Challenges in COVID-19 Pandemic Triaging: An Indian and US Perspective

<b>Background/Objectives:</b> The COVID-19 pandemic overwhelmed many health care facilities with patients, leading to an increased risk of potential transmission. Though the disease process was identical, the triaging system was unique at different sites, without a unified system for eme...

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Main Authors: Muralidhar Varma, Robin Sudandiradas, Mauli Mahendra Patel, Trini Ann Mathew, Marcus Zervos, Shashikiran Umakanth, Asha Kamath, Mahadev Rao, Vandana Kalwaje Eshwara, Chiranjay Mukhopadhyay, Vijaya Arun Kumar
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Emergency Care and Medicine
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Online Access:https://www.mdpi.com/2813-7914/2/2/18
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author Muralidhar Varma
Robin Sudandiradas
Mauli Mahendra Patel
Trini Ann Mathew
Marcus Zervos
Shashikiran Umakanth
Asha Kamath
Mahadev Rao
Vandana Kalwaje Eshwara
Chiranjay Mukhopadhyay
Vijaya Arun Kumar
author_facet Muralidhar Varma
Robin Sudandiradas
Mauli Mahendra Patel
Trini Ann Mathew
Marcus Zervos
Shashikiran Umakanth
Asha Kamath
Mahadev Rao
Vandana Kalwaje Eshwara
Chiranjay Mukhopadhyay
Vijaya Arun Kumar
author_sort Muralidhar Varma
collection DOAJ
description <b>Background/Objectives:</b> The COVID-19 pandemic overwhelmed many health care facilities with patients, leading to an increased risk of potential transmission. Though the disease process was identical, the triaging system was unique at different sites, without a unified system for emergency department triaging globally. Proper implementation of pre-screening and triaging is of paramount importance in tertiary care settings to prevent nosocomial spread of infection. <b>Methods:</b> Each country has its own triage guidelines and Infection, Prevention, and Control policies developed by its health ministry and may face significant challenges in implementing them. Triage guidelines followed by two tertiary care hospitals in Detroit, United States of America and Manipal, India are compared during the early phases of the COVID-19 pandemic. <b>Results:</b> This paper offers a unique perspective of the challenges experienced with the hospital triage practices and provides solutions to address them. The future trajectory of COVID-19 epidemiology in both countries will be determined by the adherence to best practices in Infection Prevention and Control and triage protocols. The healthcare facility triage algorithm is constantly evolving in both settings as new evidence is being added to hospital epidemiology and infection prevention practices. <b>Conclusions</b>: Training healthcare workers on new triage protocols is required. It is critical for infectious disease doctors, clinical microbiologists, hospital epidemiologists, and Infection Prevention and Control (IPC) staff to collaborate with clinicians, nurses, and other ancillary staff in order to successfully implement the triage protocols. Developing and modifying guidelines for cleaning hospital triage areas and providing high throughput for patient care are also important lessons learned. Usage of face shields and the quality of Personal Protective Equipment (PPE) should be ensured for all healthcare workers (HCWs). Resilient staff and resilient hospital infrastructure are crucial for a sustainable response to future pandemics.
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spelling doaj-art-085ee050cc614943bf32b2a9304e1d4a2025-08-20T03:26:56ZengMDPI AGEmergency Care and Medicine2813-79142025-04-01221810.3390/ecm2020018Challenges in COVID-19 Pandemic Triaging: An Indian and US PerspectiveMuralidhar Varma0Robin Sudandiradas1Mauli Mahendra Patel2Trini Ann Mathew3Marcus Zervos4Shashikiran Umakanth5Asha Kamath6Mahadev Rao7Vandana Kalwaje Eshwara8Chiranjay Mukhopadhyay9Vijaya Arun Kumar10Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, Karnataka, IndiaEdward and Cynthia Institute of Public Health, Mangalore 575007, Karnataka, IndiaDepartment of Internal Medicine and Pediatrics, Corewell Health West, Grand Rapids, MI 49503, USACenter for Emerging Infectious Diseases, Wayne State University, Detroit, MI 48202, USADepartment of Infectious Diseases, Henry Ford Hospital, Wayne State University, Detroit, MI 48202, USADepartment of Medicine, Dr. TMA Pai Hospital, Manipal Academy of Higher Education, Manipal 576104, Karnataka, IndiaDepartment of Applied Statistics and Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal 576104, Karnataka, IndiaDepartment of Pharmacy Practice, Kasturba Hospital, Manipal Academy of Higher Education, Manipal 576104, Karnataka, IndiaDepartment of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, Karnataka, IndiaDepartment of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, Karnataka, IndiaDepartment of Emergency Medicine, Wayne State University, Detroit, MI 48202, USA<b>Background/Objectives:</b> The COVID-19 pandemic overwhelmed many health care facilities with patients, leading to an increased risk of potential transmission. Though the disease process was identical, the triaging system was unique at different sites, without a unified system for emergency department triaging globally. Proper implementation of pre-screening and triaging is of paramount importance in tertiary care settings to prevent nosocomial spread of infection. <b>Methods:</b> Each country has its own triage guidelines and Infection, Prevention, and Control policies developed by its health ministry and may face significant challenges in implementing them. Triage guidelines followed by two tertiary care hospitals in Detroit, United States of America and Manipal, India are compared during the early phases of the COVID-19 pandemic. <b>Results:</b> This paper offers a unique perspective of the challenges experienced with the hospital triage practices and provides solutions to address them. The future trajectory of COVID-19 epidemiology in both countries will be determined by the adherence to best practices in Infection Prevention and Control and triage protocols. The healthcare facility triage algorithm is constantly evolving in both settings as new evidence is being added to hospital epidemiology and infection prevention practices. <b>Conclusions</b>: Training healthcare workers on new triage protocols is required. It is critical for infectious disease doctors, clinical microbiologists, hospital epidemiologists, and Infection Prevention and Control (IPC) staff to collaborate with clinicians, nurses, and other ancillary staff in order to successfully implement the triage protocols. Developing and modifying guidelines for cleaning hospital triage areas and providing high throughput for patient care are also important lessons learned. Usage of face shields and the quality of Personal Protective Equipment (PPE) should be ensured for all healthcare workers (HCWs). Resilient staff and resilient hospital infrastructure are crucial for a sustainable response to future pandemics.https://www.mdpi.com/2813-7914/2/2/18ED triageCOVID-19resilience
spellingShingle Muralidhar Varma
Robin Sudandiradas
Mauli Mahendra Patel
Trini Ann Mathew
Marcus Zervos
Shashikiran Umakanth
Asha Kamath
Mahadev Rao
Vandana Kalwaje Eshwara
Chiranjay Mukhopadhyay
Vijaya Arun Kumar
Challenges in COVID-19 Pandemic Triaging: An Indian and US Perspective
Emergency Care and Medicine
ED triage
COVID-19
resilience
title Challenges in COVID-19 Pandemic Triaging: An Indian and US Perspective
title_full Challenges in COVID-19 Pandemic Triaging: An Indian and US Perspective
title_fullStr Challenges in COVID-19 Pandemic Triaging: An Indian and US Perspective
title_full_unstemmed Challenges in COVID-19 Pandemic Triaging: An Indian and US Perspective
title_short Challenges in COVID-19 Pandemic Triaging: An Indian and US Perspective
title_sort challenges in covid 19 pandemic triaging an indian and us perspective
topic ED triage
COVID-19
resilience
url https://www.mdpi.com/2813-7914/2/2/18
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