Hence, it is crucial to understand the significance of hospital infection control in the monsoon, where science and sanitation rub shoulders and vigilance is the only barricade to the breaking of the floodgates of disease.

Why Monsoon Troubles the Healthcare System?

Monsoons are associated with humidity, waterlogging, and overcrowding, together with poor sanitation in most parts of India, particularly in urban areas such as Delhi, Mumbai, Kolkata, and Chennai. During this period, hospitals and particularly the state-owned hospitals are usually overstrained. But why?

The National Centre of Disease Control (NCDC) indicates that there is an acute increase in such diseases as leptospirosis, dengue, malaria, typhoid, hepatitis A & E, cholera, and different types of fungal infections during monsoon in India. So here is what makes hospitals breeding grounds of infection:

• Large patient volume
• Poor air quality due to stagnant moisture
• Flooding of the sanitation and waste disposal systems
• Inadequacy of adequate isolation infrastructure in smaller hospitals

Greater exposure to wet surfaces and compromised water conditions increases the risk of wetness and dirty water, which leads to a higher risk of death. It is not even helped by the fact that antimicrobial resistance (AMR) is increasing, just like the floodwaters in Bihar.

So, before diving into the conclusive evidence of why and how infection control impacts the health of an individual during monsoon, it is necessary to know about what infectious diseases an individual could contract if proper infection control is not practised at hospitals during monsoon.

1.  Respiratory Tract Infections (RTIs)

At the hospital premises, mould, wet bedding and more allergens will be caused by high humidity. Also, add the lack of ventilation. During monsoons, the hospitals turn into very fine breeding-grounds for pneumonia and bronchitis.

2.  Urinary tract infection (UTIs)

UTIs are a substantial nosocomial infection in India and can be a result of stagnant water in the bathrooms of a hospital or a lack of proper treatment of catheters.

3.  Fungal Infections

Candidiasis through aspergillosis, the doorway of fungal spores is open to the wind at times of humid months. The patients in the ICU and patients on ventilators are particularly susceptible to these fungal infections.

4.  Gastrointestinal Infections

Food poisoning, dirty water and poor hand washing lead to diarrhoea, typhoid, and hepatitis.

5.  Vector-borne diseases

The mosquitoes do not make reservations before appearing in the hospital corridors. Outbreaks of malaria and dengue begin with inadequate storage of water and uncontrolled breeding sites.

Control Measures at the Hospital

Just as it is with WhatsApp forwarding, infections spread much quickly when uncontrolled. Thus, infection control teams are unsung superheroes that stand behind the masks.

Rule One: The Golden Rule is Standard Precautions First

The Standard Precautions given by the Indian Council of Medical Research (ICMR) and

WHO (World Health Organisation) must be adhered to by every hospital.

• Hand Hygiene: Soaps and water > All. The alcohol-based hand rubs must be made available at every critical point, such as ICUs, wards, and OPDs.
• PPE: Between the patient and the doctors or caregivers of the best medicine hospital in Delhi, the gloves, gowns, masks, and even face shields are to be worn in the monsoon without fail.
• Sterilisation and Disinfection: Autoclave, UV steriliser and mopping with bleach-based solution must be as frequent as the morning and evening chai.
• Respiratory Hygiene: Coughing into elbows, wearing masks by symptomatic patients, and isolating corners as important for infection control during monsoon.

The Indian Way: Monsoon-Specific Infection Control Strategies

It is not as though all hospitals in India are well equipped. From the luxurious private hospitals of Delhi to a PHC of Assam affected by floods, the infection control practices have to be cleverly adjusted.

1.  Pre-Rains

Hospitals find the need to evaluate:

• Roof leaks
• Drainage blockages
• Wards waterproofing
• Air conditioning systems
• State of biomedical waste sites

The checklist to be done before the monsoons can literally save lives.

2.  Inside the hospital, Vector Control

• Larvicide Spraying of water tanks, basements, and flowerpots.
• Dry days once a week to clean water storage containers.

• Mosquito nets should be employed in ICUs, in particular, in the neonatal and pediatric departments.

3.  Water Quality Monitoring

Hospitals must:

• Test water samples once every week
• Make sure that the chlorination of overhead tanks is done.
• Do not use municipal water when there is a flood; use filtered or boiled water.

According to the Bureau of Indian Standards (BIS), the amount of coliform bacteria in drinking water should be zero per 100ml (it is specifically concerning in the gastroenteritis wards).

4.  Linen and Laundry Procedure

• Employ hot water laundry programmes.
• Do not hang out laundry in the open. (air spores)
• Separate, fungal-prone patients.
• Treat fungal-prone patients separately.

5.  Waste Management Re-engineering

During rains, the problem of disposing of bio-medical waste (BMW) becomes messy. Hence, proper procedure should be followed to dispose of it diligently through:

• Color-coded segregation
• Leak-proof bins
• Organising the transportation of waste to the state-run disposal service on a daily basis
• Waterproof flooring in emergency waste rooms

According to CPCB 2016 BMW Rules, failure to segregate properly is a punishable act. However, unfortunately, the implementation in monsoon becomes a side interest. That must change.

The Digital Infection Control to the Rescue

Hospitals which have adopted the use of tech have recorded a reduced rate of infections. Here's how:

• The surveillance software follows the outbreaks of HAI (hospital-acquired infections).
• Air quality monitors and thermal scanners indicate risk areas before they take place.
• Cleaning schedules or infection alerts for the staff through mobile phones.
• Use of barcode to track surgical equipment and linen.
• At low-resource settings, a simple Excel-based tracking sheet of infection trends during monsoon can even have an impact.

Training and Awareness

Even all the SOPs of the world will not work out when the hospital staff is not trained. And this is where infection control teams could excel:

• Nurses and housekeeping staff training sessions.
• Place focus on hand hygiene.
• Demo on PPE Kits with proper focus on putting on/removing the PPE Kit.
• Real situation of infectious epidemics.
• Workshops for Medical Students and Interns.
• Make them take responsibility for infection control at a tender age.
• Patient Education.
• Hang some posters in the local languages.
• In the OPDs, use AV screens to demonstrate techniques involved in handwashing.
• Request visitors to wear masks when they sneeze/cough.

A lesson we can not afford to ignore is the COVID-19 pandemic that was indeed a wake-up call. COVID-19 rocked our health sector, and infection control grabbed the attention it had not received before. Hospitals turned into war zones; masks, sanitisers and isolation guidelines. However, there is a twist: monsoon is an annual mini-COVID in the Indian hospital. Having been able to get this kind of efficiency rallied during the pandemic, why can it not be rallied on a day-to-day basis every monsoon? There should be policy interventions. In order to turn monsoon infection control into a national priority, we require:

• Infection control committees are required to be established at each hospital.
• NABH Standards with Monsoon Infection Protocols (MIP)
• Subsidy of flood-prone district hospitals
• Water safety audit by way of public-private partnerships

Skyline can be clouded by the rain, but safety should never be clouded. Hospitals are not just buildings; instead, they are lifelines. And that lifeline is weak in the season of monsoons. A threat might be lurking in every drop of water which trickles through a hole in the wall. Each unscrubbed hand, each damp sheet, each unscrubbed mosquito net might make the balance of health or hazard. However, with a proper combination of planning, training, technology and policy, it is more possible to make monsoon a reparation season, not a season of dangers. We should remember without waiting for the next outbreak. It is time to do something. Since on the scene of infection control, prevention is better than the cure, actually, it is the true cure. So, for proper cure from these infectious breakouts during the monsoon with the touch of world-class hygienic facilities, book an appointment at Sir Ganga Ram Hospital, today.