Regular Quarantine Not Required: Delhi Hospitals Ask Doctors To Vacate Quarantine Accommodation

At a time when the country is dealing with an unprecedented pandemic and a humanitarian crisis, in a series of statements issued on May 18 and 20, the state-run Lok Nayak Jai Prakash Narayan Hospital and Dr Ram Manohar Lohiya Hospital asked its doctors and health staff working in COVID-19 wards to vacate the accommodations provided by the hospitals by 12 noon on May 21.

The order was issued by hospital authorities under the directions issued by Secretary of the Health and Family Welfare on May 18.

The order by the LNJP Hospital dated May 20, stated that ¡°regular quarantine of health care workers after performing duty in COVID-19 areas is not warranted,¡± therefore asking staff on quarantine to vacate the accommodation provided in hotels and dharamshalas across the national capital.

The letter further stated that ¡°all categories of staff on quarantine are directed to vacate the hospital-provided accommodations in hotels/dharamshala latest by 12 noon tomorrow, 21st of May, 2020.

The order issued by the authorities asking doctors and health care workers to vacate accommodations.

The hospital authorities also denied bearing any extra costs if incurred by the staff in quarantine beyond the time mentioned in the circular.

¡°The hospital will not bear any extra charges accrued thereafter and the same shall be borne by the guests overstaying,¡± it said.

¡°I am really upset with this new order for the doctors not to be quarantined anymore after their duty. I stay in a hostel. We would not only be risking the spread to the hostel people/mess workers/campus residents, but also to the senior faculty, who are very vulnerable. I am worried about my fellow colleagues who have to go home to their elderly parents or pregnant wives or small children.¡±

¡°We do not want and never asked to be quarantined in a hotel, we just want a place for us to be quarantined after the duty, so that our family can be safe. I hope the petals showered on us do mean something and the government doesn't treat their ¡°corona warriors¡± in this way,¡± Rohit Sharma (name changed), a resident doctor, told Indiatimes.

There are many others who share similar sentiments.

According to the World Health Organisation (WHO) and Indian Council of Medical Research (ICMR) guidelines, doctors in Mumbai were given a schedule of seven working and 14 days of quarantine, considering the 14-day incubation period of the virus. However, later the number of days in quarantine were reduced for resident doctors, raising concerns and fear among doctors of standing exposed to the deadly virus as they contonue to work in COVID-19 hospitals.

The circular, signed by the two, stated, ¡°It was unanimously agreed that if we follow the pattern of 67% work and 33% off, the manpower will not be adequate to run the necessary amount of beds which are required for treating the critically ill patients.¡±

The order added, ¡°Unanimous decision was to give two days off after five days of continuous work. This is applicable for resident doctors only.¡±

Many doctors have cited lack of funds and lack of adequate understanding in the administration regarding the spread. Few have also pointed out the dilution of previous recommendations because of the increasing COVID spread and inability to control it.

Sharma adds that the Delhi government has levied 70 per cent tax on alcohol to earn money, which directly points at inadequate funds to fight the virus.

¡°With many of the doctors and other health care workers turning positive despite wearing the PPE and ensuring proper social distancing norms within the hospital...... This order is totally unacceptable and stupid! They are not respecting the infectivity of the virus. This also says lots and lots about the quality of the PPEs they provide,¡± another doctor told Indiatimes on the condition of anonymity.

Health care workers in contact with COVID patients for under 15 mins is "low-risk exposure"

A directive issued by Delhi's Health and Family Welfare Department dated May 18, explains a ¡°high-risk exposure¡± and a ¡°low-risk exposure¡± for medical staff attending to COVID positive patients.

A health care worker would be under the "high-risk exposure" category if he/she "without masks/face shield/goggles has a face to face contact with a COVID-19 case within one metre for more than 15 minutes or is exposed to body fluids accidentally."

A "low risk exposure is one which does not meet the high-risk criteria."

Photo of excerpt from the order managing HCWs

The doctors said that directive is quite bizarre. "According to the classification, any exposure to a COVID positive patient without a mask under 15 minutes, qualifies as "low-risk exposure," this is rather peculiar,¡± said one.

The government of Karnataka also issued a similar directive on May 16 stating that high-risk contacts will be home quarantined for 14 days and tested as per ICMR testing protocol.The order mentioned that "there is no necessity of keeping health care workers with high-risk exposure in institutional quarantine. It added that low-risk contacts "shall continue to work. They will self-monitor their health for development of symptoms. In case symptoms develop, they shall be managed as per laid down protocol in the MoHFW guidelines.

The World Health Organisation has recommended a designated quarantine for health care workers who are at high risk for infection. It also says that HCWs at high risk for infection be provided compensation for the period of quarantine and for the duration of illness.

As of May 20, the total number of confirmed coronavirus cases in India tand at 1,06,750. The death toll from the outbreak in the country is at 3,303.

Disclaimer: Indiatimes reached out to other doctors but could not get a comment. The article will be updated once we have more responses.