Dr Harsh Vardhan
Union Minister of Health and Family Welfare
Ministry of Health and Family Welfare
Re: Concern with regard to isolation and quarantine of patients suspected of or diagnosed with Coronavirus (COVID-19)
We, the undersigned persons/ organizations, are concerned with regard to the rights of persons suspected of or diagnosed with the COVID-19 virus, who are being quarantined or are kept in isolation. We are aware that COVID-19 is a public health crisis and measures need to be taken by the State to ensure its containment. Isolation or quarantining in facilities or at home are now being used routinely with complete disregard to their circumstances and impact. Moreover, isolation and quarantining of persons suspected of or diagnosed with COVID-19 should be as the last resort, as part of management or prevention of the infection, following certain procedures that are detailed later in this letter. Isolation and quarantine are therefore to be implemented with the utmost care, with cognizance of the rights and consent of those for whom this may be necessary after all options have been considered.
There have been media reports of abysmal facilities at the quarantine centres. The reports state that these spaces are filthy and have blocked toilets and no proper drainage. Use of such places to quarantine persons who are suspected to or diagnosed with COVID-19 is outrageous and must be discontinued.
The processes of isolation and quarantine must ensure that:
- The basic rights of the person to food, water, clean sanitation, electricity and good health care facilities should not be breached.
- All the places identified as isolation or quarantine centres should have the basic facilities, and the persons who are under observation must not be forced to stay in places that do not adhere to the basic standards of hygiene and health. Such a situation may cause the person to take adverse steps such as leaving the facility which would consequently harm the person and may potentially expose others to the disease.
- Strict confidentiality should be maintained by all institutions or facilities being used as quarantine centres or isolation wards. The health workers, the health care providers, and the persons in authority should ensure that the rights of these persons and their families are not violated in any way. .
- Assessment should be made of individuals who are being home quarantined, if they have all the basic facilities in their home, and it should be ensured that they are provided all the social support in terms of availability of groceries, food, and most importantly counseling for mental support.
- For those who live in very small homes with many people, and home quarantine may lead to risk of transmission, other places designated by the government for quarantine could be used. Local panchayats, ASHAs, and others may be involved to support their day to day needs. Needless to state that all those involved in such support should not be forced to do so and they along with all health care providers should be provided with the essential gear to protect themselves.
- At the airports, stamping persons does not serve the purpose of preventing the spread of the infection. Instead, it violates their privacy and stigmatizes them and should therefore be discontinued. People should be counseled and taught how to take complete precaution and the importance and reasons for staying isolated for a period of time. Further, passengers who are advised home quarantine, and stay in places far away from the airport where they have landed, it is essential that the designated health department vehicles take them to their homes, so that they do not use public transport. There have been reports of people trying to reach their homes in trains and buses.
- Care needs to be provided to the sick, including for their mental health. They should be allowed to be in touch with their family and near ones on the phone or otherwise.
- Counselling facilities should be made available at all the quarantine and isolation centres, to address any mental health concerns that they may have or might emerge. Evidence indicates that isolation and quarantine may result in mental health issues such as depression, fear or thoughts of suicide, etc.
We urge you to consider the above mentioned measures and direct the State governments to uphold the rights of all persons who may require or are currently undergoing isolation or quarantine as a last resort. Urgent measures are also necessary to ensure that there is no breach of confidentiality of persons in isolation or quarantined in facilities or at home.
These are imperative for the people’s confidence in the health system.
Jan Swasthya Abhiyan