As intensive local transmission of COVID-19 turns hospitals into disease transmission hubs, health-care workers should take all precautions within hospitals assuming that every patient as well as colleague could be a potential carrier, according to health officials.
Not just at their workplace, health-care workers should also isolate themselves from their families at home during this phase of the epidemic, not share meals together and don masks at all times so that the infection is not carried to the families, it has been instructed.
Now that community transmission of COVID-19 has already happened, the separation of patients as those from containment zones and general zones does not matter. In fact, it is pointed out that those working in the COVID pool are more protected because they are always in protective gear while it is those in the non-COVID care pool who are at higher risk of contracting the infection from patients.
Overload of samples
Doctors at medical college hospital said that while hospitals becoming disease amplification zones during the pandemic was an expected course of event, it was the overload of samples and the consequent delay in obtaining results that were creating problems.
The microbiology department at the Government Medical College here is testing some 1,100 samples a day now and uses all molecular diagnostic modalities, including RT-PCR, TruNat and Genexpert for COVID-19 testing. Now that the lab has acquired an automated RNA extraction machine, the time taken for results would be reduced.
“It will take at least two weeks for the current state of affairs to stabilise. Most doctors are donning protective masks and gloves while at work, but this protection matters after duty hours also. Quarantine has only a limited role to play as the risk of infection from the hospital is the same as that from the community. Every patient has more than two companions and they all intermingle in the hospital amplifying the risk of transmission,” a senior doctor said.
Attempts to enforce physical distancing or reducing overcrowding within the hospital have never been successful inside MCH.
At greater risk
Nature of exposure also matters. Doctors handling road accident emergencies in casualties and the surgeons operating on such cases are at the highest risk. There have been several instances of such patients undergoing emergency surgery, who later test positive, sending an entire medical team into quarantine.
It has been proposed that now that more reliable and sensitive antibody testing kits based on Elisa methods (brought out by NIV) are available, it might be possible to do a screening check amongst all healh-care workers to determine the proportion of them who might have had silent, prior exposure to the virus (IgG positivity). Those with IgG positivity can work on the front lines without the fear of infection.
