Gurugram administration issues draft SOP for Covid treatment; plans to increase beds

From providing functional services at the hospitals to procedures to be followed for attending suspected patients, the draft copy of the SOP lays down the rules for handling Covid-19 cases and states that a hospital can refer a Covid-19 patient elsewhere only if it lacks enough beds.

The district administration has prepared the standard operating procedure (SOP) for the clinical management of Covid-19 patients in both private and public hospitals across the city. From providing functional services at the hospitals to procedures to be followed for attending suspected patients, the draft copy of the SOP lays down the rules for handling Covid-19 cases and states that a hospital can refer a Covid-19 patient elsewhere only if it lacks enough beds.

Data shows that of the 1,858 active cases, 538 patients are hospitalised and the rest are in quarantine, either at home or other facilities. (Biplov Bhuyan/HT file photo. Representative image)

“It will be the responsibility of the hospital to transfer the patient to another hospital in the absence of enough beds and till that happens, the hospital would provide available medical facilities,” reads the draft SOP, accessed by HT. Several instances have been reported in the city over the past few weeks, in which private hospitals have refused to admit Covid-19 patients. The deputy commissioner in May also issued an order, making it mandatory for the hospitals to take every Covid-19 patient. At least three private hospitals have been issued notices for allegedly turning away Covid-19 patients.

The SOP allows private hospitals to transfer patients with mild or moderate symptoms to Covid care centres, which include self-paid and government-paid isolation facilities. The guidelines state that patients who do not require to be admitted in hospital because of their mild and moderate symptoms, but can’t be home-isolated either due to lack of space, will have to be transferred by the hospital to isolation centres. The district administration has already arranged more than 1,000 beds for isolation in more than 20 hotels and guest houses.

“The criteria is to keep aside beds for patients who need immediate treatment facilities. If the patient does not require hospitalisation, he/she will have to be transferred to isolation facilities. Before such a transfer, the patient has to be counselled,” said Vivek Kalia, nodal officer for health facilities. He added that the challenge many hospitals have been facing is that Covid-19 patients, who don’t need hospitalisation, insist upon getting admitted.

Data shows that of the 1,858 active cases, 538 patients are hospitalised and the rest are in quarantine, either at home or other facilities. A total of 335 beds are currently occupied by the confirmed Covid-19 cases; 62 suspected patients have been admitted for having ILI (influenza-like illness) or SARI (severe acute respiratory infection) like symptoms and given their samples for testing. 102 patients are admitted in ICUs of private hospitals, 37 patients are under ventilator support, while two of the Covid-19 positive patients are on dialysis.

To check the availability of beds in isolation centres, hospitals will have to coordinate with the nodal officer of the isolation facility. “All the information about availability of beds and isolation facilities will be soon available on the portal called coronaharyana.in,” said Kalia.

Dr Jai Prakash, district surveillance officer, said, “A total of 63 Covid-19 positive patients are in government paid hotels, while 31 in self-paid hotels.”

As per the SOP, every hospital needs to have separate counter for a Covid-19 patient. The guideline, however, doesn’t mention the time duration under which patient has to be admitted. It only states that doctors on triage duty must attend to the patient immediately depending upon the urgency of the requirement of treatment.

The guideline also focuses upon recording and reporting mechanisms of data, where hospitals will have to follow standardized reporting protocol. Each hospital will get a unique ID/password to access an internal portal to feed the data which has to be updated twice in day.

For the treatment in hospitals, the guidelines say that the patient will be managed as per the medical protocol and there will be minimal interaction between quarantine people and healthcare professional so that transmission of disease is prevented and controlled.

Besides, the health facility management team is in the process of acquiring 1,000-1,500 additional beds. Kalia said, “As the number of cases are likely to increase further in the city, we are trying to augment the existing infrastructure. Bed capacity for Covid-19 patients in SGT Medical College will be increased to 120 from 80. The college has offered 300 beds for quarantine. 10 additional hospitals under the Clinical Establishment Act will all also be requisitioned.” Currently, 921 beds are reserved in 23 hospitals for Covid-19 patients across the city.