Rapid response team
The coronavirus has not just affected our health as a population but has also managed to alter the behaviour of our whole community. It is important to learn how the community has evolved to deal with the coronavirus. While public gatherings are restricted, travelling is also discouraged. It is the Ward level Team which at the face of this calamity is acting as the Rapid Response Team(RRT) that is given the responsibility to enforce this quarantine. The RRT is expected to maintain a line list (a list of all such persons with their necessary information and relevant dates).Because the RRT is part of the community there, they are expected to know the individuals or families living there. The team has to have surveillance over the 400 odd families in that community. If this job is done with care and precision, half the battle against Corona is won. The RRT is expected to take daily updates from the people staying in home isolation and make sure that they are healthy and also that they have all facilities required for a comfortable stay. If the person has any health issues, the ASHA worker must take action, report the same to higher authorities and get the person health support. Because the people who form RRT are from the local area, they can call the persons in quarantine and have candid conversations about his well being. If there is any problem faced by a mother and child in quarantine, the Anganwadi worker is the person to tend to it.
Around 70 % of the patients are asymptomatic. They may be managed with the help of the following systems. These will be dealt with in detail in the coming chapters
2.First-Line Treatment Centers
3.Field Response home care teams
3 –Tier healthcare system
Various initiates were implemented by different state governments during this COVID pandemic, one of the effective initiative by Government of Kerala was introducing a 3-tier system for pandemic treatment.
First Line Treatment Center
The First Line Treatment Centre (FLTC) cater to patients who are below the age of 60 years and have mild symptoms with no significant comorbidities.
Second Line Treatment Centers (SLTC)
Second Line Treatment Centers(SLTC) will be formed by the Government Taluk Hospitals and designated private hospitals. SLTC will be catering to patients with moderate symptoms and those above 60 years / having any comorbidities with moderate symptoms.
Apex Centers
Apex Centers will be set up in the hospitals with advanced facilities like the medical colleges and private hospitals of each district. These facilities will be equipped to cater to all severe cases of COVID-19. Apex facilities will have ICU beds, ventilators, dialysis machines and well trained human resources to cater to all complicated cases of COVID-19.
Activation of these treatment centers:
There are 3 Phases to the way COVID-19 is treated.
Phase 1 is when a panchayat only has 3 or less than 3 cases in a population of 10,000. During this phase, all the COVID-19 patients are treated in the Apex Centers.
Phase 2 is when any panchayat starts to have more than 3 cases in a population of 10,000. Then, the SLTCs are activated. All the mild and moderate cases will be treated in the SLTCs while only the critically ill will be sent to the Apex Centers.
Phase 3 is when a Panchayat starts to have more than 10 cases in a population of 10,000. Then, FLTCs are activated to treat the asymptomatic and mildly symptomatic patients. The SLTCs continue to treat the moderately symptomatic patients and Apex Centers only treat the most severely ill.
When number of cases still goes up, the panchayat boundaries of such Hotspots are sealed to contain the virus.
Vaccines: A vaccine is a biological preparation that provides active acquired immunity to a particular infectious disease. A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins, or one of its surface proteins. The agent stimulates the body's immune system to recognize the agent as a threat, destroy it, and to further recognize and destroy any of the microorganisms associated with that agent that it may encounter in the future.
Production of vaccines: On average, it takes between 12-36 months to manufacture a vaccine before it is ready for distribution. Successful manufacturing of high-quality vaccines requires international standardization of starting materials, production and quality control testing, and the setting of high expectations for regulatory oversight of the entire manufacturing process from start to finish, all while recognizing that this field is in constant change.
COVID-19: Origin and how it became a Pandemic
COVID-19 is an infection caused by the family of viruses known as Coronaviruses. Coronaviruses are known to cause infections in both humans and animals.
Coronavirus infections range from common cold to severe respiratory or lung infection. COVID-19 is caused by infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus strain. SARS-CoV2 was unknown before the outbreak that started in Wuhan, China in December 2019.
On 11/03/2020, the WHO declared COVID-19 a Pandemic. A pandemic is defined as “an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people”.
COVID-19 Infection
COVID-19 infection is most commonly associated with symptoms like fever, dry cough and lethargy/ tiredness. Other symptoms include ache/pain, sore throat, nasal congestion, conjunctivitis, loss of taste or smell, headache , breathing difficulties and diarrhea in some patients.
Testing of COVID-19
It is recommended that people with symptoms undergo testing. We have an antigen and RT PCR test currently available in our medical field of expertise. The RT PCR test is a global standard system, it is costly(varies from Rs.500-1500 in various states) and the result is accurate ,but time-consuming (approx. 24 hours). It tests for viral RNA presence and Virus genetic material may be detected.
One of the most significant problems that we still face one year into dealing with the pandemic is the limitation faced by the mainstream healthcare facilities of any state or nation due to the uncertainty in the number of patients.
1.Uncontrolled spread of the infection
Home Quarantine: Asymptomatic patients are advised to stay at home.
Clinical eligibility for home quarantine
· The patient is covid postive by any of the confirmatory tests.· The patient is asymptomatic.
Social eligibility criteria for
home quarantine
· Facility for room isolation with attached bathroom and adequate ventilation.
Self care
· Take warm water and fluids.
· Adequate rest and sleep for 7-8 hours.
· Self monitor for symptoms and red flag signs.
How does our government respond during times of disaster?
In the event of any disaster, the decision making authority must be as decentralized as possible, in order to ensure quick communication and better understanding of the field conditions. This ensures that the decisions made by the authority are quickly implemented on the field.
Ward Member who is an elected representative from the public.
ASHA Worker (Accredited Social Health Activist) is a community health worker who is trained by the Health Department and nominated by the Local Self Government Department (LSGD).Anganwadi Worker is appointed by the Social Justice Department to work for the welfare of Mothers and Children. The Department of Social Welfare has a special wing in the collectorate. Social Security Mission is a program/wing similarly supported by the Social Welfare Department under the State Government Program. They supervise and support the ICDS and CDP. It is ultimately under the control of the Health Minister
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