In a house of about 15 m2 in a residential area of District 7, an 80-year-old man lying motionless, postcards; His wife and granddaughter are getting better. They are all F0.
“The old man is very tired, thanks to you…”, the nephew called the Quick Response Team in Tan Kieng Ward, District 7. More than 10 minutes later, Bui Cao Thang (the last year volunteer student of Thai Medical University) Binh) with the doctor present.
The old man had a stroke, lying in one place for 15 years, could not speak, had underlying respiratory and cardiovascular diseases. “SpO2 75%, give oxygen urgently,” said the doctor. Thang quickly grabbed the oxygen tank. After first aid, SpO2 gradually increased to 90%, temporarily considered critical. However, the family wishes to ask the medical team to take care of him at home because he is old and the other two are also F0.
Every day, Cao Thang, Linh Chi (volunteer students from the same school) and medical staff in Tan Kieng Ward, District 7 Medical Center share to monitor their health, visit, consult, and dispense medicine for each patient. all 119 F0 in the area according to symptoms. Particularly, the 80-year-old man could not eat and drink, so he received intravenous fluids, blood sugar and oxygen…
Ho Chi Minh City has about 15,000 F0 who are taking care of and treating at home. They were those who had no underlying disease, were asymptomatic or had a viral load (CT value) above 30 after 7 days of hospitalization. From August 1 to now, the community health team of Tan Kieng ward has examined nearly 500 cases of suspected mild, moderate and severe symptoms; emergency and successful referral for 88 severe and critical F0 cases. “Every day there are 4-6 emergency cases, but there are also 11 sudden cases,” Thang said.
Similarly, the community health teams of 10 other wards in District 7 have visited at home for 1,018 F0, 1,096 F1; hospital transfer 323 cases of severe transfer; call to advise and handle people through the call center of 3,559 cases; take 1,129 samples for rapid test…
Community health teams of all districts were established in the context that Ho Chi Minh City recorded thousands of new infections every day. From the end of July, when hospitals were overwhelmed, the city allowed asymptomatic F0 to be isolated at home. With this Delta variant, F0 is easy to suddenly change weight, so Ho Chi Minh City has set up 312 quick response teams (doctors, nurses, police, volunteers, youth unions…) in each ward and commune. , town.
Treatment of F0 at home is the first pillar of HCMC’s two-pillar treatment strategy. City leaders assessed that this method helps patients have a comfortable mentality and will get well soon. They are treated promptly when there are signs of serious change, which will reduce the number of deaths. If done well, it is possible that 70-80% of F0 patients will recover in a short time.
>> List of 312 rapid response teams in 22 districts
As a member of the quick response team of Tan Thoi Nhat ward (District 12), nurse Lam Thi Kim Tuyen (32 years old) said that whenever F0 shows signs of serious change in need of emergency (shortness of breath, rapid breathing on the upper respiratory tract). 30 times a minute, lethargy, lethargy, cyanosis of the lips, pain in the limbs, SpO2 < 95%) then the team will come to care or transfer. "But not all patients cooperate with medical staff to go to the hospital easily," Ms. Tuyen said about the team's difficulty.
Delta variation causes F0 to turn severe very suddenly, even in young people, if SpO2 is low, it must be treated immediately. But many people do not clearly distinguish the isolation facility from the first floor treatment facility, so they want to stay at home, even though the doctor has screened and assessed the risk of needing treatment. “Seeing the danger of the patient, many times I knelt down and begged to go to the hospital, they turned to me and asked to stay at home. At that time, I wanted to cry, the situation of thousands of pounds hanging hair but the patient still hesitated. Although I love them, at this time, I have to show my right role as a medical worker,” said Ms. Tuyen.
Tan Thoi Nhat Ward currently has about 60,000 people but only 10 medical staff. Response Team members have to take turns doing everything from giving first aid, taking F0 and F1 samples in the blockade area, isolating at home to supporting vaccination points, making reports, on duty…. Daily , Ms. Tuyen worked until the evening, many days she had to be on duty at night. Her husband is a police officer and is also on the frontline against the epidemic, so they have to send their two young children to a teacher near the house to take care of them. “We also want to send our children to grandparents in the countryside, but we are afraid that we will miss them and infect our family, so we have to let them stay,” Tuyen said.
Before the Ministry of Health piloted “home-based care” for F0 cases at home and in the community, Ward 1, Tan Binh District, distributed medicine bags for F0, including: Paracetamol 500g (10 tablets), Acetylcysteine (10 packs), MultiVitamin (10 tablets), throat rinse (1 vial), 0.9% saline (Sodium Chloride 0.9%), Uscadimin C1g effervescent tablets (10 tablets), gauze mask. Attached to each medicine bag is a specific instruction sheet and a QR code for people to scan the code into the Zalo group with a doctor’s consultation.
Meanwhile, in Phu Nhuan district, in addition to western medicines, the F0 package also includes Oriental medicine (Xuyen Tam Lien, Kovir, Vinaho), thermometers, blood oxygen meters, a “Companion” handbook. with F0 to recover from illness”…
In addition, the mobile medical team will visit the home to examine suspected cases of F0 belonging to high-risk groups such as lonely elderly people, people with mental illnesses, etc. to promptly take them to treatment facilities. treat. For those who have one of the symptoms such as fever over 38 degrees Celsius, cough, sore throat, diarrhea, loss of taste, chest pain, chest heaviness, shortness of breath, are instructed to contact medical staff through the radio 1022, dial 3 for advice from the Medical Association of Ho Chi Minh City, or number 4 for advice from Companion physician. When there are signs of serious change, F0 calls the hotline 115 or the phone number of the Quick Response Team to get emergency treatment and take them to the hospital.
On the second pillar of the treatment strategy, Ho Chi Minh City focused on treating 32,667 F0 at the hospital by increasing the number of beds with oxygen and medical equipment and medicines, so that the hospital could give F0 early aid when showing symptoms. The health sector has also deployed more specific antiviral drugs (remdisivir) in hospitals.
First floor of the new treatment model, there are currently 153 concentrated isolation facilities in districts with a total of nearly 24,000 beds, receiving asymptomatic or mild F0. 2nd Floor including 74 hospitals with more than 49,000 beds, treating F0 with moderate to severe symptoms, with or without underlying disease. Floor 3 including 8 last-line hospitals of the city and of the Ministry of Health, specializing in intensive resuscitation, severe and critical F0 treatment with nearly 3,900 beds.
Le Cam – Le Phuong