Measures undertaken to ensure safety of health workers drafted for COVID-19 Services

Measures undertaken to ensure safety of health workers drafted for COVID-19 Services. Smt. Preeti Sudan, Secretary, Department of Health & Family Welfare has sent DO letter to all states/UTs.

Government of India
Department of Health and Family Welfare
Ministry of Health & Family Welfare

PREETI SUDAN
Secretary

D.O. No.Z-20015/127/2019-ME.I(Pt.I)
Dated: 20th April, 2020

Dear Colleague,

Doctors and Health Professionals are at the forefront in the fight against COVID-19. Their efforts and spirit is being widely acclaimed at all levels. The skills and spirit of service amongst these professionals places them in a unique position to save people from this disease.

2. It is of utmost importance that adequate measures are taken for ensuring their safety. In this regard , several measures have already been taken from time to time. These are annexed with this letter (Annexure-1). The same may be widely disseminated amongst all the doctors and health professionals in all the government and private hospitals/medical colleges in your State for their information.

Yours sincerely,

(Preeti Sudan)

Ends: As above.

Additional Chief Secretary/Principal Secretary/Secretary (Health/Medical Education) of all States/UTs.

MEASURES UNDERTAKEN TO ENSURE SAFETY OF HEALTH WORKERS DRAFTED FOR COVID-19 SERVICES

Doctors and Health Professionals are at the forefront in the fight against COVID-19. Their efforts and spirit is being widely acclaimed at all levels. The skills and spirit of service amongst these professionals places them in a unique position to save people from this disease.

2. It is of utmost importance that adequate measures are taken for ensuring their safety. In this regard, several measures have already been taken from time to time. Some of these measures are enumerated below :

Human Resources

1. Various cadres of personnel and volunteers across sectors and departments that can also be involved in not only COVID related work but also for ensuring maintenance of other essential medical services have been identified . The respective roles of these cadres have also been mapped . An advisory in this regard was issued and is available on the website of the Ministry at https://www.mohfw.gov.in/pdf/EssentialservicesduringCOVID19updated0411201.pdf.
2. An Empowered Group (Group 4) has been set up at the National level for augmenting human resource and capacity building. This Group is working on HR and capacity building and has considered the data base of all personnel. This data base is being shared with the States to help them mobilise these cadres and volunteers. A portal with data base of such cadres is also being created.
3. An SoP for allocation of Residents/PG Students and Nursing Students as part of hospital management of COVID-19 has also been issued and placed on the website at https://www.mohfw.gov.in/pdf/COVID19SOPfordoctorsandnurses.pdf.

Medical safety:

1. Department of Health Research (DHR)/ Indian Council for Medical Research (ICMR) has recommended the use of hydroxy-chloroquine for prophylaxis of SARS-CoV-2 infection for high risk population including all asymptomatic healthcare workers involved in the care of suspected or confirmed cases of COVID-19
2. Nearly 5.11 lakh PPEs have been supplied to various States/Central Hospitals by the Central Government, which have added to the initial stock of 2.75 lakhs available with States. The Ministry has also supplied 30.32 lakh N95 masks to States which is over and above the initial stock of 16.67 lakh N95 masks with them. Since there were no domestic manufacturers of PPEs in the country, the MoHFW in collaboration with Ministry of Textiles worked to encourage domestic production. More than 50 domestic manufacturers have cleared quality tests so far and orders for nearly 1crore PPEs have been placed with them.
3. Healthcare workers are also being tested for COVID-19, who examined a confirmed case without adequate protection or who are symptomatic.
4. A high level multi-disciplinary team has been deputed to assist States in Cluster containment plan and ICU & Ventilator management.

Staffing guidelines and timely payments:

Guidance note released by MoHFW mandates timely payments for frontlines workers such as ASHAs and service providers including those requisitioned from outside of government sector. The same is available on the website of the Ministry at https://www.mohfw.gov.in/pdf/EssentialservicesduringCOVID19updated0411201.pdf

Psychological Support:

1. A dedicated toll-free helpline-08046 110007, for providing psycho-social support for health care workers has been created by using suitable professionals including psychiatry department residents.
2. Health professionals are being encouraged to practice stress management techniques. Training modules have been designed in this regard and available at the website of the Ministry .

Training/Capacity Building:

1. To build the capacities of human resources including the medical manpower who help managing patients in hospitals; as well as non-medical personnel, front line workers, who may be involved in non-medical duties such as logistics, surveillance etc., for COVID-19 management, an ‘Advisory for Human Resource Management of COVID-19’ has been prepared providing guidance to States/UTs on the human resources that can be mobilized for COVID-19 management along with possible role assignments and their training requirements.
2. The Training Resources for medical and non-medical personnel on inf ection prevention and control, clinical management including ventilation, logistics etc. is being updated regularly and is available on the website of Ministry of Health & Family Welfare . State Government and institutions are also being encouraged to conduct required training by mobilizing necessary resources.
3. Online training and webinars for Physicians and Nursing personnel is being conducted by AIIMS, Delhi! INC on management of patients with COVID-19 and Septic Shock, ventilation strategy, management of aerosol generating medical procedures, infection and prevention control practices, psychological care of patients etc. A total of 6 lakh views have been recorded as on 20.04.2020. The AIIMS webinars can be accessed at https://www.youtube.com/channel/UClhipqBlENbKtsWsVkOP vg
4. MoHFW has finalized and issued several guidelines and training material for on MoHFW website, such as:
   1. Frontline health workers including ASHA, ANM and Anganwadi Workers
   2. Pocket book for frontline health workers
   3. Facilitators guide for trainers of frontline workers
   4. SOPs for transporting a suspect/ conf irmed case of COVID-19
   5. Guidelines for disinfection of public places
   6. Guidelines for COVID waste disposal
   7. Advisory to start rapid antibody-based blood test for COVID-19
   8. Guidelines for specimen collection, packaging and transport for SARS­ CoV-2
   9. Guidelines for COVID-19 testing in private labs in India
   10. Guidelines for rational use of PPE
   11. Guidelines for setting up of isolation facility/ wards
   12. Guidelines for management of Severe Acute Respiratory Inf ection (SARI) in COVID-19 patients
   13. Guidelines for inf ection prevention and control in healthcare facilities
   14. Guidelines for use of IEC for general health facilities and designated hospitals
   15. Training of incident response system- Basic and Intermediate
   16. Guidelines for quarantine facilities
5. The Integrated Government Online Training ciGOT)- Diksha platform of the government has been utilised to ensure that uniform trainings can be conducted for healthcare professionals across the country. These can be accessed at https://igot.gov.in/igot/.
6. All health care workers including frontline workers are being trained in standard protocols for Infection Prevention Control and advised consistently to adhere to guidelines issued for infection prevention, personal protection and physical distancing norms, for facility level care, outreach visits or home-based care.
7. Currently, there are 12 courses in different languages which have been uploaded under the MoHFW tab on the website including courses on topics like-
   1. Basics of COVID-19
   2. Quarantine and isolation
   3. Infection prevention through PPE
   4. Psychological care of patients with COVID-1
   5. Infection prevention and contro
   6. Laboratory sample collection and testin
   7. Clinical management of COVID-19
   8. Management of COVID-19
   9. ICU Care and Ventilation Management
8. Courses are updated based on evolving guidelines, and newer content on diverse topics are being uploaded on the platform on everyday basis. Each course content is being uniquely designed, mapped and aligned to the requirement s of various categories of professionals, such as Doctors, Nurses, AYUSH, Allied and Healthcare Professionals, Frontline line workers as well as non-health Volunteers .
9. Till date, more than 1.77 lakh enrollments have been made for various programs on the platform which comprises more than 95,000 unique candidates. All the key stakeholders such as State Governments, statutory bodies, professiona l associations, among others are being encouraged to disseminate the inf ormation at various levels.
10. State Government and institutions are also being encouraged to conduct required training by mobilizing necessary resources.
11. A dashboard is also being prepared, for mapping all available workf orce, the trainees and volunteers, trainings undertaken by different bodies to enable a more robust communication channel.

Life Insurance Cover:

1. Under the Pradhan Mantri Gareeb Kalyan Package, the Government has announced an Accidental insurance cover of Rs 50 Lakhs for 22.12 lakh healthcare workers who may be draf ted for services for COVID-19 patients. The Scheme covers loss of lif e due to COVID 19 and accidental death on account of COVID 19 related duty. T.he scheme has been sanctioned and premium paid to the insurance company.
2. Under the scheme, claimant of any person providing services for CoVID-19 can claim the compensation if the service provider sustains loss of life due to COVID 19 and accidental death on account of COVID -19 related duty.
3. The insurance is free for the beneficiaries and the premium has been paid by the Government for these beneficiaries.

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Source: https://www.mohfw.gov.in/pdf/MeasuresUndertakenToEnsureSafetyOfHealthWorkersDraftedForCOVID19Services.pdf