The war is not over, don’t let the guard down: CARE Hospitals CEO

CARE Hospitals Executive Director Dr Raajiv Singhal says community can’t afford to take Covid-19 disease for granted

By   |  Published: 3rd Aug 2020  12:11 amUpdated: 3rd Aug 2020  12:54 am
Care hospitals launched a Care Suraksha programme aimed at reassuring the patients coming to the hospital and are taking all the precautions to ensure that there are no cross-infections, which are often common in hospital settings.

Hyderabad: The war against Covid-19 is hardly over and there is a need to adopt maximum precautions and not let the guard down, says Dr Raajiv Singhal, Executive Director and Group CEO, Care Hospitals.

The former graduate and Post Graduate from Armed Forces Medical College (AFMC), Pune and an alumnus of Indian Institute of Management (IIM), Ahmedabad, Dr Singhal maintains that the community can’t afford to take Covid-19 disease for granted.

There is a need to imbibe the habit of wearing masks and covering noses. If people become lax, then the city suffers. There are instances wherein the people are seen carrying masks in hands instead of putting them on. “I personally feel such people are basically acting against society. I strongly advise the people to wear masks and more importantly cover their noses with them,” he says.

The senior physician, who had served in the Indian Army as General Surgeon in Siachen and tough terrains of North East and has attended to numerous gunshot wounds of Indian soldiers, clearly laid out the meticulous planning that went into the response to Covid-19 pandemic by Care Hospitals in Telangana in an interaction with Telangana Today.

On the need to prepare

We all know that there was no blueprint available for management of Covid-19, because the crisis hit all of us, across the world at a lightning speed. It was up to us, to take on this crisis, start working on a war footing to ensure that maximum lives are saved. I considered this was an opportunity where we can act in time and save a lot of lives.

What Care Hospitals did?

The most important aspect on which we worked on was infrastructure, people and policies. I would put them into three verticals because we created infrastructure to deal with Covid-19, we trained manpower and ensured we had equipment to deal with the virus.

We realised from whatever was happening across the world that you require infrastructure to handle Covid-19 patients, including respiratory ICUs, isolation rooms, single rooms, ventilators and other equipment. Otherwise, Covid-19 patients will die for want of infrastructure and equipment, in addition to trained manpower.

So we came up with clinical guidelines and clinical pathways to ensure that quality of care did not suffer and clinical outcomes can be improved every day and patients given safe treatment.

On taking care of non-Covid patients and e-Consultations

We stayed connected with people seeking advice and medical help. Within the first four-days of Covid-19, we were able to start the e-Consultation platform, so that people, especially elderly, didn’t have to come to the hospital to seek medical help and at the same time, if they wanted medical advice, there should be a medium to communicate with them.

We also launched a Care Suraksha programme aimed at reassuring the patients that whoever is coming to the hospital, we are taking all the precautions to ensure that there are no cross-infections, which are often common in hospital settings.

We are doing elective work in cardiac surgery, joint replacement surgery, in fact, spinal surgeries are taking place. Our objective was that nobody should get cross-infected. I am proud to say that we have been able to maintain a zero cross-infection rate amongst our elective patients and Covid-19 patients. That’s how we have scientifically created the clinical corridors within our hospital and the manpower dealing with them.

On the unique emergency ambulance services

One of the key concerns was how do we get patients to the hospital. If somebody was trying to reach out to us, we wanted to provide them free ambulance service within the limits of Hyderabad city and the emergency vehicle will reach people within 15 minutes of time.
That is something very reassuring for people that ambulances will reach them and we will be able to give free ambulance service to the people to get the hospital. We wanted to ensure that people don’t struggle to reach the hospital, which worked very well.

On outcomes of Covid treatment

So far, we have screened more than 80,000 patients in our hospitals with Covid-19 symptoms and more than 1,000 positive patients have been treated in Hyderabad. Our mortality rate is one of the lowest in the world. We ensured elective procedures are available with zero cross-infection and our outcomes are best among patients who are getting admitted to critical areas.

Dr Raajiv Singhal

On home quarantine support

Apart from the treatment of Covid-19 patients in hospitals, we are also extending support for home quarantine, where people are being connected through video consultation. Everyone doesn’t have to come to a hospital and we have a large number of positive patients who are availing consultation from home. We are providing free ambulance service and on top of it we have Mission Suraksha, which is basically the protection shield aimed at reducing cross-infection in our hospitals.

On keeping morale of the manpower

We prefer to describe our healthcare workers as Covid warriors and Covid heroes. We have five hospitals in Hyderabad and when Covid struck, we decided that our healthcare workers should not get infected because of low-quality safety equipment. We never compromised on the quality so that our workers feel safe that whatever they are wearing is of good quality. We have been procuring highest quality PPEs, gloves, masks, sanitizers, which help our workers and patients feel they are in a safe environment.

We also have strict protocols in place and ensured chances of exposure were very low. We also reassured our healthcare workers that we will not deduct salaries and we will not ask people to leave, which bolstered their confidence, as these days, a lot of people are losing jobs in the industry. So, all these things helped us in trying to build the morale of health care workers and keep them motivated.

On capacity building and streamlined policies

At every hospital, we created a Covid core committee. All important decisions of that particular hospital are being taken by the committee, which initially used to meet every day and now every week, so that process, protocols, training and procurement was signed-off by the core committee.

We kept people informed at all levels, which was a crucial measure to create a structure approach. We also realised that if the number of cases increased, we have to save more lives and for that, we have to ramp up infrastructure. We did a lot of modifications in infrastructure, creating more isolation rooms, more ICUs, changing air-handling units, and separate air-conditioning.

Trend of Covid-19 in India

Majority of cities are going through their own cycle of learning, evolution and treatment. Few months ago, Delhi and Mumbai saw a huge jump in Covid-19 cases and now suddenly the pattern has shifted towards other cities, including Bengaluru, Chennai and Hyderabad. At present, there are indications that cases have started to increase in smaller cities like Vizag and Patna.

Every city has its own cycle and it is basically replicating how other countries have experienced. Two months ago, Italy and Spain were hotspots and now the numbers have come down in those countries. Similarly, in India, few States were hotspots but now they have crossed that situation. New York was a hotspot for many months but today positive cases are coming down. So, it is a pattern that the virus is following, based on how effectively we carry out our prevention and precautions.

On ventilators, bed shortage

A bed which can take care of the Covid patient is the most important thing. However, along with it, you should have adequate ventilator facilities, high-flow nasal cannulas, isolation rooms and staff to treat them. I think these are the four important components which are very important. Today, at Care Hospitals, we can nearly manage 200 patients on ventilators.

Where are we heading?

If we can’t end Covid-19, then we should be able to control it and that can only be achieved through discipline and cooperation. Everybody has to act in a responsible manner. Every individual has to maintain the highest level of sanitation, social distancing and take precautions to contain the infection till the time we find a proper cure. The entire world is trying to create a vaccine, and if we can get an efficient vaccine, that would be the biggest achievement.

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