Of the 310 asymptomatic COVID-19 positive patients sent home on Monday from Gandhi hospital for home quarantine, two have been rushed back to the hospital as their health conditions worsened, say junior doctors working at the COVID-19 wards. The COVID-19 patients had been sent home for quarantine as part of the Telangana government’s new strategy of discharging asymptomatic COVID-19 patients below the age of 50 years from the hospital.
While most doctors at Gandhi hospital agree that the strategy to home quarantine a positive asymptomatic patient is medically sound, some wonder if the mandatory 14-day quarantine will be strictly enforced on the ground. Telangana health department officials overseeing quarantine of migrant workers and positive COVID-19 patients say they already find it difficult to keep tabs on those arriving from other states and following quarantine protocols. With cases rising, the task of overseeing the health status of COVID-19 patients will fall solely on an already overburdened network of Auxiliary Nurse Midwives (ANMs) and Accredited Social Health Activist (ASHA workers).
Speaking to TNM, a doctor working at the COVID-19 ward of Gandhi hospital said, “Two of the positive patients under home quarantine were rushed back in ambulances as their health conditions worsened. If a patient is positive but asymptomatic, they can be treated at home; they just need timely monitoring. If they develop symptoms they can be shifted to the hospital.”
Another doctor listening in added, “This strategy looks good on paper but it will only work if the patients follow quarantine.”
Both doctors were part of protests by junior doctors overseeing COVID-19 ward duties at Gandhi hospital on Wednesday. While the strike was conditionally called off on Thursday morning, the doctors are demanding that the state government hire more patient care providers, doctors, paramedics on a war footing at Gandhi hospital as well as hospitals across the state. The doctors also want the state to decentralise COVID-19 treatment to the primary and secondary health care centres spread across the state.
With the lockdown relaxed, the state moved away from the strategy of cordoning off large streets where a single cluster was reported to barricading the houses where COVID-19 cases are reported. “It is already difficult to keep tabs on migrants and those coming into my zone from other states,” said a medical officer overseeing a team of ANMs within the Greater Hyderabad city limits.
The Public Healthcare Centre (PHC) under the medical officer’s jurisdiction has a team of six ANMs responsible for COVID-19 screening and surveying. The ANMs along with ASHA workers have to cover a population of 60,000. “It’s a lot of work,” the officer adds.
As of Thursday, there are four COVID-19 patients undergoing home quarantine under this PHC limits. The patient’s forehands are stamped and stickers are put up in front of their homes. The health department also relies on the Hyderabad police to keep tabs on the patients.
“The police will be watching the houses to see if they follow quarantine. If they need anything they can contact the District collectors office and it will be delivered to them but they will have to pay for the cost. The GHMC used to pay for essentials but they have stopped providing that service recently,” says the officer who adds, “We can manage four COVID-19 patients, since March we have witnessed 40 cases and 2 deaths in this jurisdiction. But if the cases rise more, it will be difficult to monitor each case daily.”
Read: