While a majority of people recovering from COVID-19 remain at home in Ernakulam district, a safety net is in place in case of emergencies, though the system is struggling to catch up with the surge in cases.
Excluding those who tested positive on Friday, 23,210 people are recovering at home, which is more than 90% of the active caseload of over 25,000 as on Thursday.
The test positivity rate (TPR) for the district on Friday was 27.95%, up from 26.33% on Thursday.
A centralised system is in place for patient transport and bed allocation through the Coronasafe network, the software that monitors bed availability, patient details, and transport network in real time and facilitates shifting of patients based on requirements. “Local bodies had arranged for vehicles to transport patients to hospitals during the earlier surge in cases. But when the numbers began to fall, they dismantled their systems and are now facing a shortage of vehicles. We are trying to get a decentralised patient transport system running again,” said a health official who maintained that a centralised bed allocation system that allots facilities based on need and the patient’s condition is the only way to prevent the entire healthcare system from collapsing as cases continue to surge.
A telemedicine unit with eight to 10 doctors, mostly specialists associated with the National Health Mission, Indian Medical Association, and the Health Department, is functioning for teleconsultation services round the clock.
Calls from patients recovering at home to the telemedicine service are routed through a junior public health nurse (JPHN) or ASHA worker.
Sreeja, a JPHN at Palluruthy where 84 patients are recovering at home, said she contacts people who test positive and makes sure that they have her number. Monitoring people daily is not an option, since JPHNs have other duties, including at COVID test centres, she added.
If a person recovering at home requires medical attention, they are first put in touch with the doctor at the nearest primary health centre. If further care is required, a video consultation is arranged with specialists at the telemedicine unit.
‘Stabilisation centres’ are in place at taluk hospitals to attend to emergencies in the case of those recovering at home. They are equipped with oxygen supply and medication.
There is, however, no regular outpatient system at any hospital for COVID patients recovering at home. “We were in the process of setting up outpatient services at six government hospitals for check-ups or blood tests and scans, when the second surge hit. A shortage of staff now, particularly nurses, means that it is difficult to provide such services,” an official said.
Dr. George Tukalan, IMA treasurer, who is helping out with shifting and telemedicine teams, said people recovering at home are advised to monitor oxygen saturation levels every two to three hours and are usually asked to report a fall below 95.
Though patients recovering at home are all advised to purchase pulse oximeters, many do not because they cannot afford it, Ms. Sreeja said.
