While governments across the world acknowledge that COVID will persist indefinitely, they continue in their efforts to mitigate against its effects: enhancing medical infrastructure, increasing the number of hospital beds, setting up new COVID facilities, and progressing towards the development of a vaccine.
With the lockdown extending for four phases, social distance had widened more than physical distance. While the declining Corona numbers can be attributed to strong coordination among agencies, the task of regaining normalcy and the faith of the people in an otherwise socially widened society remains crucial. The home isolation protocol of the Delhi government has been key in achieving the reimposition of normalcy. People started practicing home isolation and received regular calls from doctors and medical teams enquiring about their health. Neighbors of infected patients realized the severity of the situation and extended their support by delivering groceries and medicines. Patients were given oximeters and a helpline number to gain oxygen support whenever required.
Home Isolation of asymptomatic patients or patients with mild symptoms is the flagship scheme of the Delhi government, which has been helping people recover in the comfort of their homes. More than 80% of the people infected by Corona are recovering at home, with adequate provision of guidance and assistance from the Delhi government’s medical team. While this may come across as a whimsical notion to some, considering the intensity of Corona and its effects, home isolation protocol has proved to be the foundation of the Delhi Model response to Corona.
Under the home isolation protocol, the medical officer of the District Administration, or DSO, will instruct the patients to practice home isolation. The medical team, under the supervision of the medical officer, will make a visit to the home of the COVID-19 infected patients, get a certificate signed, and place a sticker outside the homes of the patients. If the team finds the prerequisites for home isolation unsuitable, the patients are shifted to a COVID Health Centre or a hospital, depending on their symptoms.
“I am a resident of East Delhi, and I stayed in home isolation for 20 days,” says Aman, a COVID recovered patient who was in home isolation for 20 days and feels home isolation has healed him better than if he had been taken into institutional quarantine as soon as he tested COVID positive. “Personally, it has been a long journey for me. It was a nightmare when I got to know I had tested positive for Corona, and for my family, especially my parents, it would have been the toughest way out if I would have been taken to a care centre. Because my symptoms were very mild, I received an advisory for home isolation from the medical team of the Delhi government, and guidance when they visited, and all assistance when they called every day. The authorities paid a visit to my place, placed a sticker outside my home, and prescribed me the required medicines and intake of 1.5 liters of hot water and 4 to 5 liters of normal water. A diet chart was also prepared for my intake of vegetables and fruits. I was required to separate myself from my family at home and isolate himself in a separate well-ventilated room, using separate utensils and a separate toilet.”
The recent rolling back of the home isolation protocol, which also mandated compulsory 5-day institutional quarantine of all COVID-19 infected patients by the LG, came as a huge blow to the Delhi government. Not only did the home isolation unburden the medical infrastructure of Delhi, but also helped flatten the curve of psychological imbalance brought about by the lockdown. While experts across the world suggest it is impossible to put a date on when the Coronavirus will end, the efforts of governments to attend to the unfortunate circumstances of their infected citizens reveal a great deal about good and bad governance.
The order of the LG drew strong opposition from various organizations, and RWAs, and set nothing short of a strong example of teamwork and collective action. The LG-order was rolled back and mandatory 5-day institutional quarantine was scrapped.
The provision of pulse oximeters to those infected with Corona and placed under home isolation is a further important step to ensure the well-being of the people. The daily oxygen level readings keep patients and their families hopeful of a swift recovery. Until now, around 25,000 pulse oximeters have been distributed across Delhi.
Under the home isolation protocol, The Delhi government has partnered with Step-One to provide tele-consultation and medical assistance to COVID positive patients. A calling agency connects with the patient to receive basic details and ICMR ID. If the medical team finds the condition of the patient critical, he/she is immediately connected to a doctor who will assess their situation. The patient is then connected to the Delhi government’s health team or the DSO team and informed about the nearest COVID hospital.
The ambulance services of the Delhi government have also been enhanced, with around 600 ambulances deployed in the city. Their response time has been reduced from 50-60 minutes, to less than half-an-hour. Along with the 400 ambulances available to the Delhi government, out of which around 300 are CATS ambulances, 200 additional cabs have been deployed for the transportation of patients. Various agencies have partnered with the Delhi government to provide ambulances services, including providing cabs for transportation of attendants accompanying the COVID infected patients. The medical team of the Delhi government then assists the patients and their families in hospital admissions, if required. The Delhi government has also installed computer systems outside the hospitals, which help ascertain the COVID status of a patient who has been tested but has not received his/her report.
The home isolation has had a direct bearing on the increasing number of tests in Delhi, which can further be enhanced by setting up more centres for rapid testing.
The situation in Delhi was addressed with a holistic approach and implementation of policies to support the people. Along with the execution of steps to combat Corona, Delhi thrived under the leadership of CM Arvind Kejriwal because of the transparency of information provided to the people. The DelhiCorona App, a helpline (1031), a WhatsApp number, and a website to seek information about various locations and protocols, were rolled-out to give people access to the facilities provided by the government.
In the demands of the people, and the necessary steps that were taken by the Delhi government, one thing was common – collective action. At a time when nations are struggling for a coalition with their people to combat the virus, it was the collective ask and the collective give in Delhi that inspired the real output.
While the Delhi government was ramping up its medical infrastructure, it started identifying more and more patients who could be treated under home isolation and increased testing. More people with very mild, or no symptoms came forward to get tested because they knew they would get treated at their homes. Advertisements about home isolation on behalf of the Delhi government, which is generally gaining a lot of political jeering and sneering, helped people and created mass awareness. As a result, around 1 lakh patients have recovered through home isolation, fewer people infected by COVID require hospitalization, and fewer people are exposed to further infection because they are not placed in quarantine centres.
The author is a media fellow at the Delhi Assembly Research Centre (DARC).