UPDATE : Thursday, June 4, 2020
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‘Community treatment centers save medical resources in pandemic’
  • By Kim Yoon-mi
  • Published 2020.04.01 14:47
  • Updated 2020.04.01 14:47
  • comments 0

Treating people with the mild symptoms of COVID-19 at non-hospital facilities not only prevents the transmission but saves medical resources to focus more on severe patients amid the shortage of hospital beds, researchers here said.

Professor Kim Choong-hyo of the Department of Neurosurgery at Kangwon National University School of Medicine and his team released a report Wednesday on the treatment results of 309 patients with cohort isolation at one of the largest community treatment centers (CTCs) in Korea.

On March 9, the “Gyeongbuk-Daegu 7 CTC,” located in Gumi, North Gyeongsang Province, received 309 patients confirmed with COVID-19 infection but were isolated at home due to the shortage of hospital beds, according to the research team. The CTC excluded COVID-19 patients with underlying diseases, including heart failure, chronic kidney disease, high fever, or difficulty in breathing.

The structure had been LG Display’s dormitory building but was renovated as a CTC, as the spiking number of confirmed cases in Daegu and North Gyeongsang Province overwhelmed limited hospital resources. During the first two weeks after admission to the CTC, 107 patients, or 34 percent, were discharged without any complication, but seven were transferred to a hospital due to symptom aggravation, the researchers said.

The CTC had seven physicians, five nurses, and one radiologic technician, seven public health doctors, and 24 volunteer nurses and nursing assistants.

The treatment center was separated into two zones – the clean zone for healthcare workers and the patients’ zone – to prevent cross-infection between healthcare professionals and patients.

After patients’ admission, medical workers monitored their body temperature twice a day. To minimize the access of healthcare professionals to the patients' zone, the researchers encouraged patients to install a specialized mobile application to report their body temperature. More than 80 percent of the patients complied with the use of the app.

“Utilizing CTCs has several advantages compared to isolating patients at home: strict isolation with active surveillance of patients is possible; it also lowers the risk associated with collecting viral specimens and the possibility of cross-infections,” the research team said in the paper.

However, the operation of the CTC had limitations, too, the team noted, including the lack of a negative-pressure air conditioning system and the poor adherence to the protocol of changing protective clothing between every testing of patients due to the shortage of resources.

Also, as physicians selected and admitted patients under the criteria limited to their age and a simple questionnaire, the risk factors and the severity of the disease of each patient were not fully understood, the research team said.

“Nevertheless, in terms of the efficient allocation of medical resources in a pandemic status such as this case, CTC is thought to be a novel, cost-effective and resource-saving strategy,” the research team concluded.

After Korea started operating CTCs on March 2, the number of COVID-19 patients who had no other option but to be isolated at home due to the shortage of hospital beds has dropped from 3,000 to less than 300 on March 18, the researchers added.

As of March 18, there were 12 CTCs in operation, but each had different criteria for screening, admission, and discharge of patients, they said.

The report was published in the Journal of Korean Medical Science under the title of “Out-of-Hospital Cohort Treatment of Coronavirus Disease 2019 Patients with Mild Symptoms in Korea: an Experience from a Single Community Treatment Center” on Wednesday.

yoonmi@docdocdoc.co.kr

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