Home isolation blues for COVID patients in Odisha

People are preferring home isolation despite symptoms due to poor conditions of Covid hospitals but are getting impacted without timely access to treatment support, or even the right medical advice.
For representational purposes (Express Illustrations)
For representational purposes (Express Illustrations)

BHUBANESWAR:  The Covid-19 patients in home isolation are fighting a twin battle - one with the virus and the other with the system that is supposed to absorb their stress, fears and concerns by facilitating support if they develop complications related to the disease during the period and post-Covid.

The State Government is encouraging home isolation of asymptomatic and patients with mild symptoms and has set up dedicated helplines manned by trained healthcare workers and medical practitioners but patients and their kin are in dark about the dos and don’ts and who to approach during emergencies. People are preferring home isolation despite symptoms due to poor conditions of Covid hospitals but are getting impacted without timely access to treatment support, or even the right medical advice.

66 pc people in home isolation

Two in every three Covid-19 positive patients in Odisha are currently isolated at home. According to data released by Health and Family Welfare department, around 66 pc patients in the State are in home isolation. Of the total 27,745 active cases as on September 7, as many as 18,396 people were under treatment in their respective homes.

The statistics indicate more people in districts, far away from Bhubaneswar and Cuttack, known as health hub of the State, are in home isolation than the cities and districts having more urban localities.

A whopping 94 pc Covid-19 positive patients in Mayurbhanj are in home isolation, followed by 90 pc in Bargarh, 89 pc each in Sundargarh and Koraput, 87 pc each in Rayagada and Nabarangpur districts where the infection is spreading fast. The lowest is 32 pc patients in Malkangiri and Kendrapara.

As many as 75 pc patients in Cuttack and 43 pc in Khurda are undergoing treatment at home. Home isolation becomes all the more important as the State Government works towards scaling up hospital beds with oxygen supply besides focusing on enhancing the capacity of ICU beds.

Since people with comorbid conditions are vulnerable to developing severe symptoms of Covid-19, positive cases with no symptoms and those with mild symptoms like headache, sore throat and low grade fever are allowed home isolation as per the Ministry of Health and Family Welfare guideline.

But many with diabetes and hypertension too prefer home with a hope that they would be attended as and when required. What if they develop complications?

Monitoring of health status important

A sense of uncertainty, proliferation of negative as well as false information about the virus and overdose of precautionary advice has impacted the psychological well-being of patients during the pandemic.

With a majority of the patients in home isolation in remotely located places, health experts recommend that the authorities must carry out a massive and continuous awareness drive making people aware about the facilities and hospitals to approach if there are any symptoms of the disease.

President of AIIMS-Bhubaneswar Dr Subrat Acharya advises patients in home isolation to monitor oxygen saturation level, respiratory rate, blood sugar, blood pressure and congestion in chest if any, apart from prolonged fever and cough.

“Odisha Government was very quick to set up Covid hospitals across the State. Now with more people in home isolation, the State needs to monitor their health condition through a dedicated set of medical professionals at the district level and facilitate required tests and further follow-up treatment without delay. The State has a very low fatality rate and timely medical attention for patients would further reduce the fatality,” he said. As the infection spreads to the hinterlands, patients do not know what to do and who to contact if they develop symptoms such as respiratory distress or chest pain. 

Though many would like to get tests conducted when they develop symptoms, they do not know where to do. Many complain that the personnel at the call centres set up by the Government keep them waiting for days together with assurances of resolving their issues.

“How long can someone experiencing breathlessness and chest congestion wait? Health professionals at the call centres should counsel and guide them on how to deal with the crisis. The Government can introduce mobile testing vans for blood tests, chest X-ray and measuring the oxygen saturation level,” suggested a senior physician from Balasore Dr Santanu Das, who have been attending a number of frantic calls of patients every day.

Single helpline number fails to address all issues

The State Government set up the State Health Control Room (104) which has both in-bound and out-bound call centres to address the grievances and monitor patients.

While the inbound call centre responds to calls from people on issues related to the disease, the out-bound call centre manned by medical professionals monitor the health status of people in home isolation.

With an increase in number of patients in home isolation, the Bhubaneswar Municipal Corporation (BMC), of late, has strengthened its control room and opened the dedicated helpline 1929 round the clock, while Cuttack Municipal Corporation (CMC) is yet to have a 24x7 helpline number.

The rest of the districts do not have dedicated call centres as the executives from the 104 manage the calls, leading to congestion and delay in response.

Many are of the opinion that there should be separate helpline numbers to address different issues like shifting of patients and monitoring patients with a proper coordination for better grievance redressal.

Health experts are concerned over lack of proper attention to patients in home isolation and say the State Government must come out with the well-planned communication strategy that disseminates proper medical information and provide hand-holding support for patients requiring immediate care and guidance.

“This is the time when the Government’s communication machinery must deliver. It did well when the pandemic outbreak happened during March-April-May. It is important to note that Odisha is peaking late compared to other states which is why this phase is critical for the Government to minimize fatalities and make people understand that it is putting its best foot forward,” said a senior physician.

Senior member of a Technical Expert Committee formed to monitor treatment protocol in the Covid Hospitals in the Central Odisha region says people in home isolation need immediate medical attention whenever they develop severe complications and the district surveillance teams must regularly monitor their health status.

Citing the case of a 48-year-old man who succumbed on Friday after his relatives failed to arrange an ICU in Cuttack and Bhubaneswar, he said ICUs are lying vacant in district Covid hospitals but patients are referred to Bhubaneswar and Cuttack where the caseload is high and there is stress on healthcare facilities.

“This is happening for two reasons. One, patients are unwilling to get treated at district hospitals with apprehension that they may not get proper treatment; two, doctors do not want to take risk with the fear of getting harassed in case things go wrong. The Government must ensure that treatment in districts is done under the supervision of professors at the medical colleges and hospitals. Patients need to be equally distributed instead of being rushed to the twin cities,” he suggested.

Additional Chief Secretary of Health Department PK Mohapatra said several measures are being taken to attend patients in home isolation. The dedicated helpline opened by BMC and CMC have been attending calls and queries of patients and guiding them, he said.

“If anyone has any issue in districts, they can call 104 where we have our doctors 24/7 to advise the patients. In case the patient requires hospital admission, the district control room will be directed to shift the patient to hospital. Patients can also call the telemedicine number of their district concerned where doctors are answering calls from 9 am to 6 pm,” Mohapatra added.

BMC wakes up from slumber

Doctors deputed at 1929 Call Centre of Bhubaneswar Operations Centre have started helping people fighting Covid-19. While counselling by doctors has always got a distinct touch of confidence building measures, patients panicking to join Covid hospital are now getting ample confidence to stay under home isolation, if they are either asymptomatic or mild symptomatic.

“If you have facilities like a separate room and toilet in your house, then home isolation could be a good option for you,’’ says Dr Gopal Krushna Kar, an Ayurvedic Medical Officer (AMO) deputed at the call centre.

Explaining the anxiety and stress of the Covid-19 positive patients, Dr Kar says they talk to people and build their confidence and it is good that many have started following the advice with a positive attitude.Currently, two Ayurvedic medical officers have been assigned per shift to take calls at the 1929 Call Centre.

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