Our Encounter with Omicron and the System

Keshav’s wrongful confinement in a mandatory institutional quarantine against the mandate of existing guidelines as far as I as a lawyer and my advocate understands and denial of Fortis to let him take a RTPCR test has been simply one of the biggest dark hours of my life. I for the first time realized what total helplessness feels like. I understood hopelessness in its full glory and got to know first-hand what happens to a system if is run by people who lack compassion, are apathetic and on top of that would do well with a bit of more integrity, intelligence and maturity. You feel trapped, dazed and actually disenfranchised. The feeling became much worse when we could not convince the court in the first hearing that the government should be asked to follow their own guidelines strictly. We had approached it as a last resort. I would have been happy if I thought we had been given a hearing and then denied what we were asking for. Anyway, that’s where we were, directionless and didn’t know what next. On the second hearing we got some respite and the court asked the hospital to do the RTPCR. We are feeling a bit relieved but still a little apprehensive after what we have been through and hoping for the best so that the new year brings much deserved freedom to my son. During the course of this ordeal, I found very few people in the system (who I had to interact with) who had a voice, a spine, some courage and also a pinch of integrity. To me though it was not a revelation but surely I didn’t expect the situation to be so bad. Voice, spine, courage and integrity together I knew would be rare but had no clue that it is almost near extinct. People want to save their own skin, can only look after their own interests and do their jobs in a clinical manner without any compunction, without having any regard to the fact that they are dealing with real people, like their own children and family are. It’s absolutely amazing to see how indifferent, insensitive, ruthless and drunk people can be on their authority without sparing a thought for a moment that everything is transitory including the power and authority they enjoy by virtue of the position they occupy. On the positive note, I found people amongst our friends and acquaintances who had the balls to stand with us, by us and who could find time from their busy schedules, in this hour of our ordeal. I salute them all and want to place our gratitude on record as without them, this journey would have been lonely and much more tough. Tops among them would be my advocate, Vikram Hegde. I hardly knew him, we worked together pro bono, on a matter, two years ago and kept in touch since then. A young, sharp and an articulate lawyer from National Law School Bangalore, who I bonded well with, when we met and continued to exchange news items, views and opinions on matters of mutual interest since then. When I didn’t know what next could I do to help my son, to get him justice, after having explored all possibilities which included meeting hospital authorities, bureaucrats and politicians and make them see reason, I thought of filing a writ petition in the High Court of Delhi. I don’t know why, the first name that cropped up in my mind was, Vikram. I know a lot of other lawyers and close friends who also I am sure could have helped but I chose to stick to Vikram for some reason which I also have no clue about. I called him and told him everything and without any hesitation and without losing a second this gentleman said he would help me and then in the next one hour we were sitting in his office. This was December 28th 2021 and Keshav had been inside the quarantine facility for five days. Vikram made sure the matter got listed after being admitted as urgent the very next day. I don’t have words to describe how respectful, sensitive and empathetic this gentleman is. He made us feel absolutely comfortable and gave us some hope at a time when nothing seemed to work. We discussed the pros and cons of approaching the High Court but decided that since the only downside is that we might not get the relief we are seeking. However, we thought that there is no harm in trying, as we stand a good chance to get some relief given the conviction we had about the merit of our case. Maybe we could make the court see our point and get Keshav out earlier than he normally would be in the messy circumstances that we were trapped in. Vikram had no reason to go out of his way, to do what he did. On top of everything he remained accessible to us all the time, open to everything we had to say, responded to every single message that we sent without any delay and was as committed and invested in the matter to get relief for my son as we were as parents. I could feel his sincerity. There was no personal gain for him in this matter, he didn’t owe anything to us but he became our biggest support system. Vikram please continue to be who you are and I bet you will go far. A lot of people have caliber and a lot of them are hard-working also but you on top of that have qualities that are hard to find and makes you stand out and the combination of all these attributes will take you to the top. Every day that Keshav was spending in that quarantine was like a slap on my face because I saw it as perpetuation of a wrong that was being done to him and as a mother, as a lawyer, I could not do anything. To me it was like incarceration and the court only could give the bail orders which it didn’t the first day of hearing. Our family, cousins, friends and colleagues from college, Oxford, work, my husband’s friends all tried but to no avail. Some of them rallied around us and called us almost every day and came up with probable solutions on their own and tried whatever they could. I never expected such an overwhelming support and so much concern and empathy. This goodwill kept us afloat while we were fighting a hopeless battle. Every dark cloud has a silver lining and ours was kind hearted, helpful people around us. After the court order today, which directed the hospital to do the RTPCR and asked the GOI and Government of Delhi to produce his G sequencing test, I can finally breathe and sleep easy.

Management of Omicron - Need for more Rationality and empathy

The management of Omicron in the National Capital of Delhi is proving to be ominous especially for people who are testing positive at Indira Gandhi International Airport and are coming in from the so called “high risk countries”. As per the details available, following is the list of officially recognised high risk countries as of 9th December 2021 when it was last updated. List of Countries from where travellers would need to follow additional measures on arrival in India, including post-arrival testing (Countries at-risk) 1. Countries in Europe including The United Kingdom 2. South Africa 3. Brazil 4. Botswana 5. China 6. Ghana 7. Mauritius 8. New Zealand 9. Zimbabwe 10. Tanzania 11. Hong Kong 12. Israel The situation has dramatically changed since then and our understanding of this “variant of concern” has also been enhanced. The reports and studies coming in from various sources have been saying that this variant is definitely more transmissible but not dangerous. The data for hospitalisation rates across the world and in India speaks for itself. What is beyond comprehension is that since the whole world now is under the grip of this new variant, why are people who are testing positive on arrival only from these select countries are required to undergo mandatory institutional quarantine? Why other countries are not being put on this list and tested on arrival, if we are so serious about tracking omicron? Why people in India who are testing positive but have no travel history, not being made to undergo gene sequencing test and then undergo mandatory quarantine? The institutional quarantine for people who test positive from these select high risk countries on arrival here at the international airport lasts till the gene sequencing report establishes it is not omicron, meaning if it is delta (or any other variant) which by the way has been very dangerous and we have witnessed it first hand in the summer of 2021 -, a person will be released and can do home quarantine. However, if it is Omicron the person concerned has to mandatorily do institutional quarantine till she/he tests negative, irrespective of whether the person concerned is absolutely asymptomatic with very low viral load thus requiring no medical help or intervention; there is no option for home quarantine in these cases. I understand there is a policy lag in every government, but in times of disaster and pandemic policy has to keep pace with new developments and ground realities. How does it make sense for keeping people in mandatory institutional quarantine who are Omicron positive, especially people with low viral load and are totally asymptomatic that too only those who are coming from an outdated list of select high risk countries? Is it not time to re-evaluate this policy and update it to bring in conformity with the ground reality around the world and also with the knowledge that has emerged vis a vis this new variant of concern? Why do we need to cramp our hospital beds with people who can safely quarantine at home and need no medical attention? Why should such people be made to undergo this ordeal when no other country in the world is doing that since by now there is widespread understanding that it is not required and advisable? Why shouldn’t only those people who need medical assistance go to hospital whatever the variant is? To make the matters worse the gene sequencing test report which determines your fate is being done in a very opaque manner. Patients don’t have any information about which lab it is being conducted in and how much time would the report take. It could be anything from a few days to two weeks or may be more, leading to mental trauma and anguish in people who are trapped in institutional quarantine, amongst which are very young students coming home for their vacations. Another aspect of this whole saga is the money involved. If you choose to quarantine in a private facility that the government has designated and apparently has fixed price for, you could end up paying much more than what the government has fixed if you choose to claim cashless insurance. There is a confusion about cashless medical insurance transaction Vs if you chose to pay the hospital upfront and then get it reimbursed. Choosing private facility over a government hospital is a Catch-22 situation. While the government facilities follow all the protocols and guidelines they mostly can’t keep the facility clean and hygienic; now asking for that can’t be termed elite as it is a basic human necessity and also by the way a fundamental right of every person, if that matters. If one chooses to go to a private facility it is comparatively better in terms of infrastructure and cleaniness, but the processes and protocols are the main casualty. You are totally at the mercy of the hospital and their doctors. Can the policy makers please wake up and rationalise the whole process? Can we please acknowledge, without hurting our pride, as has been acknowledged across the world that while Omicron while may be more transmissible it is definitely less dangerous and therefore not requiring institutionally quarantining. Can we please have a more transparent process for G sequencing, and can it be done in a time bound manner while keeping the patient in the loop? Can we please have all Omicron positives coming from all the countries in the world and not just the “so called dated high risk countries” and also Omicron positives we already have in India, treated equally? Can we please monitor the private designated Covid facilities more closely so that they don’t innovate, manipulate and do tricks to bypass the government mandate for payment in any event?