Home isolation of mild COVID-19 patients allowed, experts welcome move 

NEW DELHI: Top infectious disease experts and virologists have welcomed the Centre's move to allow those who are pre-symptomatic or showing very mild symptoms to isolate themselves at home under certain conditions. They said "it will allow people to take charge of their lives."

In revised guidelines on home isolation issued late on Monday evening, the Union Ministry of Health and Family Welfare said while all suspected and confirmed cases of COVID-19 are currently being isolated and managed in a hospital setting with the intent to break the chain of transmission, those with mild symptoms or without symptoms -- if diagnosed so by the treating doctor -- will now have the option of home isolation.

"The move will allow people to take charge of their lives and it's good to let communities ensure quarantine. Trust is a key to controlling this epidemic," said virologist Dr Shahid Jameel, CEO of the Wellcome Trust India DBT Alliance. "The outbreak is a public health problem that has so far been treated like a law and order problem."

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Senior virologist Dr T Jacob John from Christian Medical College, Vellore said that the government should have allowed home isolation of mild cases in early March itself when the outbreak was in its early stages.

"Nobody who is not very sick should be in hospitals," he said. "I would say there has been huge delay on the part of the Centre in coming up with the new guidelines.  The move will decrease the strain on government and hospitals and is better for the physical and mental well-being of a vast majority of people who will have only mild disease."

The provision of home isolation however includes certain conditions such as having requisite facilities for self-isolation and also calls for the quarantining of family contacts, availability of a care giver 24x7 and a communication link between the caregiver and hospital for the entire duration of home isolation.

Also, the care giver and all close contacts of such cases will have to take the anti-malaria drug hydroxychloroquine (recommended for preventing the infection) as per protocol. The patient will have to download the contact tracing app Arogya Setu on their mobiles and it should remain active at all times. 

They will also have to get their health satus monitored by the district surveillance officer and regularly inform the authorities about their health status.

The guidelines also say those under home isolation should seek immediate medical attention in case they develop complications such as difficulty in breathing, persistent pain or pressure in the chest, mental confusion or inability to arise, bluish discolorations of lips or face.

Some however cautioned against the move saying that if there are high-risk members in the family, having a COVID 19 patient could at home spur trouble.

"Also, voluntary compliance can't be assumed to be high. In my view, it would be better to repurpose vacant real-estate inventory as isolation facilities,” said public health expert Oommen C Kurian.

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