COVID-19 third wave: Reverse Quarantine is need of the hour

The most widely-adopted method of curtailing the spread of Covid-19 is quarantine.

home quarantine
Studies have shown that quarantine reduces the risk of contracting COVID-19 by 44–81 percent and mortality by 31–63 percent. (Photo source: IE)

By Dr. Hirennappa B. Udnur,

COVID-19 has played havoc with people of all groups around the world. However, studies have shown that older people, people with diabetes, hypertension, lung disease, kidney disease, and people who are immunocompromised are at higher risk of severe illness and death from SARS-CoV-2 infection.

The most widely-adopted method of curtailing the spread of Covid-19 is quarantine. Studies have shown that quarantine reduces the risk of contracting COVID-19 by 44–81 percent and mortality by 31–63 percent.

However, there is another effective mode of curtailing the spread of Covid-19. And that is reverse quarantine. Reverse quarantine involves separating those who are likely to develop severe illness (vulnerable population) from others not so much at risk, in order to reduce associated mortality and morbidity. The vulnerable population, typically the older people and the ones with comorbidities, should be kept away from the younger adults in the family who would be going out of their homes to do their jobs and may come in contact with all sorts of people, including sick ones. These younger adults may even consider living in a separate residence until risk is reduced. This vulnerable set of the population should also be kept away from attending public gatherings. Doctors say that the elderly and those who are immunocompromised are at risk of severe illness due to COVID, and to avoid that people need to practice reverse quarantine and stay away from elderly and immunosuppressive people for a period.

With Delta and Omicron cases increasing, there is a very urgent need for people to be more careful. With omicron cases increasing now, the Delta has decreased.  There have been many instances where people with sore throat, cough or cold, have avoided quarantining themselves thinking that it may have been triggered by a cold drink, or getting drenched in the rain. This could be a potential threat because Omicron is asymptomatic. The mortality rate of Omicron 1/4th of the earlier delta or other variants so far. But the risk of complications is high in the elderly immunocompromised. Protecting the elderly is vital as omicron is not causing bad complications in vaccinations in general.

How does reverse quarantine work?

  1. Visitors should be kept at a minimum in areas where the elderly and other vulnerable people live. This includes limiting visits from relatives, neighbours, and social visits from those who come in contact with a number of people on a daily basis.
  2. Each family member must do their part to reduce the likelihood of bringing the virus into the home. Working from home can help limit the exposure of younger family members to potential sources of infection.
  3. If there are vulnerable family members at home, healthcare providers working in areas with increased risk of infection, might wish to consider a temporary alternative residence, and return after a period of self-quarantine.
  4. It can be difficult to get children to adhere to all social distancing and hygiene norms. They could potentially act as virus carriers in the household without becoming ill themselves. Children may be kept from interacting with children from other homes until the crisis has passed.
  5. Washing hands before and after providing physical assistance is an effective practical step for the designated caregiver.
  6. Temporary residence or separate room in existing house and n95 mask and social distancing.

Limitations of reverse quarantine

However, it is difficult to implement reverse quarantine in a densely populated country like India with a substantial percentage of multigenerational families. A sizable portion of the population lives in cramped quarters where social distancing is quite impossible. Younger adults may not have the financial resources to purchase / rent a second home. Also, reverse quarantine can hardly be a viable option if a vulnerable person is the only earning member of the family.

To summarise, despite its limitations, reverse quarantine is a promising strategy for reducing morbidity and mortality associated with COVID-19.

(The author is with Interventional Pulmonology deptt, Critical care and sleep, Manipal Hospitals, Hebbal. The article is for informational purposes only. Please consult medical experts and health professionals before starting any therapy, medication and/or remedy. Views expressed are personal and do not reflect the official position or policy of the Financial Express Online.)

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