Sunday, March 15, 2020

COVID Preparedness what we all can do?

COVID Preparedness what we all can do?
Here are some suggestions

Dr KK Aggarwal
President CMAAO, HCFI and Past National President IMA


1.               Temporarily ban visitors in prisons: New York and New Jersey have done it by making special arrangements to help prisoners help stay in touch with loved ones will include one free phone call, two electronic messages, and five free stamps per week. Legal visits will not be impacted.

2.                Include bleaching powder and gloves in the list of essential medicines

3.               Make arrangements for special COVID 19 ambulance

4.               Make arrangements for COVID 19 special harsh vans

5.               Circulate cremation policy to all cremation grounds

6.               Create awareness about IPC section 270

7.               Instruct all emergency rooms in any medical establishment to follow COVID 19 guidelines and get them connected to COVID 19 ambulances

8.               Make provision for death body kits for safe disposal

9.               Make instructions for relations in case any death occur

10.           Involve all grades of nurses and paramedics in the loop

11.           Involve all foreign graduates waiting to clear their exam to practice in India in some capacity

12.           All COVID 19 cured patients can be assigned jobs as brand counsellors and role models

13.           All health press reports to be issued COVID prevention guidelines, surgical masks when they enter hospitals, and disinfection of their ear buds and mikes.

14.           New tele hospital visitor policy

15.           Alternate sittings in all cinema halls, air flights, trains so that all maintain a distance of three feet on the sides, front and back

16.           Do not allow any one with fever and cough in parliament, Government offices etc.

17.           Order that all chemists in the country to have green waste basket where people can despise their expired rugs, used masks etc. The same should have a mechanism to be picked up for incineration.

18.           Educate and prepare the ARMY for any assigned duty

19.           Sanction lumpsum five lac per patient for critical cases and 2.5 lac for serious cases if private hospital beds are used by the government apart from supplying all PPE and diagnostic kits

20.           Allow and liberalise off label drug policy with the consent of the patient or family.

Medical Establishments

1.               Make available surgical masks at entry, labs and imaging centers for patients with cough and fever

2.               Undertaking at admission about cough and fever and visiting affected countries

3.               No visitors allowed for social visits

4.               Advertise telecalls consultations for patients with fever and cough

5.               Allow video consults for non-emergent appointments especially for high risk patients

6.               Postpone non-essential surgeries for high risk elderly

7.               Decontaminate all ports of entry and all frequently touched surfaces three times a day

8.               Non-essential admin offices to be shifted out of hospital

9.               Do not conduct non-essential meetings in hospital auditoriums

10.           Make ten bedded Pota cabins for infected cases. Take special permissions from the government

11.           Have enough SPO2 monitoring and non-invasive ventilators in the emergency department and ICU

12.           SMS all patients about corona prevention and not to come to hospital if they have fever and cough but call the hospital helpline number if possible

13.           All hospitals should have a covid 19 help line 24X7

14.           Make surgical mask available to all healthcare workers

15.           Give work from home permission to all health care providers who are 60+ and high risk for corona death.

16.           Display uniform COVID 19 messages at the entrance

17.           Do not organise health camps

18.           Do not have people waiting at OPD or diagnostic areas

19.           Cash counters should have disinfection policy

20.           Minimize paperwork, do not touch currency with saliva

21.           Alternate sittings in OPDs so that all maintain a distance of three feet on the sides, front and back.  

Treatment options in High Risk Co-Morbid patients

1.               Do early CT scan

2.               Give Oseltamivir on day 1 as per H1N1 protocol

3.               Start Lopinavir plus Ritonavir as the diagnosis is suspected

4.               Give a course of Chloroquine

5.               Procure Remdesevir

6.               Arbidol, an antiviral drug used in Russia and China for treating influenza, could be combined with Darunavir

7.                Homeopathy: Consider COVID 19 nosode

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