Mandatory quarantine policy needs tightening

31 May, 2020 - 00:05 0 Views
Mandatory quarantine policy needs tightening

The Sunday Mail

With an overwhelming majority of the 160 cases of Covid-19 confirmed by yesterday being among returnees in quarantine centres, the value of the mandatory quarantine policy has been justified along with the regrettable need for compulsion.

The policy made sense from the beginning, since the lockdown was put into effect before Covid-19 had taken root in our communities, so it could be expected that the main danger was from citizens and residents returning from countries where the level of infection, and the subsequent risks of infection, were far higher.

This was especially so since most returning Zimbabweans were coming from countries and cities where Covid-19 had taken root.

Far more people were visiting or working in Cape Town, London or New York than were hiking through the central Sahara before they needed or wanted to come home.

But we did not have purpose-built or well-designed quarantine centres, and had to scramble to convert and equip other buildings, a bankrupt hotel in Beitbridge and the residential accommodation in closed colleges, eked out by the odd school dormitory.

And now, with scheduled phased reopening of universities, colleges and schools, the authorities are having to find alternatives, again in a hurry.

Already, a number of problems have emerged.

First, more than 100 of the quarantined people have left before finishing the absolute minimum of eight days and two negative tests.

That is a worry since some of those could well be infected and are able to spread the virus on their way home. Admittedly they had all undergone the initial screening and anyone who was ill was moved to a hospital, but the incubation period, and the fact that a decent fraction of infected people show few or no symptoms, means that some might not be identified until the second test.

Security at these makeshift quarantine centres was rudimentary and, in any case, fences and walls had been erected to keep thieves out rather than people in. Guests in a hotel and students in a college are allowed to wander in and out at will.

Secondly, and quite reasonably, the authorities expected adult Zimbabweans to co-operate in the quarantine process, seeking it more as a tiresome and irritating process rather than a tyrannical imposition of preventative detention.

And, to give our returning fellow citizens their due, the vast majority have seen it as just that.

There have been complaints, some more justified than others, and changes have been made as a result. One major change was to give priority in assigning the limited number of test kits to returning residents and to health staff at isolation hospitals and wards, meaning that extra delays were not introduced.

Giving residents of one quarantine centre the option of paying US$65 for a private test rather than wait for the delayed supplies for a free Government test was not a good call, and was reversed hurriedly.

It has also become apparent that some in quarantine centres were dishonest, not only wanting to get out too soon, but were also thieves, often released early from a prison because of the pandemic, just as Zimbabwe released a batch of non-violent prisoners early. And added to this small group were those Zimbabweans who had broken bail or fled the police here, and again they did not want to linger to have a cosy chat with a policeman. These are a small minority, but they have caused trouble way out of proportion to their numbers.

An additional danger that has arisen is the risk that living in a quarantine centre gives residents a far higher risk of infection than they would face at home. A quarantine centre is designed to find out who is sick so they are separated from those who are well. It is different from an isolation hospital, where everyone is either sick or is a member of the health staff.

This means that in a quarantine centre residents should not be crowded and, unless they belong to the same family or have otherwise been living together wherever they were before coming home, should not have to share rooms.

Screens and partitions in converted dormitories would be better than nothing.

The centre should have systematic programmes of disinfecting bathrooms, dining facilities and other common areas. Oddly enough in an isolation hospital, having large open wards is not nearly so much of a problem, since all patients are ill and cannot infect the infected.

Ideally, every returning resident in quarantine should have their own room, a lockable room with the resident holding the key so they can keep their suitcases secure.

Security at the quarantine centres must be tightened, but on the perimeter. A quarantine centre is not a prison and those made to live in one should not be treated as prisoners. Rather they must be given maximum possible freedom but simply not allowed out. So fences and gates are where security must be in place.

Some of the strain could be reduced by having a member of staff assigned daily to take shopping orders from residents for toiletries, take-away food, snacks, cigarettes, drinks and other needs or requests.

The residents would have to pay for these extras, but this could easily be arranged with deposits in advance, mobile money payments or some other suitable system.

Security for personal possessions, such as suitcases, laptops and the like, must be good if people have to live in hastily partitioned dormitories, but with frequent access.

And both returning citizens, and the community at large, need to be properly educated.

Returning residents are not criminals (well perhaps one percent are, but this is not general).

Regrettably, and necessarily, they have to be kept in quarantine.

The only freedom they have lost is freedom of movement, which the rest of us have lost to lesser and varying degrees during the lockdown, but otherwise need to be treated as law-abiding citizens with needs and rights.

And be kept securely but safely.

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