Grassroots health centers told to conduct virus tests

China's top health authority on Dec 7 instructed all medical institutions at the grassroots level to test patients who have shown symptoms of fever for the novel coronavirus.

Primary care institutions that can't carry out nucleic acid tests should team up with other institutions or third-party testing agencies, according to a notice released on the website of the National Health Commission.

The notice is aimed at improving the ability of grassroots medical institutions to detect the virus early, issue warnings and standardize the operations of fever clinics, according to the commission.

Fever clinics have played a significant role in diagnosing and isolating sporadic new COVID-19 infections as local transmissions of the virus have been promptly put under control in China, according to health officials.

Jiao Yahui, an official with the commission, said during a recent news conference that most new COVID-19 infections in China are detected either at fever clinics or via regular screening in the cold-chain industry.

The latest outbreak in Chengdu, Sichuan province, was discovered after the first case, a 69-year-old woman, visited a district-level hospital on Sunday and showed signs of infection in her CT scan image.

To step up preparedness for potential new outbreaks, an increasing number of large hospitals have begun renovating or rebuilding their fever clinics to achieve closed-loop management of feverish patients.

For instance, Beijing had finished upgrading fever clinics at 33 public hospitals, bringing the number of qualified fever clinics in the capital to 101.

In Wuhan, Hubei province, the hardest-hit city during the epidemic, each fever clinic based in a hospital contains five to 15 isolation rooms and is equipped with CT scan machines and emergency care equipment.

Due to limited resources in rural areas and communities, the notice said, the establishment of fever clinics in primary care institutions will be determined by the healthcare demands of local residents and the quantity of available resources, but all health centers at the grassroots level should strictly implement early screening and triage.

The document also requires grassroots medical institutions to report cases where diagnoses are unclear but the risk of having contracted infectious illnesses cannot be ruled out. Such patients should be isolated immediately, and their discharges from the center will need authorization.

Patients who display severe COVID-19 symptoms or show signs of rapidly worsening will be transferred to hospitals that can provide adequate treatment in a timely manner, it added.

At grassroots clinics, inventories of protective equipment should be sufficient, and medical workers should receive training on preventing infectious illnesses and possess a set of skills including the ability to conduct quarantines and disinfections.

Zhu Hongming, deputy director of the commission's primary care department, said during a news conference in February that grassroots medical institutions in China should screen, detect, quarantine, report and transfer COVID-19 patients and suspected cases, and only designated hospitals will deliver treatment.