Health experts for institutional quarantine

Medical professionals have proposed mandatory institutional quarantine centres, limitation of movement and re-educating the citizenry as measures to tame rising cases of coronavirus in the country.

The Society of Medical Doctors (SDM), Physicians Assistants Union of Malawi (Paum) and National Organisation of Nurses Midwives (Nonm) agree that the current situation was expected due to failure to handle returnees and political campaign rallies that defied all preventive protocols.

Cumulatively, by June 30 2020, Malawi had recorded 1 265 cases; including 16 deaths with 639 imported infections and local transmissions pegged at 581. There are 45 cases under investigation.

In an interview yesterday, SDM president Dr Victor Mithi said the political rallies provided a fertile ground for transmission of Covid-19 with the potential of people who contracted the disease and ignored all self-quarantine protocols transmitting the same to others.

He said: “People’s understanding of the disease is different. If you tell them to have self-quarantine it is proving to be difficult. So, having institutional quarantine would be ideal and the best thing to do. Government has designated quarantine spaces in most districts.

“Where we are going, we need to start thinking. Is self-quarantine going to be a reasonable thing to proceed with? If we say we need institutional quarantine, we also need to ask ourselves: do we have the resources to implement that? All stakeholders have to be involved because money will be required. It would be ideal to have designated quarantine centres.”

He said having failed to fully manage returnees in the past, government should draw lessons and start implementing best practices such as institutional quarantine for them, apart from other measures.

Said Mithi: “We should expect the numbers to continue increasing up to end July, and maybe we will have numbers going down. It is also a concern for us as doctors that many health workers are being infected; it’s all because most of them have not had enough personal protective equipment.

“The new government has a lot of work to do to re-educate people into following protocols on how to prevent Covid-19. The political environment was breaking that, but now we are over it. There is also need for institutional quarantine for all returnees.”

On his part, Nonm president Shouts Simeza said Malawians returning from South Africa needed to be in the country, but authorities failed to ensure that those who tested positive are looked after, leading to all protocols being ignored.

He said government should control movement of people and ensure that quarantine centres in hospitals become functional with the help of resources that donors provided to the country for the Covid-19 fight.

“Let us limit contacts of people by controlling travel. We can’t just be in a free-range system anymore. It’s not helping. And if we do that; let there be social protection measures for the most vulnerable. Institutional quarantine is yet another important step,” said Simeza.

In a separate interview, Paum president Dr Solomon Chomba said government needs to clear off existing myths of Covid-19 by reaffirming its existence to both health care workers and community members.

He also said managers of health facilities should be transparent to disclose their Covid-19 status of their employees as did Dr Mwatikonda Mbendera of Nkhata Bay. He said this helps workers to adopt ways of preventing cross infection from their fellows.

Said Chomba: “It is also evident that most patients under self-quarantine do not stay home, but are seen moving around in market places and interacting with friends thereby posing a serious danger of further spreading Covid-19. These patients, especially the symptomatic ones, develop high fevers and some nasty symptoms, which can ably be attended to at an institutional quarantine unlike self-quarantine.”

Ministry of Health spokesperson Joshua Malango said he needed to consult on the suggestions, especially on institutional quarantine.

Earlier, Presidential Task Force on Covid-19 co-chairperson Dr John Phuka said as technical people they were awaiting guidance from the new leadership.

He said new infections show that many people are getting the virus from workplaces; hence, the need for institutions and individuals to play a greater role in ensuring that the virus is tamed.