key: cord-0791134-kio0v96x
authors: Singla, Neeta; Saini, Jitendra Kumar; Purwar, Pallavi; Yadav, Pravesh; Gupta, Amitesh; Dewan, Ravindra Kumar
title: Preparedness for establishing COVID-19 services during acute emergency of COVID-19 pandemic: Experience of a tertiary care TB and respiratory diseases hospital
date: 2021-09-30
journal: Indian J Tuberc
DOI: 10.1016/j.ijtb.2021.09.011
sha: df045f1d82484bd05d9991885bf48990396d0523
doc_id: 791134
cord_uid: kio0v96x

The ongoing coronavirus disease 2019 (COVID-19) calls for setting up of well-equipped and dedicated health facilities to manage sick patients while protecting healthcare workers and the environment. An ideal high-level isolation unit requires a high level of administrative commitment, availability of space, human resource and logistics. The experience of setting up COVID-19 care facilities on a noticeably short period in a tertiary TB and respiratory diseases institute in wake of the COVID-19 pandemic is being shared here. This experience will help other hospitals in planning out the strategies and solve the difficulties they may face while opening a COVID-19 care facility under limited resources on an urgent basis.

India, especially the National Capital 'New Delhi' became the epicenter of the global pandemic during the second wave of COVID-19 in April 2021. The picture changed drastically when India began recording a dramatic increase in new cases from April 15 onwards, with more than 200,000 cases daily 1 . On 30 April 2021, India became the first country to report over 400,000 new cases in a 24-hour period. 1 . This second wave in India was widely attributed to the B.1.1.7 (alpha) variant-first identified in the U.K.which had led to sudden rise in cases in the state of Punjab. Another possible reason was a native variant, called B.1.617 (delta), with two worrying mutations, that originated in Maharashtra, the worst affected state. 2 India's capital, Delhi, announced a week-long lockdown on 19 th April, after a record spike in cases overwhelming the city's healthcare system. The positivity rate reached highest to 36.24% on 22 April 2021. The highest number of cases in a day in Delhi was 28000 during the second wave in contrast to 8500 cases in first wave. 3 According to one study, during the second wave, the mortality was about 40% higher as compared to the first wave. 4 The demand for oxygen increased drastically because the number of cases had risen exponentially. Also, probably due to more severe lung damage by the new variant, there was increased need for more ICU facilities and medicines for treating the tsunami of COVID-19 patients. More patients required oxygen support in second wave as compared to first wave (74.1% vs. 63.4%). 4 There was an urgent need to further increase the in-bed capacity to tackle the increasing number of cases. Setting up COVID-19 services in such urgent situation in terms of isolation wards, provision of oxygen beds etc. at a short notice becomes a big challenge. An ideal high-level isolation unit requires a very high level of administrative commitment, availability of space, human resource and logistics. 5, 6 Herein, an attempt has been made to share the experience of setting up COVID-19 care facilities on a very short notice in a tertiary TB and respiratory diseases Institute in wake of the COVID-19 pandemic. c) Laundry-Disposable linen, bed sheets, pillow covers, and gowns were used. These disposable one time use items were discarded as per latest BMW guidelines. 7 d) Kitchen-It was decided that food for patients will be prepared in house kitchen for admitted patients and will be delivered to their beds by support staff in disposable plates which will be disposed as per latest guidelines for general waste disposal for COVID-19

waste. Arrangement was also made for providing food to on duty staff from hospital kitchen only. Water was also served in disposable mineral water bottles to the patients and staff on duty. 

patient care was also the concern, however rapid training of these staff by the infection control team helped in a timely fashion.

1) There was a strong administrative will to start this facility starting from top to bottom and adequate cooperation among various departments These are particularly relevant to hospitals dealing with TB patients

Tracking SARS-CoV-2 variants

Health & Family Welfare -HEALTH BULLETIN for Month of

Differentials in the characteristics of COVID-19 cases in Wave-1 and Wave-2 admitted to a network of hospitals in North India

Transforming a General Hospital to an Infectious Disease Hospital for COVID-19 Over 2 Weeks. Front Public Health

Guidance for building a dedicated health facility to contain the spread of the 2019 novel coronavirus outbreak

Pollution Control Board

Guidelines for Environmental Infection Control in Health-Care Facilities

American Psychological Association

Infection prevention and control of epidemic-and pandemic prone acute respiratory infections in health care

We wish to place on record our gratitude for the Ministry of Health, Government of India, Government of NCT of Delhi and its district administration who supported the hospital continuously. Services of all the doctors, nurses, multipurpose workers, sanitation staff and those providing logistic support and made possible the implementation of COVID-19 services at the NITRD is also acknowledged.J o u r n a l P r e -p r o o f