Experiences of patients and healthcare professionals during hospital-based source isolation for COVID-19.

Hospital infection control and public health interventions recommend isolation of suspected and confirmed cases of COVID 19 to break the chain of transmission. As the numbers of infected individuals rose, the judicial use of resources demanded that only patients with moderate to severe symptoms requiring medical care are to be admitted to Dedicated COVID Health Centre (DCHC) or Dedicated COVID Hospital (DCH). Statistics show that 1 in 5 people affected by COVID

19 need hospitalization. That means almost 6 lakh people could have been in and out of isolation in hospital settings across the nation during the past few months. The ground data on how many people are in isolation is not available as the situation is still developing. The guidelines strictly recommend that suspect and confirmed cases should not be allowed to mix under any circumstances. These guidelines are operating on the basis of basic principles of resource allocation, case surveillance and public health measures such as isolation in single rooms or isolation wards in order to break the chain of transmission.

While a large majority of confirmed cases are showing mild symptoms and many are asymptomatic, and therefore quarantined or isolated at home, a significant number of individuals with clinical severity of symptoms are currently in these centres. Source isolation during epidemics often causes psychological and non-psychological outcomes in the patients. Existing reviews on the subject reveals that isolation can give rise to circumstances that deteriorate the mental well-being and safe behaviour in the patient. Higher instances of depression, anxiety and anger are seen in patients who experience the implementation of rigid contact precautions.

This study is an inquiry into the conditions that patients with moderate and severe illness were exposed to during isolation at the COVID-19 centres. Research on patient perspectives of ‘good doctors’ shows that patients and their families desired to build trust with the attending healthcare provider. Their need for information, education and empowerment was left unmet due to time constraints or lack of inclination of doctors to involve in activities that build these qualities in the patients. On the other end of the spectrum are the masses of physicians and other healthcare staff who describe themselves as ‘saturated’. The pandemic has unleashed burnout among health care workers, the effects of which varies based on age and gender. Many health care professionals encounter this state of physical, emotional, and mental exhaustion due to the demands on their bodies and mind at work and many are also experiencing personal burnout