Residential community COVID management – Webinar Takeaways

The second wave of COVID-19 has put forth a situation that demands more support from residential communities. ADDA conducted a webinar on COVID Management in Residential Communities on Saturday, 8th May, 2021 with a panel of experts who shed light on different aspects of residential community COVID Management like setting up COVID Emergency Centres, things to keep in mind while conducting Vaccination Camps, usage of masks etc. 

The panel consisted of:

1. Dr. Satyanarayana Mysore, HOD & Consultant – Pulmonology, Lung Transplant Physician, Manipal Hospitals

2. Mr. Karthik Rajagopal, Chief Operating Officer, Manipal Hospitals

3. Mr. Anish Nema, EC Member, Prestige Ferns Residency

4. Mr. Sridhar Pabishetty, Founding Director, Kautilya School of Public Space

5. Mr. Vikram Rai, General Secretary of Bangalore Apartment Federation and 

6. Mr. Mangesh Ranawade, Chairman, Maharashtra Societies Welfare Association MAHASEWA, Chairman, Kharghar Taloja Welfare Association KTCWA

The Webinar Takeaways for residential community COVID management

How can resources be arranged for residential community COVID management?

  • Volunteering teams can be requested to look at the requirements and see what can be arranged. The requests can be made for essentials such as food, oxygen cylinders/ concentrators or help with finding a bed.
  • Apartments have to be looked at as small, medium and large in terms of size categories. Extra flats or Party Halls can be used as temporary isolation centers with sanitation potential and clinical partnership to help guide from a distance. Building a funnel model or a hub and spoke model can be useful for residential community COVID management.
  • Physical infrastructure is easier to create than finding skilled medical staff. This in-between model of a Covid Care Center and home isolation should outlive the pandemic. We can look at this as a model for healthcare in the coming years. At the end of the day, it’s a bridge not a permanent solution. 
  • Home isolation is not as widely possible in the second wave for many patients due to the variants of concerns of the virus mutant and the nature of unpredictability. 
  • However, rather than being seized with fear about such a dreadful change guidelines on Care Centres must be followed while reaching out to government officials can strengthen grassroot functioning at communities. 
  • Among other things, few things like 24*7 support, medical expertise, staff etc are practical for residential community COVID management, few things are not. 
  • Do not wait for saturation to come down to 92% since valuable time has been lost in search of hospitals. CDC recommends that everytime positive patient travels in elevator, there is no need for deep cleaning, surface cleaning enough. 
  • Scale of the pandemic is huge, so reverse barrier care should be taken into consideration by protecting elderly. Since infectivity rate is high, it’s important that infection control measures are taken care of. This applies to diagnostic center tie ups when it comes to home care. 
  • Repeated bouts cough or cough attack are a sign of functional unit of lung getting inflamed. At this point, oxygen levels can fall and should be a wake up call to not ignore cough or suppress it by cough syrup. 
  • Book a bed if oxygen levels start dropping. If the saturation is on lower side, Dr. Satyanarayanan recommends booking a bed. If symptoms are less, you can always cancel the booked bed. 

On Vaccination and Vaccination Camps:

  • Private healthcare institutions like Manipal have been pushing for door-to-door vaccination. Ideal vaccine should not require too much of cold-chain dependency and should be quickly transportable. Pfizer and Moderna hard to maintain in cold chains. Covidshield and Covaxine, Sputnik and J&J follow. Till then, masking is the substitute. 
  • Propensity to form clots is high in Europeans as opposed to Indians. Clots are formed only in rare cases. Once you receive a jab, you may feel feverish but do not give up mobility and hydrate well. 

Three-tier formula should be followed while setting up a vaccination camp as part of residential community COVID management:

  1. Waiting area – For patients waiting to get their registration done. 
  2. Inoculation area – Area for getting the jabs.
  3. Observation area – Waiting area for any post-jab adverse effects. 

Besides this, inoculation area needs to be air conditioned. 

On Oxygen Concentrators:

  • Oxygen should be regarded as a medication. Proper medical approach is in place – It is not a panacea for maintaining patients indefinitely at care centers. After 7 days, patient would be put on steroid. 
  • Traditionally, all types of concentrators do not keep oxygen beyond 0-5 litres. Do not be deceived by the promise number. 

On setting up COVID Emergency Centres:

  • Large apart complexes that have vacant houses can be used for COVID Care Centres. Physical infrastructure, oxygen concentrators and planning process depends on size of apartments, number of residents etc.
  • Don’t get rid of emergency rooms after pandemic. These can be used for saving lives in emergencies after basic training is given to caretakers.
  • Roughly, a community with around 200 units can have 2 beds. No ready made formula as such for residential community COVID management. 

How can we, at neighbourhood level come together to manage the situation?

Space infrastructure, equipment, clinical and personal bandwidth are know- how’s that can be integrated among volunteers. These can come together in larger communities as opposed to smaller sized communities.

Collect data to construct a model where there are small, medium and large communities in the picture. Fostering partnerships with institutions like Manipal to collaborate small infrastructure can go a long way in effective residential community COVID management. Find opportunities to collaborate with institutions and other neighbourhoods, schools, offices and create clusters of CCCs. 

When system is not objectively accessible, people can turn protectionist. This is the ethical dilemma. First instinct is to naturally look out for ourselves. Now, it’s time to create model which takes neighbours into account.

In various portions of Navi Mumbai, isolation followed in cooperative societies has curbed the spread of virus. Societies should propogate regular testing and screening among members as part of residential community COVID management. 

From the perspective of Public Policy:

  • Rebalancing of various stakeholders in the society at large is the need of the hour. Resources pooled in and made common resources, creation of stabilization facilities etc. can reduce hoarding. BBMP’s recognition of ward’s potential to manage grassroot level zones has also proved beneficial in residential community COVID management.
  • Since people’s rights are involved in RWAs, relooking at basic bye-laws, acknowledging people’s rights should help when guidelines are flouted.

To get started on ADDA with a free COVID Essential Package, click here.

To view the presentation by Mr. Anish Nema, click here.

The Q&A Session:

Q. Is there a risk of aerosols from a COVID flat traveling to a different flat that is directly above or below and sharing a ventilation shaft?

A: In terms of building design and transmission through air ducts, there are simple solutions. If common duct is shared, using air purifier is not a bad idea. No point in looking at wash basin where virus has been reported to spread from neighbouring flats. Ensure there is collateral ventilation at home. It’s not a bad idea to wear mask at home in case of shared ducts.  

Q. Please throw some light on use of masks and types. What is the right masking practice and what type of masks can be used in current scenario?

A: N95 can last for about 6-8 hours. Go for change of mask after that. Ideally, single-use mask should not be disposed. 6 masks can be used and rotated. When double masking, use N95 inside and other masks outside the N95 covering it. You can go for 2 cloth masks which should be washed immediately after use. 

Q. What is the basic cost involved in setting up infrastructure for Oxygen? 

A: Ideally it would cost about INR 3,00,000 to go ahead and set up oxygen infrastructure. 

Q. Which brand of vaccination can communities opt for?

A: Even one dose of vaccination has shown some efficacy (around 56%). Whether it’s Pfizer, Moderna, J&J, any vaccination is stronger when coupled with the usage of mask. 

Q.  Is it necessary to get vaccinated after recovery from COVID?

A: One may need to wait for at least 2 months if you get COVID-19 from first dose, before one goes for second dose. 

If you are interested in reaching out to any of the panelists, please click here.

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