Doctors Give A Thumbs Up To The New Guideline On ‘Home Isolation For Mild Cases’, Says It Will Ease Burden On The Healthcare System

New Delhi: The Union Health Ministry on Tuesday (April 28) issued fresh guidelines for coronavirus patients in which it allowed the COVID-19 infected patients who have very mild symptoms of the infection or are “pre-symptomatic” can opt for self-isolation at home. The guidelines stated that such patients should self-isolate themselves completely and not come in contact with other family members. NDTV speaks with top doctors to know more about the guidelines and will it ease the burden on our healthcare system? Here’s what the doctors said:

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Explaining why the change in strategy for dealing with coronavirus pandemic that has been adopted by the health ministry recently, Dr Naresh Trehan, Chairman & MD, Medanta said,

As of now, the COVID-19 infected patients were immediately isolated and admitted in hospitals, makeshift hospitals or wards dedicated to coronavirus patients in order to break the chain of transmission of the highly contagious virus. Now, we have to think above this and we have to get ready for life after lockdown. From our past cases and experience what we know is that the maximum number of people, nearly 80 per cent infected with COVID-19 are asymptomatic or have mild symptoms. Now, if we put all of them in hospitals, they occupy beds which are needed for treating sick patients. As a result, there is a lot more burden on our healthcare system. Now, with new guidelines in place which gives such patients an option of self-isolation at home, it eases the burden from our healthcare systems.

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Highlighting the rules of the new guideline on self-isolation, Dr Trehan added,

The rules announced by the health ministry for the self-isolation for COVID-19 patients who have mild symptoms are pretty strict. The patients just cannot opt for this on their own, first, they need to get a certificate from their medical officer stating clearly that they have a very mild case/pre-symptomatic case. Secondly, they need to fill an undertaking on self-isolation and that they shall follow home quarantine guidelines. Thirdly, they need to stay in touch with the government surveillance officer and hospital staff. Moreover, there are guidelines for the caretakers and people who come in contact with such patients, like all of them should take hydroxychloroquine prophylaxis as per protocol. The key here is to follow these guidelines – the patient needs to wear a three-layer mask always and anybody who comes in touch with them should also wear this three-layer mask and gloves. At this point in time, this is a very good strategy.

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Talking about how the ministry of health has defined every guideline for home isolation very clearly, Dr Ashok Seth, Chairman, Fortis Escort added,

The guidelines are well defined and it is definitely a great idea because as soon as we open up the lockdown, the cases of coronavirus will pace up. We have seen in Europe and the United States how their healthcare system is overburdened, this is also being practiced by them in a way. Our ministry of health has defined it very clearly, only asymptomatic and very mild symptoms patients are allowed to opt-in for home isolation. The ministry has kept mild, moderate and severe symptoms patients separately, in the west, even patients with mild symptoms are being treated at home. We have these guidelines only for patients who have very mild symptoms.

Further explaining who is covered in the home isolation guidelines, Dr Seth said,

Very mild symptoms mean those patients who either have a mild fever, controllable fever, mild headache or body ache and cough and are not in any distress. Now, it is very important for such patients to know when they change such symptoms. If they develop symptoms like very high fever, chills followed by dehydration and delusion, pain in the chest, that is when they need to be shifted from home isolation to the required hospitals. Also, the health authorities and the medical officer is regularly checking on such patients. There is a daily, twice updation being done for such patients. So, this all is not at all an unsupervised treatment, such patients are continuously being monitored by the health authorities.

Highlighting the risk involved with very mild symptoms patients in home-isolation as the highly contagious infection can still spread to family members, Dr Trehan added,

Yes, there is absolutely a risk involved in treating or caretaking such patients. A lot of factors determine if this home isolation is good or not for an individual case, for people who don’t have separate rooms, this is a strict no-no. It is advised only for people who have isolation facilities at home to go ahead with this. Another important aspect of this guideline is that the patient and the caregiver should be thoroughly educated about the norms and what they have to follow, only then this will work. And the guidelines which have come from the health ministry are fairly detailed and explains what an individual needs to do in such scenarios.

Talking about the technology and innovations that the industry is working to make this home isolation work in the coming days, Dr Trehan said,

We are working on a technology, which hopefully will be out in some time, wherein, all the patients opting for home-isolation for very mild symptoms of COVID-19, will have to wear a patch, which will automatically detect patients temperature, coughing incidents and breathing speed. This doubly secure the patient sitting at home, as when these symptoms appear to rise, health authorities can be alerted immediately and the patient can be shifted to the hospital.