No.308/2021-2022
Aizawl the 28th September, 2021 : The Government of Mizoram, Health and Family Welfare Department issued a notification on 26th July, 2021 regarding procedures for availing exemption from payment of expenses for treatment of Covid-19 patients, as follows:-
1. Persons covered:
a) Healthcare workers and staff, including Volunteers engaged for combating the Covid-19 by or under authorisation of the Health & Family Welfare Department, Government of Mizoram.
b) Care-giver of Covid-19 patients under Home Isolation.
c) Members of Village Level Task Force/ Local Level Task Force, including the volunteers appointed by the said Task Forces to strengthen the Task Forces concerned.
d) Members of Covid-19 Executive Duty engaged by the Deputy Commissioner.
2. Circumstance for entitlement to the free treatment:
The infection of the eligible person by Covid-19 virus should have to occur while performing duties for controlling the spread of Covid-19, handling the swab samples or tending the Covid-19 patients. This should be certified -
(i) in case of Health Care Workers, by the controlling officer of the person concerned, or by the Surveillance Team Leader who conducted the Contact Tracing/ Active Case Search in the course
of which the infection was detected; and
(ii) in case of LLTF/ VLTF personnel, by the Chairman or Secretary of the Task Force concerned, or by the Surveillance Team Leader who conducted the Contact Tracing/ Active Case Search in the course of which the infection was detected; and
(iii) in case of the Care-giver, by the Chairman or Secretary of the LLTF/ VLTF concerned, or by the Surveillance Team Leader who conducted the Contact Tracing/ Active Case Search in the course of which the infection was detected;
Explanation: Entitlement to free Covid-19 treatment shall not be available if the disease was contracted while doing any activity other than Covid-19 related duties.
3. Manner of availing free treatment:
(1) The patient who wishes to claim free Covid-19 treatment shall submit at the time of admission in the Covid-19 care facility-
a) Authenticated copy of engagement/ appointment order / letter issued by the appointing authority;
b) Certification of the circumstance of contracting the Covid-19 as prescribed in the preceding Para 2.
c) Henceforth, claims to Covid-19 free treatment may be submitted in the following prescribed format:
(2) The following items shall be provided free of cost to the entitled persons by the Hospital/ covid care facility:
a) Dietary provisions as per standing norms of the Government;
b) Medicines as prescribed by the Medical Officer concerned subject to the guidelines for treatment/ management of Covid-19 patients for the time being in force:
(3) The Health & Family Welfare Department shall ensure that the required medicines FOR TREATMENT OF COVID-19are readily available in the respective covid care facilities as prescribed by the existing Treatment Protocol/Guidelines; and if the required medicine is not available in the covid care facility, the same shall be procured by the Medical Officer/ Medical Superintendent concerned, and the expenses on such procurement shall be borne by the Department.
(4) Claims submitted by any person for reimbursement of expenses on treatment of Covid-19 prior to issuance of this Notification may be entertained and paid from the allocation for running the Covid care facilities, subject to submission of the required appointment orders and certificates of proof of infection while performing the Covid-19 related duties as mentioned here above, and limited to the treatment prescribed by the existing guidelines for treatment as indicated under the following Para
4. Prescribed treatments as per the adopted Guidelines dated 27.05.2021 of the Director General of Health Services, Ministry of Health & Family Welfare, Govt, of India are as highlighted hereunder:
4.1 Asymptomatic patients: Persons tested Covid-19 positive, but without any Covid-19 symptom.
a) Placement: To be isolated at home (home isolation) or CCC with monitoring by tele-consultation.
b) Mainstay treatment: No medication required for COVID-19 infection; continue medications for other co-morbid conditions, if any; promote tele-consultation by patient; promote COVID appropriate behaviour (mask, strict hand hygiene, physical distancing); advise healthy balanced diet with proper hydration; advise patients and family to stay connected and engage in positive talks through phone, video-calls, etc.
c) Investigations: Usually, no investigation required at this stage.
4.2 Mild Symptomatic: No shortness of breath; no difficulty in breathing; Respiratory rate < 24/minute; Sp02: > 94% on room air; take 6- minute walk test with no shortness of breath.
Placement: Home Isolation (with tele-consultation) Or Covid Care Centre
Mainstay treatment: Promote COVID appropriate behaviour (mask, strict hand hygiene, physical distancing); advise healthy balanced diet with proper hydration; advise patients and family to stay connected and engage in positive talks through phone, video-calls, etc. Self-monitoring for fever, breathlessness, Sp02 or worsening of any symptoms; Anti-Pyretic and Anti-tussive for symptomatic relief; Inhalational Budesonide (given via Metered dose inhaler with space device) at a dose of 800 mcg BD for 5 days) for cough; No other COVJD-19 specific medication required.
Investigations: Patients may have to be investigated further if symptoms persist or deteriorate.
4.3 Moderate Symptomatic: Shortness of breath experienced with difficulty in breathing; Respiratory rate more than 24/minute but less than 30/minute; Sp02: 90-93% on room air.
Placement: Admit in DCHC or Covid Hospital.
Mainstay treatment: Oxygen support to be titrated to maintain Sp02 between 92%-95% in patients without COPD (Chronic Obstructive Pulmonary Disease). In case of COPD, oxygen therapy may not be required as target Sp02 is between 88%-92% which by definition of moderate cases is already present. Control of co-morbid conditions especially diabetes. Steroids have to be given if Sp02 is below 92%. Practise proning for better oxygenation of lungs. Obtain baseline investigations and repeat the same as per need.
Further treatment by steroids, anti-coagulants and/or of immune-modulators (immunosuppressant) shall be guided by the results of the baseline and repeat investigations. Prophylactic doses of anticoagulants such as LMWH or unfractionated heparin.
4.4 Severe Symptomatic: Severe shortness of breath and difficulty in breathing; Respiratory Rate more than 30/min; Sp02< 90% on room air except in COPD patients.
Placement: Admit in ICU of Covid Hospital.
Mainstay Treatment: Immediate oxygen therapy, initiate at 5 L/Min and titration to reach target Sp02 > 90% in non-pregnant adults and 92-96% in pregnant patients. Steroid therapy. Baseline investigations to be repeated as per need. Further treatment by steroids, anticoagulants and/or of immune-modulators (immunosuppressant) shall be guided by the results of the baseline and repeat investigations. Prophylactic doses of anticoagulants such as LMWH (Low Molecular Weight Heparin) or UFH (Unfractionated Heparin)eg. 40 mg. enoxaparin S/ C daily. Anticoagulants may also be administered based on clinical judgement.
