Seeking order amid chaos

Command centre to help those looking for hospital beds

Signs saying “double masking mandatory” welcome the visitors at the non air-conditioned hall on the seventh floor of the office of the National Health Mission (NHM) here.

Amid the whirring of pedestal fans and air-coolers placed in corners, a team of about 50 people work in shifts round the clock in an attempt to match demand with supply — COVID-19 patients in urgent need of oxygen or hospitalisation. This is the Unified Command Centre (UCC), the new nerve centre for COVID-19 management in Tamil Nadu that became functional on Friday, mainly to handle bed capacity at hospitals.

What happens inside the centre may look chaotic with some looking at the giant displays, many on phones and running around to communicate with one another. However, this is the ordered chaos inside the centre that intends to help control the chaos outside with many people frantically searching for hospitals, particularly in Chennai.

SOS lines

On Friday, the government announced that patients in need of oxygen and intensive care can call 104 helpline or post on the Twitter handle @104_GoTN.

Among those in UCC are people hand-picked from different teams, including many doctors. S. Uma, a doctor by qualification and Additional Collector of Ranipet, has been deputed as the nodal person.

As the number of cases continue to rise, Darez Ahamed, Executive Director of Guidance Bureau and former NHM Mission Director, who has been deputed to handle the bed capacity, says UCC is an attempt to prevent the situation prevailing in places such as Delhi from happening in Tamil Nadu.

“If we imagine 104 and Twitter as our eyes and ears to know the demand and hospitals as our personnel to treat, what is perhaps needed is a brain to coordinate. That is what we want UCC to do,” says Dr. Ahamed, who was instrumental in setting up the centre.

How it works

Requests received by the 104 helpline team, situated elsewhere, and the Twitter handle, which is monitored at UCC, are fed into the centralised system where they are categorised based on severity and other parameters. Requests for beds from all other channels like the helpline run by the Greater Chennai Corporation also flow into this system.

The real time data on the pending requests are put up on a giant display. A separate team monitors the live locations of all ambulances on another screen.

Those from UCC, mainly doctors, call the patient’s attenders to assess the situation. Once they ascertain the patient’s needs, they begin the hunt for a hospital bed. A team from the Chief Minister’s Comprehensive Health Insurance Scheme, sitting at UCC, liaisons with the hospitals.

Those handling insurance at individual hospitals are the nodal persons for updating UCC about bed availability and fulfilling the requests for beds. WhatsApp groups have been formed to handle these communications internally.

As of Saturday, UCC was tracking nearly 500 hospitals across Tamil Nadu, with almost 164 of them in Chennai. With the government asking all private hospitals to allocate 50% of their beds to COVID-19 patients, these numbers will go up soon.

Since its launch, requests have started flooding UCC.

G.S. Adhityan, a doctor from NHM, who is part of UCC, says emergency cases are accorded the priority. “We get requests for medicines or beds for those who may not really need a bed. UCC is not catering to such requests at the moment as other channels are available,” he says.

With cases rising sharply, UCC, despite the resources and power at its disposal, is finding it difficult to get beds in Chennai. However, a majority of requests are fulfilled. The situation in the rest of the State is normal now, officials say.

Capacity planning

Dr. Ahamed says capacity planning for the surge has been happening in parallel in anticipation of a sharp increase in active cases in the coming days. A separate team has begun visits to many private hospitals to assess their capacity and see if they can be increased. He says that apart from increasing capacity, effective triaging is the need of the hour to handle the demand for beds.

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