LAHORE: Recently, a picture of two minor siblings, who tested positive for coronavirus, shared by some social media users kicked off a debate about home isolation of certain Covid-19 patients, especially children.

The picture showed a health team transporting a 10-year-old boy and his younger sister from their Ravi Road residence to a hospital in an ambulance. Their mother had handed them over a backpack with their stuff, including toys, as well as a copy of the holy Quran.

The children’s father was already being treated for the illness at the Expo Centre field hospital and requested the authorities to shift his children with him.

Experts seem divided over the issue of home isolation, as some health professionals say keeping infected patients at home would pose a risk due to cramped spaces in some low-income areas as well as lack of awareness owing to low literacy rate in Pakistan.

But many experts suggest the government allow selected patients of Covid-19 to isolate at home, who can follow the standard operating procedures.

University of Health Sciences Vice Chancellor Prof Dr Javed Akram was in favour of home isolation for patients belonging to privileged families, particularly those who have members in the medical profession.

He said the federal government had highlighted in its guidelines for the provinces to isolate at home confirmed patients showing mild symptoms. However, after the Chinese delegation during its visit to Pakistan opposed this idea, the Punjab government strongly discouraged home isolation and issued directions to the health authorities to shift all patients to either hospitals or quarantine centres.

“We, health experts, will suggest the Punjab government hospitalise only those confirmed patients whose education level is relatively humble and the awareness level is inadequate,” said Prof Akram.

He said it is a well-documented fact globally that the isolation of such patients at home would lead to transmission of the virus. He suggested the health authorities relax policy for educationists, health professionals and people from well-to-do families, who were aware of the protocols of isolation and social distancing, and allow them to stay at home if they tested positive for the virus.

Prof Akram was also against the government policy to shift all Covid-19 patients to hospitals through police. “The health authorities should shortlist from confirmed patients those who qualify for home isolation to ease burden on the hospitals,” he suggested, adding that the patient’s family must make the final decision about home isolation.

“A mandatory electronic band should be given to the patients to monitor their movement digitally like in other developed countries whereby authorities can trace the mobility of patients wearing a chip with the accuracy of one or two feet,” Prof Akram said.

Regarding children, the senior doctor said those who test positive for the virus along with their parents, and belong to under-privileged families, must be kept in a private room of a government hospital instead of isolating them separately.

At Children Hospital Lahore, he said, non-infected parents were allowed to stay in rooms with their children, who were being treated for coronavirus. The parents were given personal protective equipment for their stay and luckily none of them contracted the virus. This can also be done for the families who can afford to take care of their children at home, Prof Akram suggested.

A senior official of the health department somewhat supported the idea, saying that under the revised guidelines, Covid-19 patients facing multiple health issues, including heart, asthma, sugar and blood pressure, required hospitalisation. Besides, most of the under-privileged families had limited space in their one- or two-room houses.

He claimed that so far, the number of patients tested positive for coronavirus in Punjab was not alarming and the state-run hospitals and quarantine centres had enough capacity to manage maximum number of patients.

A proposal was under consideration to review the guidelines in a couple of weeks to grant selected patients permission for home isolation, he claimed.

Published in Dawn, April 16th, 2020