CHANGING STRATEGIES
The obstetric care area was modified according to the new clinical needs and divided into three separate sections : Green, Orange and Red zones for non-Covid suspect, Covid suspect and Covid positive patients respectively.
All admissions were screened for Covid-19 by verbal questionnaire method. Covid suspect patients were tested by RT-PCR on admission to Orange zone. Asymptomatic patients were admitted to non Covid suspect (GREEN) zone and no covid testing was done. In case, these green zone patients developed symptoms during hospital stay or were being taken up for Elective surgery or were a contact of Covid positive family member, they were tested by RT-PCR.
With the spread of the pandemic, the patients in our green zone (asymptomatic healthy pregnant females) also had a significant positive report. Due to this the healthcare workers in the green zone as well as the non-infected pregnant females were at risk of exposure as they looked after different zone patients in different levels of PPE.
After taking approval from Institutional Review Board, we implemented the Truenat test as Universal screening for this low risk population while keeping them in a holding area for a short period. After the Truenat test report was found negative, they were shifted to the Green zone along with the healthy individuals. The pregnant females having positive Truenat report were shifted to the isolated area in Orange zone and a confirmatory RTPCR test was sent. (FIGURE 1) . These women were later managed and discharged as per the institutional policy. After discharge, these women were followed up on day 15 for development of any Covid related symptoms.