QUARANTINE

‘Quarantine’ is defined a strict isolation imposed to prevent the spread of disease. It is a state, period or place of isolation in which people or animals that have arrived from elsewhere or been exposed to infectious or contagious disease are placed.

The first time I had heard the word was at an impressionable age when I was young and growing up. I heard it from my father. We were in Munnar. I was in the Lower Primary School where the medium of instruction was Malayalam. I am speaking of a Munnar still ruled by the English even after the independence where no one could ever dream of an education in the English Medium.

Papa had served the British at Singapore. He went there in search of a job. The foray preceded the Second World War. He was happy when he was selected for a job at the Naval Base. Soon the War began. The Japanese took over the Naval Base. It was forced labour under the Japanese. There was no escape. Somehow he survived the hardships and when the War ended he managed to reach India. He was forced by his parents to stay back. He was dissuaded from a  return to Singapore for employment. Sentiments ruled over reality. I believe he rued it till he passed away in 2008.

Papa relished recalling stories of his life at Singapore. The stories gave us a much bigger and more than life size image of him. In one of his stories, he exposed us to ‘Quarantine’ and what it meant. It was harsh.

With the relentless onslaught of Covid -19 ‘Quarantine’ has surfaced once again. It is ‘Quarantine’ anywhere and everywhere. The initiated and the uninitiated into the English Language, the language of our much hated oppressors of the past, have learned the hard lesson what ‘Quarantine’ is in the hardest way.

Well, today I am afraid to reveal if I suffer from even a cold. I am afraid to sneeze or cough. I could be quarantined. That too for a lengthy fourteen days coupled with an extension of yet another fourteen days. It is all for the good of humanity and for my own safety, I am told. I am already under reverse quarantine. I understand I would come off it once Herd Immunity is developed. When it would be, no one knows. People like me aged over 65 and children below 10 are locked in. My fundamental rights remain suspended on that count.

Posters proscribing the entry of the reverse quarantined into shops and public spaces are displayed prominently. The guard at the entrance closely scrutinizes all who attempt to enter and forbids the reverse quarantined.

When the Lockdown was initially implemented in March 2020 we were discussing what we would do in case someone at home fell ill and had to seek medical intervention. We learned many Hospitals were literally dissuading patients from approaching them unless it was an emergency. The pandemic had ensured the closure of some hospitals with limited manpower.  

Life went on smoothly till the 8^th of June. It was a tornado that had hit us on that day. Our Mother, 95 years and 96 to be in August suddenly developed breathlessness. She was in good health till then. We had ensured that she had periodic medical attention. She had been on drugs advised by the doctors.

As her condition worsened we took her at once to a private hospital.  They looked after her well. Little did we know that it would be three admissions to the hospital for her in as many weeks. There were complications. She was finally discharged on 3^rd July on abatement of the original disorder but with a severe disability. She was totally bedridden. She still is.  The Doctor assured us that the disability would wear off as time progressed.  He said it occurred since she had been totally confined to the bed for a fortnight. With the knowledgeable, one cannot cavil nor lampoon.

While we stayed in the Hospital attending to the patient we could hear persistent alerts on the P A System on Novel Corona Virus. They left no stone unturned in the combat. No one was allowed to enter the Hospital without approaching the Corona desk where the Receptionists were at once aggressive and invasive to prise out information or recent history of the entrants.

The strong arm measures enlightened us Corona is a vicious adversary. Fatality becomes a distinct possibility if it is ignored. We did some research on the pandemic and the cost of treatment. We found to our dismay the cost was prohibitive and unaffordable to the average Indian.   If the three or four members of a family are unfortunately struck by the virus it would cast a very heavy economic burden on the family no matter if they survive or succumb. They would lose everything they have.

Here is an insight into the pricing of the medicines to counter Covid-19. Hetero has priced Remdesivir at Rs.5400.00 for a 100mg injection vial and Cipla at Rs.4000 per vial. A five day treatment with Remdesivir would work out to Rs 24000-32000 per patient. Glenmark has priced Favipiravir 200mg tablet at Rs.103.00 with a course of treatment costing Rs.12566.00 per person. Treatment with Itolizumah, basically a drug for psoriasis that reportedly shows therapeutic effects in severe Covid-19 infections progressing to acute respiratory syndrome costs Rs.32000.00 per patient.(The Hindu, July 22, 2020 - Why are re-purposed medicines expensive? The burden of a pandemic will have to be borne by Governments and pharmaceutical companies alike)

Let us return to our mother admitted in the hospital for severe breathlessness. As she developed complications   she had been referred to a host of specialists. They were all considerate. The Cardiologist discovered a Cardiac issue. The Gastroenterologist found that she had Clostridium Difficile an infection promoted by the high potency antibiotics administered to resolve breathlessness. The Orthopedic Surgeon discovered a slightly dislocated shoulder. The Neuro Physician said she suffered from Senile Chorea. Both the super specialists opined she would be better off without medicines from them at the advanced age. A senior doctor from the Department of Medicine too had a look at her. There were regular blood checks, Xrays, ECGs , Echo Tests and an  Ultra Sound Scan. Then it was the turn of the Physiotherapist. He visited her for two days at the fag end of her stay in the hospital.  Though I have no experience in the medical field I personally feel Physiotherapy could have been initiated a little earlier as our Ammachi (Mother) retains the invalid status even after three weeks from the discharge.

The discharge summary mentioned 19 tablets per day for the patient. One of our relatives is a Neuro Physician in the USA. He had a look at the list of medicines. He enquired whether the list was consolidated by a GP. He said it was the system there. He said it limits the number of medicines.

As the practice in India widely differs from the practice in the USA it is apparent Covid-19 patients would be prescribed quite a large number of medicines in India. I am not blaming our medical fraternity. It is the protocol.  However the escalation in the cost for Covid-19 treatment makes it prohibitive for the common man.

Though it is apparent Quarantine is inevitable for survival the confinement within four walls too is equally hazardous. It would invite Vitamin D deficiency. Calcium deficiency may cause deterioration in bone density. One may even go into depression.  Devoid of exercise and physical activity you could attract severe health issues that could be lethal. Children would grow up deprived of social skills.

It’s a Catch 22 situation. To put it satirically either you hang or you would be hanged. You have no way out nor salvation.

(Catch 22 is a novel by Joseph Heller)