Kochi: In response to the surge in COVID-19 cases authorities have decided to open COVID First-Line Treatment Centres (CFLTCs) across Kerala. The state government has directed that CFLTCs with at least 100 beds be made operational in each panchayat. More than 8,000 doctors will be required to run these temporary facilities aimed to ease the strain on COVID hospitals when a large number of cases are reported regularly as a result of the community transmission of the disease.

As per the norms of the health department, a 50-bed CFLTC needs four doctors. Finding so many doctors for setting up CFLTCs under many local self-government bodies in the state would be a big challenge. 

The grama panchayats which are the local self-government bodies at the village level in Kerala number 941. (The count of municipalities and corporations are 87 and 6 respectively.) 

The service of a doctor will be required full time if an outpatient (OP) ward is to operate in the CFLTCs from 8 am to 6 pm. As a doctor taking care of COVID patients cannot perform other duties, doctors from other government hospitals cannot be temporarily posted at CFLTCs.

The current proposal is to deploy doctors in six shifts. They will also have to quarantined after 14 days of duty.

Besides doctors, at least three nurses have to be assigned to a 50-bed hospital per shift. Finding so many nurses for CFLTCs in each panchayat will be a big ask. 

Although these special healthcare centres are set up by local self-governing bodies, it is the district health department and the National Health Mission (NHM) unit at the state level that have to provide the required doctors and nurses. 

The government directive also says that each CFLTC should have an ambulance, which means a few thousands of them will be needed for all the CFLTCs in the state.

In many districts, efforts are on to post doctors from less busy government hospitals and final-year PG students from medical colleges in CFLTCs. There are also plans to use telemedicine services if needed.

At present, the cost of starting a CFLTC is being borne by the village panchayats through plan outlay, own funds and sponsorship.

The panchayats will be reimbursed Rs 25 lakh for opening a 100-bed CFLTC, Rs 40 lakh for opening a centre with more than 100 and less than 200 beds, and Rs 60 lakh for centres with more than 200 beds from the state relief fund.

It will be the responsibility of the local authorities to find volunteers and cleaning staff for the centres. But the panchayats will find it difficult to draft volunteers for COVID duty owing to fears.

While the health department will supply the medicines, other facilities, including food, will have to be provided by the local bodies through sponsorship and other means.

Facilities at CFLTCs

The temporary hospitals will have an enquiry/examination counter, a doctors’ consulting room, observation room, nursing room, pharmacy and store. There will be separate wards for men and women. The local body will provide beds and mattresses.

Ambulance service will also be available 24 hours a day.

A centre will have the capacity to treat at least 50 to 100 patients. It will also have a tele-medicine facility.

The district collector makes announcements regarding the opening of a CFLTC.  

COVID-19 has so far claimed 56 lives in Kerala. The state reported over 1,000 positive cases each on Wednesday and Thursday and the number dropped to 885 on Friday.