The Union Health Ministry has released a new set of guidelines to be followed on the detection of suspect/confirmed COVID-19 cases in non-COVID hospitals and other centers. There have been reports of hospitals being shut after a few healthcare workers (HCW) working there turned out to be positive for COVID-19. Also, some non-COVID health facilities have reported COVID-19 cases in patients admitted for unrelated/nonrespiratory illness, causing undue apprehension among healthcare workers.
Although the Ministry had issued comprehensive guidance to prevent the occurrence of Hospital Acquired Infection (HAI) in health facilities, the practise of universal precautions might still be lacking in many of our hospitals, the Ministry has observed.
A COVID-19 case with mild/asymptomatic/atypical presentation may go undetected and inadvertently transmit the infection to other patients and healthcare workers, putting these individuals at risk of contracting disease and compromise the functionality of the healthcare facility.
The guidelines are intended for both — COVID-19 healthcare facilities (public and private) as well as non-COVID ones. Under those guidelines, Hospital Infection Control Committees (HICC) has been given the responsibility to handle the situation.
"This committee will ensure that HCWs are properly oriented with infection prevention norms. Authorities need to be informed if anyone is infected and those must be kept under isolation in the same hospital. Only one dedicated HCW should look after the patient with all the necessary precautions," Joint Secretary for Health, Lav Aggarwal told media on Tuesday.
The Ministry said a person tests positive, he/she shall be moved to a dedicated COVID centre with all safety precautions and all those who came in contact with the person must be put under a 14-day quarantine. Their details must also be shared with the local health authorities.
All close contacts (other HCWs and supportive staff) of the confirmed case should be put on Hydroxychloroquine chemoprophylaxis for a period of seven weeks, keeping in mind the contraindications of HCQ, the Ministry says.
If HCWs are suspected/confirmed COVID-19 cases, the aforementioned protocol has to be followed. The worker should be immediately taken off the staff roster. All healthcare facilities (HCF) must have a staffing plan in place including a contingency plan for such an event to maintain continuity of operations.
Staff in HCF can be divided into groups to work on a rotation basis every 14 days and a group of backup staff which is pooled in case some high-risk exposure/HCW with suspected COVID-19 infection is detected, the Ministry has recommended.
The Ministry has observed that there could be two likely scenarios after single/multiple cases are reported at non-COVID facilities based on which decision on whether to continue operations there will be based.
Based on the scope of the cluster and degree to which the hospital has been affected (HCW patients and HCW contacts), degree of the risk to the patients visiting the hospital such as those with chronic diseases, etc. the decision can be made based on a risk assessment.