The state witnessed another day of 7K plus tests and 1K plus fresh cases of Coronavirus infection, the second time this week. The inference that can be drawn from the figures that is likely to become more and more common in the coming days is that rigorous testing is underway at micro containment zones level where practically every single resident is being put under the scanner as the government embarks on a grand exercise of leaving no stone unturned to trace all the carriers of the virus. There were a series of setbacks to the government’s expectation on how the Covid-19 pandemic ought to progress in the second wave as it juggles in enforcing the new national policies of controlling the more belligerent variants while having to suffer some bumps during local adaptation of these policies. The central policy on home isolation was enforced in toto in the state for asymptomatic patients as instructed in the guidelines on pure good will, keeping faith on those who sought the arrangement and without actually making any sort of physical verification on how it is performing in the local perspective.
Even though there is no official admission or denial available, the major cause of fast spread of the virus in Manipur in the second wave has been attributed to poor supervision of home isolation patients and violation of the protocols of home isolation by the patients and their family members themselves which promoted the passing on of the contagion to other family members as well as friends and neighbors. Over dependence on the family caretaker alone to manage the set of guidelines that a sick persons should follow during his recovery turned out to be giving a long leash to the carriers of the fatal contagion. This had purportedly led to a ripple effect like spread covering chunk of a settlement within a short period of time leading to arithmetic growth in number of fresh cases. On account of this, slowly but surely many people are wondering whether admission of patients to home isolation through filling up of a set of questions over the phone without even taking up physical verification is a desirable mode of adjudging whether a patient with a highly transmissible virus should be left free without supervision by experts among a group of people, some of them vulnerable of developing severe medical conditions. There are stories circulating in the grapevines that many asymptomatic patients lied in their responses to the questionnaire while describing the suitability of their residences for home isolation as well as listing the types of facilities available there. They preferred to lie in order to stay at their homes and risk more transmission instead of leaving home for a short period and comfortably recovering in a community health isolation centre where there are adequate health care givers who can monitor their health condition efficiently round the clock and there is very low threat of spreading infection.
The implementing of home isolation care in a typical rural household is a very difficult task as separate bedrooms with doors, proper ventilation, large unshared space, and toilets are very rare. Even, when there is such option, the operation of monitoring sudden appearance of acute symptoms of the patient which needs hospitalization or effect on the health of other family members is a tough challenge. The family caretakers are likely to be ignorant on the basic rules of management of the patients and containment of the virus. In most houses it would not have been possible to stay at a distance of six feet all the time let alone stay inside a closed door. Use of disinfectant or washing frequently touched surfaces or disposing used articles and cloths have to followed thoroughly with precisely the same caution as in the environment of a hospital. How many of them will have gone through this rigor. It is also possible that the caretakers or other family members during contact with the ill person or his/her environment do not use additional protective gears like gowns, PPE, gloves among others except face masks.
The focus should be on moving a asymptomatic patients to CHIC units in the vicinity to prevent the formation of chains of infection. Only when the field workers from the health department is convinced that existing facilities and knowledge of the family caretaker is sufficient to negate all possible ill effects after careful probing, the permission of home isolation should be issued. With regards to the high figure of fresh cases that we are encountering at present, the government is attending to it with the right earnest, preparation and plan and we hope its steady dip will be witnessed very soon.
