COVID-19 Proposals CORLHS 20 March 2020

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  1. Stop and curtail all routine and non-emergency hospital visits by restricting routine clinics and I implementing telephone consultation and prescribing essential medications for long period keeping adequate social distance.
  2. Cancel all routine non urgent surgeries until further notice.
  3. Maintain units of with minimum staff divided into small teams which works on 10 to 14 day rosters. Other staff is staying at home with strict instructions to stay at home to avoid community acquired COVID 19 infection. Ministry should develop a system to deal with staff who signs daily attendance registers. Small units can be amalgamated to run essential services. Remaining staff can be temporarily transferred to needed units or institutions.
  4. We need to prepare accommodation for working staff near to hospital. This is important to staff who are working and also to who may need quarantine in the case of exposure. Government needs to acquire hotels, hospitals and houses with dedicated transport and food and other supplies to address this problem.
  5. As the COVID 19 is likely to go for community spread 80%of patents will have mild disease and only need isolation to prevent spread. As per the severe 20% and 5% needing ventilators, we need have a better plan. We need a place, a suitable designated hospital or hospitals, ventilatory equipment and most importantly mobilization of staff (anesthetists intensivists nurses) from other hospitals with PPEs. Mass Ventilation is not a joke. This should be centrally planned together with Anesthetists, intensivists, physicians etc. Otherwise bad ventilation can kill people as it needs proper management of ventilation, ET tube management and fluid balance etc. As per hospitals concerned Neville Fernando and huge KDU hospital at Werahara (75 ICU beds) are on the cards. KDU has the advantage of military discipline. But we need centrally planned mobilization of staff and equipment under the professional advice of anesthetists intensive care and other physicians. 
  6. Ensure adequate supply of face masks including N 95 masks and PPEs.
  7. COVID 19 tests (PCR and IgM tests) should be available to all exposed and suspected health care works removing the present restrictions based on case definitions.
  8. Public announcements using all forms of media including social media to inform to patients that they should come to hospitals only for emergencies to protect themselves getting infected. Dedicated telephone hotlines should be available for each hospital so that patients can obtain advice especially on non-corona medical problems.
  9. Ministry of health should promote social distancing to maximum to limit virus spread. This is especially focused to address use of public transport, public gatherings, meetings etc. All non-essential gatherings including religious ones should be banned until further notice.
  10. As per corona exposed and suspected cases the compulsory quarantine should be imposed by legally binding order.

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