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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.

Bengaluru, Apr 24: Karnataka Chief Minister BS Yediyurappa on Thursday held a meeting with state officials to address the situation in the wake of COVID-19 pandemic.

Due to COVID-19, the prices of the crops have come down. It was instructed to buy those vegetables and keep them in cold storage and then sell. It was also instructed to export fruits, vegetables which cannot be kept for a long time to other states and countries.

Wherever there is a scarcity of drinking water, it was decided to supply water immediately.
Chief Minister Yediyurappa had earlier spoken to Union Minister Sadananda Gowda and took information regarding fertilisers.

As fertilisers' demand is less in the international market, the Union minister for fertilisers said that farmers will be given fertilisers at less than the actual price.

As some of the associations/guilds have violated the lease conditions by not starting the actual work which they have got the land for in Bengaluru, they have been instructed to return the land to the government where the lease conditions have been violated.

As far as the irrigation department is concerned, much water is stored in dams. It was decided to utilise the same for the cultivation of crops and for the purpose of drinking.

As far as the education department is concerned, it was instructed to give online training to students.

With the help of state television channel Doordarshan, it has been decided to teach students about the syllabus and other activities till the reopening of school.

The KSRTC has lost hundreds of crore due to the reduction in bus services due to COVID-19. So, they were instructed to use buses to transport goods to generate revenue.

The government also decided that salary for the doctors, who are working on a contract basis against COVID-19, will be increased significantly.

Kasaragod, Apr 19: Kasaragod, Kerala's COVID-19 hotspot, is the only district in the southern state lacking adequate health infrastructure.

In spite of treating the highest number of COVID-19 patients in the state with meagre infrastructural facilities and even without the support of a medical college in the north Kerala district, no deaths have been reported due to coronavirus.

The state health department views the performance of M Kunhiraman and his team, consisting of Janardhana Naik and Krishna Naik, at the General hospital in Kasaragod as a success story.

"Not only did they control the situation quickly with minimum infrastructure, they also started turning out a large number of negative cases within a few weeks and creditably ensured zero mortality.

This can be showcased as a best global model," Chairman of the Information Education and Communication (IEC) Committee and Project Director Kerala State Aids Control Society, R Ramesh said.

Recalling the ordeal, Janardhana Naik said his first major challenge was the physical examination of a patient with suspected COVID-19.

"Even with the PPE kit, nobody knew how effective they were and it took a whole 30 minutes to wear them properly.

But as time passed, we got accustomed to it," he said.

The traditional method of dealing with a patient involved knowing his or her history, observation and physical examination.

For hundreds of years, the hands-on body approach has been the soul of the doctor-patient relationship -- taking the pulse, tapping on and listening to the chest, feeling lumps.

With the onset of COVID-19 all that has changed.

"In fact, the whole exercise was fraught with grave risks because everything connected with COVID-19 was new.

Doctors have to keep a distance even though the physical examination wearing a Personal Protective Equipment (PPE) is difficult.

Sounds from the body are inaudible, vision is blurred through the smog-covered goggles and a stethoscope seldom has any use," Janardhana Naik said.

It was from March 15 that the hospital started receiving COVID-19 patients, primarily from Dubai.

By the time the first person came, the hospital was ready for him.

Soon, patient numbers began to swell and in a couple of weeks they reached about 91.

From then on, it was teamwork.

Committees were formed for each and every task, including the help desk, IT, treatment, medical board, training, food, waste disposal and data maintenance.

Initially, patients had many misgivings about the hospital.

"Some were disillusioned and even aggressive. Some were not happy with the facilities the hospital had to offer.

But gradually through good treatment and counselling by a psychiatrist, who visited the hospital on alternate days, the confidence and mood of the patients changed and they became friendly with the staff," Naik elaborated.

Counselling was also given to the concerned family members of the patients.

Besides treatment, the medical staff had to spend a considerable amount of time clearing the doubts of patients.

When they got discharged some patients insisted on seeing the faces of the medical staff, who till then were anonymous entities covered from head to toe.

Some even wanted to take selfies with them.

However, the medical team politely turned down their requests and preferred to remain hidden in their work attires.

The mood of the patients also rubbed off on the doctors and hospital staff.

All the physicians and hospital staff are now more confident of dealing with contagious diseases after treating COVID-19 patients.

"Our previous experience of treating H1N1, Chikungunya and Dengue cases helped us a lot.

Words of encouragement from the Health Minister K K Shailaja, Health Principal Secretary Dr Rajan N Khobragade and Health Services Director Dr Sarita R L gave us the impetus to build up confidence.

Moreover, the field health workers did a wonderful job in containing the viral spread," Naik added.

As the number of coronavirus cases rose, the state government on April 5 deputed a 26-member medical team from Thiruvananthapuram to set up a COVID-19 hospital in the district.

They turned a block of the under construction Government Medical College as a hospital-like facility, setting up a 200 bed facility to treat coronavirus patients.