While about 15 first-line treatment centres (FLTCs) are currently functioning in the district, an increase in the number of COVID-19 cases could mean that additional centres would be opened up soon, irrespective of the strain it could place on healthcare staff.
About 1,152 patients, mostly mildly symptomatic, are being monitored at FLTCs, according to data from the district information office. Besides patient care, FLTCs were collecting samples for testing and could assess patients in home isolation to manage the infection at the local body level, said Mathews Numpeli, district programme manager, National Health Mission (NHM).
Additional FLTCs could place a strain on health workers, but the pressure would have to be managed either through an increase in working hours or bringing in staff from the private sector, he added.
Physicians from taluk hospitals have been placed on rotation at the Adlux second-line treatment centre, where about 115 patients with more severe symptoms, are admitted. The facility is equipped with a mini ICU, emergency medication and crash carts to provide patients with emergency care before they are shifted to the Government Medical College Hospital (MCH) at Kalamassery if their condition worsens. About 30 people, including staff nurses, two physicians and cleaning staff, are required to work in shifts daily to manage the centre.
Other doctors from the government service have also been posted at PVS Hospital, which recently began functioning with 14 beds. Operations at PVS, which could treat about 120 critically ill patients, were likely to be scaled up to 36 beds by next week, and could reduce the patient load on the already burdened MCH, said an official associated with the functioning of PVS Hospital. With a capacity to treat 300 critically ill patients, the MCH was currently treating about 250 patients, while the number had hit 270 last week, said a doctor at the hospital.
While taluk hospitals had so far been set aside for non-COVID patients, they could also be roped in soon to handle a few COVID patients, said Dr. Numpeli. Doctors from the taluk hospitals were posted on a rotation basis at PVS Hospital and other COVID facilities to train them in handling COVID treatment, he said. According to Dr. Numpeli, about 500 to 600 fresh appointments of health workers had been made through NHM since March.
But for doctors, the strain so far had been immense, said a doctor in the government service, who asked not to be named. “The problem of low staff availability is structural. Only 21 posts of physicians exists in government hospitals in the district. Even if volunteers are taken in or AYUSH doctors are posted at FLTCs, the few specialists in the system will continue to remain burdened. There is hardly any time to train fresh recruits,” she said. If taluk hospitals not large enough to be able to segregate COVID and non-COVID patients effectively began taking in COVID patients, infections could spread from there, she added.
Junior doctors posted at FLTCs had eased the load a little, the doctor said. But, 22 of the 91 junior doctors in the district, besides others across the State, had not received their salaries for about three months, said Krishnapriya T. S., secretary, Kerala Junior Doctors Association. Across the State, some of them had quit in the past few weeks, she added. With two doctors at an FLTC with about 200 beds, the workload could be tremendous for them too, and most of them were on call round-the-clock when they were on duty, she said.