One month after the Prayut Chan-o-cha government launched its home and community quarantine programme for people infected with Covid-19, the system is found to have so many flaws that infections are soaring, with a surge in fatalities, some of whom were left dying at home without proper care.
The rise in home deaths concerns mainly most vulnerable people, like stay-at-home elderly, who had no access to health services. It triggered a public outcry. On July 30, there were 21 cases of home deaths.
At the same time, infections hit a record yesterday, surpassing the 20,000 threshold with another 522 "probable cases,'' which require further RT-PCR testing to confirm if they contracted the virus.
Initially, the Public Health Ministry wanted all infected people, including those with mild or no symptoms, to be admitted to field hospitals.
However, a sharp increase in infections following the Thong Lor cluster in April, forced the agency to adopt the more practical home and community isolation programme, spearheaded by the National Health Security Office (NHSO) in collaboration with the Department of Medical Services (DMS).
In theory, the programme is ideal, with active case finding through rapid antigen test kits (ATK) and a follow-up mechanism for each stay-at-home patient who is required to contact the NHSO at its 1330 hotline.
The home isolation programme includes three meals a day, a thermometer, and oxygen test device and medicines. Health personnel are assigned to conduct telemedicine with the patient on a daily basis. Should these stay-at-home patients not recover, they will be transferred to community isolation centres and field hospitals.
Yet in practice, several infected people complained they were left in the cold, as the NHSO hotline is always busy. Those who were lucky enough to get through only received voice mail messages, with no return calls.
Attempts to contact other health agencies through the hotlines were also futile. With these flaws, several people with mild or no symptoms found their health deteriorating and needed hospital beds which were mostly not available.
A pharmacist who self-tested positive through an AKT said she tried to call the NHSO and like other desperate patients, waited for return calls from the office and other agencies for seven days and finally gave up. She treated herself and is now recovering.
A volunteer doctor, who works at a private hospital, said medical supplies are ample, but the system is so overwhelmed that patients can't get access to the service.
He said with the sluggish distribution of medicine, there will be more deaths in the home quarantine group.
What is needed is more medicine distribution centres at the community level, that will give infected people better access. The centres should be streamlined, with well-designed queuing and a clear communication system to prevent chaos. This is just one solution.
Home isolation with an efficient telemedicine system is key to solving the crisis at a time when hospital beds are in short supply.
Hospitals across the country must be prepared to support home isolation programmes given the sharp rise in infection cases.
Prime Minister Prayut, with absolute power stipulated by the emergency decree, must step in and provide every support to the NHSO and ensure the home isolation programme is not trapped in a predicament which will see more loss of lives.