Ernakulam District Emergency Response Plan

This page describes the categorisation of healthcare institutions, patients and emergency response plan on how to isolate/transfer suspects/patients.

The Comprehensive Emergency Response Plan at Ernakulam District can be downloaded from the link below.

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COVID19- Ernakulam Emergency Response Plan 6th April 2020.pdf

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District Emergency Response Plan

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Ernakulam District Surge Plan Ver 7.pdf

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Ernakulam District Surge Plan

Categorisation of Health Care Institutions for Covid Response Plan (Ernakulam District)

Background: The healthcare institutions which respond to the Covid Emergency have been classified into three plans. (Plan A, B and C).

CLASSIFICATION OF HEALTHCARE INSTITUTIONS

Healthcare Institutions in the district are classified into three Plans. This classification is based on whether the institution falls under Government or Private sector and also considering the capacity and facilities available at the institution 1. Plan A Institutions : Institutions under this plan are for providing healthcare services for two types of patients a. All patients who are covid positive b. All patients who are covid suspects needing ICU and Critical Care Support

2. Plan B Institutions : Institutions under this plan are for providing healthcare services for two types of patients

a. All patients who fall under patient category (A) who do not have facilities for home isolation.

b. All patients who fall under patient category (B)

Plan B institutions are government sector healthcare institutions which have facilities for Isolation and Basic Treatment of Covid suspect patients.

3. Plan C Institutions : Healthcare Institutions in the private sector who have facilities for treating Covid positive and Covid suspect patients fall under this category. The services of Plan C institutions will be utilised under the following scenarios. A. When government facilities (Category A and Category B) are overburdened.

B. Covid Positive or Covid Suspect patients who seek treatment at private healthcare institutions and want to continue treatment there itself.

C. Patients in Government sector healthcare institutions who wish to transfer themselves to private healthcare institutions.

The Health Department of Ernakulam District has clinically categorised patients in three categories (Category A, B and C).

THE GUIDELINES FOR HEALTHCARE INSTITUTIONS FOR ISOLATION/ TRANSFER & SHIFTING AS PER EMERGENCY RESPONSE PLAN IS BELOW

SL	Scenario	Actions Required	Remarks
1	Asymptomatic Travellers/ Primary Contacts with isolation facility at home*	Ensure Mandatory Home Isolation for 14 days.	· Look for symptoms daily · Address their medical, Non-medical & Psychological needs.
2	Asymptomatic Travellers/ Primary Contacts without isolation facility at home*	Mandatory isolation for 14 days at SHORT STAY HOME	· Look for symptoms daily · Address their medical, Non-medical & Psychological needs. · All shifting to be done in coordination with District Control Room
3	Any traveller/primary contact who developed mild symptoms -Category A (Mild Symptoms AND <60 years AND No-comorbidity) during initial 14 days & with isolation facility at home*	Mandatory Isolation at home extended for a total of 28 days.	· Closely follow up symptoms by Medical Officer (Tele Consultation) · Reclassify every 12 hours; Arrange video consultation at TeleHealth Help Line if required
4	Any traveller/primary contact who developed symptoms during quarantine period (Category A- mild symptoms AND <60 years AND No Co-morbidity) & without isolation facility at home*	Shift to Isolation Facility at Taluk Hospitals/Identified Sub District Hospitals in designated Ambulances	· All shifting to be done in coordination with shifting facility and with green signal from TeleHealth Help Line
5	Any Traveller/Primary Contact in Category B	Shift to Isolation Facility at Taluk Hospital/Identified Sub-District hospitals in designated Ambulance	· All shifting to be done in coordination with shifting facility and with green signal from TeleHealth Help Line
6	Any Traveller/Primary Contact in Category C	Shift to Isolation Facility at GMC Kalamassery/ Identified District Apex Institutions in Critical Care Ambulances	· All shifting to be done in coordination with GMC Kalamassery / Identified District Apex Institutions

Isolation Facility at House (Only if ALL the following are feasible)

1. Single bath attached room inside the house dedicated for the person to be in isolation.

2. One healthy person (without any morbidity/ 18-60 years) at house to hand over food/ basic needs

3. Facility for not interacting with Elderly/people with Comorbidity

Organisation Structure for Clinical Management

Tiers	Human Resources	Co-ordination	Actions	Requirements
Ward Level Core Team	ASHA supported by JHI/JPHN	ASHA	Inform Medical Officer if any body in Isolation has any symptoms including mild	Training of all ASHAs
Panchayat/ Municipality	(Private/Retired staff to be pooled) 10 Doctors 4 Nurses 2 Lab Technicians 2 Pharmacists 1 Palliative Care Nurse	Medical Officer PHC	Tele Consultation for Anybody with Respiratory Symptoms Tele Consultation for Anybody in Quarantine Essential Lab Tests/ Medicines for People in Quarantine	Tele consultation Facility at PHC Training for Field Clinical Team · Publishing Phone Numbers of Tele-consultation facility and Doctors/Nurses and informing each and every households 2 Vehicle (Own) for Movement of Field Clinical Team in Emergency with PPE Kits.
Short Stay Homes	Doctor on Call/ JHI	JHI	Inform Medical Officer if anybody in Isolation has any symptoms including mild	Training of all staff
First Line Treatment Centres	Identified Hospitals (Taluk Hospitals, Private Hospitals)	Nodal Officer at Each Institution	Triage & Manage Category B patients & Category A patients without facility for Home Isolation Refer to Apex Treatment Centres based on Referral Protocol	Infrastructure, Protocols attached separately 4 Ordinary Ambulances (Double Chambered) & 2 Critical Care Ambulances (Need to increase based on need)
Apex Treatment Centres	Identified COVID Treatment Centres (Government & Private)	Nodal Officer at Each Institution	Manage Patients referred from First Line Treatment Centers / Field	Infrastructure, Protocols attached separately
District Tele Health Help Line	30 Trained Doctors 30 Social Workers	Nodal Officer- Tele Health Helpline	Provide Guidance to Doctors/ Nurses in the field on a case to case basis Provide Tele Video consultation to patients referred by Doctors/Nurses Coordinate Transfers among different institutions	24* 7 - 30 Phone Connections Infrastructure, Protocols attached separately