Nghe An: Initial advantages in implementing treatment of Covid-19 patients at home

Establishing a mobile medical station to treat F0 at home

On January 4, 2022, the People's Committee of Nghe An province issued Document No. 12/UBND-VX "on the implementation of a mobile medical station model in Vinh city and Cua Lo town to manage and care for people with Covid-19 at home". According to the document, the Health Insurance Fund will pay for medical examination and treatment costs for patients with health insurance cards according to current regulations of the law on health insurance.

The provincial budget supports various types of expenses, including: medicines, chemicals, consumables, essential medical equipment directly serving treatment; expenses for waste treatment, disinfection spraying; testing for quarantined subjects... Policies and regimes for patients and forces directly involved in treating patients according to regulations. Other related expenses arising during the treatment of patients.

Doctor Tran Thi Giang Lam, in charge of the Nghi Phu Commune Mobile Health Station, collects health information of Covid-19 patients being treated at home via phone. Photo: Thanh Chung

The budget of Vinh city and Cua Lo town covers other related costs including ensuring facilities for mobile medical stations; allowances for support forces participating in epidemic prevention and control tasks of mobile medical stations (except for those directly treating patients); transportation costs... People pay for their own food and living expenses during the days of treatment at home (drinking water, towels, masks, hand sanitizer, mouthwash, toothbrushes, soap and essential items, other costs).

The Provincial People's Committee has assigned specific responsibilities to the Department of Health, Department of Finance, Department of Natural Resources and Environment, Department of Information and Communications, Provincial Social Insurance, Vinh City People's Committee and Cua Lo Town People's Committee in implementing the mobile medical station model in Vinh City and Cua Lo Town to manage and care for people with HIV.Covid-19at home

Implementing the direction of the Provincial People's Committee, on January 5, Nghe An Department of Health issued Instruction No. 60/HD-SYTNVY providing temporary guidance on implementing the mobile medical station model in Vinh city and Cua Lo town. According to the instruction: Each commune and ward in Vinh city and Cua Lo town must arrange 1 mobile medical station; requisition 1-2 rooms of commune and ward medical stations to arrange a workplace for the mobile medical station.

There must be a notice sign in front of a house where someone is in quarantine. Photo courtesy of TH

The initial staff of the mobile health station is 2 medical staff, including at least 1 doctor, to take care of 1-20 Covid-19 cases. When there are 1-10 more Covid-19 cases, 1 more medical staff will be added. In addition to the professional staff, the People's Committee of the commune or ward will establish a Covid-19 care team. The team has at least 2 people, each team manages 10-20 Covid-19 patients being treated at home. When there are 1-10 more Covid-19 cases, 1 more person will be added. The team leader can be the Party Cell Secretary, Head of the Residential Group or Head of the Building Management Board, apartment complex.

F0s who are treated at home are those aged ≥ 3 months to ≤ 49 years old; have not detected underlying diseases; have received enough doses of vaccine; and have no abnormal health signs. Caregivers for Covid-19 patients under 16 years old or unable to live independently if they wish... F0s who are not treated at home are pregnant women; children under 16 years old who wish but do not have a caregiver or the caregiver has underlying diseases.

Facilities for F0s to be treated at home must meet the following requirements: Individual housing; apartments in collective housing areas or apartment buildings where Covid-19 patients are registered as permanent or temporary residents; have a private room or house and a separate toilet area for Covid-19 patients... In the patient's room, in front of the house gate, there must be a yellow waste bin. The house must not use central air conditioning, and there must be separate eating and drinking utensils for the patient...

Tasks of the mobile medical station: Manage and monitor Covid-19 patients at home and in the community (identify and make a list of Covid-19 patients in the area, a list of Covid-19 patients treated at home according to the assigned area; guide, advise, regularly monitor the health and support the care of Covid-19 patients treated at home according to the instructions of the Ministry of Health; organize medical examination and treatment remotely and at home; guide and dispense medicine for Covid-19 cases treated at home; detect, provide first aid, and promptly refer Covid-19 cases with severe progression to Covid-19 treatment facilities appropriate to the patient's condition; summarize Covid-19 cases in the area that have recovered and Covid-19 cases that have completed home treatment; report to competent authorities on the Covid-19 epidemic situation in the area under their responsibility; Covid-19 testing; Vaccination Covid-19 vaccine; Communication on Covid-19 prevention and control; examination, treatment, and medication for Covid-19 patients with other diseases (if any).

Suitable, effective and convenient for patients

Associate Professor, Dr. Duong Dinh Chinh - Director of Nghe An Department of Health said: The implementation of the mobile medical station model in Vinh city and Cua Lo town to manage and care for asymptomatic and mild Covid-19 patients at home is very suitable and effective in the current situation. This helps improve response capacity and readiness on the spot; create favorable conditions for asymptomatic and mild Covid-19 patients to be isolated, monitored and treated at home; contribute to minimizing the impact of the Covid-19 epidemic on economic development, security, order, safety of families, communities and society; contribute to reducing the burden on Covid-19 isolation and treatment facilities... In the immediate future, the treatment of asymptomatic and mild Covid-19 patients at home is only applied in the two localities of Vinh city and Cua Lo town - where there are adequate conditions in terms of facilities, equipment and human resources.

Isolating Covid-19 cases at their place of residence by inter-family groups or households is very appropriate and effective in the current situation. Photo courtesy of Thanh Son

After the documents were issued, at this time, Vinh city and Cua Lo town issued decisions to establish mobile medical stations in wards and communes. Some wards and communes in the area have activated mobile medical stations, put into practice caring for and treating Covid-19 patients such as Nghi Phu commune mobile medical station, Hung Dung ward (Vinh city).

Mr. Ha Van Trung - Chairman of Nghi Phu Commune People's Committee said: Immediately after receiving instructions, the commune arranged to set up a mobile medical station at the commune health station; Vinh City People's Committee has decided to set up a mobile medical station. On January 9, upon receiving news of cases in the area, the Commune People's Committee directed the implementation of the process of handling people infected with Covid-19 in the community, including: activating the mobile medical station; setting up a hotline; approaching households; assessing and evaluating home isolation conditions; posting warning signs at homes where people infected with Covid-19 are isolated; Issuing a Decision to apply measures to isolate people infected with Covid-19 at home; Assigning local human resources to ensure security, order, and compliance with home isolation; establishing and directing the implementation of the Covid-19 Care Team; ensuring logistics for facilities managing people infected with Covid-19; Widely disseminate information to the public and monitor... In general, the implementation of mobile medical stations and patient care is going smoothly.

Management and care of patientsCovid-19Asymptomatic and mild symptoms at home are very suitable, contributing to reducing the load on Covid-19 quarantine and treatment facilities. Photo: Document

At this time, Nghi Phu Commune Mobile Health Station has 4 staff, including 2 health station staff and 2 final year students from Vinh Medical University. The station is providing care and treatment for 5 asymptomatic and mild Covid-19 patients in the area.

Doctor Tran Thi Giang Lam - Head of Nghi Phu Commune Health Station, in charge of the mobile health station, shared: Every day, the staff of the mobile health station is on duty 24/7 to receive information from patients, housemates, and care teams for Covid-19 patients; monitor and update information on the health status of Covid-19 patients via phone; provide health guidance and consultation to Covid-19 patients and caregivers; in necessary cases, provide direct support to Covid-19 patients; create medical examination and treatment records of Covid-19 patients to make payment for medical examination and treatment costs... The mobile health station has been performing its assigned tasks well. Relatives and patients are very comfortable when receiving care and treatment right at home.

Information from mobile health stations in wards and communes, besides the advantages, there are still some concerns and problems in the process of implementing mobile health stations and caring for patients that need to be resolved soon, namely: Facilities and medical equipment of mobile health stations are still cramped and lacking, relevant levels and sectors need to soon make additional investments and support. Human resources of mobile health stations according to documents of the Provincial People's Committee and instructions of the Department of Health are not guaranteed. There is still a problem of fear in caring for and treating patients at home. The waste treatment process needs to be carefully calculated, especially when the epidemic spreads, many patients receive treatment at home.../.