Home isolation: Why you aren’t in it alone

New Delhi: Virendra Singh spent just a few hours of panic after testing positive for Covid-19. The 50-year-old was comforted when he soon received a call from the local government dispensary. “Mr Singh, you have tested positive, but no need to fear. You can defeat Covid in the comfort of your home,” reassured the caller. Then an Accredited Social Health Activist, or ASHA volunteer, visited his house in a protective suit, gave him an oximeter and medicines, and briefed him and his family about the home isolation protocols.

Perhaps the most incredulous aspect of home isolation was the constant communication that Singh had with the health authorities. It began with Singh receiving a phone call in which the caller motivated the virus-affected man to remain positive and then noted his pulse rate, oxygen saturation level, body temperature and urine output.

The call had come from a private agency hired by the government for the task of keeping in touch with home-isolated Covid patients. The nurses called Singh every single day, wishing him a quick recovery and noting down his vital parameters, with reassurance given each time that Delhi government would ensure hospitalisation in case of deterioration in his condition.

Astonishingly, even the sub-divisional magistrate’s office phoned Singh to ask if things were all okay and if food was available. Most SDMs call the patients to check how they are coping, building in the process an assurance of a support system for the Covid patients. They also supply food to those in need. Experts believe the sense of being looked after contributes to a high percentage of recovery in home isolation.

Singh continued eating normal food, taking care only to avoid mutton, liver and fried and processed meats, talked with family members from behind the doors, watched movies and caught up with friends on video calls.

Phone calls came very morning for the next 10 days. By the end of the 17th day, Singh was deemed to have recovered from the infection. He was among the 1,13,374 Covid patients to have beaten the virus in the comfort of their homes. After Delhi government launched the home isolation programme in April, over 1.3 lakh patients have preferred home isolation. Only 41 died.

Most recovered patients described home isolation as pleasant because of the daily morale-boosting calls and because living with family members provided them the psycho-social support to recover quickly.

Before 8am each day, the government sends a list of patients in home isolation to the private agency tasked with communicating with the patients. The agency has 220 trained nurse callers at present. They phone patients in Delhi from their residences across India. Patients told TOI that the daily callers were always polite. “The district surveillance units call up a random 5% of the patients being monitored by the private agency to check whether they are being properly monitored,” revealed a government official.

As the world battles the pandemic, Delhi’s pioneering treatment model has emerged as an effective solution. All the 11 districts have 24x7 surveillance units and an unsung army of health workers risking infection to reach out to the patients. The journey from infection to recovery at home requires a suspect to dial 1031, Delhi government’s Covid helpline, and then follow the instructions.

The individual’s information is incorporated into the daily master list of Covid-positive people, which lands in the local dispensaries in every district. Phone calls are made from the dispensaries to the patients, and the consent of asymptomatic individuals and those with mild symptoms are received for their isolation in their own homes. Other details ascertain if they fulfil the eligibility criteria.

Patients living in areas like Noida or Gurgaon but have address proofs in Delhi are transferred to their own states. ASHA workers physically verify the addresses of the patients, entering the houses in PPE kits to stamp the left hand of the patient and get a certificate signed. “ASHA workers provide patients with oximeters and brief them on the process of home isolation. The neighbours are also motivated to support the affected household and to see to it that the family follows the Covid guidelines,” disclosed the government official.

A team headed by a doctor mans the district surveillance units 24x7. “If necessary, a patient or relatives can call the emergency number, 102. The doctor remotely assesses the patient’s condition and suggests steps. Mostly, such patients are advised admission into hospitals and ambulances are sent to their addresses,” said the official.

After 17 days of the onset of symptoms — 10 consecutive days without fever —patients can end their home isolation, following the assigned health team endorsing the step. There is no need for tests once the isolation period is completed.