The Indian Council for Medical Research (ICMR) and other stakeholders have called for each tertiary government hospital in the country to have one critical care unit for coronavirus, and training of health professionals to handle the spread of COVID-19.
The points were made in an issue of Indian Journal of Medical Research dedicated to coronavirus. The researchers wrote: “Given the implications of importation of cases and (its) impact on the local epidemiology of COVID-19 in secondary foci, it is essential to break ground on preparing health facilities to combat a local cluster of COVID-19 cases…. Biocontainment provides value for money in the longer term, even if it is a resource-intensive affair in the short term.”
In a guidance to build such “well-equipped dedicated health facilities (DHF)”, the ICMR focuses on building new bio-security wards, or creating makeshift facilities in tertiary healthcare facilities.
The researchers stated that a DHF must be a “self-contained establishment that can meet most of its daily needs with only essential but limited contact with the outside world”. The basic requirements include water, cleaning practices, adequate floor space for bed, hand-washing facilities, ventilation, isolation rooms, protective equipment, regulated traffic flow of people to minimize contact, and rodent control.
“When transmission-based precautions are being practiced, the ideal condition is to have single occupancy rooms for every patient,” the researchers pointed out. “Since that may not be feasible in every scenario, the practice of cohort isolation can be followed with a spatial separation of =3 feet (or 1 m)…. It is rarely possible to create an ideal room.”
The paper also details technical training for physicians and nurses.
Another ICMR paper, from the agency’s bioethics unit in Bengaluru, looks at how to ethically respond to a COVID-19 outbreak. “Efforts must be in place to gather public support and trust and remove unnecessary anxiety, panic or scare,” the paper states. “Since it is not possible to predict the region for outbreak or its extent in advance to support prior planning, holistic, well informed, and fast-track approaches at the central level are critical. Dealing with an outbreak may require an inter-ministerial master plan involving not only MoHFW [Ministry of Health and Family Welfgare] but also other Ministries, Departments and Agencies.”
The ICMR also released a paper by the National Brain Research Centre, Gurgaon, which highlights how pandemics result in “gradual erosion of state capacity and increase in poverty (as well as) national security and State power.”
It states, “The occurrence of COVID-19 in developed countries also highlights the fact that developed countries and rich populations are not immune to the outbreaks of infectious diseases.”
The journal includes a World Health Organization (WHO) paper highlighting one of the reasons that epidemics such as H1N1, H5N1, SARS, METS, and COVID-19 have taken off: “weak surveillance at human-animal interface.”
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