Many home isolation patients reporting to hospitals after symptoms worsen

 thehindu.com  09/16/2020 18:07:34 

When 56-year-old Maqsood Ahmed from Bhoopsandra tested positive for COVID-19, he was quick to opt for home isolation. A diabetic, he assumed his mild symptoms were negligible and that he could recover easily at home. But on the fifth day, he developed complications and his oxygen saturation dropped drastically. The family had to call the BBMP helpline requesting admission.

This is not an isolated case. Volunteer doctors assisting the BBMP in triaging positive patients said they are getting at least 10 to 15 calls a day seeking admission from patients who had earlier refused hospitalisation. This apart, many are going to private hospitals directly after their symptoms worsened following five to six days of home isolation.

When we call the patients after their reports turn positive, most go out of the way to explain that they have as many rooms as the number of cases in the family. Last week, a family of seven tested positive and they said they have seven rooms. It is unfortunate that patients are not honest when we do a tele-assessment of their symptoms and hide several facts, said Nihad Niloufer, a volunteer doctor from StepOne, a group assisting the BBMP.

Poornima S., another doctor from the group, said a 69-year-old obese patient from Kanakapura road, who has been on continuous positive airway pressure therapy machine for sleep apnea for the last 10 years, did not reveal this during the tele-consultation. After three days, his son called saying the patient had developed severe breathing problems, she said.

Mohammed Rafiuddin Rashid, COVID care consultant at HBS Hospital in the city, said in the last one week, he had seen at least 60 patients whose conditions deteriorated a few days into home isolation.

Attributing it to negligence on the part of the patients, Dr. Rashid said: It is unfortunate that people dont realise that oxygen is not the only treatment needed for COVID-19 patients. People can develop heart and neurological complications, which can turn fatal. I have seen three home isolation patients die in our casualty last week due to cardiac and other complications.

Ameen Muddasar, volunteer from Emergency Response Team, a group that helps and guides COVID-19 patients to get admission, said: We have been getting several calls from home isolated patients seeking admission. It is unfortunate that some are not taking the home isolation concept seriously.

C.N. Manjunath, nodal officer for labs and testing in the States COVID-19 task force, said the viral load in some patients can increase after the fifth day and that is the reason for some under home isolation turning critical. We are seeing many low-risk patients crossing over to high risk. People should watch out for breathlessness and fatigue, apart from saturation and heart rate, he said.

Risk assessment

It is important that the risk assessment of all patients who choose home isolation is done in detail. Even mildly symptomatic patients can have hidden complications. Soon after they test positive, patients should undergo a chest X-ray. Their inflammatory markers such as D-dimer and C-reactive Protein should be tested based on which a decision on home isolation or hospitalisation should be taken, Dr. Manjunath said. During home isolation, patients should regularly monitor pulse rate and heart rate. If the heart rate is more than 110-120 along with low oxygen saturation, it is a matter of concern, he added.

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