NEW DELHI: The Centre on Tuesday released a detailed guidance document for the management of COVID-19 patients across the country saying that cases should be treated in three categories of health facilities, depending on their severity.
'We are issuing standard operating procedure for care of novel coronavirus to ensure that hospital beds are used only for moderate to severe case—while also effectively keeping every mild or suspect case under close monitoring,' an official in the Union Ministry of Health and Family Welfare said.
All the three categories of the facilities will be linked to the Integrated Disease Surveillance Programme (IDSP) said the government and all suspected cases, irrespective of the severity of the disease, will be tested. Further management of the cases will depend on their clinical status and result of testing.
The COVID Care Centre (CCCs) will offer care only for cases that have been clinically defined as mild or very mild or suspect.
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The CCCs can be makeshift facilities and may be set up in hostels, hotels, schools, stadiums and lodges, etc -- both public and private. If needed, the existing quarantine facilities could also be converted into CCCs. Hospitals like community health centres, handling regular and non-COVID cases, could be designated as the CCCs as a last resort.
Wherever a CCC is designated for admitting both confirmed and suspected cases, they must have separate areas for such cases, with preferably separate entry and exit. The cases must not be allowed to mix under any circumstances.
The guidelines say that individual rooms should be provided, as far as possible, whenever a suspected case is admitted to the CCCs.
The next in line is the Dedicated COVID Health Centre, which are hospitals that will offer care for cases clinically defined as moderate.
These should either be a full-fledged hospital or a separate block in a hospital with preferably separate entry, exit and zoning. Private hospitals may also be designated as the DCHC. These hospitals will have beds with assured oxygen support.
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Dedicated COVID-19 hospitals, on the other hand, are meant to offer comprehensive care primarily for those who have been clinically assigned as severe.
'Private hospitals may also be designated as the DCHs. These hospitals would have fully-equipped ICUs, ventilators and beds with assured oxygen support,' the document said.
For the assessment of patients, in addition to those arriving directly through helpline or referral to the healthcare facilities, in field settings during containment operations, the supervisory medical officers must assess the severity of the case detected and refer them to the appropriate facility, the Centre has suggested.
The government has further guided that states may identify hospitals with dedicated and separate space and set up fever clinics in such hospitals. The fever clinics may also be set up in CHCs, in rural areas subject to availability of sufficient space to minimize the cross-infection risks.
In urban areas, civil or general hospitals, urban community health centres and municipal hospitals may also be designated as fever clinics.
These could be set up preferably near the main entrance for triage and referral to appropriate COVID dedicated facility. Wherever space allows, a temporary make-shift arrangement outside the facility may be arranged for this triaging.
As per available data, nearly 80 per cent COVID-19 patients have only mild symptoms and may actually not even require hospitalization but the government so far has been hospitalizing every confirmed patient.