While India is keeping upbeat on daily covid-19 cases and deaths, the country has no data on the numbers of residents of long-term care facilities such as nursing homes, old age homes and mental hospitals, who might have been infected or died from confirmed or suspected coronavirus.
The World Health Organization (WHO) in its latest policy brief --Preventing and managing covid-19 across long-term care services-- has pointed out that because residents of long-term care facilities have been less likely to be tested or admitted to hospital than people living in private households, it is likely that countries that do not include deaths outside hospital are underestimating the death toll of covid-19.
An international initiative to track data on deaths of residents of long-term care facilities only found publicly available data for 21 countries in May 2020. Without data on the impact of the infection on long-term care facilities and on people who rely on care and live in the community, there is a risk that the resources needed to prevent and mitigate the impact of covid-19 in the long-term care sector such as funds, workforce, tests, PPE and other equipment may not be provided adequately and in a timely manner, the WHO said.
The policy brief outlined that residents of long-term care facilities are often facing higher risk, lower preventive measures and inadequate resources to manage covid-19, as well as reduced access to essential health services, as health systems experience constraints in the context of a covid-19 surge.
There are about 47 government psychiatric institutions in the country apart from several private or NGO run destitute homes that all are overcrowded. “In the larger scenario of control of the Epidemic, through various means, the policy for testing correctly places emphasis on contact tracing and follow up. As such, the mandatory requirement of Photo ID and contact mobile number would seem necessary," said Dr Nimesh Desai, Director Institute of Human Behaviour & Allied Sciences (IHBAS), Delhi government adding that the difficulty with those provisions is that for the homeless mentally ill persons on the street. “They are brought to us who also require testing as their Right, and for preventing further transmission, gets delayed very much or does not happen at all," he said.
The apex global public health agency has said that covid-19 pandemic has affected older people disproportionately, especially those living in long-term care facilities.
The WHO also pointed out that some countries have experienced extremely high covid-19 incidence, morbidity and mortality these facilities. Elder Care homes, private run destitute homes are largely unregulated in India and there is limited data available on their activities. However, ministry of social justice and empowerment has issued guidelines for covid-19 prevention measures for such facilities, it still remains difficult to determine the extent to which infection protocol measures are being adopted.
“Most of the Long-term care, Old Age facilities are owned by private owners as a business establishment. They tend to hide such information because it would generate negative perceptions about their establishments," said Himanshu Rath, Founder, Agewell Foundation, a nongovernmental organization working for elderly.
“The other inmates get rattled and new prospects get compromised. Moreover, in absence of any standardisation policy there is hardly any inspection or supervision of such facilities ever done by any third party," he said adding that local government authorities overlook and keep the casualties low.