The news was hit by death of a prominent musician, Manu Dibango, known for his ability to play jazz music, whilst self isolating at home. He was one of the initial victims of Covid-19. Deaths of prominent persons as well as those that are not so prominent have been reported.
One of the managements of Covid-19, following a diagnosis is self isolation. Whether this is associated with overall improvement in outcomes has continued to be a subject of discussions.
THE PROBLEM
Self isolation is an act by which an individual imposes a voluntary withdrawal from physical contact with other persons, with aim to decrease their chance of infection by a pathogen. In the current period, the pathogen is Covid-19 virus. This intervention has been utilised in order to:
reduce community transmission of Covid
reduce clogging the health care system
reduce overall population death rate from the virus and its complications
Wether above objectives are being achieved over long term, remains to be demonstrated.
However, what is known is the fact that whenever lock down is imposed in a community, cases of Covid tend to decline and the health systems are eased to attend to other diseases. Once the restrictions are relaxed, there has been rebound effects - which have required repeated lock downs in several western countries.
Self isolation is however, not without consequences.
Whereas the WHO's definition of health states that, "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity", it seems the focus of attention of governments at the moment is on physical health. Mental and social well-being is relegated to the background.
Social isolation is not an innocent phenomenon. Some clinicians have identified the fact that Social isolation is associated with increased morbidity from chronic diseases and carries with it a high all-cause mortality. Detrimental health behaviours, such as smoking and reduced physical activity may mediate over 30% of this effect (https://blogs.bmj.com/bmj/2020/04/09/the-effects-of-isolation-on-the-physical-and-mental-health-of-older-adults/).
The manner and process of self isolation could be made in such a humane manner, and with understanding of local resources rather than a one-size-fits-all phenomenon.
In some instances, once the results of the covid test has been sighted by the health care personnel, a phone call is immediately made to the victim and most of the communication leaves the person despondent. The attention is getting "rid" of the victim from the rest of "healthy" persons, without adequate plans to safeguard deterioration of the person that has become unwell.
The attention is getting "rid" of the victim from the rest of "healthy" persons, without adequate plans to safeguard deterioration of the person that has become unwell.
It is suggested that an individualised and comprehensive approach is embarked upon, in order to support return to health of any covid virus infected person.
RECOMMENDATIONS
The flow-chart below represents my thinking process as to what is practical, taking into account different access to resources, health care delivery systems, social security infrastructure as well as transport accesses. In other words, it is unlikely to be successful, if the process of self isolation that is being carried out in a developed country is fully transplanted to a developing country without modification.
There is a definite risk of progression of disease, following resolution of initial symptoms of covid, due to what is commonly referred to as the cytokine storm. Those with initial mild symptoms are often sent to stay at an isolation centre, with plan to report if their symptoms are getting worse, before active transfer and intervention in hospital is embarked upon. This process is however, not suitable for every person and or location.
Owing to overcrowding and poor accessibility to healthcare facilities, the use of special facilities and hospitals would be ideal for developing countries. There however, remains a small portion of the population that would be suitable to stay in their own homes and who can have enough rooms, able to recognise own symptoms and or organise urgent help. The presence and support support for victims of covid can mitigate the gap in social and mental healthcare everyone is entitled to.
GENERIC ACTIONS FOR SELF-ISOLATING INDIVIDUALS
Rest - Get some rest. Catch up on some lost time. Read your favourable book, literature or game. Watch a movie, comedy or sermon.
Eat - Eat a balanced diet. A colourful dish is often rich. Ensure servings of fruits and vegetables. Get some multivitamins into your gut.
Check - Check your temperature, pulse rate, and oxygen saturation (if you have a pulse oximeter). You must not have these. But if you start getting unwell, alert someone close by.
Talk - Talk to people. There is no gain in remaining secretive about what may end up becoming public. It is only a fool that does not shout for help, when there is still strength to do so. Talk on telephone (the person on the other end of the phone can assess how you are sounding, and may alert you, if any concerns)
Meditate - Think about life. Think positive thoughts. Think about your responsibility to yourself and to others. Take deliberate deep breaths - inspire and expire deeply, to check that you lungs are expanding well.
Exercise - Move your limbs. Covid comes with increased tendency for blood to clots in their vessels. Exercise to the extend that your energy permits. This will hasten recovery.
Cover - Cover your mouth and nostrils when you come into contact with the rest of people. This does not matter whether they have the infection or not. There are variants of the virus, and you do not want to acquire another variant of the infection whilst recovering from the one you were infected by.
Seek health/call - Seek care. It is often others that recognise the dangers you are going through. Do not trust your judgement when it comes to seeking care. This applies to health care professionals as well as non professionals.
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