THERE is no proven preventive or curative intervention available as yet for COVID-19 that has brought social and economic life to a standstill. The World Health Organisation has, therefore, recommended that governments should develop a response plan with three steps in focus — test, treat and trace. Government plans appear to be mired in missteps and mismanagement in each of the three steps. The number of COVID-19 tests has significantly increased, but treatment and contact tracing still take place without any locally developed standards. Health services directorate general records of Friday show 20,065 cases of infection and 3,882 cases of recovery, with 298 death. Of the 16,878 active cases, only 6.41 per cent are cared for in hospital, which suggests a large majority of the infected people taking treatment at home. Patients with mild symptoms being treated at home complain that the Institute of Epidemiology, Disease Control and Research or other authorities have just left them alone; patient follow-up barely exists; and recovery confirmation repeat test is often denied. This gives an insight into treatment protocol failure that government should attend to.
COVID-19 patients treated at home require regular medical advice, follow-up and a thorough consultation with healthcare providers to trace everyone the patients may have come in contact with. The institute is expected to contact COVID-19 patients for contact tracing, but many report that the only communication they have with the institute is about their infection status and the officials have not brushed aside the allegation. They acknowledge their failure that they are not doing contact tracing rigorously because of mass transmission of the infection. Given the COVID-19 crisis magnitude and plans to relax mitigation efforts, communities need a large number of trained contact tracers to quickly locate the patients, assist in isolation and work with patients to identify people having been in close contact with them. Not only the authorities have failed to adequately bring patients at home under the healthcare purview, they have recently announced that patients having no symptoms could be declared cured without confirmation tests. Public health experts and virologists find the decision to be reckless as this would lead to a higher risk of community transmission.
The reality of COVID-19 outbreak counters the government claim of adequate preparedness as health managers are far from putting in place an effective testing, treatment or contact tracing mechanism. The number of infected cases is increasing, with more than a thousand being now confirmed a day. It is not too late for the government to collaborate with the private sector, both on financial and human resources fronts, to ensure trained teams of healthcare providers for quality home care for COVID-19 and contact tracers to locate and monitor infection symptoms in community.