Anup K.C.
The global pandemic COVID-19 is spreading at an alarming rate posing a severe threat to public health and grippingnormal life of billions of people in almost210countries and territories. In wake of outbreak of highly contagious COVID-19, several countries across the globe have put the public under quarantine in an effort to stunt the spread of the coronavirus.
Quarantine is defined as a confinement or separation for those who apparently have been exposed with an agent or confirmed case of the disease. Quarantines are for such people or groups who don’t show any symptoms but have been exposed to the infected person(s). This practice will aid to monitorsymptoms of disease thus ensuring early diagnosis and treatment of the patients and preventing further spread. Contrary to this, isolation is a separation of symptomatic or diseased person from general public for treatment and prevention from transmission. Both isolation and quarantine can be either voluntary or imposed by authorities. Several governments have statutes on human quarantine during epidemic to safeguard public health.
In context that Nepaldoes not have predefined regulations to manage Isolation and Quarantine during outbreak of contagious disease, the Department of Immigration on 13th March issued measuresin line with the International Health Regulations (2005) to avert the spread of COVID-19. It states that anyone travelling from abroad is subjected to quarantine for at least 14 days effective from day of arrival.Foreign citizens including diplomats should follow self-quarantine measures while Nepali citizens including Non-Resident Nepalis (NRN) and foreigners entering Nepal are subjected to home quarantine. In addition to it, a division bench of Supreme Court has issuedan interim orderin the name of government to ensure WHO standard quarantine facilities for foreign returnees .
All three tiers of government have set up quarantine facilities to house people exposed to COVID-19 cases. Health officials are urging people be in quarantine as per WHO guidelines. However it has been felt that our government has failed to effectively communicate what has been mentioned in the WHO guidelines. With the increase in incidence of the disease, the importance of being in quarantine is being increased.
A recent news report on The Kathmandu Post read that foreign returnees kept in quarantine are not following social distancing measure and are sharing a same bed, cigrattees, tobaccos and many things. There are many other instances where measures in quarantines are poorly followed. In such case, there is greater possibility of cross-transmission eventually leading to massive outbreak of COVID-19 and all the efforts including long lock down of state will go on vain.
The WHO has warned that if due process is not followed, quarantine may lead to further contamination and spread of the disease. The WHO’s guidanceon quarantine of individualsrecommends to providewater for personal hygiene including frequent handwashing, providing medical assistance and nutritious foods and asking to maintainsocial distancingas part of Infection Prevention and Control (IPC) measures. In case single rooms are not available, beds must be kept at least 1meter apart. The IPC measuresfurther mentions to washing clothes with soap ordetergents; cleaning surfaces likes areas of kitchen, washbasins, toilet,taps, lock of door and gadgets with disinfectants; and waste disposal in sanitary landfill. The cleaning personnelare instructed to wear gloves while cleaning or handling body excretion with a need to wash hand with soap water before and after wearing gloves.
The quarantined person must maintain personal hygiene measures. Daily follow-up with medical care, special medical arrangement for person with immune suppressed and comorbidities, and referral mechanism of suspected COVID-19case are other essentials should be considered duringquarantine. Regardless of any signs and symptoms of COVID-19,every quarantined personis subjected to laboratory test when the quarantine duration ends.
Most importantly, in order to limit the psychological distress, anxiety, loneliness, depression, negative feelings and fear of infection associated with long-term quarantine,psychosocial counselling withthe adequate supplies of basic needs, information about disease, regular communication with family andaccess to social mediashould be assured. Despite the unprecedented situation caused by global outbreak of COVID-19, the government must adhere to its responsibility of ensuring citizen's Right to emergency services, Right to information and provide special care to disabled, elderly and marginalized people without any discrimination.
- The author is an MSc. in Bio-statistics and Epidemiology from SRM University, India.