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The Union health ministry has released guidance document on management of suspect or confirmed cases of COVID-19 in government earmarked railway coaches named as COVID care centres.
Considering the possibility of increase in cases of COVID-19, government has taken the decision to utilize railway coaches as COVID care centres. It has earmarked 215 railway stations for the deployment of railways isolation coaches to be used as COVID care centres for suspected or confirmed patients categorised as mild or very mild cases. These stations will be deployed across 23 states and Union Territories. Further, the Ministry of Railways, as its contribution to national cause, has initiated conversion of railway coaches into COVID care centres to provide additional beds for COVID-19 patients as and when required.
The special train coaches, after formation shall be cleaned, and disinfected as per protocol for disinfection of quarantine facilities issued by Union health ministry.
Railway coaches will be used for the cases suspected/confirmed, and categorized into very mild/mild as per the guidance document on appropriate management of suspect/confirmed cases of COVID-l9: Railway Coaches – COVID care centre issued by the Union health ministry. Guidance document on appropriate suspect/confirmed cases of COVID-l9 aims to observe the patients as mentioned in scope for their symptoms and clinical condition. In case of change of the symptoms/clinical conditions, suitable reference would be given to the designated centre/hospital for further management.
As far as possible, wherever cases are admitted in the COVID care centre coach, preferably individual cabin should be assigned for each case. Should the situation warrant, up to a maximum of two confirmed patients can be assigned in individual cabin.
Railways will designate state wise nodal officers for allocation of trains and for coordinating with the respective State/UT Government. The railways will share the list of their nodal officers, with the States/UTs. The States\UTs shall also designate a nodal officer for coordination with railways.
State/UTs would send their requisition through their nodal officer to the nodal officer of railways following which the railways will make allocation of these coaches to the State/UTs.
After the allocation by the railways, the train shall be placed, at required station with necessary infrastructure and handed over to District Collector/District Magistrate or one of their authorized persons.
The state government shall map at least one COVID-19 dedicated hospital for each train so that patient can be shifted to the hospital in case of emergency. The State\UT government shall make suitable ambulance arrangements for shifting the patient preferably one basic life support ambulance with oxygen and ambu bag should be stationed at the railway station where the train is placed.
In the list of stations, there are 85 stations where the railways shall provide necessary healthcare staff. The respective state/UT government may place a request for placing the coaches at the other 130 stations only if they agree to provide staff and essential medicines at such stations.
The railways would be responsible for provision of all the items as prescribed by the Union health ministry for the COVID care centres, including arrangements for oxygen cylinders in each coach and other necessary items such as including linen etc. Para-medic staff on train shall do bio medical waste segregation at source. The respective state or district shall do waste disposal.
The staff deployed on the special train coaches would work under the overall supervision of the Chief Medical and Health Officer (CMHO) of the concerned district or the nodal officer identified by the respective district collector or magistrate.
Guidelines issued by Central Pollution Control Board (CPCB) or State Pollution Control Board (SPCB) related to treatment of COVID-19 patients shall be strictly followed when the train is handed back to railways. The staff deployed for the train shall ensure all biomedical waste bins are cleaned and emptied.
The railway stations identified include Delhi, Mumbai, Bengaluru, Hyderabad, Chennai, Kolkata and all major cities in states like Punjab, Uttar Pradesh, Rajasthan, Gujarat, Assam, Arunachal Pradesh, Haryana, West Bengal, Jammu and Kashmir, Madhya Pradesh, Telangana, Bihar, Andhra Pradesh, Odisha, Chhattisgarh, Tripura, Tamil Nadu, Goa, Maharashtra, Jharkhand, Uttarakhand and Karnataka.
The most number of stations are in Maharashtra (27) followed by Uttar Pradesh (21), West Bengal (18), Bihar (15), Madhya Pradesh (14) and Assam (13). Railways currently has prepared 5,150 such coaches and there are plans afoot to convert some of them into 'hospitals on wheels' with facilities to treat all kinds of patients.
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