State bars home isolation option, then reverses decision

Nagpur: On Tuesday morning, the state government announced that the option of home isolation will not be available for Covid-19 patients in 18 districts where the positivity rate is still high. By evening, however, the decision had been overturned.
Now, though home isolation will be permitted, the emphasis will be more on admitting patients in Covid care centres (CCCs), especially in rural areas.
The districts where home isolation was to be withdrawn included Akola, Amravati, Gadchiroli and Wardha in Vidarbha. Also in the list of 18 was Pune, Nashik, Ahmednagar, Kolhapur, Thane, Satara, Sangli, Latur, Beed, Raigad and Ratnagiri. The positivity rate in these districts is higher than the state average.
The state did not issue any clarification on the change of decision but only released a revised note. The meeting was chaired by deputy chief minister Ajit Pawar.
“Patients in home isolation in these 18 districts should be brought down and should be negligible. We have realised that monitoring in home isolation was not effective and the the infection was spreading to other family members as well,” said health minister Rajesh Tope.
Sources informed that withdrawing the option of ‘home isolation’ would have been a disastrous decision. A senior member of the state Covid task force told TOI that it would have resulted in fewer people turning up for tests, something the state cannot afford at this stage.
“People who have no symptoms generally don’t wish to get admitted in Covid Care centres. If institutional quarantine would have been made compulsory, every positive patient would have to be admitted in CCCs. Fear and stigma of going to CCC is still there. This would have resulted in denial and discouragement towards tests,” said the member not willing to be named.
A senior district official told TOI that the higher-ups had never discussed the idea of institutional isolation for everyone. “The announcement had come as a surprise because no district would have that many beds in CCCs. Even now, there is a careful selection of patients who are to be admitted to CCCs given the manpower constraints,” the official said.
Many districts including those having higher positivity rate, have already resorted to initiatives like mass testing at marketplaces, random testing at checkpoints and testing through mobile vans. “These initiatives would have taken a setback if people would have opted out of tests fearing institutional quarantine. Therefore, the decision was revised,” added the member.
However, the state government has made it clear that more emphasis should be given to institutional quarantine now as cases have started reducing. “We must avoid a spread of Covid through violation of home quarantine,” the revised note said.
The state government also allowed gram panchayats to spend 25% funds from the grants received under the15th finance commission and also revenue generated minor mineral development fund. It was decided that Covid centres will be set up at the village level.
Officials said that due to lack of monitoring in these 18 districts, the death rate too is going up. “Many patients who are in home isolation are landing up to the hospital in really bad condition,” said an official.
A senior doctor from Gondia Medical College said that institutional isolation is the fundamental way to treat an infectious disease. “But the numbers are so overwhelming at present that it’s not a practical solution,” he said.
Meanwhile, districts in Nagpur division can expect some relaxations in restrictions from June 1 or 3. Districts in Amravati division would have to wait longer as in Akola and Amravati — the two main districts — the positivity rate is still above 15%. Yavatmal, Washim and Buldhana also have more than 10% positivity rate, but, they are not in red zone as positivity rate is reducing at a fast rate.
Barring Wardha, all districts in Nagpur division have less positivity rate than the state average. Bhandara, Gondia, and Chandrapur have shown significant a drop. Focus will now be on Wardha and Gadchiroli.
Home Isolation in Vidarbha
45,592 | Patients under treatment in Vidarbha on May 25
31,000 | In home isolation
70% | Under-treatment patients in Vidarbha in home isolation
78.4 % | Amravati; 81% Akola; 75% | Nagpur; 50% | Yavatmal; 58% Gondia
10% | State Maharashtra eekly (May 17-25) positivity
Districts with positivity higher than the state average:
Satara | 23%
Ratnagiri, Sindhudurg | 21%
Raigad | 18%
Beed, Osmanabad, Kolhapur, Pune, Hingoli | 17%
Akola, Amravati | 15%
Solapur, Sangli | 13%
Washim, Wardha | 11%