Care as per need: Hosps divided into 3 types

Just like the patients, the Brihanmumbai Municipal Corporation (BMC) has split the healthcare facilities for Covid-19 positive persons into three categories – Covid

Just like the patients, the Brihanmumbai Municipal Corporation (BMC) has split the healthcare facilities for Covid-19 positive persons into three categories – Covid Care Centres (CCC), Dedicated Covid Health Centre (DCHC), and Dedicated Covid Hospitals (DCH) – depending on the severity of the infection, in accordance with the directives and standard operating procedure (SOP) issued by the Union ministry of health and family welfare, director general of health services, on Thursday.

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CCCs are institutional quarantine facilities set up in hostels, hotels, guesthouses, lodges, stadiums, banquet halls and schools for high- and low-risk contacts, who are not identified as Covid-19 positive, but need to be kept under observation. Cases of contact with Covid-19 positive persons, who are to be quarantined for observation, will be admitted to CCCs.

The three categories of patients are mild (fever, cold, slight weakness, feverish), moderate (pneumonia with no sign of severe diseases, weakness, shortness of breath) and severe (pneumonia patients with low respiratory rate and co-morbidities or other existing conditions). Mild and moderate cases will be sent to the Dedicated Covid Health Centres. DCHCs are peripheral hospitals namely Masina Hospital, BPT Hospital, Sewri, Sai Hospital, VN Desai Hospital, Bandra’s Bhabha Hospital, Hindu Hridaysamrat Balasahab Thackeray Trauma Care, Bhabha Hospital, Rajawadi, Bhagwati, ESIC Hospital, MT Agarwal Hospital. The most severe or critical cases will be treated at tertiary care hospitals or Dedicated Covid Hospitals. These include Bombay hospital, St George Hospital, GT Hospital, Saifee Hospital, Jaslok Hospital, HN Reliance, Breach Candy, Wockhardt, Nair, Kasturba, KEM, KJ Somaiya, Global Hospital, SL Raheja, PD Hinduja, Lilavati Hospital, Seven Hills, Kokilaben Hospital, Nanavati Hospital, LH Hiranandani and Fortis Hospital, Mulund.

There are 26 DCHs across the city with 1,851 beds and 109 intensive care unit (ICU) beds; 25 DCHCs with 1,130 beds, and 186 number of CCCs with 11,997 beds.

The BMC’s circular read: “..available data in India suggests that nearly 70% of the cases affected with Covid-19 either exhibit mild symptoms, or very mild symptoms. Such cases may not require admission to Covid-19 blocks/dedicated Covid-19 hospitals. The purpose of this document is to put in place such SOPs to ensure optimal utilization of available resources and thereby providing appropriate care to all Covid-19 patients. This will ensure that available hospital bed capacity is used only for moderate to severe cases of Covid-19.”

The SOP mandates that all three facilities will ensure a separate earmarked area for Covid-19 positive persons, and suspected cases, who will not be allowed to mix with each other. It mandates that all Covid-19 suspected cases, irrespective of the severity of the disease, will be tested for Covid-19.

Municipal commissioner Praveen Pardeshi had first spoken of this plan with Hindustan Times on Tuesday, and said: “Special care is needed for patients who have an additional health condition attached to coronavirus, such as a heart ailment, diabetes, hypertension, leukemia, among others. We need to fight the infection in these patients much in advance and care for them in advanced hospitals. I cannot mix high-risk patients who also have co-morbidity, with other Covid-19 patients who do not have other health issues. When that is happening I am not able to pay proper attention to these critical patients. So I need to separate them from the other patients and pay better attention to them.”