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Bengaluru, Jun 20: The Karnataka Health Department has issued guidelines on the admission of COVID-19 patients in private hospitals after clinical assessment, mandating that the district surveillance officer (DSO) should be first informed to initiate further procedures, an official said on Friday.

"A health team sent by the DSO should visit the home or hospital where the patient is staying. The team should conduct a rapid assessment of his or her health condition," said Karnataka's Additional Chief Secretary Jawaid Akhtar.

In the rapid health condition assessment, the team should first check the patient's body temperature, followed by SpO2 (oxygen saturation) level and confirm if there are any comorbidities such as hypertension, diabetes, tuberculosis, HIV, cancer, stroke etc.

Depending on the health condition of patients, Akhtar said, two categories have been made.

"Those who have body temperature greater than 37.5 degrees Celsius, SpO2 level below 94 percent, elderly (above 60 years) and suffering from known comorbid conditions should be taken to a dedicated Covid hospital (DCH)," he said.

"All other patients, even if older but not suffering from co-morbidities, those below 60 and suffering from co-morbidities and asymptomatic cases should be taken to a dedicated Covid health centre (DCHC) or a private hospital as opted by the patient," he added.

Private hospitals have been asked to pitch in due to the rising number of cases in Karnataka. Currently, there are 2943 active cases in the state after 337 cases were reported on Friday.

"The patients are assessed clinically and evaluated at DCHCs or private hospitals with appropriate diagnostic tests. After evaluation, if the patients are asymptomatic, they are shifted to a COVID Care Centre (CCC) for further management," said Akhtar.

CCCs are expected to be equipped with ventilated rooms, pulse oximeters, handheld thermal scanners and blood pressure apparatus.

A nurse has to be present round the clock for every 50 patients and should visit each patient twice a day for assessment whereas the medical officer has to visit the CCC once a day. He should also be available on call in case of an emergency.

Staff serving food and others should wear personal protective equipment and an N-95 mask. Explaining the procedures at DCHCs, Akhtar said general examinations for medical conditions like body temperature, BP, pulse, oxygen saturation and urine output should be in place.

Investigations such as complete blood count, fasting blood sugar, random blood sugar, liver function tests, renal function tests, ECG and chest X-ray facilities should be available.

"DCHCs should ensure that above examinations are over in an orderly timeline of 24 hours and depending on the examination, the patient is continued to be lodged at the DCHC or sent to DCH or CCC," said the senior officer.

Likewise, the discharge policy should be done as per the protocols issued by the Health Department from time to time.

The Karnataka government is yet to fix an upper limit on the cost of treating COVID-19 patients in private hospitals. While reports indicated that this could be capped at Rs 5200 per day, health officials are yet to specify this is the case. Private hospitals in the state have asked the government to take a collaborative approach in deciding the fixed cap on treatment cost.

The current physical distancing guidelines provided by the World Health Organisation (WHO) and by the US Centers for Disease Control and Prevention (CDC) may not be adequate to curb the coronavirus spread, according to a research which says the gas cloud from a cough or sneeze may help virus particles travel up to 8 metres. The research, published in the Journal of the American Medical Association, noted that the the current guidelines issued by the WHO and CDC are based on outdated models from the 1930s of how gas clouds from a cough, sneeze, or exhalation spread.

Study author, MIT associate professor Lydia Bourouiba, warned that droplets of all sizes can travel 23 to 27 feet, or 7-8 metres, carrying the pathogen.

According to Bourouiba, the current guidelines are based on "arbitrary" assumptions of droplet size, "overly simplified", and "may limit the effectiveness of the proposed interventions" against the deadly pandemic.

 She explained that the old guidelines assume droplets to be one of two categories, small or large, taking short-range semi-ballistic trajectories when a person exhales, coughs, or sneezes.

However based on more recent discoveries, the MIT scientist said, sneezes and coughs are made of a puff cloud that carries ambient air, transporting within it clusters of droplets of a wide range of sizes.

Bourouiba warned that this puff cloud, with ambient air entrapped in it, can offer the droplets moisture and warmth that can prevent it from evaporation in the outer environment.

"The locally moist and warm atmosphere within the turbulent gas cloud allows the contained droplets to evade evaporation for much longer than occurs with isolated droplets," she said.

"Under these conditions, the lifetime of a droplet could be considerably extended by a factor of up to 1000, from a fraction of a second to minutes," the researcher explained in the study.

The MIT scientist, who has researched the dynamics of coughs and sneezes for years, added that these droplets settle along the trajectory of a cough or sneeze contaminating surfaces, with their residues staying suspended in the air for hours.

"Even when maximum containment policies were enforced, the rapid international spread of COVID-19 suggests that using arbitrary droplet size cutoffs may not accurately reflect what actually occurs with respiratory emissions, possibly contributing to the ineffectiveness of some procedures used to limit the spread of respiratory disease," Bourouiba wrote in the study

Mangaluru, Jun 21: A total of 51 private hospitals and medical colleges empanelled under the Suvarna Arogya Suraksha Trust (SAST) have been allowed to treat Covid-19 patients in Dakshina Kannada and Udupi district. Among them 30 are in Dakshina Kannada and 21 are in Udupi. Here is the full list:

Also Read: 518 private hospitals across Karnataka can now treat covid patients