With a population of more than 33 lakh, Ernakulam district additionally has a large community of migrant workers and the state's biggest international airport. However, the district has managed to control the spread of coronavirus and has done effective contact tracing for almost all patients.
Though the district currently has 115 active patients, anticipating a surge in the number of COVID-19 cases in the coming months, especially when the international commercial flight services resume, the district administration, under Collector S Suhas, has chalked out a detailed ‘COVID-19 Surge Plan’.
The plan is based on a seven-stage prediction model, which is, in turn, based on the current trend in the surge of cases. Officials have planned the treatment, care and housing for up to 22,500 COVID-19 patients — Mild, Moderate and Severe — across all these seven stages.
The surge plan lays down centres and hospitals and how many beds will be allocated in each government and private centre, to accommodate patients at all stages.
Currently, officials are expecting 80% of the active cases to be those with mild symptoms, while 15% will have moderate symptoms and 5% of the patients will have severe symptoms.
For instance, in the first stage, patients in all three symptom categories will be sent to the Government Medical College Hospital (MCH) in Kalamassery for treatment.
From the best stage onwards, those with mild symptoms will be sent to first-line treatment centres (FLTCs), set up at block-level and municipality/panchayat-level.
Some of these FLTCs include the Adlux Convention Center in Angamaly, Rajiv Gandhi Indoor Stadium and Cochin International Airport Ltd (CIAL).
When the active patient load reaches the second stage (51-300), an expected number of 240 patients with mild symptoms (80% of 300 active cases) will be sent to Adlux Convention Center in Angamaly, 45 patients with moderate symptoms (15% of active cases) and 15 patients with severe symptoms will be sent to MCH, Kalamassery.
If the district progresses to the next stages, more treatment and care facilities have been added for each category of symptoms.
At the peak (now calculated), if the district has 22,500 active patients, it is estimated that 18,000 patients will have mild symptoms, around 3,000 will have moderate symptoms and around 1,100 people will have severe symptoms.
In this scenario, 600 patients with severe symptoms will need to be treated in private hospitals, and around 350 beds would be allocated at the Medical College hospital in Kalamassery.
While there are 17 block-level FLTCs (775 beds), there are 99 municipality/panchayat-level FLTCs in phase one. A similar number of centres has been identified for phase two.
In the event of a community spread, 19 COVID Care Centres with over 950 beds have been identified for admitting those suspected to have COVID-10 and exhibiting mild symptoms in the event of a community spread.
People who are under home quarantine — travellers and contacts of COVID-19 patients — will have telemedicine consultation, where healthcare workers will contact them on a daily basis.
If they develop symptoms, healthcare professionals will manage and prescribe medicines. If further evaluation is needed, they will be directed to district telemedicine (20 doctors around the clock), who will contact the person with symptoms on WhatsApp three hours or eight hours every day.
If swab collection is required, the patient will be transported to the lab. If found positive, the patient will be shifted to a COVID treatment facility.
All persons visiting clinics and hospitals for out-patient consulting must wear masks and ensure to use hand sanitiser. The public, too, can also use the telemedicine system for consultation before going to the hospital.
Health workers must check the travel and contact history, as well as respiratory symptoms, fever, loose stools and anosmia (decreased ability to smell). Those suspected to have these symptoms will be immediately sent to the fever clinic for examination.
If the patient must be admitted, they will be isolated and their swabs will be collected. If the facility to collect swab or isolation is not available, the patient will be transported to nearest health facility.
The patient will be under isolation till the results are out. If positive, he/she will be shifted to a COVID treatment facility.