DEDICATED COVID HEALTH CENTER

In current pandemic of COVID-19 second wave, Govandi-deonar has been affected badly. Hospital is located at Deonar Municipal colony. Hospital is near fire brigade near Sai Temple. These areas have been declared as containment zones in past. In this context, With tremendous rise in cases , We have set up Dedicated COVID Health Centre (DCHC).
Spandan has continued to provide health care services in spite of the fact that we are in the red zone. With a holistic approach, Spandan takes care of the entire slum population around the hospital by educating people and how to stay safe & change their lifestyles to remain healthy. Spandan has distributed ration kits to hundreds of slum dwellers of Annabhau Sathenagar and has opened counselling centres.
With the help of community youths, we have also screened number of covid suspected individuals in the community and guided them for further investigations and management.

We have 20 beds and they are connected with central oxygen line. Prompt treatment will help them to recover faster and will prevent complications. Not only we provide medical management to covid patients, we have intensfied our health promoting efforts and advocacy in slums.

1. Location of the DCHC: SPANDAN HOLISTIC MOTHER-AND-CHILDCARE HOSPITAL
Near Deonar Fire Brigade, Municipal colony, Deonar,
Mumbai – 400 043, Maharashtra, India.
It is 10 Min. from Chembur, 10 min. from Ghatkopar-Mankhurd Link Road and 5 min. from Eastern Freeway.

Major Activities Proposed:
• Dedicated COVID Health Centre (DCHC) for covid patients in Spandan Holistic Mother-And-Child Care Hospital, is essentially integrated holistic multidisciplinary Center.
• Holistic prompt medical management of patients with mild and moderate covid
• Homoeopathy, yoga and nutrition therapy as adjuvant to modern medicine treatment.
• Physiotherapy especially by Respiratory physiotherapist.
• Multidisciplinary team work involving chest physician, internal medicine experts, neurologists and competent RMO.
• INFORMATION,EDUCATION AND COMMUNICATION: M-East ward regarding COVID_19, Not only we will provide medical management to covid patients, we will intensify our health promoting efforts and advocacy in slums.
• Preventive and health promotive care in this area.
• Providing holistic integrated care including psychology counseling in this area
• Holistic post covid care
Physiotherapy in Covid 19:
Once stable, if indicated the main goal in respiratory physiotherapy is to mobilise secretions and ease the work of breathing. Interventions may include techniques such as positioning, autogenic drainage, deep breathing exercises, breath stacking, active cycle of breathing mobilisation and manual techniques (e.g. percussion, vibrations, assisted cough) to aid sputum expectoration. These interventions can be performed at any stage of the disease where appropriate and safe to perform.
During the acute phase of COVID 19, Lazerri et al suggest any interventions that could potentially increase the risk of breathing are contraindicated and should be avoided.
Physiotherapy may be:
• Beneficial in the respiratory treatment and physical rehabilitation of patients with COVID-19, although a productive cough is a less common symptom
• Indicated if patients with COVID-19 present with airway secretions that they are unable to independently clear. This may be evaluated on a case- by-case basis and interventions applied based on clinical indicators, and may also be utilised in high risk individuals e.g. patients with existing comorbidities that may be associated with hypersecretion or ineffective cough (e.g. neuromuscular disease, respiratory disease, cystic fibrosis etc). 
Physiotherapy will have a strong role in providing exercise, mobilisation and rehabilitation interventions to survivors of critical illness myopathies associated with COVID-19 in order to enable a functional return to home. 
Positioning is a vital component of management for the mechanically ventilated COVID-19 patient, with regular turning recommended to prevent atelectasis, optimise ventilation and prevent pressure sores. Positioning can include lateral (side lying) positioning but may also include prone positioning, which is well recognised to treat hypoxemic respiratory failure. Prone ventilation is ventilation that is delivered with the patient lying in the prone position. Prone ventilation may improve lung mechanics and gas exchange, thus improving oxygenation in the majority of patients with ARDS, and could improve outcomes. Current reports suggest prone ventilation is effective in improving hypoxia associated with COVID-19 and should be completed in the context of a hospital guideline that includes appropriate PPE for staff and that minimise the risk of any adverse events, e.g. accidental extubation and breaking of the circuit. With adult patients, prone positioning is recommended for at least 16 hours per day
Physiotherapy is an important intervention that prevents and mitigates the adverse effects of prolonged bed rest and mechanical ventilation during critical illness. Rehabilitation delivered by the physiotherapist is tailored to patient needs and depends on the conscious state, psychological status and physical strength of the patient. It incorporates any active and passive therapy that promotes movement and includes mobilisation
Role of Yoga in covid 19 pandemic:
We follow Ayush guidelines in this regard.
1. To improve general immunity among the population.
2. Rehabilitation of vulnerable populations (children, elderly and those with comorbid conditions such as diabetes and hypertension) and to those patients in isolation/quarantine with or without mild symptoms.
3. To add-on Yoga based interventions and Meditation practices in covid-19 cases in isolation and hospitalization for psycho- social care

During this ongoing coronavirus pandemic, when we are all bound to live a restricted life under the constant fear of infection risks, it is natural for anyone to develop anxiety. The continuous flow of negative news, the inadequacy of daily resources, everything is adding to this growing anxiety and depression. Being confined at home for such long periods of time, can be mentally challenging for us. When our mind is flooded with the uncertainty of the future, we often experience sleepless nights causing fatigue. Many of us are unable to relax our mind during this time thereby increasing the stress on our minds.

During this time, it is important to understand that mental health is very important for survival. To help with this growing level of anxiety and depression, we must lead a healthy lifestyle, stay connected to our loved ones, and practice yoga at home.
Continuous anxiety or stress can manifest many health conditions such as high blood pressure, muscle tension, breathing issues, etc. Stress is the element that triggers our sympathetic nervous system causing all these health issues and in such situations, yoga can help us to stay calm.
Cultural Asanas and Meditational asanas, both have great role to play in Covid 19.
The posture and asanas of yoga help us to reduce muscle tension, joint issues and relax our sympathetic system, resulting in a relaxed mind. There are a lot of yoga poses which help us to manage our blood pressure level and anxiety. Yoga also teaches us to regulate our breath, which can make a person feel relaxed and at peace.
Role of Homeopathy in Covid 19: https://www.spandan.co/homeopathy-rescue-in-pandemic/
Homeopathy, founded by German physician Dr. Samuel Hahnemann, came into existence in 1796 and in a short time, achieved its fame and glory because of the pivotal role it played in dangerous epidemics of scarlet fever, Typhus, Cholera, Flu and Plague. It was these successes that placed the practice of homeopathy so firmly in the consciousness of people worldwide.

CCRH, Ayush Ministry has given certain guidelines and we follow the same’
 Suggested medicines are as adjuvant to Standard Management guidelines in the hospital setting only with the approval of authorities and willingness of the patient/guardian.

 The prescription is to be given only by institutionally qualified practitioner.

 Medicines like Phosphorus, Chelidonium, Veratrum Viride, Iodum, Camphora, Cinchona officinalis, Lycopodium, Ars. iod., Antim ars., Stannum met, Carbo veg., can be prescribed on symptomatic indication.

The medicine selected for each patient is tailored to person specific, taking into
consideration, his/her mental make-up, physical symptoms, and characteristic
particulars etc. In case of long term illness, besides the above mentioned factors,
age, occupation, previous illnesses and life circumstance unique to that individual
irrespective of the disease which he/she is suffering from, are also taken into
consideration; thus the dictum “Homoeopathy treats the patient but not the
disease”.
After the appropriate medicine is selected, it is essential to decide the requisite
potency, dose and repetition which is imperative for optimum response and faster
recovery in each case. Different types of potencies such as decimal or centesimal
potencies can be employed for treatment as are required for acute diseases.
However, selection of potency of the remedy is dependent on various factors like
susceptibility of the patient (high or low), type of disease (acute/chronic), seat/
nature and intensity of the disease, stage and duration of the disease and also the
previous treatment of the disease(24).
Based on GUIDELINES for HOMOEOPATHIC PRACTITIONERS for COVID 19, published by CCRH

Mental Health In Covid 19 and Spandan’s Approach:

As who has rightly said: Fear, worry, and stress are normal responses to perceived or real threats, and at times when we are faced with uncertainty or the unknown. So it is normal and understandable that people are experiencing fear in the context of the COVID-19 pandemic.

Added to the fear of contracting the virus in a pandemic such as COVID-19 are the significant changes to our daily lives as our movements are restricted in support of efforts to contain and slow down the spread of the virus. Faced with new realities of working from home, temporary unemployment, home-schooling of children, and lack of physical contact with other family members, friends and colleagues, it is important that we look after our mental, as well as our physical, health.

Spandan skilfully uses Homeopathy, psychotherapy, counselling and Yoga to deal with the mental health problems.