As India gears up for a surge in Covid-19 cases, policymakers in New Delhi could do well to take a look at China’s “fangcang” shelter hospitals, which according to a new study in medical journal Lancet, played a critical role in controlling the outbreak of the coronavirus pandemic in the country.
Simply defined, the “fangcang” shelters for Covid-19 patients in Wuhan, the first epidemic epicenter, were public spaces like stadiums, convention centres, exhibition centres, gymnasiums, factories, and warehouses that were remodelled to become temporary large-scale health-care facilities.
These shelters had their job define to act as buffers or mass quarantine spaces under medical supervision for patients who had tested positive for Covid-19 but showed mild symptoms and did not need urgent treatment. They were only transferred to a hospital if their condition worsened.
These shelters helped in a major way by freeing up the heavily burdened medical infrastructure in Wuhan in February and early March by taking in and isolating the positive patients with mild or moderate symptoms who would have ended up spreading the infection if allowed to stay in contact with family and community members. It was one reason why home isolation for Covid-19 patients with mild to moderate symptoms wasn’t allowed.
“They served to isolate patients with mild to moderate Covid-19 from their families and communities, while providing medical care, disease monitoring, food, shelter, and social activities,” the study by experts from China, the US and Germany, titled “Fangcang shelter hospitals: a novel concept for responding to public health emergencies” said.
The study said that early epidemiological evidence showed that more than half of Covid-19 patients in China had at least one family member with the disease, and 75 percent to 80 percent of clustered infections were within families.
The shelters had three key characteristics: rapid construction, massive scale, and low cost; and five essential functions, — isolation, triage (order of treating a large number of patients), basic medical care, frequent monitoring and rapid referral, and essential living and social engagement.
“Early descriptive evidence suggests the Fangcang shelter hospitals were a major reason for the successful Covid-19 control in China. The number of confirmed cases in Wuhan steadily declined from February 18, 12 days after the first Fangcang shelter hospitals started admitting patients,” the paper said.
Wuhan authorities built 16 such shelters in three weeks in February.
“By March 10 (when all the shelters were shut down), the 16 hospitals had provided care to about 12,000 patients. In caring for and sheltering such a large number of patients who would otherwise have been confined to their homes, these shelter hospitals effectively supported China’s Covid-19 policy of leaving no patient unattended or untreated,” the authors said.
According to the paper, in Wuhan, the bed vacancy rate in traditional hospitals designated for the care of Covid-19 patients increased from 4 percent on February 4 to 16 percent on February 22, when 16 makeshift hospitals had started admitting patients.
Are other countries emulating the experiment?
“Other countries facing the Covid-19 pandemic should consider using Fangcang shelter hospitals as part of their public health response,”says the study.
It also recommends that the future design and construction of large public venues (eg, stadiums, convention centres, exhibition centres, gymnasiums, factories, and warehouses) should integrate features facilitating the conversion of these infrastructures to Fangcang shelter hospitals, such as interior equipment that can be rapidly removed, entrances that are large enough for hospital beds, and ventilation systems that reduce the risk of cross-infection.”
Some countries are already following the example.
Serbia is building Fangcang shelter hospitals by converting public venues into health-care facilities to isolate and treat patients with mild to moderate Covid-19.
Iran, the USA, the UK, and Spain are implementing measures that are similar to Fangcang shelter hospitals.
The authors said: “It was likely that many other countries, including in sub-Saharan Africa and Asia will also need to adopt such measures to ensure sufficient capacity to both effectively isolate and care for the large number of people who will experience mild to moderate Covid-19.”
