Within seven days, average daily patients triaged and treated is over 50

COVID-19 has hit Mysuru. Family, friends and colleagues are infected, hospitals are flooded with patients, there is a shortage of beds, and ambulances are screaming through the streets. There are curfews and lockdowns, and death is in the air. 

So how is the healthcare system of Mysuru District coping up with the increased number of patients? It is through a time-tested, effective strategy to face the challenge of a sudden large load on the healthcare system — the concept of ‘triage’. 

This means that when there are a large number of people needing urgent care and there are limited resources, the victims are divided into multiple categories based on severity of disease. The most severe are treated first as any delay will cost lives. The rest are treated later as per their level of severity. 

This idea was first introduced by Napoleon’s military surgeons to treat battlefield injuries and showed immediate impact. It is now standard practice in many countries when treating mass casualties. Screening services for early detection of patients is one of the important capabilities of the health system with a proper referral system. In the crisis of respiratory infection of COVID-19, screening based on symptoms is one of the key measures. 

The District Administration has seen success in the triage system labelled as ‘COVID Mitra’ Triage and Counselling Centres that have been opened at three Assembly Constituencies — Chamaraja, Narasimharaja and Krishnaraja. 

Early intervention is the key to avoid people flocking to the hospitals with complications, requiring oxygen and ventilators. Treatment should begin once a patient shows symptoms. Within seven days starting the initiative, the average daily patients triaged and treated in each Primary Health Centre and COVID Mitra centres is about 50.

A media release from the District Administration said that the number of persons triaged every day in a taluk is almost equal to daily fresh cases. Therefore, the delay in treatment of COVID-19 patients has been removed. This should result in reduced need for hospital admissions, medical complications and need of ICU and ventilator beds as proportion of total COVID-19 patients, the release added. 

COVID Mitra Centres have primarily been started to remove all confusion and anxiety among people. These centres will have doctors, medical staff and technicians. Besides, oxygenated beds will be available to patients in case of emergency. All COVID Mitras are supplied with necessary medication and Corporate Social Responsibility (CSR) funds of various companies are being used for some of them.

 ‘COVID Mitra’ Centres have been established at Seth Mohandas Tulsidas Hospital, JLB Road; Beedi Workers Hospital, NR Mohalla and at Government Ayurveda Hi-Tech Panchakarma Hospital on KRS Road.

The medical team of COVID Mitra consists of final year MBBS students, dental students, nursing students, retired doctors, nurses, retired nurses and paramedics. As all patients do not require hospitalisation, doctors’ team will interact with COVID-positive patients with asymptotic or mild symptoms and decide whether they should be hospitalised or put in home quarantine. 

Critical first 5-day cycle of COVID-infected

Most critical time for intervention and control of COVID-19 are the first 5 days from the day of onset of symptoms. These are the crucial days during which the following cycle plays out:

Day 1 : Onset of mild symptoms

• Patient’s immediate reaction is self-denial that COVID-19 has caught up with him.
• The patient is both scared and unclear how to approach a doctor immediately.

Day 2 : Wait and watch

• The patient waits.
• It is this wait that turns fatal or leads to complications for many patients.

Day 3 : Symptoms worsening

• Time to take a COVID test

Day 4 : Test result comes (if the patient is lucky)

• Panic grips and frantic search for hospital bed starts.

Day 5 : CONDITION deteriorates

(Panic and rush to hospitals, but no beds)

• At hospitals no one attends to the patient until the patient gets admitted.
• Numerous patients try to get admitted, but no beds

Therefore, the patient takes admission into the hospital out of panic and after delaying treatment for the most critical first five days of the disease. The outcome of the patient is seriously compromised due to these delays.

COVID Mitra — The immediate Triage and Treatment Solution

 Mysuru District Administration understood that the solution lies in immediate triage and treatment from day-1 of onset of symptoms when patients are relatively healthy and can fight the virus in a much better way.

What is COVID Mitra?

   COVID Mitras is based on Information, Education and Communication (IEC) and work on the principle of local Primary Health Centres (PHCs) continuously available and liaising with the community and citizens. 

• Each of the hundreds of PHCs of Mysuru district have been turned into COVID Mitra Centres where primary focus is triage and treatment of patients from day 1 of catching symptoms. 
• No RT-PCR test or CT scans are needed to start the treatment of symptomatic persons.

The moment a person walks in with symptoms: 

The person is medically examined by the Physician and triage is completed and immediate follow up treatment is started resulting in one of the following as per medical status of the patient:

• Medication with advice to isolate and stay at home
• Admission in COVID Care Centre
• Admission in Hospital

Each patient, irrespective of the follow up action, immediately starts receiving appropriate medication against the disease.

Contact COVID Mitra

Chamaraja Constituency

Govt. Ayurveda Hi-Tech Panchakarma Hospital:

0821-2519922

Narasimharaja Constituency

Beedi Workers Hospital:

0821-2517422

Krishnaraja Constituency

Seth Mohandas Tulsidas Hospital:

0821-2517922