Bed shortage prompts new isolation plan

Bed shortage prompts new isolation plan

People express mixed feelings about home confinement

Workers clean a new field hospital opened on Friday at the 11th Army Circle on Chaengwattana Road in Bangkok. (Photo: Chanat Katanyu)
Workers clean a new field hospital opened on Friday at the 11th Army Circle on Chaengwattana Road in Bangkok. (Photo: Chanat Katanyu)

Isolating at home may help ease the kingdom's hospital bed shortage but some Covid-19 patients are worried as the disease can suddenly turn deadly.

"It only took seven days for my wife to go from coughs to deadly pneumonia and me five days to being on the brink of ICU [Intensive Care Unit] care," said a former Covid-19 patient who asked to only be identified as Tong.

"Covid-19 is very dangerous. It can quickly develop into a severe condition," Mr Tong said. "We cannot underestimate it."

As the Public Health Ministry prepares to roll out its home isolation project for Covid-19 patients exhibiting few to no symptoms, Mr Tong said the plan is risky because a patient's condition could quickly worsen, and without close monitoring by medical staff, the disease can be fatal.

The ministry is encouraging some Covid-19 patients to recover at home in response to the kingdom's bed shortage. Its technology-aided home isolation programme for mild or asymptomatic Covid-19 patients will meet hospital treatment standards, according to the ministry's Department of Medical Services.

Since April, over 200,000 people have been infected by the coronavirus, and almost 50,000 are still being treated at hospitals and field hospitals.

The care and treatment for the patients in this project includes regular medical check-ups via telemedicine services. The necessary medical equipment and free daily meals are to be delivered to the patients at home.

"I would suggest that the medical team be very careful when selecting which patients are suitable for home treatment," Mr Tong said.

"It is true that some patients only suffer very mild symptoms, but there is still a considerable risk of the disease escalating. [Patients] can also infect others -- those who live with them."

Bank, a 32-year-old man who has recovered from Covid-19, agreed that it is better for patients to be close to doctors because the deadly virus can very quickly affect the lungs.

A delayed medical response could make conditions dangerous, he said.

Kannikar, another to have recovered from Covid-19, however, said she decided to join the ministry's project because her condition was not severe. She said that as a nurse, she knew how to take care of herself.

"I want people to know that home isolation is not something bad," Ms Kannikar said. "You are still being closely monitored by a medical team."

"The best thing [about the project] is that you have more privacy when you are at home," she added.

According to Dr Manus Potaporn, deputy chief of the ministry's Department of Medical Sciences, the department has issued guidelines for home isolation for Covid-19 patients with mild or no symptoms.

He said patients who qualify for the project must have no chronic diseases and be younger than 60.

Currently, patients in Bangkok -- where hospital bed shortages are most severe -- are being targeted for the home isolation project.

Dr Manus said home isolation should not be the primary method for medical treatment, but is an option for patients, although it is not suitable for everyone.

"Patients who are self-isolating at home should live alone or with as few family members as possible. Doctors will decide who gets to stay home, and whether a patient is qualified to do so or not, he said.

He added that his department is also working with the Bangkok Metropolitan Administration to set up a community project that would allow infected patients to isolate at schools or temples, if approved.

These patients would be taken care of via a telemedicine system.

Nimit Tien-udom, member of an NHSO board committee, believes that, as a rule, all coronavirus patients must be treated in hospital.

However, he agreed that some patients can be treated at home if their condition is not severe due to bed shortages.

Mr Nimit noted that the project needs to have an emergency transfer system in case the condition of patients at home worsens.

He said the COM-Covid-19 Network, where he is a coordinator, supports community isolation, adding that at least 70 leaders from 23 communities in Bangkok have already been trained to cope with the disease.

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