How we handled COVID crisis? Experience of an Indian tertiary level NICU

Background: Coronavirus disease (COVID-19) has imposed several challenges in clinical care. With rapid increase in the disease, there has been lot of incidences of COVID-19 positive exposure among the healthcare workers resulting in major crisis. Aim: The aim of the study was to emphasize various methods that can be used to manage COVID-19 crisis due to accidental exposure. Methods: An unprecedented exposure occurred to a COVID-19 positive healthcare worker in the Neonatal Intensive Care Unit (NICU), which led to quarantine of almost 90% of the primary staff. The methods undertaken included communication and continuation of clinical care through teleconsultation (video calling, zoom meetings for clinical decision, telecharting of daily prescription, and facilitating manpower from allied departments [only one pediatric resident each day], and restoration of services with come back). Results: There were total 11 babies at the time of exposure. Two babies were on respiratory support. The parents were counseled through teleconsultation. Nine babies could be discharged during quarantine period and there was no significant deterioration in the clinical condition of the two babies on respiratory support. All the babies were tested for COVID-19 as per post-exposure protocol and remained negative. Conclusion: With the help of teleconsultation and support from allied specialties and other health facilities, the crisis of COVID-19 exposure can be handled well.