A comprehensive design for prevention and management of COVID-19 in a tertiary medical institution in Bangladesh

Abstract

Introduction: Containment of the further spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and reducing fatality due to coronavirus disease 19 (COVID-19) represent a pressing challenge to global health services. Here, we present a management blueprint for both the containment of SARS-CoV-2 and treatment of COVID-19 through a comprehensive approach.
 Methodology: A cohort of 130 consecutive patients identified as positive for SARS-CoV-2 by testing of nasal swab by polymerase chain reaction were managed at a peripheral city of Bangladesh between 1 April and 31 May, 2020. Based on their clinical status, 64 of them were initially selected for isolation (Isolation Group) and 66 recommended for hospitalization (Hospital Group) as per the direction of the “Central COVID-19 Control” Center. Both groups of patients were allocated to receive standard of care management and oxygen inhalation, and intensive care unit management as and when necessary. Based on the conditions of the COVID-19 patients, there was an active system of patients being transferred from the “Isolation Group” to “Hospital Group” and vice versa.
 Results: Twelve patients of the “Isolation Group” were transferred to the hospital, as they exhibited symptoms of deterioration. Four patients of the “Hospital Group” died during the observation period of two months in the intensive care unit. However, there has been no fatality among the patients of the “Isolation Group”.
 Conclusions: The concept of “Isolation” and “Hospital Management” with the participation of the community seems to be an effective management strategy for COVID-19 in developing countries.

Temporary COVID-19 Specialized Hospital: Management Strategies for Public Health Emergencies

“…Preventing and controlling the spreading of the virus in the temporary specialized hospital is a crucial task. 16 Cleaning area disinfection and polluted area disinfection are the two categories of disinfection management. 24 However, the cleaning of the disinfected region, infected area, and buffer zone should be done by different cleaning workers using diverse cleaning instruments.…”

“…22,23 Sixth, Disinfection management; preventing and controlling the spreading of the virus in the temporary specialized hospital is an inevitable task. 16 Disinfection management is divided into (A) Disinfection of the cleaning area and (B) Disinfection of polluted areas. 24 Different personnel using various disinfection tools should carry out the disinfection work of the disinfected area, infected area and buffer zone.…”

“…15 (6) Disinfection management prevention and control of the spreading of the virus in the temporary specialized hospital. 16 (7) Drug supply management strategies comprise medicine supply and medication management. 17,18 (8) Medical waste management to prevent secondary pollution, including medical waste collection, treatment, transportation, temporary storage, and handover.…”