To ensure optimal utilisation of resources to provide care to novel coronavirus patients, the Union Health Ministry on Tuesday proposed classification of health facilities into three categories COVID Care Centre, Dedicated COVID Health Centre and Dedicated COVID Hospital.
These COVID-19 dedicated facilities will have separate earmarked areas for suspected cases and confirmed cases, and ensure the available hospital bed capacity is used only for moderate to severe cases of the infection, it said in a document.
The ministry said that under no circumstances should suspected and confirmed cases be allowed to mix. “Series of measures have been taken by both the central and state governments to break the chain of transmission. One among these is to isolate all suspect and confirmed cases of COVID-19,” it said.
“However, as the number of cases increases, it would be important to appropriately prepare health systems and use the existing resources judicially,” the ministry said.
The document stated that available data in India suggests that nearly 70 per cent of cases affected with the infection either exhibit mild or very mild symptoms. Such cases may not require admission to COVID-19 blocks or dedicated COVID-19 hospitals, it said.
COVID Care Centres
COVID Care Centres will offer care only for cases that have been clinically assigned as mild or very mild or as suspect cases.
These centres can be makeshift facilities and can be set up in hostels, hotels, schools, stadiums, lodges, among other places, both public and private.
If the need be, existing quarantine facilities can also be converted into COVID Care Centres, the standard operating procedures (SOPs) in the document stated.
Functional hospitals like community health centres (CHCs), which can handle regular non-COVID cases should be designated as COVID Care Centres as a last resort.
This is important as essential non-COVID medical services like those for pregnant women and newborns are to be maintained, it said.
Every Dedicated COVID Care Centre must also have a dedicated basic life support ambulance (BLSA) equipped with sufficient oxygen support round-the-clock for ensuring safe transport of a case to dedicated higher facilities if the symptoms progress from mild to moderate or severe, the SOPs said.
The human resource to man these care centres can be drawn from AYUSH doctors. The Ministry of AYUSH has also carried out training sessions. Their work can be guided by an allopathic doctor, the SOPs stated. The Dedicated COVID Health Centre (DCHC) are hospitals that will offer care for all cases that have been clinically assigned as moderate and these should either be a full hospital or a separate block in a hospital with preferably separate entry and exit zones, it said.
Role of Private Hospitals
Private hospitals can also be designated as COVID Dedicated Health Centres. These centres must necessarily be mapped to one or more Dedicated COVID Hospitals and every DCHC must also have a dedicated basic life support ambulance equipped with sufficient oxygen support for ensuring safe transport of a case to a dedicated COVID Hospital if the symptoms progress from moderate to severe, the SOP said.
Dedicated COVID Hospitals
The third category — Dedicated COVID Hospitals will offer comprehensive care primarily for those who have been clinically assigned as severe and these should either be a full hospital or a separate block in a hospital, it said. These hospitals will have fully equipped intensive care units, ventilators and beds with oxygen support.
The Dedicated COVID Hospitals would also be referral centers for DCHCs and COVID Care Centers. All these facilities will follow strict infection prevention and control practices, the ministry said in the SOPs. States and union territories have been asked to identify hospitals with dedicated and separate space and set up fever clinics, which can be set up in CHCs, in rural areas, it said. In urban areas, the civil or general hospitals, urban CHCs and municipal Hospitals can be designated as fever Clinics.