Earlier this week, one of the COVID-19 response volunteer teams, was assigned an unusual task — to secure a special child and shift him to the hospital where his mother had been admitted in an emergency condition.
The child with disabilities was in a traumatised state, huddled in a room on th second floor of an apartment in the city. The team that went to take his mother to hospital had reported to the war room that the boy had resisted attempts to take him along, and that they had to rush immediately to hospital to save the mother.
“As there was no one immediately available to take care of the child, a second team was despatched to the place. Though the boy put up a struggle, we managed to take him to the hospital and be with his mother,” said A. Anand, a volunteer attached to the Karikalmpakkam PHC.
This LL.M degree-holder and DYFI affiliate has mobilised around 30 volunteers for tele-triaging services and is part of a 150-strong fraternity of student volunteers.
The volunteer base, which includes about 100 final year medicine and nursing students, is allocated any one of the network of 33 PHCs covering town, peri-urban and rural areas and assists the Health Department streamline care of patients placed in home isolation through a combination of “tele-triaging” and home visits by PHC personnel.
The youth volunteers have proved to be vital cogs in the 24/7 information blockchain connecting the COVID war room with healthcare personnel on the ground.
These volunteers launch into action every morning as the results of an estimated 8,000 to 9,000 tests taken across the Union Territory come in and of which roughly 1,000 turn out to be positive in Puducherry.
Contact tracing
A large part of their work involves “tele-triaging” of patients testing positive, documenting their condition, contact tracing, coordinating with PHC personnel and generally serving as an interface with the PHC personnel and the team of experts in the war room which operates the 104 helpline.
On a daily average, tele-triaging is done for over 800 cases in addition to 450-500 PHC triages and over 650 home visits. A cloud-based app (StepOne) helps filter tele-triaged patients by age, co-morbidity and current health status. PHC teams then prioritise which patient can be managed at home and which require hospitalisation.
Health officials said the volunteers have helped in early identification of clusters within a short time of detecting an index patient in an industrial site, trace contacts of patients testing positive and arrange for the temporary custody of kin of children whose parents need to be hospitalised with their next of kin.
“The home-centred strategy for monitoring patients which was active in the first wave has been revived for nearly a month has helped guide recovery through a combination of contact over phone and physical visits. Equally importantly, they have ensured that hospital resources can be earmarked for the seriously ill,” said T. Arun, Health Secretary.
However, a few leaks in the system, mostly related to the lack of precautions taken by people, have surfaced during the tele-triaging intervention that show up the difficulties that volunteers have to navigate and provide leads on how the spread is facilitated by breach of COVID-appropriate behaviour in society.
One tele respondent disclosed that he attended a funeral in the interval between taking a test and availability of result, another who tested positive said he would “give a ring back as he was riding” while there were many who provide inaccurate contact/address information while taking the test.
“The proportions of those who slip through the system is now only abut 1% though they still constitute a health risk in the community. So, it is important that those who get tested to stay in isolation and not mingle with others,” said Duarisamy at the war room.
Health officials say that almost 90% of patients can achieve recovery with basic tablets and periodic monitoring. The proportion of home isolation patients in the active cases tally was in the 85-90% range.
“The combination of tele-triaging and home visits has proven to be one of the important measures that has driven down the pandemic spread. We have also decentralised RT-PCR testing to the community PHCs to limit the travel of those volunteering for a test,” Dr. Duraisamy added.
