GURUGRAM: A man walks into a hotel, folder in hand, and tells the receptionist he has Covid-19. His scooter is parked outside — that’s how he got here. Not in an ambulance. After a few minutes and a quick glance through the Covid test report, he is shown the way to his room.
The man is asymptomatic. He has no symptoms but he does have Covid-19. But he is not in breach of any rule when he makes his way to an isolation facility while coming in contact with several other people along the way. Tracing the steps from the time a person feels the need to get tested to the time the person recovers is replete with gaps — in protocol and in implementation.
In mid-May, the Centre had said Covid-19 patients with mild or no symptoms can isolate themselves at home or in paid facilities instead of hospitals, whose resources could then be exclusively used for critical patients. “But until four days ago, there was no directive from the health department on how a government-run paid isolation facility has to be availed. Finally, they were told to take in only those patients who have been referred by the health department,” a doctor at one such isolation facility told TOI. The man who had simply turned up at the hotel to get admitted, the doctor said, must have “gotten himself tested at a private lab and then headed to the government isolation facility on his own.”
Gurugram has 1,066 rooms for institutional isolation — 688 in 15 government-paid facilities and 378 in nine hotels. As of Sunday evening, Gurugram had 1,998 active cases but only 474 in hospital. That means the MCG and district officials have to monitor 1,525 patients who are in home isolation or paid isolation.
And the problems start right with the first step — seeking a test. Anyone who wants to be tested for Covid-19 has to call the government helpline or a private lab and the sample will be collected at home. But in many cases, people get to the lab on their own to get tested, coming in contact with people along the way and expanding the contact chain.
Between the test and the results coming in, those tested should be asked to stay in home quarantine (earlier, they would only be quarantined in institutions). But there is no way to make sure that happens. Test results take about two to three days to come in, during which a person who has the infection can end up spreading it. “We are working to shorten the testing time to 48 hours,” said Gurugram chief medical officer Dr Virender Yadav.
Meanwhile, the lab that conducts the test has to pass on the information to MCG, which then follows up with the lab about the results. Every lab has to use an RT-PCR app (named after the primary Covid-19 test in use across India) to enter patient information in real-time. Here, another problem comes up. Because there is no authentication process, TOI found out that many people end up giving wrong or fake numbers and addresses. So when MCG tries to get in touch with them about their test results, they can’t be reached. So far, TOI has learnt, 100 such Covid-19 patients in Gurugram are untraceable. The MCG has set up teams to look for them.
For the patients who are notified and asked to stay in isolation, two sets of problems come up. The first, specific to paid isolation centres, is how the patient gets there. If a patient at an isolation centre develops symptoms, a doctor at a government facility said, the district administration moves them to a hospital. But there are no guidelines to mandate ambulances or administration-managed transportation for asymptomatic patients going to an isolation facility.
The second problem, like in the interim between tests and results, is monitoring. “It is difficult to keep tabs on people in isolation. Our teams call them every day to check on them, but it is not easy to ensure they follow protocols,” CMO Yadav acknowledged. At paid isolation facilities, a senior MCG official said, sometimes patients “just don’t listen”. He went on: “I was on a routine visit to a government paid isolation centre and saw a Covid patient walking along the corridor with an empty bottle. I asked why he had stepped out. He said he needed water. I asked him to go back and call the reception. But this is a recurring problem.”
With 80% of the cases in Gurugram turning out to be asymptomatic, the strategy has to be in place, health officials told additional chief secretary in a meeting recently. “The administration will launch a campaign encouraging home isolation,” an official said. Gurugram added 169 cases on Sunday to reach a count of 3,294.
The man is asymptomatic. He has no symptoms but he does have Covid-19. But he is not in breach of any rule when he makes his way to an isolation facility while coming in contact with several other people along the way. Tracing the steps from the time a person feels the need to get tested to the time the person recovers is replete with gaps — in protocol and in implementation.
In mid-May, the Centre had said Covid-19 patients with mild or no symptoms can isolate themselves at home or in paid facilities instead of hospitals, whose resources could then be exclusively used for critical patients. “But until four days ago, there was no directive from the health department on how a government-run paid isolation facility has to be availed. Finally, they were told to take in only those patients who have been referred by the health department,” a doctor at one such isolation facility told TOI. The man who had simply turned up at the hotel to get admitted, the doctor said, must have “gotten himself tested at a private lab and then headed to the government isolation facility on his own.”
Gurugram has 1,066 rooms for institutional isolation — 688 in 15 government-paid facilities and 378 in nine hotels. As of Sunday evening, Gurugram had 1,998 active cases but only 474 in hospital. That means the MCG and district officials have to monitor 1,525 patients who are in home isolation or paid isolation.
And the problems start right with the first step — seeking a test. Anyone who wants to be tested for Covid-19 has to call the government helpline or a private lab and the sample will be collected at home. But in many cases, people get to the lab on their own to get tested, coming in contact with people along the way and expanding the contact chain.
Between the test and the results coming in, those tested should be asked to stay in home quarantine (earlier, they would only be quarantined in institutions). But there is no way to make sure that happens. Test results take about two to three days to come in, during which a person who has the infection can end up spreading it. “We are working to shorten the testing time to 48 hours,” said Gurugram chief medical officer Dr Virender Yadav.
Meanwhile, the lab that conducts the test has to pass on the information to MCG, which then follows up with the lab about the results. Every lab has to use an RT-PCR app (named after the primary Covid-19 test in use across India) to enter patient information in real-time. Here, another problem comes up. Because there is no authentication process, TOI found out that many people end up giving wrong or fake numbers and addresses. So when MCG tries to get in touch with them about their test results, they can’t be reached. So far, TOI has learnt, 100 such Covid-19 patients in Gurugram are untraceable. The MCG has set up teams to look for them.
For the patients who are notified and asked to stay in isolation, two sets of problems come up. The first, specific to paid isolation centres, is how the patient gets there. If a patient at an isolation centre develops symptoms, a doctor at a government facility said, the district administration moves them to a hospital. But there are no guidelines to mandate ambulances or administration-managed transportation for asymptomatic patients going to an isolation facility.
The second problem, like in the interim between tests and results, is monitoring. “It is difficult to keep tabs on people in isolation. Our teams call them every day to check on them, but it is not easy to ensure they follow protocols,” CMO Yadav acknowledged. At paid isolation facilities, a senior MCG official said, sometimes patients “just don’t listen”. He went on: “I was on a routine visit to a government paid isolation centre and saw a Covid patient walking along the corridor with an empty bottle. I asked why he had stepped out. He said he needed water. I asked him to go back and call the reception. But this is a recurring problem.”
With 80% of the cases in Gurugram turning out to be asymptomatic, the strategy has to be in place, health officials told additional chief secretary in a meeting recently. “The administration will launch a campaign encouraging home isolation,” an official said. Gurugram added 169 cases on Sunday to reach a count of 3,294.
