In the one week between June 28 and July 5, Bengaluru’s COVID-19 count more than tripled, with 7240 new cases. The surge in cases has overburdened the city’s healthcare capacity, and as a result, there have been many reports of patients not finding hospital beds or treatment on time. This has led to panic and confusion about what one should do on testing COVID-positive.
“The panic and fear of COVID is actually worse than COVID itself. That’s what we have to address before anything else,” says Dr Giridhara R Babu, Professor, Head-Lifecourse Epidemiology, Indian Institute of Public Health. Dr Giridhar is a member of the state government’s COVID expert committee as well as the ICMR task force for COVID.
In case you or a family member suspect COVID or test positive, what do you need to do? Here is a guide on how you can be prepared, and what measures you can take.
“We were late in increasing capacity, but now most things are in place and all that’s left is community participation. The first thing for citizens to do is to protect themselves – avoid the 3Cs and do the 3Ws”, says Dr Giridhara.
Avoid the 3Cs:
- Closed spaces with poor ventilation
- Crowds (more than 2 people)
- Close Contact
Follow the 3Ws:
- Watch your distance (social distancing of at least six feet)
- Wear a Mask
- Wash your hands
2. What to do if you develop symptoms?
According to Dr Giridhara, in the majority of cases, patients develop only mild/moderate symptoms or no symptoms at all.
Common early symptoms are:
- Shortness of breath
- Sore throat
- Body Aches
- Sudden loss of smell and taste, commonly reported by new COVID patients.
However, some asymptomatic patients may not experience any of these.
Stay home: “If you develop symptoms, don’t panic. The important thing is to stay at home and isolate yourself,” says Dr Giridhara.
On July 4, state government initiated a policy of permitting home isolation for asymptomatic or mild patients, indicating they can be treated sufficiently well at home.
Keep a pulse oximeter handy: Blood oxygen saturation levels (SpO2) play an important role in determining the severity of symptoms. If the SpO2 level is below 90%, the patient’s condition is considered severe and they need urgent treatment. If the level is above 95%, the patient is considered mostly asymptomatic. “We are requesting the government to provide oximeters for every patient who is advised home isolation,” says Dr Giridhara.
Consult a doctor: If you notice symptoms, talk to a doctor, preferably through tele-consultation. You can also use the ArogyaSetu Self Assessment App. Based on this preliminary assessment, the decision on whether or not to get tested should be made.
Testing Criteria: All symptomatic patients from containment and buffer zones with ILI and SARI symptoms (acute respiratory infection with fever AND cough) will be tested immediately. Those from non-containment and buffer zones will be tested based on doctor’s advice.
Getting Tested: Until the results of tests are out, you should stay isolated at home as much as possible, according to Dr Giridhara.
Testing is done at fever clinics/swab collection centres at the district and taluk levels. There are at least 113 fever clinics/swab collection centres in Bengaluru (66 private and 47 government), where your samples can be taken.
From fever clinics/swab collection centres, samples are sent to one of the 25 ICMR-approved testing labs in Bengaluru. All fever clinics and labs send all test reports to the BBMP or the State Health Department. Hence, you may not get your results from the lab and may instead get them from BBMP.
Details of BBMP Health Officers
You can contact the Health Officer of your BBMP zone, in case of emergencies. They are also responsible for testing primary contacts of COVID-positive patients.
|East Zone||Dr Siddappa||9480684214|
|R.R. Nagar||Dr Balasundar||9480685435|
Quarantine Vs Isolation
- Quarantine: Restricting movement of people who may have been exposed to the virus, to check if they are developing any symptoms.
- Isolation: Separating the suspected and/or infected person from those who have not contracted the virus.
Source: Bengaluru Apartment Federation Guidelines
3. What if you test positive?
If you test positive, first inform your District Surveillance Officer (DSO)/BBMP local ward officials, and call one of the following helplines:
If you are an apartment resident, you should immediately inform your local residential/apartment association, who can offer support and ensure that authorities are informed.
Labs will directly inform the BBMP/State authorities about positive results. BBMP is to send a health team to the patient’s residence for a medical screening. They will check the patient’s body temperature, SpO2 levels and co-morbidities (like hypertension, diabetes, TB, HIV, cancer, etc.)/pregnancy.
Depending on your symptoms, the health team will decide if you are eligible for home isolation or need treatment at a COVID facility.
Preparing an Isolation Kit
Whether you are eligible for home isolation, or if you need to go to a care centre or hospital, it is good to get a kit ready. (Courtesy: Design Beku)
1) Contacts of family doctor/neighbourhood doctor, RWA office bearers/local volunteers
2) Contact numbers of COVID helpline of your district, district hospital, ambulance, medical store, medical oxygen cylinder provider, local plasma bank, people who have recovered recently from COVID-19, private and government COVID-19 testing labs servicing your area.
1) Insurance details, medical records, list of allergies, etc.
2) Form for COVID testing: Spare copies with data filled for everybody, to save on exertion when you are sick
3) Home isolation declaration, printed, with a few spare copies and extra blank sheet
1) Finger pulse oximeter with spare batteries. Epidemiologist Rifa Khan suggests procuring one per family, or the local RWA or apartment association could keep a few stocked.
2) Face masks, thermometers, regular medicines
3) Toiletry and sanitation kit
4) Water bottle and cutlery (for use during quarantine), electric kettle and electric steamer
5) Garbage bags for proper disposal of trash
6) Large can of Sodium Hypochlorite or a disinfectant like Lizol, and hand sanitisers
7) Mobile charger, cable, power bank, laptop
8) Cash, credit card, cheque book, banking details, etc., for payments at the hospital
How to help contact tracing
It is good practice to keep a journal listing your daily contacts. In case you test positive, all your contacts can be quickly informed and asked to go into quarantine.
If your household help, cook or driver are primary contacts, ensure you/your family members inform them immediately. They as well as their other contacts (secondary contacts) need to quarantine themselves as per BBMP surveillance team’s orders.
Share the name and phone number of your primary contacts in the last seven days, with the government surveillance team . If you had visited public places like shops, office, gatherings, etc., list this down along with the date and time. Keep this list ready to hand over when required.
4. Moving to a COVID Facility
Based on the screening, the patient is recommended one of the following options – home isolation, or treatment and isolation at Covid Care Centres (CCCs), government hospitals or private hospitals.
Those with body temperature less than 37.5℃, and SpO2 levels over 95%. They are moved to a Covid Care Centre (CCC) or advised home isolation.
CCCs are hotels, hostels, halls, etc., which have been turned into facilities for COVID patients. Earlier, they were only meant for symptomatic non-patients, but now mild or asymptomatic cases are treated there.
All CCCs are to be equipped with pulse oximeters, handheld thermal scanners, and BP apparatus. They are also supposed to have one nurse per 500 patients at all times.
“Patients are given a choice on how they want to be treated, depending on their symptoms. If the patient’s symptoms are minor, as is likely to be in most cases, they are given the choice of either isolating at home or at a COVID Care Centre. We expect that most will choose home isolation when possible, as the important thing is to save beds for those who really need it [severe patients],” says Dr Giridhara.
Home Isolation for Asymptomatic Patients To be eligible for home isolation, you must meet the following criteria: * Assessed by the health team of district/BBMP authorities * Has to be clinically asymptomatic/mild: temperature <38℃, SpO2 levels > 95%, age below 60 years * Should not have co-morbidities such as kidney disease (requiring dialysis), heart disease, stroke, TB, cancer, HIV. Should not be immuno-compromised, or be on steroids or immunosuppressants * Pregnant women four weeks before the expected date of delivery are not eligible for home isolation * Must have necessary facilities for self-isolation at home and quarantining of immediate contacts - separate and well-ventilated room * If the home is not found to be suitable, or if the patient’s symptoms worsen, they are moved to either CCCs or hospitals. Read full guidelines on home isolation here (Karnataka government's Covid-19 site).
“If the medical team finds that you have symptoms which require treatment, there are three options – government COVID hospitals (free treatment), private hospitals (with insurance), and private hospitals for those who can pay more for treatment,” says Dr Giridhara.
According to a list released on July 4 by Dr Sudhakar K, Minister of Medical Education, there are 19 government hospitals/medical colleges for COVID treatment in Bengaluru. Of these three are Designated COVID Hospitals (DCHs) and 16 are Designated COVID Healthcare Centres (DCHCs).
There are 72 private hospitals for COVID treatment in the city, according to Dr Sudhakar, Minister for Medical Education.
There are two ways to get treated in private hospitals. If a patient is referred to private institutions by public health authorities, treatment cost is subsidised by insurance packages under the Ayushman Bharat-Arogya Karnataka (Ab-Ark) scheme.
Cost is higher if a patient approaches private hospitals directly, though the state government has capped costs. Following is the per-day treatment cost fixed for private hospitals.
Whether you are sent to a DCHC or DCH will depend on your symptoms.
- Patients with mild-moderate symptoms
If body temperature is more than 37.5℃ and SpO2 levels are between 90-94%, the patient will be moved to a Dedicated COVID Healthcare Centre (DCHC).
At the DCHC, a more comprehensive health check-up will be done. Your BP, temperature, oxygen levels, blood sugar levels, renal and liver function tests, CBC, ECG, etc., will be checked. Depending on your results, you may be sent to a Dedicated COVID Hospital (DCH) for more comprehensive treatment.
- Severe Cases
If your oxygen levels are below 90%, you will be sent to a DCH directly. If you’re aged above 60 years with comorbid conditions or are immuno-compromised, the same applies. If a patient’s health deteriorates at a CCC or DCHC, they too are sent to a DCH.
- Dial 108 for Arogya Kavacha ambulance to shift patients
- Dial 1912 if a government or private hospital denies bed
108 service will ascertain if the person is COVID-positive or a suspected case, and arrange for an Advanced Life Support (ALS) ambulance to a nearby treatment facility in consultation with the BBMP’s bed allocation team.
If the person has not undergone a COVID-19 test, but has breathlessness, asthma or ILI, they will be shifted immediately to a COVID hospital and tested compulsorily.
After treatment, a patient can only be discharged if they meet certain criteria. All discharged patients are to be under 14 days of home quarantine and self-monitoring.
Following are the discharge criteria for different categories of patients:
- No symptoms
- No fever
- Oxygen levels over 95% maintained
- Respiratory rate less than 24 per minute
- Patient remains asymptomatic 10 days after the test
- No fever or symptoms for three consecutive days
- 95% oxygen levels for four days
- Resolution of breathlessness and inflammatory markers
- Above conditions are maintained for at least consecutive 10 days after onset of symptoms
- No fever or symptoms for three days
- Oxygen at 95% for four days
- Resolution of breathlessness and inflammatory markers
- Complete clinical recovery
- Should test negative three days after recovery
[Corrigendum: This article previously said that pregnant women four weeks before the expected date of delivery are eligible for home isolation. This has been corrected to say that this category is not eligible for home isolation.]