As Mumbai continues to witness a steady spike in the number of Covid-19 cases, Brihanmumbai Municipal Corporation (BMC) on Monday decided to reiterate the old guidelines pertaining to the decentralising of hospital bed management. The circular warns hospitals against admitting covid patients directly without intimating ward-level war rooms.
In a bid to curb inconvenience to Covid-19 patients with the fresh surge in the number of cases, the Mumbai civic body has come out to reiterate the slew of policies and SoPs that were framed earlier at year. "The strategy is patient-centric, a tried and tested one, and will ensure systematic allotment of beds," BMC commissioner Iqbal Singh Chahal said.
Mid-May 2020, when Covid-19 cases were at their peak in the city, the Maharashtra government had decided to reserve 80% of beds in private hospitals to treat Covid-19 patients. However, with Mumbai’s covid curve showing an improvement later, many such private hospitals and nursing homes were delisted.
The circular issued on Monday has directed the hospital managements to strictly adhere to the guidelines of admitting only symptomatic and asymptomatic patients with comorbidities in dedicated Covid-19 hospitals. It further directed that asymptomatic patients without comorbidities or patents showing mild symptoms are to be admitted in Covid care centres and Covid health centres or should isolate themselves at home if they have a separate room and toilet.
The circular pointed out that as per the guidelines issued by the Central government for managing Covid-19 patients all asymptomatic positive patients are to be kept in Covid care centres (CCC), moderately symptomatic positive patients in dedicated Covid health centre (DCHC), and critical Covid positive patients with comorbidities in dedicated Covid hospitals (DCH).
Currently, there are around 30 DCH and DCHC, including civic, government, and private hospitals, in the city to deal with Covid-19 patients.
The circular reads, “It is observed that despite guidelines and orders issued last year, patients are admitted directly by the hospitals without information/ intimation to ward war rooms."
"Covid positive patients in facilities should be ideally used for symptomatic patients and asymptomatic patients with comorbidities. Therefore, once again it is reiterated that DCH and DHCH facilities should be used only for symptomatic patients and asymptomatic patients with comorbidities. These guidelines are to be followed strictly by all concerned. A deviation will be viewed very seriously, which may be kindly noted," said BMC official.
The ward officials have been asked to first exhaust the hospital beds available with them, then refer patients to Jumbo field facility hospitals. After which hospital beds in other areas provided by the BMC and government allotted and the last resort will be to allot beds at the private hospitals which have been acquired by the BMC.
The Assistant commissioner of each ward has been given discretional powers to take possession of available beds in their wards and deploy staff like teachers or any other staff in shifts for bed allotment in war rooms. Hospitals have been warned against violating the above guidelines or action will be taken against them under the Epidemic act 1897.
How ward war rooms function
Every morning at 8 am the epidemic cell of the BMC issues a list of patients who have tested positive for Covid-19 in each ward. The war room will then reach out to these patients. And these patients will be allotted beds depending on their symptoms and accommodation and location. If the Patient of highly symptomatic, an official from the health department of the ward will reach out to the patient at their residence and check their oxygen level and temperature. Their details will be shared with the ward war room and which will help the patient secure a hospital bed. The staff leaves the patient's house only after confirming the allotment of a hospital bed.