A centralised control room and volunteer-driven software that began to take shape early in the trajectory of the pandemic in Ernakulam district, is now helping the district administration handle the surge in COVID-19 cases and allocate beds.
The control room with large data-filled screens and monitors was buzzing with activity on a Sunday when the State is under lockdown and streets are empty.
While the control room has only recently catapulted into the limelight, it has been functioning out of the Integrated Command, Control and Communication Centre at the JLN Stadium metro station for nearly a year now. The new addition is the oxygen war room that monitors the availability of oxygen at various hospitals.
It runs on an open source software, Coronasafe Network, that began to be built by a team of volunteers in March last year, around the time that other countries were watching healthcare systems teeter beneath the weight of rising COVID cases. The software was introduced back then anticipating the sort of surge that the district is now witnessing. Hospitals in the district, including private ones, were introduced to the software, and data began to be collected on beds, ICUs, and ventilators available.
A set of 30 to 40 people handle one part of the control room that verifies data from over 70 private hospitals and around 12 government ones. While hospitals directly enter data on bed availability onto the Coronasafe system, the staff at the control room monitor the data to ensure that it is regularly updated and correct. Another part of the control room comprises the ‘shifting team’ that negotiates with hospitals and attempts to make beds available for patients who need them. The third part of the control room is the oxygen war room that includes officials from the Motor Vehicles Department and Revenue Department, and will ensure that oxygen is mobilised for any hospital in need. Hospitals have been provided with a helpline to contact the war room in case of shortage, and staff at the war room will negotiate with suppliers.
“The system is crucial for ‘load balancing’. If not for it, a district like Ernakulam, which has a small medical college hospital as a tertiary care facility, would have struggled to handle the situation a long time ago,” said Dr. Athul Joseph Manuel, secretary, IMA Cochin Chapter, who has been coordinating work at the control room. He points out that the system is useful if it is set in motion before the surge.
Since the software was developed by volunteers who are still part of the team, it can be changed or updated based on need, which is how the oxygen supply module was recently introduced to address the possibility of oxygen shortage, Dr. Athul added.
The system has a patient card with details of everybody who has tested positive. If the patient is to be transferred to a facility, the patient card, with all clinically relevant details, is sent to the receiving hospital in advance. If the patient is to be shifted, the patient card is marked for shifting.
The centralised control room is bolstered by seven taluk-level control rooms and call centres in each panchayat. Once positive, a patient would call the panchayat-level call centre or field staff, and is triaged and categorised as ‘non-breathless’ or ‘breathless’, while ‘breathless’ is further sub-divided into ‘severely breathless’ or a ‘non-emergency’. Shifting to first-line treatment centres or domiciliary care centres is managed by the taluk-level control room, while shifting to tertiary care facilities is handled by the centralised one.
The system is in place to ensure that patients do not have to run around to hospitals themselves for beds, said Dr. Mathews Numpeli, district programme manager, National Health Mission. “Both COVID and non-COVID bed occupancy status is collected from all hospitals. Oxygen production, transport, consumption, and balance available are monitored through dashboards to intervene in time. There might be delays, but the patient is transferred to the ‘correct’ bed using this system. Despite the massive caseload, we are still able to monitor the situation only because we have this war room,” he said.
