For Kerala, when COVID-19 struck, it was not a last-minute crash course on dealing with a contagious microbe. The learning was on right from 2017, when the State had rolled out the Anti Microbial Resistance programme, in which infection prevention and control (IPC) was a strategic point.
The Nipah outbreak in Kozhikode in 2018 was perhaps the first major test of the lessons learned. And Kerala did emerge victorious in the battle, but lost nurse Lini Puthussery. This time, Health Minister K.K. Shylaja had given a mandate to health-care workers — that there should be no casualties among them. So far, a nurse at the Kottayam medical college and two field workers in Ernakulam have been affected by COVID-19. All have recovered.
A lot of credit for the performance must go to the infection control programmes being practised in medical colleges and other government hospitals.
A hand-washing initiative was launched at the Ernakulam General Hospital, and a thousand new mothers were trained. Earlier, this programme was not assigned importance by many, but it is now the most effective tool in the fight against COVID-19, said A. Anitha, Superintendent of Ernakulam GH.
While the State’s target of zero infections in health-care workers has been compromised, protection for health-care workers is being provided by adhering to norms, according to Ernakulam DMO N.K. Kuttappan.
IPC has been an ongoing programme with daily training sessions. The State has created master trainers among nurses and link nurses to take the classes. It is not just the doctors and nurses who need to be watchful of infection control, but every person who works in the hospital, down to ambulance drivers and the cleaning staff, are important players in keeping infections at bay.
Many things have to be taken care when preparing COVID care centres as it is a droplet infection. Engineering controls are crucial, especially in maintaining air-conditioning and checking its airflow. It is with such knowledge that other areas are set up in relation to the isolation wards — the donning and doffing area of personal protection equipment included.
Rajaram K.K., Superintendent of General Hospital, Kasaragod, which has reported about 90 COVID-19 patients so far, said at the hospital, which was converted into a COVID treatment centre, cleaning constantly touched surfaces was given prominence.
Every two hours, the isolation wards, including their windows, were cleaned with 1% bleaching powder solution. Floor was cleaned every four hours.
Working in four-hour shifts, the hospital required 240 to 300 PPE every day, he added. Nothing went out of the isolation wards, not even the case sheets.
