On Tuesday evening, Kerala Chief Minister Pinarayi Vijayan in his daily press meet for coronavirus updates informed the media that more than 18,000 people in the state were under observation. This is nearly 6,000 more than the number on the previous evening.
With the number of suspected cases on the increase, it raises concerns about how hospitals are preparing to accommodate them.
Health Minister KK Shailaja, when asked this, said that there are standard operating procedures in place. â€śEvery district has kept aside a certain number of isolation wards in anticipation of the increasing number of coronavirus cases. Preparations have been made to accommodate new patients. This is being done in three phases. As the Chief Minister said earlier, we should be prepared for a situation of a community spread of the disease,â€ť the minister said.
Infrastructure is being stepped up in government hospitals in phases - A, B and C. Dr Habeeb Naseem, Superintendent of Kollam Medical College, says that the hospital currently has 30 beds for isolation in phase A, with ventilators and other accessories as required. "In phase B, 25 more beds shall be added and in phase C, we shall vacate a hostel for interns and add 30 more beds,â€ť he says.
The government has also consulted with private hospitals for assistance as plan B or C if there is a spike in the number of cases. "As of now, we are managing the numbers with the facilities available at 34 government hospitals. In each district minimum two government hospitals have been equipped," says Dr V Meenakshy, Additional Director of Health Services (Public Health) to TNM.
In Ernakulam, District Magistrate and Collector S Suhas has given an order that available spaces in various educational institutions, hotels, hostels, and unutilised rooms in private hospitals be made available for coronavirus cases.
â€śWhereas I am personally and subjectively satisfied that an immediate prevention is desirable for preserving and containing spread of infection further and that there is sufficient ground for proceeding under Disaster Management Act 2005, I, S Suhas IAS being the District Magistrate, Ernakulam and Empowered Officer of Disaster Management Act hereby commandeer these rooms for accommodating the persons requiring quarantine as per requirement,â€ť the order says.
It further says that the police and rural and sub-divisional magistrates of the district shall contact such institutions to ensure accommodation for quarantined persons, in consultation with the district health authority.
Uniform protocol in govt hospitals
Government hospitals also also following the guidelines issued periodically by the Health department. At Kollam Medical College, they follow an ABC protocol, both for screening patients and for infrastructure usage.
â€śIn the early days when the first cases of coronavirus came from Wuhan in China, there was no panic like the kind we see today. People would make enquiries on Disha (government helpline) or with the DMO (District Medical Officer) office before visiting the hospital. But now people rush to the hospital as soon as they have the slightest doubt. So we need to screen them properly,â€ť says Dr Habeeb.
The hospital identifies three categories of people who come for testing. Category A includes those who have not had contact with anyone who tested positive for the disease and those who didnâ€™t visit any coronavirus-affected countries. They may be advised home quarantine if the doctor deems it necessary. Category B includes those persons who have had contact with positive cases but do not need admission to the hospital. Their swabs will be collected for testing and they will be sent for home quarantine with a printed list of instructions to follow. The third category â€“ C â€“ includes those who need to be admitted to the isolation ward of the hospital and will be discharged only if their test results come back negative.
The decision on who belongs to category B (home quarantine) and C (hospitalisation) is made depending on the severity of the symptoms, says Dr Habeeb.
â€śWho should be tested also depends on the intuition of the doctor. The Italian at the Varkala resort who tested positive had belonged to category A but the doctor felt that he should be tested. Once the test came back positive, he was admitted to the Thiruvananthapuram Medical College,â€ť the doctor says.
(With inputs from Saritha S Balan)