New Delhi: Home quarantine for Covid-19 patients in Delhi is now barred for the first five days after the Union health ministry allegedly found the national capital in violation of isolation guidelines.
The Delhi Disaster Management Authority (DDMA), chaired by Lieutenant-Governor Anil Baijal, issued an order Friday that makes five-day institutional quarantine mandatory for Covid-19 patients. On Thursday, ThePrint has learnt, the Ministry of Home Affairs issued a similar advisory to the Delhi government at a review meeting chaired by Union Home Minister Amit Shah.
Earlier Friday, the Union Ministry of Health & Family Welfare had referred to “instances of home quarantine being allowed” by certain states for severe cases of Covid-19, even in congested urban areas.
Noting as much, health ministry Joint Secretary Lav Agarwal ordered strict observance of government guidelines on home quarantine, which restrict it to pre-symptomatic and mild cases under specific conditions.
A government officer told ThePrint that the “instances” mentioned by the health ministry were essentially from Delhi.
“It was found that Delhi was not following the home quarantine guidelines properly. In some areas, it was found that Covid-19 patients were in home quarantine in crammed one-room houses and were meeting neighbours, leading to a further spread,” the officer said. “That is the reason it was also pointed out in the review meeting held on Thursday.”
The Ministry of Home Affairs spokesperson refused to comment on the development. The Delhi government issued a statement saying its “home isolation programme has been one of the most successful initiatives in the battle against corona”.
The Aam Aadmi Party (AAP) government in Delhi also said the new order will “discourage people from testing and further spread coronavirus as asymptomatic and mild symptom patients will resist testing and will not be quarantined”.
What the DDMA order states
According to the DDMA order, there will be no home quarantine for Covid-19 patients without physical verification. Issued by Baijal, the order called for mandatory “five-day institutional quarantine of each case”, adding that a patient will be allowed into home quarantine only if there are no further symptoms that require hospitalisation.
It wasn’t immediately clear whether the order will also apply to patients already diagnosed. ThePrint has approached the Lieutenant-Governor’s office for clarification and will update the report once a reply is received.
The order also stated that services of PORTEA, a company employed to check up on self-isolated patients through phone calls, are being discontinued with immediate effect.
Patients in home quarantine, the order added, will be subject to mandatory physical verification by teams of district surveillance officers under the supervision of the district magistrates.
The order comes at a time when the Delhi government is grappling with a surge in Covid-19 cases (2,877 cases were reported on 18 June). There have been complaints of lack of staff at hospitals, with nurses reportedly resigning over fears of infection and long shifts, even as the Delhi government looks to bolster its institutional capacity by engaging hotels as alternative Covid care centres.
At the review meeting Thursday, held to chart out a “common anti-Covid-19 strategy” for the National Capital Region, the MHA also asked Uttar Pradesh and Haryana governments to provide details of the total hospital beds they have, along with the number of oxygen cylinders, ICU facilities and ambulances they have at hand.
AAP leaders react
In its statement, the Delhi government said it had “treated thousands of mild and asymptomatic cases at home so far through daily monitoring and counselling”. Home isolation protocol is being carried out strictly as per ICMR (Indian Council of Medical Research) guidelines of the central govt,” the government added in its statement.
It also said the provision for home isolation had “encouraged a lot of people with minor symptoms to come out and test as they knew that they will not be taken to a hospital or quarantine centre forcibly”.
“Today’s order of the central government stopping home isolation will discourage people from testing and further spread coronavirus,” it added.
The government also questioned the “different parameters” employed for Delhi. “Are ICMR guidelines still applicable to the rest of India, then why are there different parameters for Delhi?
“There is already a serious shortage of doctors and nurses to treat serious patients, where would medical manpower come for taking care of these quarantine centres?” read the statement.
“We have been completely supportive of the central government in our collective fight against corona, but this arbitrary decision will seriously harm Delhi. They should re-consider this decision,” it added..
AAP leader Saurabh Bharadwaj tweeted that compulsory institutional quarantine is a “nightmare for many people”, adding that the Delhi government was implementing mandatory institutional quarantine in congested areas where toilets/hydrants are shared by residents.
Compulsory Institutional Quarantine is a nightmare for many people. People with mild symptoms dread this thought of being taken to a Hospital or Quarantine Centre
For some place like JJ Clusters where Toilets/Hydrants r shared, its needed and it's being implemented
Not for all https://t.co/6dVNKet2Vu
— Saurabh Bharadwaj (@Saurabh_MLAgk) June 19, 2020
He also said it was futile to make quarantine facilities out of railway coaches.
“It is a futile exercise to fill the General passenger Dibba of Railways which r being camouflaged as Covid Hospitals. In Heat of June-July, these railway coaches without AC will act as Ovens for patients,” he tweeted.
What the guidelines say on home quarantine
The order issued by Aggarwal, which was copied to Chief Secretary Delhi and Additional Secretary (UT), elaborates on the circumstances under which home quarantine can be allowed.
“The treating doctor has to satisfy himself that the patient opting for home isolation should be allowed based on medical assessment of his residential accommodation. There is also an undertaking that the patient has to give to the doctor,” the order said.
“All such cases of home isolation further shall be monitored by teams of well-oriented doctors on a regular basis, their discharge should follow the required guidelines and shall be reported as per norms,” the order said.
They are in line with earlier guidelines issued by the health ministry in May, which restrict home quarantine to mild/pre-symptomatic patients provided they meet certain conditions.
Under the guidelines issued 10 May, home quarantine is allowed provided “the person should be clinically assigned as a very mild case/ pre-symptomatic case by the treating medical officer”.
“Such cases should have the requisite facility at their residence for self-isolation and also for quarantining the family contacts. A caregiver should be available to provide care on 24 x7 basis,” they add, while also urging a communication link between the caregiver and hospital.
The guidelines also call for the administration of hydroxychloroquine as a preventive for the caregivers and all close contacts of people in home quarantine “as prescribed by the treating medical officer”.
The guidelines have been drawn up keeping in mind the fact that a very large number of Covid patients are asymptomatic and do not need any medical attention. All that is needed is to keep them isolated to prevent the disease from spreading.
In April, the Indian Council of Medical Research (ICMR) head of epidemiology and infectious diseases, Dr R.R. Gangakhedkar, had said that 69 per cent of Covid patients in India are asymptomatic. A study by ICMR researchers last month had pegged the figure at 28 per cent.
This is an updated version of the report