‘Home isolation’ option major contributor to growing Covid-19 cases, say experts

Published April 16, 2020
THE field isolation hospital set up at the Expo Centre.—White Star
THE field isolation hospital set up at the Expo Centre.—White Star

KARACHI: Letting a significant number of coronavirus patients opt for ‘home isolation’ instead of admitting them to designated isolation facilities is a major factor contributing to the growing number of local transmission cases, especially in Karachi, it emerged on Wednesday.

Of the 1,668 coronavirus cases reported in the province so far, 1,097 are in Karachi. Most of the local transmission cases, currently estimated to be 1,037, have also been reported in Karachi.

Speaking to Dawn, health experts said the government should have ensured from day one that all positive cases being diagnosed were admitted to the designated isolation facilities, which should have been upgraded to a level that families had no reservations over their loved ones being admitted to those centres.

The continued rise in local transmission cases, they pointed out, could largely be blamed on Covid-19 patients who were either asymptomatic or reported with mild illness at hospitals and did not follow the medical guidelines at home.

“We can’t admit such patients as the hospital has limited space, which is meant for critical patients. Some of these patients are either referred to the Expo Centre or quarantine facilities in Gadap and Dumba Goth or asked to strictly adhere to certain guidelines to prevent spread of the virus at home.

1,200-bed field isolation hospital at the Expo Centre has fewer than 50 patients

“But, what we have seen is most people don’t follow the guidelines and maintain relations with family and friends, (which is resulting in spreading the infection in the family and community),” said Dr Samreen Sarfaraz, a leading infectious diseases consultant looking after the Covid-19 facility at the Indus Hospital.

These people, she said, were unable to understand why the disease was being described as serious because they had mild illness.

In addition, she said, people were still not convinced why it was important to offer prayers at home and attended religious gatherings.

Sharing similar concerns, Dr Abdul Ghafoor Shoro, representing the Pakistan Medical Association, asked why the 1,200-bed field isolation hospital at the Expo Centre was not being utilised for coronavirus patients.

“Still, the facility has fewer than 50 patients. It’s so much waste of human and financial resources,” he said.

On people’s reservations over isolation units, he said much of these concerns either had to do with false stories circulating on social media or factual reports that they watched on TV channels. “In both cases, it’s the government’s job to address public concerns and upgrade isolation facilities to a level that families and the patient feel comfortable there.”

Dr Qaiser Sajjad, also representing the PMA, criticised the government for designating four wards of the Civil Hospital Karachi, a major public sector tertiary care hospital of Sindh, and its OT Complex for coronavirus patients.

“Where would hundreds and thousands of non-Covid patients go now? The government should have made use of the existing isolation facilities for treatment of Covid-19 patients,” he said.

According to sources, the government has identified a number of sites in Karachi as isolation facilities.

They include 800 flats in Labour Colony of Malir district, a 25-bed hospital in Korangi, a 50-bed hospital in Faisal Colony and a 50-bed hospital in Mansoor Nagar.

However, the only isolation facility properly equipped is the field hospital set up at the Expo Centre being run with the support of the army and other public and private sector stakeholders.

“We can’t do forced admission to the isolation facilities. People are just not willing to get admitted to these units,” said health department spokesperson Atif Vighio, adding that the district health officers maintained a close contact with patients who opted for home isolation and received daily updates.

According to him, more than 400 patients are currently in ‘home isolation’ in Karachi alone.

Published in Dawn, April 16th, 2020

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