Logistics and protocols key to managing peak of pandemic
Dealing with a pandemic of this proportion on a war-footing meant synchronising the supply and logistics chain in the health-care sector and Dubai’s Covid-19 Command and Control Centre (CCC) effectively achieved that, making sure that every medicine, every bed, and every health-care professional was put to optimal use to get the best results.
Dr Essa Kazim, Head of the Hospitals and Medical Services Team at Dubai’s CCC described in detail the treatment protocol and procedures that facilitated effective management of the situation on the ground.
“While managing patients across Dubai, we were following the national guidelines for the management of Covid-19, announced by Abu Dhabi, in cooperation with all the health regulatory bodies in the UAE. We decided to form a treatment protocol task force in Dubai headed by the Mohammad Bin Rashid University, which had representatives from Dubai Health Authority (DHA) and the private sector,” said Dr Kazim.
Dealing with a dynamic situation
Nothing was left to chance and every crucial decision-making aspect was linked to the international developments.
“At the Covid-19 treatment protocol task force, we go through the most recent literature, particularly peer-reviewed publications, to obtain the latest evidence for treatment of Covid-19. The team brings out a document on treatment protocol, which is regularly updated. This document has been circulated in the public and private sector,” explained Dr Kazim.
Apart from the protocol task force, CCC also follows the practice of convening regular weekend meetings to take stock of the plans of action.
“At a virtual forum held every Saturday afternoon, we have participation from the members of both public and private-sector doctors in Dubai, Abu Dhabi and other emirates,” Dr Kazim said.
Once the modalities are discussed, CCC goes a step further in terms of implementation of the protocol. Dr Kazim said: “We then press the inspection teams into service. These teams were formed during the initial days of the pandemic. The teams visit the hospitals, both government and private, to ensure that patients are being treated in the right manner. Additionally, they conduct reviews at random. The reports of these treatments are presented to us for review and we ensure that there is uniformity of treatment protocol across Dubai. Obviously, doctors would use their clinical judgement in managing the patients under them,” said Dr Kazim. One of the finest examples of patient management was the development of an elaborate matrix of grades in terms of severity of disease to help select the right procedure and methodology that suits each COVID patient. This categorisation adopted by the health care planning team proved to be a boon in patient management.
We formed a matrix for categories of patients. Every category was defined, in terms of symptoms and treatments required, and based on that we decided on where the patient was required to be moved.” Dr Essa Kazim | Head of Hospitals and Medical Services Team, CCC
Matrix formed
“In collaboration with the DHA, we formed a matrix for categories of patients depending on the severity of their disease. This began from the very mild, asymptomatic patients to the critically ill patients. Every category was defined, in terms of symptoms and treatments required, and based on that we took decisions about where the patient was required to be moved,” Dr Kazim explained in detail how it worked.
“Even the Dubai Corporation for Ambulance Services (DCAS) was told what parameters they had to look out for. This matrix was available to the Central Bed Management Centre, the Command Centre, the ambulance services, and the hospitals. There was complete clarity about what kind of care a patient required and where he or she needed to go. Patients with mild symptoms could go to isolation facilities. The whole system functioned as one single coordinated unit,” he elaborated.
Dr Kazim said the way Dubai managed it there was coordination from the leadership all the way down. The leadership was involved in every aspect of the management of the pandemic. It was a multidisciplinary exercise with the involvement of many other bodies such as the security services, the relevant government departments such as Dubai’s Roads and Transport Authority (RTA), and Dubai Municipality. Complete and comprehensive coordination of Team Dubai was evident in this.