29 March 2020
New Delhi: The All India Institute of Medical Science (AIIMS), Delhi has issued a preparedness document to address the cases of novel Coronavirus in the country.
The document called COVID-19 Preparedness Document', which was issued on March 27, is meant for circulation within the hospital. The document, however is dynamic and may be modified as per the progression of the disease in India and when more data was available regarding epidemiology, transmission, and treatment.
The preparedness document is a comprehensive compilation of guidelines to provide the health workers information of various aspects of the disease and its Clinical management.
It deals with issues like Case definition, Clinical features, Laboratory diagnosis, Infection control measures, Clinical management and other matters like isolation, quarantine, etc.
According to the document, all symptomatic individuals, who have undertaken international travel in the last 14 days, all symptomatic contacts of laboratory confirmed cases, all symptomatic healthcare personnel, asymptomatic direct and high risk contacts of a confirmed case fall in the category of suspected novel coronavirus case and should be tested once between day 5 and day 14 after contact. While a person with laboratory confirmation of COVID-19 infection, irrespective of clinical signs and symptoms is considered as confirmed COVID-19 case.
The document showed clinical features of the disease that has been adopted from Report of the WHO-China Joint Mission on Coronavirus Disease 2019 based on 55,924 cases and a study on 1,099 cases by Guan in which symptoms like fever, dry cough, fatigue, sore throat, headache, shortness of breath, nausea or vomiting, nasal congestion, diarrhea and many others have been considered.
The document stressed upon proper doffing of PPE material by the health care personnel. Doffing to be performed only in the designated area, check for any leak or soiling in PPE before doffing. If any, disinfect the area before doffing. Doffing room should have two chairs, one labelled 'dirty' and the other 'clean'. All PPE must be discarded in the yellow bin. Hand hygiene must be performed after every step," said the document.
According to the document the disinfection of high touch surfaces like doorknobs, telephone, call bells, bed rails, stair rails, light switches, wall areas around the toilet should be done every 3-4 hours while at low-touch surfaces such as walls, mirrors, etc. mopping should be done at least once daily.
"In case of onset of danger signs like shortness of breath, hemoptysis, altered mental status, patient should immediately inform the nearest health centre or call 011-23978046," said the document.
The document also advised precautions to be taken by the hostel residents at the AIIMS, according to which, the residents are to stay alone in separate rooms till 14 days after their duties in corona unit are over, not to travel outside or within country unless absolutely indicated, food should be ordered from canteen to their room, daily clothes used by the residents to be washed themselves and not to be given to laundry and proper hygiene of the toilets.
It also advised for the doctors not to go to public places and to report to the hospital authority if any of their friends, hostel staff develop fever or othe respiratory symptoms.