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A COVID surge is likely in India. What might happen? A hotspot' develops in a crowded area. Thousands of patients swarm crowded hospitals , overwhelming ICUs, infecting other pts and HCWs making tough choices on rationing care necessary. How can we prepare?
@UTobyM @rashmi
@UTobyM @rashmi
This is not unlike a war/mass casualty situation with a few key caveats . It continues over a longer period, can infect and kill HCWs thus reducing staff and also cause non COVID mortality among people not able to access healthcare during a surge. https://www.indiatoday.in/india/story/over-50-doctors-medical-staff-test-positive-for-covid-19-govt-probing-if-they-got-infected-from-patients-1662917-2020-04-03
We need large rapidly modifiable centers for COVID treatment at emerging hotspots. Sounds... like an army field hospital? https://www.dailymail.co.uk/news/article-8171767/US-Open-tennis-stadium-converted-temporary-hospital-amid-COVID-19-outbreak.html
So we rethink COVID care. regular isolation with some inexpensive local innovation? @PrinSciAdvGoI @AbhishkKishore
Whats most important in a COVID Hospital?
If you said PPE you are on the right thread. Protecting HCWs is critical. HCWs are more likely to get infected and die in surges. This robs the system of critical manpower.
https://www.nytimes.com/2020/03/24/world/europe/coronavirus-europe-covid-19.html. Protect staff. They are critical and irreplaceable.
https://www.nytimes.com/2020/03/24/world/europe/coronavirus-europe-covid-19.html. Protect staff. They are critical and irreplaceable.
Patients with COVID related ARDS have a bad prognosis, pts who are intubated fare much worse. So the goal should be to keep pts out of ICU. https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30110-7/fulltext
CPAP is a good way. Patients who need non invasive support can be managed outside ICU. Helps people stay out of ICU. Innovative CPAP deployable ideas abound. Can be easily designed and made in India. https://www.foxnews.com/tech/italian-engineers-innovate-life-saving-design-again-using-snorkel-masks-for-covid-19-patients
We are in midst of a ventilator gold rush. What is rapidly deployable? A 'pneumatic' vent / army transport ventilator runs on air pressure and doesnt need electricity. Can be deployed by EMTs. Ford is making thousands. @nuttynaidu https://www.autoblog.com/2020/03/30/ford-ge-coronavirus-ventilator-production/#slide-2220784
Splitters are other ways of using one ventilator for many patients. Always a position of last resort @MuddaKaushik https://techcrunch.com/2020/03/26/prisma-health-develops-fda-authorized-3d-printed-device-that-lets-a-single-ventilator-treat-four-patients/?guccounter=1&guce_referrer=aHR0cHM6Ly9kdWNrZHVja2dvLmNvbS8&guce_referrer_sig=AQAAAIffmp1SIUl8IlfuSh9hr9pW-O_y6lBWp2KsZMbTxBPswxsKhAnwmUhhPsdm_Dja8vQmM0RV7YSNHPjcJU359vvtiA2-Iclc-B6XC9ki7mM__7N8qNiG8Cc0ZGVE8CM3OgyIttbjRxwgSp6sYj0ZOIP8qT083TZv0YwgUtAyLpTX
Summary: COVID surges can be managed. Emerging Hotspots developing/predicted by AI should have rapidly deployable COVID field hospitals with local innovation. Focus on usable ventilation strategies (CPAP, pneumatic vents) that are inexpensive mass produceable and easy to use.
