Emran Hossain | New Age May 09,2020
Virologists and public health experts warned that the new clinical management guideline enabling the release of COVID-19 patients with mild symptoms from hospitals would turn poor neighbourhoods into coronavirus hotspots.
They shared their fear with New Age after the health services directorate in its daily online press briefing on Friday revealed for the first time the conditions set in the new guideline for the release of COVID-19 patients from hospital.
‘The technical committee has set a number of conditions for the release of COVID-19 patients from hospitals,’ announced health services additional director general Nasima Sultana as the press briefing began.
A man or woman could be released from hospital if they recovered from fever and did not need any medication for it and other respiratory infection symptoms such as dry cough has decreased remarkably, she said.
The new guideline proposes to check through tests if the viral infection is still present in the patient before releasing them but it was not mandatory in case of those showing mild symptoms for three days, she said.
Nasima said that such patients must stay in isolation at home or designated places for 14 days and then undergo tests to find out if they are still carrying the coronavirus.
‘This makes it clear that the government has decided to release patients before they are free of coronavirus,’ said public health expert Rashid-e-Mahbub.
He said that the rich and middle-class people could afford to self-isolate at home but for the poor living in cramped shanties and houses self-isolation is out of question.
‘The government should make clear its plan about managing the health of the poor COVID-19 patients,’ he said.
‘I believe that the infection will increase among the poor in the coming days,’ said Rashid.
The World Health Organisation initially confirmed that the new coronavirus, which causes the disease COVID-19, could spread if an infected person sneezed in the open.
Later numerous studies revealed that the virus could stay viable on surfaces up to three days.
‘Other studies revealed that the new coronavirus could remain viable in a scrotum for 39 days and in stool for 10 days,’ said Dhaka Medical College virology department’s associate professor Monira Pervin.
‘The symptoms might look mild in an infected person but the virus he or she is carrying is still highly infectious,’ she said.
Over four million people live in decrepit neighbourhoods in slums and slum-like conditions in Dhaka alone where toilet is always shared, often among dozens of families.
The housing garment factory workers stay in is overcrowded with a dozen or more people using the same room at a time.
About 70 per cent homes in villages are still made of temporary materials and the toilets they use are often in conditions that cannot be sanitised.
Monira said that households able to dedicate separate toilet for COVID-19 patients might still find it difficult to keep the spread of the virus in check because the infected person secrets it in billions.
She said that the high infection rate in Canada and the US might be attributed to the extent to which the culture of sharing toilet among family members existed in those countries.
‘There are many weaknesses in the concept of isolation at home,’ she said.
Another problem faced by many middle-class COVID-19 patients is that they were thrown out of their rented houses, even the physicians were not spared.
The formulation of the new guideline saw a surge in the number of patients registered as recovered in the government estimate.
In the 24 hours until Friday, 191 people were released from government hospitals though the daily recovery figures were in single digits until May 2 since the first COVID-19 case was detected on March 8.
The recovery rate jumped from 2 per cent to 16 per cent in the gap of a week until Friday.
‘The new guideline was formulated to relieve hospitals of some stress,’ said MA Faiz, a member of the technical committee for clinical management guideline for COVID-19 patient.
‘People have to take some responsibility too. At the end of the day this is about their health,’ he said.