Odisha govt tells districts to strengthen Covid care facilities

Additional Chief Secretary, Health and Family Welfare P K Mohapatra in a letter to all district magistrates-cum collectors and commissioners of municipal corporation said that the local authorities should provide critical care in available Intensive Care Unit (ICU)s and High Dependable Unit (HDU) at the district level. More training should be imparted at the grassroots level and district level hospitals, so that patient management is accurate and referral should be reduced, Mohapatra said, adding that all medical facilities should follow the notified referral policy to enable seamless coordination between the sending and receiving hospitals.

In view of the extra load on medical facilities in the state capital following surge of coronavirus cases, the Odisha government has asked district authorities to strengthen Covid care facilities and to refer less patients to hospitals in Bhubaneswar and Cuttack. Additional Chief Secretary, Health and Family Welfare P K Mohapatra in a letter to all district magistrates-cum collectors and commissioners of municipal corporation said that the local authorities should provide critical care in available Intensive Care Unit (ICU)s and High Dependable Unit (HDU) at the district level.

More training should be imparted at the grassroots level and district level hospitals, so that patient management is accurate and referral should be reduced, Mohapatra said, adding that all medical facilities should follow the notified referral policy to enable seamless coordination between the sending and receiving hospitals. He said the cluster district concept must be followed.

Patients insisting on being referred to Bhubaneswar and Cuttack should be counselled and dissuaded, as there is life risk in transport. Patients in transit should be accompanied by emergency medical technician so that the patients do not develop hypoxia during transport, he said, adding unless stable, the patients should not be transported, the letter said.

Close monitoring and timely early stage treatment should be given to cases so that fewer patients become serious to be put in ICUs. This apart, he said in order to decrease the load on ICU, there should be step down ICUs and the patients, who have become stable in ICU, should be shifted to step down ICU or HDU or Semi ICU beds. The concept of virtual ICU may be started so that appropriate care can be given by expert advice from remote tertiary hospital level, Mohapatra suggested to the district magistrates.

He said more number of dialysis beds, maternity beds, oncology beds, trauma beds may be created for COVID patients, especially in peripheral facilities. Diagnostic facilities such as CT Scan, Ultrasound of lungs should be strengthened in peripheral hospitals, advised Mohapatra, adding peripheral doctors can be trained in these diagnostic procedures.

Wherever possible, trained manpower can be mobilised from low burden districts to high burden districts, he said, adding that the treating teams should be provided with timely required support in terms of equipment and drugs. The teams working in COVID facilities and especially in ICUs should be regularly encouraged and their efforts appreciated to keep up their morale in these difficult times, Mohapatra said.

The ACS Health said that there should be continued structured discussions amongst the treating teams and state level experts through online meeting and seminars so that latest protocols can be discussed and there is cross learning and mentoring across the teams. Meanwhile, sources said Bhubaneswar alone houses 4,568 active COVID cases of the state's total 32,214. "As the facilities in Bhubaneswar and Cuttack are full with the patients from other districts, the local authorities face difficulties in treatment of critical cases in the twin cities," a senior health department said.

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