Experts say that as testing and contact-tracing of COVID-19 cases continue, support for people forced to self-isolate must not slack.
This is the conclusion of a study published in the peer-reviewed online journal, BMJ, titled, ‘COVID-19: Why test and trace will fail without support for self-isolation.’
It may be recalled that the Nigeria Centre for Disease Control, in collaboration with the Federal Ministry of Health, had developed a patient’s handbook for home-based care of mild COVID-19 cases.
Since the beginning of the COVID-19 pandemic, Nigeria has been managing confirmed COVID-19 cases in government designated hospital-based isolation/treatment centres to ensure recovery of cases as well as to prevent community transmission.
As the pandemic has evolved, there is an increasing number of people who are asymptomatic or present with mild symptoms. To reduce the pressure on resources in treatment centres and ensure these resources are sufficient for people with moderate to severe symptoms, home-based care has been introduced.
According to the NCDC, home-based self-isolation is “when a patient confirmed to have COVID-19 by a laboratory test is mandated to restrict activities and movement to a room in their home.”
It says that in households where more than one family member is confirmed to have tested positive for COVID-19, it is advisable that family members form cohorts within the household, to limit the risk of cross-infection.
“During the entire period of home-based isolation, the patient is required to refrain from going to public places such as workplaces, schools, markets, churches, mosques, meetings, etc.; and they are also advised to avoid using public transport like buses, taxis etc., among requirements.
According to the NCDC, “Eligibility for home-based care will be determined by a health care worker.
“The criteria include: any patient below 60 years old who is clinically stable, no history of a noncommunicable disease asymptomatic or mild symptoms; normal oxygen saturation; has available space for optimal self-isolation; or any patient discharged from treatment centres for home care. This is to allow them to complete their isolation period,” NCDC added.
Those who present with severe symptoms or comorbidities are not eligible for self-isolation, NCDC says.
And, should symptoms worsen, patients are advised to contact the State Case Management Team immediately.
Daily, the agency states the number of COVID-19 patients who are being managed in the communities, noting that their treatment is managed in line with COVID-19 protocol guidelines.
As of Tuesday, the NCDC says, those treated and discharged from home-based care include “744 community recoveries in Lagos State, 100 in Rivers State, 78 in Plateau State, 72 in Kaduna State and two in Benue State.”
Using the UK model, co-author of the publication in peer-reviewed online journal, BMJ, Muge Cevik, warns that, “Economically marginalised communities generally cannot simply choose immediately to modify their transmission networks through changes to their living or working contexts in the absence of specific support.”
The publication notes that COVID-19 is known to have disproportionately affected the poorest in society, often in jobs that either cannot be done from home or are unstable, or in industries such as hospitality that are not stable enough to survive the closures that lockdowns and social distancing have wrought.
“To stop working and isolate is to cut off your livelihood with immediate effect,” Cevik, who researches infectious diseases at the University of St Andrews, says.
The researchers say it is not only financial support to stop working that is needed. “People also need help to prevent spreading the virus to others in their households,” they warn.
Continuing, Cevik says, “This is a concern for those needing to self-isolate who have tested positive or been in contact with a positive case, as well as for [healthcare] and other key workers who want to protect their families from potential exposure. Or, indeed, those who live in accommodation too small or unsuitable to isolate properly from the rest of the household.”
“Without support, self-isolation — a key pillar of the test, track, and isolate plan to slow the spread of COVID-19 — simply doesn’t work,” the study warns.
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