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Wednesday, Jun 24, 2020 14:30 [IST]

Last Update: Wednesday, Jun 24, 2020 08:44 [IST]

Cornering Covid, whichever way

The Delhi health department on Monday issued a new set of guidelines for how patients will be assessed, requiring anyone who tests positive through a lab-based swab test to be taken to a Covid care centre where a medical officer will determine whether they are eligible for home isolation, and anyone who tests positive through a rapid antigen test be assessed on the spot at testing centres or in their localities.
With 62,655 cases, the national capital on Monday surpassed Tamil Nadu to become the second worst-hit by Covid-19 among various states and union territories, according to the data released by the respective governments. Even by death count, which stood at 2,233, Delhi is on the second spot among the states and union territories.
The guidelines ended confusion over the status of mild and asymptomatic patients after the Delhi Disaster Management Authority (DDMA), headed by Lieutenant Governor Anil Baijal, first made it mandatory on Friday that all Covid patients stay in institutional quarantine for at least five days, and then retracted the order the following day amid opposition from the Delhi government. Monday’s new guidelines – signed by the Directorate General of Health Services (DGHS) - appeared to reconcile some differences between DDMA and the state government on the issue of home isolation.
The new SOPs have been issued to ensure that everyone who qualifies for home isolation gets the best medical attention and anyone who doesn’t have facilities to do the same, gets moved to Covid care centres. Even if the patients are asymptomatic, the Delhi government said it wanted to ensure they get regular medical attention and all the assistance they need.
The Delhi government’s new emphasis on home management of covid cases can be seen either as a cop-out, or as a pragmatic idea to make the most of a bad situation. As infections keep up their surge and testing falls short, the city’s healthcare infrastructure seems on the verge of being overwhelmed. The administration may have made a series of tactical errors, but its thrust on home care is both realistic and sensible under the circumstances. It has offered to provide free oximeters to home-bound patients and even promised to provide oxygen support if need be.
Covid-19 is a tricky ailment for a medical system to deal with because it affects most patients only mildly, but causes a sudden deprivation of oxygen in those hit most severely. Some analysts have wondered if it makes any sense to have all infected individuals occupy hospital beds, given that only about one in 20 would be at risk of dying (without immediate oxygen support). Now that beds in Delhi are scarce, health workers overstretched and lab tests are failing to aid pandemic control, perhaps home reliance is the way to go (under medical advice). But those with dangerously low oxygen in their blood should be able to rely on cylinder supply.
Experts feel that home isolation is essential for managing Covid-19. The kind of care a patient gets at home he/ she will never get at a hospital. However, this is not fit for all and that is where the problem came in. 30% of Delhi lives in slums, where several people stay in the same rooms, home isolation is not feasible in such cases.
But, at the same time, you cannot have ten patients coming into the Covid centres just to get assessed. You would be exposing ten vehicles, ten ambulance drivers, and ten attendants to the infection. So for every ten cases, you are exposing 30 people. Instead, sending one team with a doctor to a patient’s house is logistically sounder.
Now, the Delhi government needs to keep its word. Strict state-issued guidelines would need to be in place, of course.

Sikkim at a Glance

  • Area: 7096 Sq Kms
  • Capital: Gangtok
  • Altitude: 5,840 ft
  • Population: 6.10 Lakhs
  • Topography: Hilly terrain elevation from 600 to over 28,509 ft above sea level
  • Climate:
  • Summer: Min- 13°C - Max 21°C
  • Winter: Min- 0.48°C - Max 13°C
  • Rainfall: 325 cms per annum
  • Language Spoken: Nepali, Bhutia, Lepcha, Tibetan, English, Hindi