Covid care at Home

Owing to shortage of availability of beds in the city, Covid patients often are left with no option but to opt for home isolation packages 

As on April 26, there are 52,733 people with Covid-19 in home isolation in Delhi. The city reported 20,201 cases in the last 24 hours, it has in fact seen daily positive cases consistently above 20,000 since April 17, reaching a peak on April 20 with 28,395 positive cases. 

But with Delhi seeing massive surge in cases, mirrored across India, the Ministry of Health and Family welfare pointed out that 80% of Covid-19 cases are either asymptomatic or with mild symptoms — meaning they don’t require hospitalisation. But despite this, it’s not to say that some of those in home isolation are not forced into that predicament despite symptoms worsening, as Delhi is running out of beds.

According to the Delhi government, Covid bed website (coronabeds.jantasamvad.org) there are just 12 Covid-19 ICU beds remaining in the Capital city and 1,714 normal covid beds as of April 26. This number is also doubtful, as we found last week in our report that many of the ICU beds claimed on the website were unavailable. Reports by various news organisations, have shown patients outside hospitals, on pavements, in private ambulances, gasping for breath, with no beds inside.

There is a guideline in place from the Health Ministry which says that for hospital admission, patients with severity of symptoms will be given precedence over those with a mild or moderate range of symptoms. But even so, ones who are immune-compromised, like HIV patients, organ transplant recipients, those undergoing cancer therapy, and those aged more than 60 years should compulsorily be admitted to COVID Care Centre (CCC) even if they are mildly symptomatic and are not eligible for home isolation.

But people are finding themselves with no place to turn to as beds run out.

The silver lining, if one can call it that, are options for people with mild symptoms to be monitored and consultations online. There are private hospitals who offer home care facilities. We found this being offered by Medanta, Fortis, Max and Apollo hospitals.

We called Medanta hospital in Gurgaon enquiring on their home isolation packages, with it starting at Rs 4,900 for 15 days of care and going up to Rs 21,900.

The lowest in the package includes daily nurse monitoring, self-monitoring tool with built-in critical alert mechanism, for consultations with the doctor on the 3rd, 7th, 10th and 15th day, and a dietician consult. The other packages are for Rs 9,900, Rs 11,900, and Rs 21,900 which include equipment like pulse oximeter, which monitors the oxygen saturation level.  

A representative we spoke with said calls keep coming every hour “back-to-back” inquiring about these home isolation packages. The first in line of inquiries for Medanta’s online care, she tells us the package is determined by what level of care the individual requires.

“After I get a call, I inform my seniors who then take the next step. The patient will have to first consult with one of our doctors. And the doctor will look at all the reports and accordingly decide what sort of care would be appropriate.”

We also found Fortis offering what they call “Covid-19 Home Quarantine Packages.” In Delhi, Fortis in Shalimar Bagh – whose 218 Covid beds are full (and so are its 50 Covid ICU beds) – offers a Rs 6,000 package for a duration of 17 days. This includes app based real time monitoring, two telephone or video consultations with “Internal Medicine/Pulmonology” then a call with a psychologist, and then a guidance, they say on when to seek medical assistance.

Fortis Gurugram is giving more options with packages worth Rs 5,000 as well as Rs 6,000 with different help being provided.

The slightly cheaper category will get the patient an “App-based self-reported input to check Temperature, Heart Rate, Respiratory Rate, increase in symptoms & new symptoms”. They also have a Corona assistant, who they say will help in implementing home isolation protocols and unlimited access to Corona Helpline for query resolution. It even gives an Isolation kit with essentials like sanitizers, gloves, thermometer, disposable crockery.

But more importantly they would receive two doctors consultations, and in case of worsening of symptoms, they would receive access to Healthcare Professionals for discussion of their condition.

The Rs 6,000 package says it would give them a dedicated single point of contact, app-based, real-time monitoring of symptoms, 24×7 medical/nursing assistance, two telephone or video consults amongst others.

Then there’s Max healthcare which provides 10 Days Covid-19 Care at packages starting from Rs 500 per day. This includes doctor tele-review daily, vitals monitoring by trained nurses on call, twice every day, guidelines on self-monitoring, isolation, personal & home hygiene and Covid-19 medical kit with digital thermometer & SPo2 probe.

Their website says that more than 1,600 patients have been treated at home by them. The Delhi government website tells us that Max Super Speciality hospital at Patparganj has 276 Covid beds occupied with 25 vacant, while its Shalimar Bagh hospital has zero beds available out of the 242. For the ICU beds none of the 72 or 91, respectively, were available.

Lastly, Apollo’s home plans range from “Basic plan” for Rs 4,199 for 14 days, which gets the patient a physician every alternate day virtually and a nursing supervisor everyday over the phone.

Its “Advance plan” which they say is to “focus on clinical, emotional, dietary, mobility and immunity needs” comes at Rs 8,399 with the same as in the basic plan but including a motivational activity virtually every other day; “Tele Rehab”, with daily session virtually in week-1 to then alternatively in week 2. And then a dietician and a counsellor once a week.

These home isolation packages are an option to consider, with the mounting stress on a positive patient’s head on what is to come next. Another reason is to get some sort of direction on what therapy to take during a mild symptomatic phase, with people hoarding oxygen and Remdesivir when they don’t need it. Doctor Randeep Guleria, Director of All India Institute of Medical Sciences, while addressing concerns and issues related to Covid, pointed out that the shortage of oxygen and medicines was due to “hoarding” in homes.

 (Cover: A view inside an isolation ward at Eldeco Utopia housing society in Sector 93, on June 13, 2020 in Noida, India. The housing society has organised a five-room isolation ward for the residents in need of home quarantine. // Photo  via Getty Images )