The Union health ministry has issued guidelines to be followed on detection of suspect or confirmed COVID-19 cases in non-coronavirus health facilities and said hospitals located in proximity or catering to COVID-19 containment zones should treat all patients as suspect cases until proven otherwise. The move comes after a few hospitals closed down following the detection of the disease among its medical workers. The ministry said although a comprehensive guidance to prevent occurrence of hospital acquired infection in health facilities was issued, the practice of universal precautions might still be lacking in many of our hospitals”. Also some non-COVID health facilities have reported confirmation of COVID-19 in patients admitted for unrelated/non-respiratory illness, causing undue apprehension among healthcare workers, sometimes leading to impaired functionality of such hospitals, it said. The ministry also said that a COVID-19 case with mild or asymptomatic presentation may go undetected and inadvertently transmit the infection to other patients and healthcare workers, putting these individuals at risk of contracting the disease and compromise the functionality of the healthcare facility. According to the guidelines by the ministry, the Hospital Infection Control Committee (HICC) has well-defined composition, roles and responsibilities. These include surveillance for fever, cough or breathing difficulty through either self-reporting or active and passive screening at the beginning of their shift, it said. The Committee will also monitor patients (who have been admitted for non-COVID illness) for development of unexplained fever/cough/breathing difficulty during their stay at the hospital. For hospitals located in proximity or catering to COVID-19 containment zones, it might be desirable to treat all patients as suspect COVID-19 cases until proven otherwise and exercise standard care,” the ministry said. When a coronavirus positive patient is identified in a healthcare facility, not designated as COVID-19 isolation facility, officials should Inform the local health authorities about the case, assess the clinical status of the patient prior to referral to a designated COVID facility and the patient should be immediately isolated to another room, the ministry said. If the clinical condition permits, such patients should be masked and only a dedicated healthcare worker should attend this case following due precautions, it said. Also, all contacts of this patient (other patients being managed in the same room or ward, healthcare workers who have attended to him/her, support staff who may have come in close contact, caretaker/visitors etc) should be quarantined and followed up for 14 days. “Once a suspect or confirmed case is detected in a healthcare facility, standard procedure of rapid isolation, contact listing and tracking disinfection will follow with no need to shut down the whole facility,” it said. If the hospital authorities are reasonably satisfied that the source case/s have been identified and isolated, all contacts have been traced and quarantined and adequate disinfection has been achieved, the hospital will continue to function. “if the health facility still continues to report new hospital acquired COVID-19 cases in the following days, it would be advisable to temporarily close the defined section of the health facility where the maximum number of healthcare-associated infections (HAIs) is being reported. After thorough cleaning and disinfection, it can be put to use again,” the ministry added.
