The city has been witnessing a steady rise in the number of new COVID cases since the past few weeks. On April 23rd, the city recorded 3,842 fresh COVID cases. With the extremely high contagion rates of the virus in its mutated forms, the numbers have been spiralling out of control, creating shortage in the availability of beds, drugs and even oxygen in many cities. Naturally, the panic among citizens is also palpable and it is neither uncommon nor unnatural to find people grappling with uncertainty over what to do and how to respond if they, or any of their family, test positive.

Here is a guide, compiling authentic facts and guidelines, that will help readers figure out how to go about COVID care without loss of time, when to seek hospitalisation and what to do in situations when hospitalisation gets delayed.

First things first. What are the symptoms and where are the testing centres?

• Common early symptoms of the disease include cough, fever, shortness of breath, sore throat, congestion, headaches, body aches, sudden loss of smell and taste, commonly reported by recent COVID patients. However, some asymptomatic patients may not experience any of these.
• Whether you are a frontline worker in close contact with known COVID-19 patients, or an asymptomatic person, buy an oximeter to measure oxygen levels in the blood every day. An oxygen saturation level of 95% is considered normal for most healthy individuals. An oxygen saturation level lower than 90% is considered to be worrisome and calls for immediate medical attention.
• Get a swab test done from any of the ICMR accredited laboratories if you have symptoms of COVID-19. The new ICMR rule states that any person can get tested without a doctor’s prescription. In a private lab, you will have to pay at the rates decided by the lab in question to get your swab test done. Get the list of ICMR-accredited laboratories here.
• According to a notification released last December, the Tamil Nadu Health Department had capped the test cost at Rs 1,500 for private labs. In case of home collection of samples, an additional Rs 500 can be charged. For persons with Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS), they can be charged a maximum of Rs 1,200 for individual tests and Rs 900 for pooled testing.
• Testing can also be done at the sample collection centres and fever camps being conducted by GCC in all the zones. The results will be sent via SMS within 24 hours of the swab. If the result is positive, it will also reach the concerned corporation official in your zone.  

I’m COVID positive. What next?

Soon after testing positive, do not fret and go about searching for beds. Visit the nearest screening centre to check the severity (mild, moderate and severe) of the disease.

Here is the list of COVID screening centres set up by the Chennai Corporation.

Patients are categorised into three groups and managed in the respective COVID hospitals:

Treatment centre	Patient category	List of centres
COVID Care Centres/Home Isolation	Mild cases: Suspected cases, clinically assigned as asymptomatic/high-risk negative cases (None above 50 years of age or those with comorbidities should come under this category)	Athipattu TNHB quarters Anna University Presidency College hostel Velammal Engineering College Dr Ambedkar Government Arts College Bharathi Women’s College Jawahar Engineering College IIT-Madras NSTI Guindy Guru Nanak Arts and Science College University of Madras hostel Jerusalem Engineering College Mohammed Sathak Nursing College
COVID Health Centre	Moderate cases: Suspect and confirmed cases clinically assigned as mild-moderate cases.	Communicable Diseases Hospital RSRM hospital ESI Ayanavaram Tambaram TB hospital KK Nagar Peripheral Hospital Tondiarpet Peripheral Hospital – I Tondiarpet Peripheral Hospital – II (RSRM)  Anna Nagar Peripheral Hospital Periyar Nagar Peripheral Hospital Institute of Obstetrics and Gynecology (IOG) Kasturba Gandhi Hospotal (KGH) Madras Medical College (MMC) – RIO Omandurar Medical College (OMC) – RIO The list of private hospitals that offer COVID Health Centre facility can be found here.
Dedicated COVID hospitals for severe cases	Severe & high-risk cases: Suspect and confirmed cases clinically assigned as severe/with co-morbidities / vulnerable / elderly	The list of private and government tertiary care institutions for patients can be found here.

The civic body is permitting private hospitals to run private care centres for patients with mild symptoms at hotels or other agencies with properties. This was done in view of expected demand in future for care centres. At present, the corporation has over 12,000 beds in its care centres.

Before moving to a COVID Care Centre or a hospital, keep the kit of documents and other essentials ready.

• Essentials: Clothes, mobile, laptop, charger, debit cards, oximeter, facemasks, thermometer, toiletry and sanitation kit, water bottle, electric kettle and hand sanitisers
• Documents: Insurance details, medical history files, list of allergies.

Home isolation for 14 days is likely to be recommended by the treating medical officer from Chennai Corporation or one’s personal doctor if 

• He/she comes in contact with a COVID-positive patient. It is vital to monitor the temperature during this period.
• When a citizen is COVID-positive but asymptomatic
• When the patient has mild symptoms such as cold, cough, fever, diarrhoea and headache.
• If the patient has no comorbidities such as hypertension, diabetes, heart disease, chronic lung/liver/kidney disease etc.

In these circumstances, the caretaker should monitor the health of the patient regularly and the patient should be hospitalised if the symptoms turn severe (such as difficulty in breathing, dip in oxygen saturation to lower than 90%, persistent pain/ pressure in chest and discolouration of lips/ face.)

When a COVID patient has recovered and is back home, he/she will be isolated and symptoms will be monitored to ensure the person is cured.

A minimum of two rooms with attached bathrooms and a caretaker is a must for home isolation. If your home is not conducive, get in touch with the Corporation official who will suggest a COVID Care Centre (for example, educational institutions and hotels) in your vicinity.

For persons in home isolation, a health worker from GCC will check your health status every day either personally, or through a phone call. Do not hide any details as it will affect the assessment. 

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Read more: Current COVID protocol to follow if you are travelling to Chennai

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How to go about hospitalisation?

• Choose the nearest government hospital and check bed availability. If there is no response from the government agencies, call up the Corporation official in your zone 
• You can contact the concerned GCC official from your zone to enquire about the government hospitals. 
• If you want to opt for a private hospital, call them beforehand and check for bed availability. Here is a list of private hospitals and their contacts.
• It costs about Rs 2 -3 lakh in an average private hospital (higher in some hospitals) for the seven day COVID treatment package
• If you have medical insurance, there is a high chance that your treatment is covered in it. Keep your insurance company posted about your treatment details.  
• The patient should go to the hospital (government or private) in an ambulance only. Call helpline number 108 to call an ambulance. If you have chosen the private hospital, authorities will send home an ambulance. 
• Please note that most hospitals will not allow a family member or any attendant to stay with the infected person due to the risk of spread. 
• Provide the details of all the people you were in contact with. Contacts are persons who have been exposed to a confirmed case anytime between two days prior to onset of symptoms and the date of isolation (or a maximum of 14 days after the onset of symptoms)

What to do if I do not get a bed at a hospital?

It is important to stay connected with your family physician until you test negative and get treated. Dr Madhu Pai, Professor & Canada Research Chair of Epidemiology & Global Health, McGill University has shared a few guidelines for home management on Twitter:

Early COVID 

• Get a pulse oximeter 
• Mask yourself and family members to protect everyone
• Open windows and ensure proper ventilation
• Stay (isolate) at home and rest
• Stay hydrated
• Analgesia (paracetamol)

Oxygen saturation >92%

• Paracetamol for fever and aches
• Hydration with water & fluids with sugar and salts (ORS)
• Sleep prone on your stomach if possible, to improve lung oxygenation
• Inhaled budesonide (steroid) 2 puffs twice a day until symptoms resolve

Oxygen saturation <92% (Seek hospital care)

• Home oxygen if available (use the lowest amount to keep saturations >92%)
• Monitor oxygen saturation and urgently seek hospital care, if saturation is <85 or oxygen needs are 4L per minute
• Sleep prone on your stomach, to improve lung oxygenation. Check here for more details on this.
• Hydration and paracetamol for fevers

What is the discharge policy?

a. For mild/very mild/pre-symptomatic cases 

• Patients can be discharged after 10 days of testing positive, provided they have been found without a fever for 3 consecutive days at the COVID care centre. 
• No need for a negative RT-PCR test prior to discharge 
• Patients will be advised to follow home isolation for a further period of 7 days after discharge 

b. For moderate cases 

• Patient can be discharged 10 days after a positive test, and if they have been asymptomatic for 3 consecutive days
• No need for a negative RT-PCR test prior to discharge 
• Patients will be advised to follow home isolation for a further period of 7 days after discharge.

c. For severe cases 

• Patient will be discharged upon clinical recovery 
• They must have a negative RT-PCR test after resolution of symptoms 

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Read more: Catch the latest on vaccination, fever camps, hospital beds and night curfew in Chennai

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Resources

It is normal to feel anxious, confused or sad during a crisis. Talk to the people you trust to ease your emotions. You can also contact GCC tele-counselling centre for psycho-social support: 044 4612 2300 / 044 2538 4520

Also read:

• India’s COVID response: A choice between decisive action and national distress
• The second wave: All about the latest COVID testing, containment and vaccination protocol in Chennai

(Inputs from Greater Chennai Corporation, Tamil Nadu Health & Family Welfare Department and Ministry of Health & Family Welfare Department)