With the recent spike in new cases in the second coming of the coronavirus, health officials have ramped up monitoring of home isolation cases through a combination of remote and door-to-door outreach measures designed to guide recovery by avoiding a hospital visit as far as possible.
Proportionate to the spurt in new COVID-19 cases during the second wave of the pandemic has been the enlargement of the pool of home isolation cases in the Union Territory.
Health officials estimate that there has been a 20-fold increase in COVID-19 cases compared to the figures in early March. This trend has simultaneously pushed up the number of home isolation cases in the Union Territory.
As on Tuesday, of the 5,073 active cases, 4,169 patients were in home isolation.
“With 80% of patients testing positive for COVID-19 remaining asymptomatic, the focus is on guiding their recovery without the need for a hospital visit, ” said T. Arun, Health Secretary.
The first point of triaging is at local PHCs, where a patient who tests positive is evaluated to determine between hospitalisation or home isolation, based on ICMR guidelines. If closely monitored and followed by at the level of each PHC, very few home isolation patients experience aggravation of symptoms to a state of emergency that warrants their hospitalisation in a critical care facility.
“This is more or less the strategy everywhere as hospitalising an asymptomatic patient will use up precious resources, from beds to clinical care, that are otherwise critical for the treatment of the moderate-to-severely ill coronavirus patients,” he said.
A team of over 300 anganwadi workers has been tasked with carrying out door-to-door visits to check on the health status of patients on a daily basis. In addition to this, ASHA volunteers are carrying out daily house visits as part of surveillance measures.
Consultation services
The outreach measures also include consultation services over the IVRS and a round-the-clock helpline 104.
At a recent video call with ICMR experts, chaired by Lt. Governor Tamilisai Soundararajan, the home monitoring strategy was one of the elaborately-discussed issues.
The expert advice of an ICMR panel, led by Prabhdeep Kaur, was to equip anganwadi workers with pulse oximeters to check oxygen saturation levels of patients on alternate days and to develop intermediary care (COVID care centres) in between hospital and home isolation points of care.
Mortality analysis
“What we are also seeing from our death audits is that during surveillance visits, people hesitate to disclose whether they are running a temperature or suffering from a headache or body pain. Many of these persons may have been infected and by the time they turn weak and require hospitalisation, precious time in diagnosis and treatment is lost,” Mr. Arun said.
In fact, mortality analysis in the second wave is virtually mirroring the 2020 pandemic pattern.
Late diagnosis and delay in reporting to hospital is contributing to 75% of recent COVID-19 fatalities, the Health Secretary said.
In a majority of recent deaths, patients who died with 24 hours to 48 hours of hospitalisation had waited for five or six days without undergoing a test for their symptoms and reached a healthcare facility only after severe breathing difficulty.
Health officials have appealed to everyone to visit a PHC and get tested for coronavirus symptoms, such as a persistent cough, running nose, or fever.
Officials also urged for utmost compliance with safety protocols — masking, hand sanitising and social distancing, along with the fourth pillar of vaccination — as one of the distinguishing features of the second wave of the pandemic has been its unusually high transmissiblity.
Street-level zoning and partial restrictions in a radius around areas with high number of home isolation cases is also being implemented.