NMC allows home isolation of asymptomatic Covid patients

Nagpur: Two days after converting four big quarantine centres into Covid Care Centres (CCCs) and discharging over 1,000 suspects, the Nagpur Municipal Corporation (NMC) went a step ahead on Monday evening to permit home isolation of asymptomatic Covid-positive patients.
The major announcement came on a day the district touched a new high of 274 Covid-19 cases and ten deaths. TOI learnt about the key decision on Saturday, but held back the news following requests from officials.
As on date, 569 patients are admitted in all three dedicated Covid hospitals — AIIMS, GMCH and IGGMCH, which have around 1,200 beds in total. The move is likely to free up around 80% of these beds, since those many are said to be asymptomatic patients there.
Confirming the development, municipal commissioner Tukaram Mundhe told TOI that they “have decided accordingly”, when asked about isolation of asymptomatic patients at home. The announcement was made following a press conference of district guardian minister Nitin Raut at the divisional commisioner’s office. Divisional commissioner Dr Sanjeev Kumar, deputy director of health services Dr Sanjay Jaiswal, district collector Ravindra Thakare, GMCH dean Dr Sajal Mitra, IGGMCH dean Dr Ajay Keolia and key health officials were present.
“It is a joint decision. District administration had already initiated it in Kamptee,” said collector Thakare, when asked if the district administration was following NMC.
Nagpur follows Mumbai and Pune in adopting the Union health ministry’s July 2 revised guidelines for home isolation of very mild/pre-symptomatic/asymptomatic Covid-19 cases. The norms were later adopted by the state public health department on July 7, based on which the NMC too revised its policy.
Dr Mitra said it is the need of the hour. “Cases are surging drastically. The move will definitely cut the strain on facilities and help concentrate on critical patients,” he said, adding that patients not meeting the home isolation norms will be kept in CCCs.
As per the norms, patients suffering from a compromised immune status — especially those with HIV, cancer and transplant recipients — are not eligible for home isolation. Elderly patients with co-morbidities like hypertension, diabetes, chronic lung, liver or kidney ailments shall be allowed home isolation after assessment by medical officer.
All patients will have to be clinically assigned as asymptomatic, and ensure they have adequate facilities before proceeding for home isolation.
Though no date has been announced for implementation of the new norms, the civic body is likely to follow the policy in the next two days. The health officials said, “Only in-principle decision has been taken. The implementation part would be done by NMC. The home isolation is optional. Those not having facilities will have the option to stay at a hotel or CCC,” they said.
NMC health teams would continue contact tracing and admit high risk suspects in institutional quarantine, from where they would either be shifted to hospital — if tested positive — or released for 14-day home isolation. Later, the eligible patients will be allowed home isolation, which will be a total of 17 days. The isolation period includes first 10 days without fever/other symptoms, and next seven as home quarantine. After home quarantine, no tests will be needed.
On July 24, the NMC had planned to cut institutional quarantine period to seven days, amid the steep rise in cases. The next day, it suddenly decided to release Covid suspects who were negative in the first test at all quarantine centres, beside converting VNIT hostel, Pachpaoli police quarters, Symbiosis hostel and Vanamati into CCCs. TOI had reported these developments and highlighted the shortage of beds at hospitals.
The asymptomatic patients in home isolation would remain under the supervision of zonal medical officers. The quarantine centres and CCCs would primarily cater to needy patients, officials said.
The Guidelines
* Patients to be sequenced as fit for CCC, DCHC, or DCH
* Clinically assigned asymptomatic Covid positive patients having facilities for home isolation to qualify
* NMC to form rapid response teams and deploy ambulances in each zone
* Zonal medical officers to monitor asymptomatic patients
* Patients need to report difficulty in breathing, dip in oxygen saturation, persistent pain/pressure in chest, mental confusion or inability to get aroused
* Patients suffering from immune compromised status (HIV, transplant recipients, cancer etc) not eligible for home isolation
* Elderly patients aged more than 60 years and those with co-morbid conditions shall only be allowed home isolation after proper evaluation by treating medical officer
* Care giver should be available to provide care 24X7
* Communication link between caregiver and hospital prerequisite for entire duration of home isolation
(Detailed guidelines at mohfw.gov.in)