LAUSR

BACKGROUND In the state of Karnataka, India, the first case of COVID-19 was diagnosed on 9th March 2020. As stated by WHO, around 15% of COVID-19 patients require ICU (Intensive Care Unit) care. Keeping this in mind, along with the increase in COVID-19 patients in Karnataka, it was predicted that the prevailing general wards & ICUs would be overburdened with the added non-COVID-19 diseases and infirmities. Hence, it was decided to setup a separate infrastructure so as to reduce the chances of transmission among the patients within the hospital. Thus, the board at SDM College of Medical Sciences & Hospital, Dharwad, Karnataka, took the responsibility to establish a fully equipped 100-bedded hospital in its premise as part of national & state service to combat the outbreak. AIM To establish an isolated, fully functional hospital, equipped with all necessary diagnostic & critical care facilities to treat patients diagnosed with COVID-19 in North Karnataka, India. METHOD DESIGN Conversion of a Cranio-Facial Unit (CFU) building, consisting of 3 floors into a 102 bedded hospital, divided into COVID-19 wards & ICU. The bed strength of the CFU building was utilized, adding more beds to wards where feasible, & converted to a fully functional COVID hospital. SETTING A temporarily closed (due to COVID-19 Pandemic) Cranio-Facial Unit (CFU) building at SDM college of dental sciences & hospital, in North Karnataka, India. The facility is located near the main hospital, i.e., SDM college of medical sciences & hospital, Dharwad, Karnataka, on the outskirts of district Dharwad, near a small village called Sattur. RESULT A complete stand-alone hospital was setup, comprising of an 88 bedded, fully functional general ward, 6 bedded fully equipped ICU & 8 bedded fully equipped step-down ward & 1 Operation Theatre (OT). Due to the prompt setup of a fully functional hospital, 290 patients were admitted & treated. The same was duplicated in the main hospital's super specialty building during the 2nd wave in India for which the beds were increased to 513 (53 ICU beds & 460 ward beds). DISCUSSION Given the sudden surge of cases, it became imperative to setup a facility that can manage the patients on a short notice; this was solved by transforming the CFU building that was inactive at that time because of the nationwide lockdown. This brownfield project was undertaken as an ideal location to covert the CFU unit into a COVID-19 specific hospital that can handle the requirement of beds as asked for by the government & administrative agencies initially. CONCLUSION A facility set up on a war footing to tackle the pandemic in the region with focus on factors like adequate infrastructure, contactless treatment, establishment of strong communication channels to ensure proper counselling of the patients and their relatives and adherence to timeline is an example of situational approach in disaster medicine.