Aiming to reduce the number of deaths due to the novel coronavirus, the Delhi government on July 14 asked healthcare facilities to minimise time taken in admission of COVID-19 patients and to allocate a health care worker each for critical patients.

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It also asked them to accord priority to high-risk patients during admission. High-risk patients include the elderly, pregnant women, immuno-suppressed and pediatric patients, and those having co-morbidities, such as cancer, hypertension and diabetes. In an advisory, the Delhi government's health department also stressed on the need for round-the-clock availability of a dedicated well-trained team for transportation of patients to appropriate treatment zones without any delay. The facilities have been asked to ensure real-time monitoring of blood oxygen saturation levels and use early warning score cards for monitoring in wards. "Any fall in oxygen saturation to be managed immediately... prompt remedial measures to be ensured," the advisory read.

The healthcare staff has been asked to provide oxygen therapy in a staged manner, as per the clinical guidelines of the Union Ministry of Health and Family Welfare. Senior resident doctors and specialists are required to closely monitor the condition of COVID patients at regular intervals, it said, adding tele-consultation with experts from AIIMS may be done as required.

For COVID-19 patients needing critical care, a "single command and control structure may be formed for better inter-department coordination", it said. The healthcare facilities have also been asked to make arrangements for continuous renal replacement therapy or sustained low efficiency dialysis with technicians as most of the critical COVID patients develop acute kidney injury. Hospitals have been asked to report deaths in a prescribed format with accurate data. The government also directed internal death committees of hospitals to suggest remedial measures to lower mortality.