Greetings from Indian Academy of Pediatrics!
· All clinicians should keep themselves updated about recent developments of COVID-19 including global / domestic spread of disease. They should access reliable web sites such as the WHO, CDC for the same.
· Non essential international travel as well as travel to those areas in India where there is intense transmission should be avoided.
· It would be prudent to not organize seminars, meetings and conferences at this time.
· Visitor entry in the nursing homes, clinics and hospitals should be restricted.
· Well baby visits and immunization visits can be scheduled at a particular time where there is minimum mixing with sick patients.
· Hand rubs should be made available in the OPD and IPD setting and health care workers, patients and relatives should be encouraged to use them frequently. Regular cleaning of hospital floor, high touch surfaces and equipment should be done.
· Doctors should set up a system of triage of patients with respiratory illness in the outpatient department and separate these patients from other patients in a separate area of the OPD. These patients should be given a simple surgical mask to wear. Doctors should use surgical masks themselves while examining such patients and practice hand hygiene frequently.
· All patients presenting with fever, cough, sore throat or breathing difficulty should be asked for history of international travel in the past 2 weeks. Contact with people who are sick and who have travelled internationally should also be enquired for. If there is respiratory illness with a positive travel history then patients should be referred to government designated centers for isolation and testing. The doctors should maintain a record of the patients referred to the government centers.
· Patients admitted with severe pneumonia and/ or acute respiratory distress syndrome should be evaluated for travel history and placed under contact and droplet isolation. These isolation precautions mean keeping these patients in either separate rooms or cohorting patients with similar illness in one room with at least 1-2 meter distance between patients. The doctor and nurses should wear a surgical mask while approaching these patients and use gown and gloves while touching these patients. They should practice hand hygiene before and after patient contact. Regular decontamination of surfaces should be done. They should be tested for etiology using multiplex PCR panels (respiratory and pneumonia panel) in if logistics permit and in case no pathogen is identified consider testing for COVID-19. They can liaise with government authorities about transferring such patients to designated centres or sending the respiratory samples for testing if the patient is too sick to be transferred.
· Doctors should stop spreading myths and false information about the disease and try to allay panic and anxiety of the public
Dr Bakul Jayant Parekh Dr. G. V. Basavaraj
National President, IAP 2020 Hon. Secretary General, IAP 2020 & 2021