COVID-19 | Case for reverse quarantine to keep the elderly safe

Public health experts for quarantining specific geographic locality to look for community transmission

The death of a 68-year-old man owing to COVID-19 at Pothencode, near here, without any evidence of how he could have contracted the infection has thrown open the possibility that silent transmission of the disease could be happening in the community. However, one can clearly establish community transmission only when more such cases surface in the community.

Isolated cases

“One has to move away from the assumption that total prevention of COVID-19 is possible and accept that despite the best efforts, isolated cases with no known source will turn up in the community. Our best bet would be to try and contain the spread to a specific geographic locality and reduce the speed of transmission through stringent social distancing and lockdown measures. Low-level community transmission might actually render herd immunity to the community but special measures will have to be taken to protect the elderly during this time,” a public health expert said.

He pointed out that the significance of the route map of the deceased was more an indication of the places he could have acquired the infection from. For every single case of infection with unknown source, there will be several with mild infection and scores of those who are asymptomatic.

Geographic location

“In such situations, a core geographic location should be fixed, based on the recent activities and local travel history of the deceased. After leaving a good buffer zone around this area, all people within this geographic circle should be quarantined and all those with respiratory symptoms (if the infection has been passed on, symptoms would surface after the median incubation period) should be tested for COVID-19. Another strategy which should be immediately implemented wherever possible is reverse quarantine, wherein the elderly should be protected by keeping them separate from the rest of the people within homes and preventing anyone from introducing an infection to them,” a senior epidemiologist said.

Ideally, a hospital should be included within the circle of quarantined area, where facility to collect samples, oxygen facility, and appropriate ventilation should be arranged, where those who develop symptoms can be isolated and treated, rather than move them all to busier hospitals where there is risk of cross infection to other patients.

The Health Department has already swung into action and has locked down Pothencode and three adjacent panchayats for the next three weeks and people have been asked to stay at home.