New phase requires asymptomatic patients to self-quarantine

EXPLAINING a new phase of the response to covid19, Ministry of Health officials said asymptomatic covid19 patients would now have to self-quarantine.

The new response includes stricter enforcement of quarantine orders and using the force of law, as well as changing protocols for admitting and discharging patients, to ensure as many beds as possible are available.

Chief Medical Officer Dr Roshan Parasram said patients with mild or no symptoms would spend an average of 20 days in quarantine, but most would be in their homes.

He spoke at the ministry's virtual press briefing on Wednesday

Those who test positive and have symptoms will be treated for seven days in quarantine. Then, if three days pass and they show no further symptoms they will be ordered to self-quarantine for ten days to ensure they cannot transmit the disease.

Those who test positive and show no symptoms will spend ten days in quarantine, and must then also self-quarantine for seven days. Those who show no symptoms will be monitored for ten days from the day they test positive

Parasram also said the requirement of a negative test for people in step-down facilities have been changed to a clinical examination.

“People who are in step-down facilities, we would be able to discharge them quicker. That would happen between today and tomorrow.”

He said measures which need to be taken to self-isolate include: staying at home without going out in public, not having visitors, washing hands before interacting with pets; using separate facilities or cleaning after use if sharing; wearing a mask – even while at home; and having food and medical supplies delivered where possible.

He said county medical offices of health will have a list of all those who test positive and will monitor them by phone to see if they have got better or worse or stayed the same. They will also ask if any family members or anyone around the patients are experiencing any symptoms. If they are, the CMOH will send people to test them.

Hospital care for extreme symptoms

People with worsening or extreme symptoms will be immediately taken to the Couva or Caura hospitals in the first instance. If they have worsening symptoms , in between calls, people can go to any hospital or contact the GMRTT ambulance service as well as the hotline numbers 877 WELL or 800-WELL.

Parasram said measures put in place by recent health ordinances would be expected to take effect in a matter of days, since it takes about 14 days for any action to take effect when it comes to the virus.

“If there isn’t a change, then that would mean that there wasn’t a change in behaviour,” Parasram said.

He added while the measures were less strict than measures taken in the earlier phase, the new protocols are heavily dependent on personal responsibility for them to work. If people do not comply, the ministry can still enforce orders through the force of law.

Parasram noted that these measures were recommended by the World Health Orgainization (WHO) for countries with community spread.

Health Minister Terrence Deyalsingh, answering questions at the briefing, said the decision to advance to an elevated response was made in a matter of days.

“We considered the options between Monday and this morning. This was always part of our plan. But we are officially launching this phase this morning,” Deyalsingh said.

He said the spike in positive cases was expected but now there needs to be a serious response from the ministry.

Khan: Hospitals only for sick patients

Former health minister Dr Fuad Khan, who has been advocating for asymptomatic people to quarantine at home, welcomed the change, saying it took a long time for government officials to understand the strategy of separating the sick.

“Hospitals are only for sick covid19 patients, not well ones,” he said.

He also said the rise in cases is not a matter to worry about, because as tests continue the ministry would see that there are asymptomatic cases.

“Their policies need to be changed. They have to look at the destruction of the economy with the public health ordinances. We have to go back to the opening of gyms, restaurants, and other business as well as churches and other religious institutions with the use of sanitisation, social distancing and the wearing of masks. We need to open the schools with the use of masks as well.”

The Ministry of Health reported 159 new covid19 cases on Wednesday. The ministry's 6 pm update said TT now has 1,411 total cases with 1,204 active cases.

The total number of samples submitted for testing is 22,255.

Deaths remain at 15 with 192 people discharged from the State's care.