With the Delhi government ramping up testing, the number of COVID-19 positive cases in the city is creating new records almost on a daily basis. There is also a group, including some medical professionals, who feel that the virus will eventually get to each of us, or at least most of us, and we should just stay prepared and reasonably cautious, without getting into panic mode.
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So how shall we manage and what can we expect, if we test positive for the virus?
According to the new rules announced by Delhi Chief Minister Arvind Kejriwal on June 22nd, home quarantine is the way forward for most people even if they test positive. Only those with moderate to severe symptoms, and those with comorbidities, will be directed to Covid Care Centres and dedicated hospitals of their choice. Medical officers will take a call on what’s next for those who test positive.
While there are fewer complaints of beds not being available—possibly because of the emphasis on home quarantine—getting an ambulance still remains a challenge.
Rates for treatment in private facilities have been notified by the Delhi government, and in all likelihood, the hospital you go to will have these displayed. A government official is also present in the private hospitals, to deal with any issues that may arise.
Be informed, be prepared
1. People in Delhi who test coronavirus positive through a lab-based swab test will be contacted by a health department official, who will guide the patient first to a government centre for a medical officer to assess whether they qualify for home isolation or need hospitalisation.
2. Anyone who tests positive through a rapid antigen test will be assessed by a doctor at the testing centre itself or at centres in their vicinity.
3. The medical officer will determine how severe the patient’s COVID-19 infection is and will also check for co-morbidities.
4. Asymptomatic or mild cases, or positive cases with no symptoms, will be considered for home isolation.
5. A separate team will determine if a person’s home is fit for quarantine. If their home does not qualify, then even mild or asymptomatic cases will be transferred to a care centre.
Is your home fit for home quarantine? For home isolation, a person's apartment must have at least two rooms and separate toilets so that family members and neighbours are protected. They will be counselled by health department officials, and if a separate room with a toilet is not available at home for the exclusive use of the patient, he or she will be directed to a Covid Care Centre.
6. All home isolation cases will be contacted telephonically for nine days by a team, who can either be from health centres or are students from various medical colleges. This will be followed up through tele-consultations. While the health department will call up regularly, patients are provided a list of numbers that they can call for prescription of medicines, details of when to take the temperature, diet etc
Patients allowed home isolation would be provided pulse oximeters by the medical officer at the testing centre which they need to return after they are discharged. Which normally is 10 days after they first test positive.
7. All moderate and severe cases will be transferred to Covid Care Centres or dedicated COVID Hospitals, depending on the medical officer’s assessment.
8. Patients and their attendants can choose the hospital convenient to them, from a list they will be shown. While some patients may want a private facility, the number of beds in government hospitals is more.
From June 4th, all COVID hospitals have been directed to shift patients from the ambulance or whichever vehicle the patient is arriving in, to the triage area, no questions asked, within 15 minutes. The order also provides for bed or sitting space depending on the patient’s condition. The doctor is expected to attend to the patient within 60 minutes, “depending on the urgency of requirement of treatment”.
If a bed with the required level of facilities—eg oxygen, ventilator—is not available at the hospital where a patient arrives, it will be that hospital’s responsibility to transfer the patient to another hospital having the necessary facilities, and provide medical treatment till then.
From June 26th, government COVID hospitals like LNJP have been directed to allow one attendant per patient in an earmarked area, and CCTVs installed in wards, for monitoring purposes.
9. Patients who are asymptomatic but have other health conditions like diabetes, blood pressure, lung diseases etc, will also be directed to stay at Covid Care Centres or hospitals of their choice.
10. Treatment will be according to the latest guidelines issued to the hospitals and Covid Care Centres. But they will undergo regular temperature and pulse oximetry monitoring, and discharged after 10 days of onset of symptom or no fever for three days, without any testing prior to discharge. Patients will be advised to isolate themselves at home and self-monitor their health for the next seven days.
11. If the oxygen saturation dips below 95% while at the Covid Care Centre, the patient will be moved to a dedicated COVID hospital.
12. If symptoms of fever, cough or breathing difficulty shows up after being discharged from the Covid Care Centre, the patient has to contact the Centre or the state helpline or 1075. In any case, the patient’s health will be followed up through teleconference on the 14th day.
13. Private hospitals like Max, Medanta and Fortis are offering “Home Care” packages for COVID patients
14. Of course, people testing positive should have already checked out their health insurance policies, packed their bags, and arranged all their IDs, credit or debit cards, cash, and devices (phone, laptops and chargers), books, biscuits, herbal infusions, steamers, electric kettles etc. handy.