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All patients visiting hospitals in and around the containment areas identified by local authorities will be considered “suspected Covid-19 cases” and those admitted will undergo mandatory diagnostic tests for coronavirus disease regardless of symptoms, according to a central notice Tuesday.
Initially, advice from the Union Ministry of Health also advocated a clear demarcation between outpatient departments (OPDs) and wards, and asked doctors to adhere to the same federal guidelines that are followed in treating Covid-19 patients, even while caring for OPD patients.
According to a ministry official, the notice sent to state governments aims to prevent the spread of the deadly infection in health centers, especially in light of the appearance of some of these cases in parts of the country.
“There is a detailed guide from the ministry on how to prevent hospital-acquired infection. But there have been cases where hospitals reported the spread of the infection and even closed in some cases, likely because they had patients who had Covid-19 even though their symptoms were not pronounced enough … The new notice asks them to treat all patients as suspected cases of Covid-19, and take the required security measures, “said the senior health ministry official who declined to be identified.
For example, Lady Hardinge Medical College’s pediatric intensive care unit in central Delhi emerged as a hotbed of infections last week, with 12 healthcare workers testing positive for Covid-19. Two babies in the room, one 45 days old and one 10 months old, were infected. The 45-day-old baby died Saturday morning.
Since March 2, when the first infection was reported in Delhi, at least 80 healthcare workers and doctors have been infected in the national capital.
“Hospitals are likely to become high-risk areas. This is because doctors are not evaluating everyone; that’s not possible, “said SK Sarin, director of the Institute of Liver and Biliary Sciences (ILBS)
“… if the population has a large number of people without symptoms, and if they enter hospitals, doctors and nurses will become infected and then pass it on to others: colleagues, families and patients,” said Sarin, Who is the chairman of a five-member committee that advises the Delhi Prime Minister on Covid-19, he said, explaining the challenges faced by workers and healthcare facilities.
According to the Indian Council of Medical Research (ICMR), the country’s apex health research body, about 80% of people infected with the Sars-CoV-2 virus, which causes Covid-19 , have no symptoms, or have very mild symptoms.
The central announcement came on the day that all 11 Delhi district magistrates, as well as deputy police commissioners, among other officials, held discussions with Lt. Governor Anil Baijal and CM Arvind Kejriwal of Delhi via video conference. Some of them raised issues facing frontline workers.
“The increase in the number of health workers, those who enter hospitals and their contacts with positive results is cause for concern. Hospital authorities may not be taking adequate measures to protect themselves from infection, including those not treating Covid-19 cases. There is an urgent need to correct these errors, ”said a district magistrate, requesting anonymity.
A statement issued by the Delhi LG office said the city-state health department had been instructed to take all precautionary measures.
According to the central notice, those admitted to hospitals will have to undergo RT-PCR (reverse transcriptase polymerase chain reaction test, which is a confirmatory test to detect Covid-19. Results take between five and six hours.
“RT-PCR is the gold standard when it comes to case confirmation, and the results of rapid tests (or antibody tests) are still not foolproof, especially for early diagnosis … And hospital staff It has been aimed at monitoring patients especially for any development of unexplained fever, cough or respiratory disease (symptoms of the disease), “added the official.
If a patient tests positive, everyone who has had contact with him / her will receive hydroxychloroquine, an antimalarial drug, which is considered prophylaxis, a treatment to prevent disease, according to ICMR guidelines. However, the government has said that the drug should be taken under strict medical supervision, as it could have serious side effects, especially in those with underlying health conditions, such as heart and kidney disease.
Each hospital in the country, be it a dedicated Covid-19 or non-Covid-19 center, was previously ordered to have a Hospital Infection Control Committee (HICC), which will be responsible for creating an effective mechanism to report initiation. of symptoms suggestive of Covid-19 in health workers.
This includes monitoring for fever, cough, and shortness of breath, among others, either through self-report or active and passive detection at the start of shifts.
“Whenever a patient other than Covid-19 or any healthcare worker is suspected of having symptoms similar to Covid-19, or the results are positive for Covid-19, HICC will take action, investigate the matter. and will suggest an additional course of action … fast Isolation, contact listing and disinfection follow-up will continue, without the need to shutdown the entire facility, ”the notice said.
He said that if the primary source of an infection could not be established and if a hospital continued to report a large number of cases among patients and healthcare workers, the facility should become a dedicated Covid-19 hospital and local health department. should be notified
“In terms of precautions, we are treating new patients as if they were Covid-19 positive, even while performing emergency surgeries. We are disinfecting our operating rooms after surgeries, and our staff wears personal protective equipment (PPE) and takes other necessary precautions. All hospitalized patients are being evaluated regardless of Covid-19 symptoms … The same is true for patients who are frequent visitors, such as those undergoing chemotherapy, dialysis, etc. they are also being tested, “said a Max Healthcare spokesperson.
