Union Health Ministry has allowed gated residential complexes to set up small Covid care facilities within its premises. A detailed guideline for setting up such facilities within the residential complexes by resident welfare associations (RWAs) or non governmental organisations has been published.
The facility will be dedicated for management of suspect/asymptomatic/presymptomatic/very mild cases of COVID-19, residing in the particular residential complex. The RWAs will have to find resources to manage the facility. It is also not meant for elderly patients, children below 10 years, pregnant or lactating women and patients with comorbidities (diabetes, hypertension, heart disease, kidney disease, chronic respiratory disease, cancer, other immune-compromised states). Such patients will have to be admitted to the appropriate Covid Care Health Facility. The guideline also specifies that such Covid Care Facilities will be linked to the surveillance team (IDSP) and an ambulance provider.
The complete set of guidelines for the setting up of such coronavirus care facilities is available on the health ministry website, here are some key points:
The Covid Care Facility will be a makeshift facility. This may be set up in community hall/centre, common utility area etc within the premises of residential complex or empty flats which are isolated location-wise from the rest of the occupied dwelling.
The Covid Care Facility should have a separate entry/exit. Entrance to have mandatory hand hygiene (sanitiser dispenser) and thermal screening provisions for caregivers.
Beds shall be placed with spatial separation of at least 1 meter (3 feet) from one another.
There would be partitioned areas to keep suspected and confirmed cases separated. Suspect and confirmed cases must not be allowed to mix under any circumstances.
Adequate natural room ventilation shall be ensured. Putting up exhaust fans to vent out air from the facility (to open area) is desirable.
For air-conditioning/ventilation, the guidelines of CPWD shall be followed which inter alia emphasises that the temperature setting of all air conditioning devices should be in the range of 24-34 degree Celsius, relative humidity should be in the range of 40-70 per cent, intake of fresh air should be as much as possible and cross ventilation should be adequate.
The Covid Care Facility should have a separate toilet for suspect and confirmed cases with proper cleaning and supplies.
Post signages in the perimeter and on the entry indicating that the space is an isolation area.
Posters/standees/AV media on dos and don'ts for patients and caregivers to be displayed prominently.
Temporary donning/doffing room (changing room) would be created with partitions for wearing and taking off PPE for the staff.
Preferably double door entry to be created through partition, etc.
A doctor residing within the gated complex or that provided by the NGO will facilitate daily medical examination of the admitted patients.
A caregiver designated by the RWA/Residential Society/NGO shall be identified to provide care to the patients. Such caregivers will follow instructions at Annexure I and also instruct patients accordingly.
The doctor and the caregiver so selected will undergo training on the iGot platform on Covid management and Infection, prevention and control practices.
Further support for clinical assessment, sample collection, packaging and transportation will be provided by the local rapid response team.
Patient care at Covid Care Facility
Patients admitted to Covid Care Facility will be clinically assigned as suspect/asymptomatic/presymptomatic/very mild. The local RRT/District Surveillance Officer or their nominee will be responsible for clinical assessment and admission of the patient to Covid Care Facility.
At all times, the patients so admitted will use a triple layer medical mask.
The identified medical officer shall be responsible for assessment of the patient(s). The doctor will examine the patient and monitor the vital signs (including respiratory rate, pulse rate, oxygen saturation and temperature).
The caregiver will keep records of patients admitted to such facilities.
The caregiver will maintain records of the vitals of all patients
There will be an oversight mechanism through video camera monitoring or through the guards so that the admitted patients do not leave the facility premises, visit their household, park or other common utility area.
Food for admitted patients shall be arranged by Facility preferably in disposable plates.
Keep the patient's personal belongings to a minimum. Keep water pitchers, cups, tissue wipes, and all items necessary for attending to personal hygiene within the patient's reach.
Any patient-care equipment (e.g. stethoscope, hand held infrared thermometer, blood pressure cuff and sphygmomanometer) that is required for use by other patients should be thoroughly cleaned and disinfected.
Immediate medical attention must be sought if serious signs or symptoms develop. These could include: i. Difficulty in breathing ii. Respiratory rate > 24/min iii. Dip in oxygen saturation (SpO2 < 95%) iv. Persistent pain/pressure in the chest v. Mental confusion or inability to arouse vi. Slurred speech/seizures vii. Weakness or numbness in any limb or face viii. Developing bluish discolorations of lips/face
If a suspect case admitted to Covid Care Facility tests negative, the patient will be assessed by the treating doctor and will either be discharged (on medication, if applicable) or referred to a non-Covid facility as per requirement.
In case of positive asymptomatic/pre-symptomatic/very mild cases, the patient would be discharged as per the discharge policy applicable to home isolation patients available on the health ministry website.