How Ernakulam’s centralised war-room is making a difference in fight against Covid-19

A centralised war-room to streamline hospital admissions and flow of medical oxygen combined with a decentralised health system is making the difference in Ernakulam district administration’s fight against Covid-19 in Kerala.

Ernakulam, the financial hub and home to the state’s busiest airport, has over 61,000 Covid-19 patients under treatment as of Friday, the highest in the state. Around 10,000 of them are admitted to various hospitals, domiciliary care centres, first and second-line treatment centres (FLTCs and SLTCs) with the remaining under home isolation. A total 74 out of 82 panchayats in the district have been classified as containment zones due to high transmission rates.

For nine days starting Saturday, Kerala is set to enter a complete lockdown.

In Ernakulam, the centralised system, thrust on technology and the efficacy of the grassroot health management in the state, is helping families of Covid-19 patients find hospital resources without having to run from pillar to post as seen in cities like Delhi. While a separate war-room to monitor oxygen supply is a fresh initiative, considering more patients during the second wave are complaining of breathlessness and needing hospitalisation, the centralised facility to shift patients from home isolation to hospitals in Kochi has been in place since May last year. This year, due to the crushing second wave, it’s relevance has only grown bigger.

Dr Vivek Kumar, additional district medical officer, explained how the system works. “The centralised war-room has different units such as surveillance, oxygen, shifting of patients, teleconsultation etc. For the sake of accuracy, we have decentralised the various units of the war-room while retaining the centralised system at the district level. For example, if a patient has to be shifted to a FLTC nearby, it is routed through the taluk-level control room in that area. But if the patient then has to be shifted to a Covid hospital or apex hospital ICU, it will be routed through the centralised system,” he said.

“When a person tests positive, he/she has to inform the local health workers in the area. The medical officer in the area can arrange teleconsultation services if required. If the doctor determines that the patient needs to be shifted to a hospital, the war-room is contacted which, depending upon availability of beds, makes the shift,” he added.

As private and government hospitals in Kochi reach saturation levels of their capacities, the district administration is moving fast to add oxygen-supported beds at community-level health centres. In collaboration with BPCL, around 500 oxygen beds are being readied, which an official said, can be hiked to 1000 beds depending on the district’s surge plan.

In the oxygen war-room in Kochi, around 50 volunteers work in two shifts from morning till night, updating data constantly on the oxygen stocks available at government and private hospitals in the district. The dashboards are built on open-source software. The volunteers also keep a watchful eye on the movement of oxygen and cryogenic tankers through the district, making sure there are no hurdles. Such tankers and the staff associated with them have been classified as ‘essential’ and anyone blocking their movement will attract action under the Disaster Management Act.

Mathews Numpeli, the district programme manager of the NHM, said all hospitals, in the government and private sector, have nodal officers who have been directed to update their daily occupancy levels in terms of normal beds, invasive and non-invasive ICU beds, ventilators and oxygen stocks on a portal that can be accessed at the same time by the volunteers in the war-room. Before a patient is shifted, calls are made to the hospital to double-check as well, he said.