Self-quarantine not effective, govt must arrange residential quarantine

We have to work according to the guidelines of the World Health Organisation, the US Centres for Disease Control and Prevention, and the Chinese Centre for Disease Control and Prevention (for experience). 

People are talking about home quarantine. Actually there is no term as "home quarantine". It should be "self-quarantine" or isolating oneself completely. 

Self-quarantine means that one has to stay in one's own room, not just in the home because many other people live in the home. If anyone is in self-quarantine, they will have to stay in a room with an attached bathroom. However, in our villages rooms with an attached bathroom are rare. 

For self-quarantine, one has to isolate oneself from others, and isolate one's bedroom and bathroom. Are these facilities available in our villages? If not, letting a quarantined person mingle in society will be very risky for us.

When we send any expatriate returning from a coronavirus-affected country to their village home, we must make sure that they are indeed in self-quarantine. 

I personally will not advise self-quarantine if the Bangladesh government's healthcare system does not have any mechanism that can ensure self-quarantine. 

Self-quarantine is also not effective in preventing the coronavirus infection. The government should therefore arrange large residential quarantines at their expense. .

There are also questions about the place where the residential quarantine will be set up. It will definitely not be in a hospital where other patients and their relatives will also stay. The quarantine should also not be set up at any place that is visited by healthcare officials and even cleaners. 

China has set up separate temporary hospitals at places such as stadiums, gymnasiums and open spaces.

The residential quarantine should be placed outside any area having a high population density. It should also be kept highly sanitised at all times. There should also be provisions for isolation, quarantine and hospital facilities. 

The people who the government has released might be quarantined in the stadiums in their respective districts. If that is not possible, separate hospitals have to be built for quarantine, isolation and treatment of coronavirus-infected patients. 

There should be four health teams. Three of them will perform duty on eight-hour shifts, and the other will be a reserve team.  The entire team, from doctors to cleaners, must stay there for as long as they are required. If anyone leaves the place, they will go through a 14-day quarantine. The director of the hospital will grant them leave after the quarantine period is over. Or else, they must continue performing their duty.

Only conducting tests in the IEDCR is not enough. Since Dhaka City is so densely populated, all coronavirus suspects who have not shown any symptoms yet must also be tested.

What is being done at present is on a very limited scale.  Necessary facilities must be arranged in several medical colleges and in the Bangabandhu Sheikh Mujib Medical University as early as possible. This is because we have to be prepared.

Bio-safety labs also have to be established in medical colleges at the divisional level. 

There is also a need for tests after the collection of samples in a scientific way, transplantation and preservation at the IEDCR. This entire procedure must be ensured. If the testing facility can be made available in the division-level and at the medical colleges, it will be easy to monitor the process. 

If there is no quality management, the situation might turn worse. We do not have any scope to be complacent. 

The army can be given the responsibility of the residential quarantine, as they have the experience of building field hospitals.

The Ministry of Health and Family Welfare has got an allocation of Tk50 crore to tackle coronavirus. The ministry must specify the priorities. Issues such as laboratories, kits, quarantine systems and health manpower need to be tackled urgent.

If enough laboratories and kits are available, quarantine is done properly, and health personnel are properly trained, it will be possible to face any probable outbreak. We can, and we must do it.

Prof Muzaherul Huq, is an health expert.