A peep into how hospital mock drill will work as ‘janata curfew’ is imposed

While the citizens of India isolate themselves in their homes through Sunday, health care workers will be working overtime at all government hospitals to check if hospitals are prepared for a drastic rise in novel coronavirus (COVID-19) cases. 

The Ministry of Health and Family Welfare (MoHFW) has provided an algorithm for doctors, nurses, lab technicians and attendants to conduct mock drills in government hospitals. 

While Kerala recorded three cases in the end of January and the beginning of February, after an interval of a month, from beginning of March till date, up to 285 cases have been recorded and are rising by the hour. While from January 30 till March 15, there were close to 107 confirmed cases of COVID-19, over the past six days, the cases have more than doubled to 285. Only 23 persons have been declared cured as of now.

As on March 17, highly placed in sources in MoHFW have said that 8541 isolation beds in states and union territories, 593 in All India Institute of Medical Sciences, 150 in Safdarjung hospital, 127 in Ministry of Coal, 200 in Ministry of Steel, 1100 in Railways, 400 in Ministry of Labour, 3135 in Government Medical Colleges and 992 beds in private sector have been identified.

For quarantined beds, 5900 along with added capacity of 5000 in Armed Forces, 5000 in para-military forces, 1000 in Labour, up to 20,756 in states and union territories as also 12,483 in Railways have been identified. Further list is being compiled, the source said.

Up to 1000 government hospitals were trained via video conference on Saturday to conduct the impending mock drill, said Lav Agarwal, joint secretary, MoHFW.

The mock drill algorithm defines personnel required in different settings of consultation rooms, waiting rooms, emergency rooms, labs, admin areas, intensive care unit facilities, and details of major hospitals with nodal persons and emergency numbers available in the hospital. 

The mock patients will first arrive at consultation room where doctors and nurses will physically examine the patients with respiratory symptoms. They will physically examine patients without any symptoms, but based on patient’s self-declaration. “The room should have personal protective equipments, drugs, hand washing and sanitizer facility,” the MoHFW protocol states in the drill.

Cleaners will constantly make rounds of the room with disinfectants and sanitise the spaces after and between consultations. Waiting rooms will be well-ventilated areas with exhaust fans and open areas. 

In emergency, inpatient and isolation facilities of hospitals, doctors will be armed with PPE, drugs, oxygen apparatus, suction machine and hand washing facilities. 

The algorithm further defines that lab technicians should focus on collection of respiratory samples, while those staffers who are not in contact with suspected or confirmed COVID19 patients will work on logistics, supply and record maintenance. 

ICUs will be manned by respiratory doctors and anaesthesiologists, along wit ICU nurses and Operation Theatre technicians. They should be equipped with PPE, oxygen supply, emergency medicines, monitors, defibrillators and ventilators. 

The drill will also involve healthcare workers being trained to transport suspected COVID19 patients into referral facilities. The drivers will be separated from main compartment in which these patients will be driven. They will be trained on how to assist for embarking and disembarking of a patient, and cleaners will clean and disinfect the ambulance after every patient is transported.

Experts have referred to the spike of cases since last five days as an exponential growth, and all countries like China and Italy have gone through the exponential curve of exacerbation of cases in a short span of time. 

“This is just the tip of the iceberg, there is infection in the community and many more cases may be undetected in community. if anyone today says that we are still in Stage two of local transmission and have yet not touched Stage three of community transmission, he is just closing his eyes to the fact that we are few days away from a Spain, China or Italy-like situation,” said Arvind Kumar, Head, Centre for Chest Surgery, Sir Ganga Ram Hospital. 

Kumar said, “While in a large country like India the condition will be mild, we should not overlook rampant undernutrition, people suffering from lung-related ailments, diabetes, heart diseases which is so common in our country and kind of health resources and infrastructure we have. This large number of cases will convert into a large number of deaths.”

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