Covid-19: Chennai widens home quarantine eligibility

P Rajan, a 26-year-old supervisor in a cargo company on furlough, begins his day attending a roll call at the corporation ward office at 7.30 am. He then goes around in his two-wheeler to the six streets assigned to him in ward no. 76 of Thiru-Vi-Ka Nagar, one of the most densely populated localities in Chennai which has reported more than 3,981 Covid-19 positive cases and 81 deaths, where he checks on 11 families under home quarantine.

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He is among the 3,500 young volunteers, contracted since mid-June till September by the Greater Chennai Corporation (GCC) to monitor and support 18 different categories of people under home quarantine.

Volunteers, who range from college students to office-goers are called FOCUS (Friend of Covid Person Under Surveillance).

They form part of a strategy developed by the GCC that is pegged on home quarantining even those who are likely to be infected to prevent the spread of the coronavirus disease (Covid-19). Chennai accounts for 66.5% of the total number of Tamil Nadu’s cases, and is among the top five cities in the country in terms of case-load.

This comes at a time when the state placed Chennai, Kancheepuram, Tiruvallur and Chengalpet -- the worst affected districts -- under complete lockdown till June 30.

Earlier this month, Chennai’s civic body developed 18 categories, comprising mixed groups of people, under their new uniform strategy called home quarantine and isolation monitoring system (HQIMS).

These include those awaiting Covid-19 test results, positive patients undergoing home treatment, discharged patients, international and domestic passengers coming via flights, trains, road or sea, family and extended contacts, and people with influenza-like illness identified through the 500-odd fever clinics run by the corporation, among others.

Most people in these categories are already mandated to be in 14-day isolation, but it has widened the net on who must undergo isolation.

“Home quarantine is the crux in controlling an epidemic,” says Dr Prabhdeep Kaur, deputy director, National Institute of Epidemiology and one of the members of the state appointed medical panel to assist in the government’s Covid-19 management. “If people follow it properly and they are monitored and supported, it can be very effective in reducing transmission.”

Currently 117,000 homes in Chennai are under HQIMS. The cyclical strategy of 14-days of home quarantine makes these numbers dynamic and at any point 250,000 houses out of 1.075 million houses in the city are expected to be under quarantine and volunteers will be scaled up proportionately.

This new system was developed to keep up with the evolving situation of the pandemic. “In April, all positive patients were treated at the hospital. The concept of home quarantine for treatment progressed at a later stage,” says the corporation’s deputy commissioner for revenue and finance, Meghanathan Reddy who is overseeing this project.

In the early days of the pandemic, larger geographical areas were designated as containment zones. This was later limited to rows of streets and then half a street. But the virus continued to spread internally when people interacted inside the quarantine zones or slipped outside. Also when lockdown restrictions eased, officials found it harder to control movement. So barricading specific homes became more effective. The only challenge was to ensure a family’s basic needs were met while they stayed inside which is now addressed through thousands of these volunteers. Several states have roped in citizens to help out with the health crisis brought on by the coronavirus pandemic, including Delhi.

Rajan lives in ward 75 in Thiru-Vi-Ka Nagar and signed up to be a volunteer for the ward adjacent to his on June 15 (I’ve changed to 15). He delivers groceries, picks up prescriptions and arranges for the garbage disposal, by calling up the conservancy worker once the yellow bags (meant for disposal of Covid-19 waste) are full. But the bulk of his work involves pleading with families under quarantine and their neighbours to wear masks and maintain social distance during interactions. The volunteers also engage with other field workers of the corporation, such as the medical team that conducts fever camps every day, (and a team of surveyors) going door-to-door with thermal scanners.

“I wanted to help in some way when I saw news reports of sufferings across the world and of our people walking back home to their native states,” Rajan said. “I just put myself in the position of these affected families. If my family had to be isolation, who will help us? That’s how I go about serving these families,” he said.

His family was worried about the risk of infection. “My mother was the most worried, but they understood,” he said. The corporation has provided gloves and masks for the Focus volunteers, and he carries a sanitiser too. They carry ID cards issued by the corporation.

“Every day we get data of 10,000-15,000 people who need to be home quarantined under various categories,” Reddy said. “We send that data to the various zones who forward it to the volunteers.”

Each volunteer is assigned anywhere from five to 10 streets for the city’s 200 wards. They are paid Rs 500 a day. The volunteers  file details in a booklet which is collected by ward level officers and sent back to the HQIMS desk at the corporation headquarters.

This system is only for those who can effectively isolate themselves at home. For those who don’t have facilities like separate bathrooms for instance, their contacts are taken to quarantine facilities, and those who test positive for the infection are either kept in hospitals, or healthcare centres and Covid care centres, depending on the severity of the symptoms.

“Even if there is 70% accuracy, we are limiting lakhs of people from going out and transmitting the virus,” GCC commissioner G Prakash said about the HQIMS, adding, “Under these categories, we are able to isolate people who are positive, possibly positive and potential carriers.”