Another important measure is to aid the recovery of people who have been discharged from an Intensive Care Unit. Both cases have a common requirement - the isolation center. Health care Isolation centers (HCICs) provide a “COVID-19 level of care” and/or a “quarantine level of care.”
General conditions for an isolation building
- They must be prepared to admit individuals from congregate settings and hospitals. They may serve as a step-down setting after a hospital stay if necessary, to maintain isolation or clinical needs.
- Individuals admitted to isolation units must have a COVID-19 level of care.
- It should be well equipped with adequate personal protective equipment for the staff. This PPE includes (but is not limited to) medical/surgical masks,N95 respirators, eye protection/face shields, extended and reusable gowns, including cloth isolation gowns, disposable gloves.
- The ventilation system should be designed in a way that inside air does not mix with the outside air.
- It should be well equipped with hand sanitizers for the usage of medical and cleaning staff.
- They must be located in physically discrete spaces.
Preparation of the isolation area
- Ensure that appropriate handwashing facilities and hand-hygiene supplies are available for the safety of the patient and the medical staff.
- Stock the sink area with suitable supplies for handwashing, and with alcohol-based hand rub, near the point of care and the room door.
- Ensure adequate room ventilation.
- Post necessary signages around the isolation ward or building.
- Keep a record of staff members working in the isolation areas for possible outbreak investigation and contact tracing.
- Keep minimal furniture which is easy to clean and does not conceal or retain dirt or moisture within or around it.
- Stock the PPE just outside the isolation room (e.g. in the change room).
- Place waste bags inside a bin. In fact, use touch-free garbage bins.
- Restrict the patient's personal belongings to a minimum. Keep water pitchers and cups, tissue wipes, and all items necessary for personal hygiene, within the patient's reach.
- Thoroughly clean and disinfect common patient-care equipment (e.g. stethoscope, thermometer, blood pressure cuff and sphygmomanometer) that is required for use by other patients before use. Infact, dedicate a separate one for each patient, if possible.
- Place an appropriate container with a lid outside the isolation room door where equipment that requires disinfection or sterilization can be placed.
- Ensure scrupulous daily cleaning of the isolation room or area.
- Set up a telephone or other method of communication in the isolation room or area so that patients can easily communicate with health-care workers. This reduces the amount of PPE donned by healthcare professionals after each visit to the patient.
Wearing and removing personal protective equipment
Before entering the isolation room or area:
- Collect all equipment needed.
- Clean your hands with an alcohol-based hand rub or soap and water.
- Put on PPE in the order that prevents self-contamination.
Leaving the isolation room or area
- Remove PPE in the changing room. In the absence of one, ensure that the PPE will not contaminate either the environment outside the isolation room or area, or other people.
- Remove PPE in a manner that prevents self-contamination. Remove the most contaminated PPE items first.
- Sanitize your hands immediately after removing gloves.
- Remove the mask or respirator last (by grasping the ties and discarding in a rubbish bin).
- Discard disposable items in a closed rubbish bin.
- Place reusable items in closed containers.
Laundry checklist for isolation center workers
1. Clothing, towels, linens and other items that go in the laundry
- Wear disposable gloves when handling dirty laundry from an ill person and then discard the gloves after each use. Thoroughly wash hands immediately after gloves are removed.
- Launder items using the warmest appropriate water setting for the items and then dry the items completely.
- For handling, consider placing a bag liner that is either disposable (can be thrown away) or can also be laundered.
2. Soiled linens or clothing
- Immediately remove and wash clothes or bedding that have blood, stool, or body fluids on them.
- Wear disposable gloves while handling soiled items and keep soiled items away from your body. Clean your hands (with soap and water or an alcohol-based hand sanitizer) immediately after removing your gloves.
Inside an isolation building - Dubai
Dubai Health Authority (DHA) recently released a video which gives us an inside look into the Covid-19 isolation facilities.
In the video, Abdulla Abdulrazzaq Balouma, the director of general services & administration affairs department shares some insight on the isolation process once patients are out of ICU and emphasized how attention to detail is prioritized in order to ensure infection control and how patients are provided with the best standard of treatment while they recover from the virus which has hit the entire world.
In just 15 days, 350 comfortable and fully equipped rooms were built to accommodate patients whose health needs to be stabilized after coming out from the ICU. A lot of technical precision goes into the isolation building. This precision also adheres to the highest medical standards and includes the following measures:
- Attaining approximately 97% cleanliness by constant disinfection and sanitization.
- Implementing an AC system which considers the outside air positive and inside air negative and does not mix the two. This ensures safety for the medical staff deployed in the isolation buildings.
- Setting up garbage bins in isolated areas which specifically cater to the disposal of COVID-19 contagious items. These bins come with a signage which instructs operators not to touch them with their hands.
- Sanitizers and signages have been set up throughout the isolation building to ensure that the medical staff are protected at all times.
- There are several entertainment avenues for patients. These include TVs, coffee makers, phones and other amenities which provides comfort and allows patients to be at ease in the isolation facility.
- Patients are given five healthy meals a day in order to revive their immune system. The meal plan is designed by a specialized Nutrition Management Team.
However, the facilities mentioned above require a lot of time and effort on part of the government and the DHA. Many staff members are unable to see their families for days in order to ensure that the rooms are ready for patients. Hence, the DHA has appealed to all to stay home and break the chain!