Head of the Hospitals and Medical Services Team at Dubai's COVID-19 Command and Control Centre
Suchitra Bajpai Chaudhary | Chief Reporter
Dealing with a pandemic of this proportion on a war-footing meant synchronising the supply and logistics chain in the health-care sector. 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.
A unified treatment protocol
“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 in Dubai, Abu Dhabi and other emirates,” Dr Kazim said.
Inspection on implementation
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.
Categorisation of patients
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 healthcare planning team proved to be a boon in patient management.
“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.
"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.
Capacity preparedness
“Capacity preparedness was one of the key aspects in the management of the pandemic. We constituted the healthcare capacity planning team right at the onset of the pandemic. We focused on utilising the facilities at the government and private sector as one health system in Dubai. The team consisted of the CEO of Dubai Health Care Corporation from Dubai Health Authority (DHA), together with the CEOs of major private hospitals in Dubai. We were able to admit patients utilising all the available bed capacity in Dubai," Dr Kazim said.
3,000 bed field hospital
Dr Kazim continued: “We built a field hospital at World Trade Centre with 3,000 beds. We had piped 800 of them with oxygen for critical patients at the ICU level. Luckily, we did not require that, but we were prepared. We also had a very effective supply chain and procurement team that sourced ventilators from across the world. They were able to source 570 new ventilators, in addition to what we had.”
Re-purposing health-care professionals
The health-care capacity planning team tackled the staffing of nurses and other professionals in a very imaginative way.
“We had experienced some shortage of nursing staff initially. However, at the beginning of the lockdown, with cessation of elective work and surgeries, nurses and doctors were available and we were able to re-purpose these healthcare professionals to work in areas outside their area of speciality. These nurses and doctors worked under the supervision of the ICU in-charges. However, we needed more and with no planes flying, we used government-to-government diplomatic channels and were able to fly the nurses in from India to support our health care capacity,” Dr Kazim said.
Well prepared at all times
As the operation ran smoothly, the team did not take its eyes off the target and continued even when there was a lull and planned for possible surges in cases. Dr Kazim added: “We identified trigger levels and worked out elaborate plans to tackle such situations. When a typical trigger level was identified, we were ready to deploy our plans. Therefore, we were prepared at all times. We were able to tap into the private health-care sector and double the ICU capacity as well as capacity for COVID wards and High Dependency Unit (HDU) beds.”
Kudos extended to non-COVID treating staff
Dr Kazim said while all eyes were on the COVID management team and the frontline warriors, it was important to acknowledge the contribution of the team of doctors and nurses managing non-COVID patients. These medical staff had taken on additional responsibilities in the absence of their colleagues who were busy fighting the pandemic.
“One cannot undermine the contribution of these doctors and nurses who managed the treatment of non-COVID patients. They are the unsung heroes too and deserve kudos,” concluded Dr Kazim.
Dr Essa Kazim, Head of the Hospitals and Medical Services Team at Dubai's COVID-19 Command and Control Centre.
