The Madhya Pradesh government plans to leverage the increased awareness of COVID-19 and the network of private practitioners to ramp up fever clinics across the State to detect symptoms early, augment sampling, streamline the referral system and bring down mortalities.
As cases surge, and fan out over newer territories, around 1,000 fever clinics planned in both urban and rural areas will act as the first point of care for possible COVID-19 patients, facilitating early identification and treatment of influenza-like illnesses (ILIs) and severe acute respiratory infections (SARI) which may help stymie the coronavirus’s advance, say officials.
The clinics provide an opportunity, says believesMohammed Suleman, Health Additional Chief Secretary, for patients to directly approach a clinic even if certain areas are not monitored by health workers. “People now know reporting in time to hospitals can reduce the risk,” he said.
Initial fatalities in the State can be ascribed to late presentation at hospitals, added Mr. Suleman, besides co-morbidities. “Active surveillance and early testing can help counter that. And fever clinics can aid this,” he said.
Earlier, reluctance of patients with symptoms to come out prompted a door-to-door survey for patients with SARIs and ILIs. “But the method demanded huge manpower and resources and time. Whereas, a fever clinic is based on people’s trust. Without them, people wouldn’t know who to approach in case of symptoms.”
Onus on community
The onus, with presumably increased awareness over months, rests on the community. A few fever clinics, already operational at hotspots Bhopal and Indore, were witnessing increased footfall in the past 10-15 days, Mr. Suleman said. At a clinic in Bhopal’s Bairagarh, Day 1 witnessed seven patients, which jumped to 36 on the second day. In Banganga in Indore, 166 patients approached a clinic on the first day and 336 on the second.
The model leverages technology and a network of private practitioners across cities who can now refer a patient with COVID-19-like symptoms to a fever clinic, a process enabled through a mobile-based application, for instance, in Indore.
The clinics are being set up in densely populated areas.
In a hotspot, at least one clinic will function out of a government hospital, dispensary or primary healthcare centre for 50,000 people in urban areas and one block in rural areas. In other districts, one urban clinic will cater to 1 lakh people, while a rural one to one block.
At the clinic entry, patients will be triaged (prioritised based on illnesses needing urgent attention) and examined, based on which samples of those showing COVID-19 symptoms will be collected, they will be given medicines and referred to a COVID-19 centre.
Madhya Pradesh, among the worst COVID-19-hit States, had adopted best practices from States like Andhra Pradesh, Karnataka and Kerala and set up working fever clinics to devise a unique model, the first in north India, explained Saloni Sidana, Additional Mission Director, State unit of the National Health Mission.
“The clinics will help prevent exposure of other patients with those having COVID-19-like symptoms,” she said. “It’s a holistic approach as the clinic will act as a treatment facility, a drug distribution centre and a sampling unit or be tagged to one, at the same time.”
For non-COVID-19 illnesses, the outpatient department at hospitals hosting the clinics will remain functional, as will other primary healthcare centres. “Here, informing people about fever clinics becomes important,” said Dr. Sidana.
