positive persons were sent home for isolation/quarantine in Dimapur.
The patients are hospitalised only if he/she is highly symptomatic, develops complications, and need oxygen and other support.
So far, a majority of the travellers entering the State, or those found positive after contact tracing or during Rapid Antigen Tests, are being advised home isolation, after consultation.
Those sent to home quarantine are prescribed a list of medicines for a period of time, with the rider that they should get themselves tested again after a few days.
Nagaland Page talked to some of those who have been advised home isolation after testing positive for COVID-19, and found that apart from following the medical advice and prescription, they just have to stay at home for at least 10 to 14 days.
One of them said that even though he stays at home, he does not have a separate single room with toilet attached, and asked what would happen to the other members of the family who come in contact with him.
As per the revised guidelines for home isolation of mild/asymptomatic COVID-19 cases, issued by the Union Ministry of Health & Family Welfare, patients clinically categorized as mild/asymptomatic should have the requisite facility at their residence for self-isolation and for quarantining the family contacts.
According to the guidelines, a caregiver should be available 24×7. Besides, a communication link between the caregiver and the hospital is a prerequisite for the entire duration of home isolation.
The guidelines say that the patients need to be monitored on daily basis noting the temperature, heart rate (from pulse Oximeter), SpO2% (from pulse Oximeter) and also record whether they develop any breathing problems.
Last year, almost every person coming from outside the State was sent to institutional quarantine facilities maintained by the State Government or paid quarantines. However, there are no such facilities this year, except for hospitalisation of serious patients in COVID Hospitals and COVID Care Centre in Dimapur.
While most in home quarantine have recovered during the course of time, some have also developed complications and shifted to hospital for further treatment.
As per the guidelines, a home quarantined person needs to be shifted to hospital if he/she develops difficulty in breathing, his/her oxygen saturation dips below 94%; develops persistent pain/pressure in the chest; and have mental confusion.
A COVID-19 positive patient, currently in home quarantine, told Nagaland Page that he was doing fine at home and has no fever or any other complications. When asked whether the Health authorities have checked on him, he said they had called him to enquire about his condition and would call him again in the next 6 days.
While medical experts believe that home quarantine is good for mild and asymptomatic cases, as such people do not have serious medical problems, they, however advise to immediately seek hospitalisation if they develop breathing problems.
However, in Dimapur, home quarantine has become a compulsion for the Health Department due to lack of beds and other infrastructure in hospital.
In a recent incident, a woman who had tested positive for COVID-19 went to District Hospital Dimapur, and then to the COVID Centre at Chumukedima, for treatment but was instead advised to home quarantine due to inadequate facilities and infrastructure.
When she first started showing symptoms, she thought it was Common Flu and decided to take care at home since going outside was not advisable, her daughter told Nagaland Page.
However, her health deteriorated and she suffered from Diarrhoea. So her children took her to the hospital where she tested positive.
However, the person in charge at the hospital suggested that being quarantined at home would be better since the hospital doesn’t have ‘satisfactory facilities’.
When the patient’s oxygen saturation level dropped to 76, she was taken to Chumukedima COVID Centre, in search of an emergency bed. “We waited for about half an hour before they gave us an emergency room,” said the daughter.
According to the daughter, the ‘environment’ at the Chumukedima COVID Centre was not good ‘as people do not maintain or follow proper guidelines’.
So the family decided to take the mother home and take care of her themselves after buying the prescribed medicines. The daughter is taking care of the mother at home now.
Whenever the mother’s oxygen level drops below normal, she would help normalise her breathing through steaming, relaxing and other exercises to increase the oxygen level.
She said that she did not receive any calls from doctors asking about her mother’s health, except from the contact tracing unit. She added that the entire family will be going for testing as well.
The Health Ministry’s guidelines also underline the role of State and district Health authorities, who are supposed to monitor all cases under home isolation. The guidelines say that the health status of those under home quarantine should be monitored by the field staff/surveillance teams through personal visits along with a dedicated call centre to follow up the patients on daily basis.
It also says that all family members and close contacts should be monitored and tested as per protocol by the field staff.
It is more than likely that the woman’s case is one in many where the patient did not get the necessary facilities to help fight the infection.
While private hospitals are yet to start COVID treatment in Nagaland, people suffering from the deadly virus have to either look after themselves at home or depend on the inadequate facilities available at COVID hospitals.
Home quarantine has indeed become the millstone around the family’s neck ~ health-wise and every-wise ~ in the face of an ‘overwhelmed’ health system in Nagaland and across the country.
(Page News Service)