Change in running procedures of CFLTCs may affect Covid caseload management

According to sources, the delay in reopening the CFLTCs was due to a change in procedures for running the centres by local bodies.
A health worker looks from a swab collection entre at Kaliyakkavila near the Kerala-TN border. RT-PCR test has been made mandatory for those travelling to TN | Vincent Pulickal
A health worker looks from a swab collection entre at Kaliyakkavila near the Kerala-TN border. RT-PCR test has been made mandatory for those travelling to TN | Vincent Pulickal

KOTTAYAM: Even as Covid-19 positive cases have been spiralling at an exponential rate across the state in the second wave, a delay in starting or reopening more Covid First Line Treatment Centres (CFLTCs) owing to a change in procedural formalities is likely to affect the caseload management.  

Health experts have pointed out that “shortness of breath” is more intense among symptomatic patients in the second wave, which warrants non-invasive ventilation support. However, the health department appears to be struggling to provide beds having oxygen support facility to high-risk patients as beds in Covid hospitals and Second Line Treatment Centres (SLTCs) are rapidly being filled with medium-risk patients due to a dearth in sufficient number of CFLTCs.

“In the second wave, the virus is spreading at a rapid pace and hence, the number of patients who need hospital care has also increased proportionately. Though many of them can be given medical care at CFLTCs, they are now admitted to Covid hospitals and SLTCs, taking the space of beds having oxygen support,” said a senior official with the health department.

According to authorities, more number of patients required non-invasive ventilation support like BiPAP (Bilevel Positive Airway Pressure), CPAP (Continuous Positive Airway Pressure), and High Flow Nasal Cannula in the second wave.

“The requirement of invasive ventilation is comparatively low in the second wave. We have more than 500 beds in peripheral hospitals and 125 beds in Government Medical College Hospital (MCH) in Kottayam that are equipped with non-invasive ventilation facilities. However, we are unable to shift patients who do not require oxygen support but already occupy these beds. We can shift them if more CFLTCs are available,” said the official.

According to sources, the delay in reopening the CFLTCs was due to a change in procedures for running the centres by local bodies. During the first wave of the Covid outbreak, district collectors were empowered to release the funds for running CFLTCs. “On the previous occasion, we were directed to submit expense bills of the CFLTCs to the collector, who was empowered to approve bills and sanction the amount. However, this time we have been directed to submit the operations of the CFLTCs as a separate project and present it through the district planning council (DPC), which is delaying the process,” said an official at the panchayat department. 

Moreover, projects have to be uploaded through ‘Sulekha’, planning monitoring software for local bodies, and the system is yet to be made operational for the same. This apart, many local bodies are facing fund crunch after the assembly elections. Meanwhile, authorities said the government is planning to withdraw the changes and district collectors will be empowered to release funds without submitting projects. “We hope that a special order will be issued in a couple of days to resolve the crisis,” said an official.

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