Covid-19 Care @ SRM

• More than 5000 patients with Covid-19 treated in the second wave of Pandemic.
• Less than 1% mortality of Covid -19 cases.
• Dedicated selfless service by Frontline Warriors.
• Nil Mortality in the Doctors and Nurses attending to Covid-19 patients.
• Preparedness and watchful expectancy for the expectant third wave of Covid-19 with the Paediatric, Anaesthesia and Intensivist team.

The Covid-19 Pandemic caused disruption to lives of all human beings. In India a total lockdown was ordered by the Government on 24th March 2020, initially for 6 weeks and subsequently on numerous occasions.

SRM Medical College Hospital and Research Centre was identified by the Government of Tamil Nadu as one of the major hospitals in Chennai zone to treat COVID patients. We were tasked to prepare 200 beds facility for COVID treatment. Accordingly, two wards were converted in to COVID wards and six beds ICU along with COVID operation theatre for established.

The Ground floor of SRM Hospital was divided into three Zones.

• Zone ‘A’ comprising (i) Casualty (ii) Fever clinic in adjoining areas,
• Zone ‘B’ for screening and entry of Medical staff.
• Zone ‘C’ for screening and entry of patients attending various clinics.

Thermal scanning at entry points was mandatory. COVID prevention guidelines thus strictly follows by all concern inside the campus. An exclusive clinical pathway was developed for patients with suspected COVID from Zone ‘A’ to the COVID ward in the first floor with 100 beds capacity. Donning and doffing arrangements were made and thorough training was given to the Doctors, Nurses and Health Care workers. The remaining 100 beds were located in the 2nd floor. COVID ICU with six beds was established exclusively for COVID patients. The wards were made patient friendly, by providing a separate dining hall, TV facility and two way communication to relatives – friends via Tele link. A few snippets of our activities as reflected in local news paper is reproduced below.

In addition, an innovative Voice to text software has been installed in the computer inside the COVID ward with connectivity to a computer outside the ward, where case sheet is printed. This has been done to eliminate the use of paper records inside the ward to prevent spread of the virus and also avoid typing and contaminating the keyboard.

The patients were monitored round the clock by doctors, nurses and other health care workers. All the doctors, nurses and sanitary workers have been well trained in the use of PPE including donning and doffing.

A Hospital Administrative group was created with the Pro-Vice Chancellor, Medical & Health Sciences as Chairman and the Dean, Deputy Dean / Vice Principal, Medical Superintendent, Deputy Medical Superintendent, Chief of General Medicine, Nursing Superintendent, Administrative Heads of HR, Finance, Biomedical Engineering, Operations & IT. This committee met daily to assess the challenges faced by the hospital and planned remedial actions. By this, a coordinated action was initiated in controlling and managing COVID patients as well as protecting all health care workers.

Honourable Minister of Health and Family Welfare, Government of Tamil Nadu, visited the Hospital in 16th April 2020 and expressed profound satisfaction with the arrangements.

SRM Medical College Hospital and Research Centre was the only hospital in Tamil Nadu to be selected to conduct Phase – I, II & III Clinical trials of the indigenous vaccine, “COVAXIN” developed by Indian Council of Medical Research along with Bharat Biotech Ltd., Hyderabad. Dr. Satyajit Mohapatra, Professor of Clinical Pharmacology, was the Principal Investigator. While Phase – I and II have completed in Feb 2021, Phase III is nearing completion by July 2021. The COVAXIN had been cleared for emergency use. It has been administered to 50 million adults in India alone. Permission has been granted by Biotechnology Industry Research Assistance Council (BIRAC), Govt. of India to establish a Clinical Trial in our hospital for vaccination trial. Again, our hospital is the only centre selected for this purpose.

The second wave of the Covid-19 Pandemic hit us like a Tsunami in late March 2021 even as we were picking up pieces from the onslaught of the first wave. The second wave engulfed us with much more ferocity. Located in the outskirts of Chennai, Chengalpattu district reported the second highest number of COVID 19 cases, next only to Chennai metropolis.

The number of cases and variants with unusual presentations were encountered. The striking future of the second wave was a greater proportion of patients presenting with breathlessness, Hypoxia requiring oxygen support. It was heart-breaking to witness young patients who becoming breathless within minutes with drop in oxygen saturation levels leading on to death. Indeed oxygen was a ‘life saver’.

Owing to fear and anxiety caused by the first wave, a vast number of people had approached our hospital in the second wave. More COVID patients from other cities moved in as they were not finding a bed. More patients from rural areas came to our hospital, as the pandemic spread far and wide. As more and more people became infected and fell sick, the hospitals and health care centres became overwhelmed with patients who needed medical attention and lifesaving oxygen. The Doctors and other Health Care Workers (HCW) who had toiled on in the first wave had become weary and tired. This was managed humanely- by rotation of work force, quarantining procedures, offering support, mental health counselling and individualistic interventions. With the sole purpose of duty to fellow men and women, all staff members in our SRM Medical College Hospital continued to serve the ill and the needy.

The “Accident & Emergency” department was revamped, with setting up of additional Emergency COVID ICU. Triage areas marked as ‘Orange’ and ‘Red’ are created and cordoned off.

All moderately to severely sick COVID patients are admitted in our Hospital Block. The hospital block is segregated into multiple areas – the COVID Wards (COVID Ward -1, 2, 3 & 4) for mild cases are housed in a separate floor, the ‘Suspected COVID’ (Pro-tem) Ward is separate. About 600 patient-beds are shared among these wards. The Intensive Care Units (ICUs) for very sick patients are converted to COVID ICUs with round the clock monitoring and supply of oxygen. Additional ICU’s were created, taking the total number of COVID ICU beds to 40. We enhanced our capacity to accommodate 200 patients who were positive- with mild symptoms, who do not need oxygen support- in a separate ‘M’ Block (Medical Block), adjacent to the Hospital. This block – an erstwhile hostel for students, which had been empty since the first wave – is repurposed and converted into a medical facility in the shortest possible time.

Measures have been taken to optimise the use of Liquid Medical Oxygen- which had become a precious and scarce commodity.

There is a huge need for ventilators, BiPAP and CPAP machine to deliver the oxygen to COVDID patients. We had, to some extent, augmented these by local purchase during the intervening period between the two waves of Pandemic. However due to worldwide restrictions in transport and breakage of supply-chain, complicated by surge in demand from every hospital, there is a shortage of life saving oxygen concentrators and other essential equipment to fight the COVID pandemic. With a predicted third wave, we have to double our efforts in this fight.

Immense help is received from our Sister Institutions and Students worldwide, in our fight against this virus. We would like to humbly acknowledge the support and appreciation for our kind hearted Donors Tzu Chi Foundation, Taiwan, -who in the time of this ‘once in a century disaster’ of COVID Pandemic- are helping us. This keeps motivating us to do our best for our fellow human beings.

Oxygen Concentrator, Tzu Chi Foundation, Taiwan – Donation