PESHAWAR: The health department has directed all the medical teaching institutions to allocate 20 per cent beds for Covid-19 patients, start coronavirus tests round the clock, feed data to the health system on daily basis and make available additional staff to ensure best possible care of the pandemic-hit people.

A letter issued to all the MTIs entitled “policy direction,” under sub-clause 2 (A) of section-7 of Khyber Pakhtunkhwa Medical Teaching Institutions Reforms Act, 2015 states that health minister shall issue such policy and other directives to MTIs from time to time which shall be binding upon them.

The MTIs have been directed to share data with health department on daily basis, ensure availability of well trained clinical and non-clinical staff and contact the latter in case of staff deficiency. The MTIs have been asked to immediately arrange additional staff through walk-in interviews and contractual hiring or request the locum to remove staff deficiency.

The letter said that health department should be contacted for need-based training of staff. The MTIs should scale up their Covid-19 capacity by allocating 20 per cent high dependency beds with central oxygen supply, monitors, non-invasive ventilation, etc.

Health dept asks MTIs to conduct tests round the clock and hire additional staff

The letter said that the beds should be allocated in two phases. In the first phase, at least 10 per beds should be specified for Covid-19 and as many in second phase for which hospitals should submit a plan within one week to the Covid-19 Emergency Operation Centre (EOC). Of the dedicated beds, 25 per cent should be ICU/ventilated for the Covid-19 patients.

According to the letter, the department expects the MTI-based clinical laboratories to run 24/7 and also receive samples from other hospitals during the pandemic and don’t refuse swabs. The MTIs concerned should contact the EOC for capacity issues, it added.

The letter said that report should be made available in less than 24 hours and any delay must be communicated to the department. In case of deviation from the quality indicators, the department may close the laboratory. It added that all laboratories were expected to begin round-the-clock services by July 6.

The MTIs should revise elective services ensuring safety of patients and staff to prevent adverse effects. They have been instructed to share their preparedness and escalation plan with the department and submit the case to the department for financial assistance on emergency basis.

The directives also included proper waste management. For Covid-19 patients, the municipal waste is also considered as infectious waste. Therefore, each hospital must make special arrangements for the waste disposal of the Covid-19 patients The MTIs must make necessary arrangements for the security of the hospital, including its internal security system and close coordination with law enforcement agencies to ensure peaceful atmosphere.

The letter said that no hospital should refuse admission to any Covid-19 patient. In case, an MTI is full to the capacity, it should contact control room for bed management at the director-general health services offices for making alternate arrangements.

It said that MTIs must ensure that a Covid-19 emergency preparedness plan was in place along with escalation plans to cope with the increasing number of cases with clear roles and responsibilities of all key stakeholders. Key elements of plan may include command and control, communication, safety and security, triage, case management, infection control measures and media management.

Each hospital should have an effective coordination and management team to coordinate regularly with the health department, other hospitals and other relevant departments in the context of the national Covid-19 crisis, the letter said.

Published in Dawn, June 24th, 2020