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?