IIT KGP Lends Support to COVID Quarantine

The super-specialty hospital of IIT Kharagpur, to be named after Dr. B C Roy, has become COVID Quarantine Centre for Inter-state Travelers to West Bengal

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IIT Kharagpur’s super-specialty hospital has been busy for the past few weeks. While the facility is yet to be operationalized, who are these people walking into the hospital?

About a month back, with the announcement of the lockdown, a large influx of people moved to the borders of Bengal from various southern states with medical documents. They were patients and their families returning from Chennai, Bengaluru, Hyderabad, Vellore after undergoing treatment or health check-ups. As per hygiene and safety protocols they were scheduled to be tested for COVID. But testing about 300 people would have taken extensive facilitation for the local state administration. Here is where IIT Kharagpur came to the rescue. About 9200 sq.m. area spread over two floors of the superspecialty hospital of IIT Kharagpur was made available to the district administration of Paschim Medinipur to be used as a quarantine facility for these passerbys.

The phase I of the IIT Kharagpur super specialty hospital was scheduled to start its outpatient department in June-July. Following this, the phase with 400 beds was planned to be extended with the launch of inpatient specialties encompassing Cardiology, Cardiac Surgery, Neurology, Neurosurgery, Orthopaedics, Medical & Surgical Gastroenterology, Obstetrics & Gynaecology, Urology and Nephrology. The phase II was scheduled at a later stage with an additional 350 beds and Comprehensive Cancer Care, Radiology etc.

Registrar Prof. Bhrigu Nath Singh said, “We were ready with the structural construction though the handover from the construction company L&T was not taken due to some LAN, integration of modular OTs and few service lifts related works which are going on and expected to be completed shortly after lockdown period is over. Most of the medical equipment for OPD was already procured, hiring of medical doctors/visiting consultants/staff was going on since last year, advertisements were already placed for Medical Superintendent and Chief Administrative Officer.”

Due to COVID lockdown the plan had to be stalled. The work can now be resumed only after the situation normalizes following a revised schedule with the OPD launch expected to be postponed until the end of this year. 

Prof. Virendra Kumar Tewari, Director, IIT Kharagpur who has been busy reaching out to campus residents and students in small groups shared his delight to have been able to facilitate this initiative.

“The upcoming hospital is rightly being used to serve its cause towards the healthcare of the people even before its launch. We received a request from the office of the District Magistrate about three weeks back and immediately communicated our agreement towards it. We are in contact with district administration and the local community and ready to offer necessary help within our capacity,” he said.

What made the hospital appropriate for COVID quarantine?

Vaibhav Chaudhary, IAS, Sub-Divisional Magistrate, Kharagpur said, “We had about 300 people coming in after the lockdown was implemented and they were stuck at the border as they could not travel further into the state without being tested for COVID. While we could test 50 samples in a day, we needed a facility to accommodate the others. The hospital facility was well suited for the purpose with the huge available area, built-in structure, adequate toilets, electricity. Even the elevators were put into operation.”

He further remarked, “the location of the hospital was a vantage point as it is away from inhabited rural areas due to which we could avoid any speculation among the local community regarding accommodating these people.” 

Chaudhary confirmed building temporary wooden compartments to ensure social distancing within the allocated areas. The district administration had also arranged for meals and other necessary items for those accommodated in this facility.

“We shall continue to use the facility for further batches of people coming in for reasons as considered acceptable to the state administration,” he added.

Left with a new hope

This initiative inadvertently has given a preview of IIT Kharagpur’s superspecialty hospital to the people for the first time. Those who were quarantined at the facility were not only overwhelmed witnessing the facility but also left with the hope that they might just find the answer to their prayer for best-in-class healthcare well within their reach and budget. Many of them, who are native of various remote areas in the districts of southern West Bengal, have to frequent hospitals elsewhere in India. Apart from the financial burden the journey itself takes a toll on their health. They are now pinning their hope that this hospital would become the one-stop facility for their healthcare needs.

And the corona war continues

The Indian Air Force on Sunday (May 3, 2020) held flypast and showered flowers at the Institute’s medical facility to salute the corona warriors.

The Institute apart from delving in R&D to fight COVID-19 is also engaging in social outreach to help large sections of people. Last month IIT Kharagpur also launched an initiative to support about 10000 people around the campus who are dependent on the campus for their livelihood through various temporary jobs. The alumni of the Institute are donating funds generously to sustain these people who are affected by the COVID-19 lockdown for a few months through supply of food and essential items and PPEs. The Institute has also contributed Rs. 1 crore to the PM Cares fund raised from employees and other sources. A disinfection tunnel for inbound vehicles and good carriers has also been built coupled with WHO approved sanitization facilities such as hand wash, appropriate use of PPEs.

The evolving grammar of healthcare

The Clinical Biomarkers Discovery Laboratory at IIT Kharagpur is actively involved in using the newly emerged field of metabolomics, which is capable of providing biological end-point markers of the cellular processes that occur as a result of disease. The lab focuses on the use of metabolomics for comprehensive identification of disease biomarkers and understanding of the pathogenic mechanism underlying complex human diseases. Prof. Koel Chaudhury, who heads the lab, talks to the KGP Chronicle about how she has used the metabolomics approach to investigate women’s health, the progress her team has made and the future challenges.

Could you please give a brief summary of your research in the medical/life sciences domain?

The approach to illness and disease management has changed considerably with the evolution of medicine. In the past, medicine was strictly practiced according to the symptoms presented by the patient and was essentially based on the individual expertise of the physician, and thus was known as intuition medicine. Presently, medicine is based on the evidence produced by scientific research which also include the clinical trials, and is termed as evidence-based medicine. Most of the medical treatments today are designed for the average patient using the “one-size-fits-all” approach. Unfortunately, this type of treatment is seen to be very successful for some patients but not for others. In future, medicine is to be practiced according to algorithms that will take into consideration the patient’s characteristics, e.g. their genome, epigenetics, microbiomes, proteomes, metabolomes, environments and lifestyle to make diagnostic and therapeutic strategies precisely tailored to individual patients. It is envisioned that this will lead to the emergence of an effective P4 (predictive, preventive, personalized and participatory) healthcare system.

Our team uses the multi-omics approach including quantitative proteomics, NMR and mass spectrometry-based metabolomics to identify robust biomarkers in serum/urine/tissues/exhaled breath condensates/bronchoalveolar fluid which can assist in early disease prediction, identify disease sub-categories and predict individual disease risk. We also use ‘omics’-driven studies to enhance our understanding of the disease pathogenesis and monitor the therapeutic effect of drugs so that personalized therapeutic strategies targeting the underlying disease etiology can be developed.

What are the challenges that the research will help address?

Some of the clinical research questions our team is presently addressing using the ‘omics’ approach are listed below:

  1. What is the underlying cause of unexplained recurrent miscarriage?
  2. Can a set of biomarkers be developed for early prediction of spontaneous miscarriage (during first trimester of pregnancy, i.e. <12 weeks of gestation)?
  3. Can Stage I endometriosis (usually exists without signs and symptoms) be diagnosed early?
  4. What is the pharmacometabolomic effect of the drug dydrogesterone (a synthetic form of progesterone) in women with recurrent miscarriage?
  5. Is Asthma-COPD Overlap (ACO) a new disease entity?
  6. Can serum biomarkers replace the invasive right heart catheterization diagnostic procedure in patients with pulmonary hypertension?
  7. Is differential diagnosis of the two granulomatous restrictive lung diseases, chronic hypersensitivity pneumonitis (HP) and advanced-stage sarcoidosis possible?
  8. What is the effect of long-term doxycycline in improving COPD disease conditions?

In what stage of development is this research?

  • Potential markers have been identified in the exploratory patient cohort of various diseases; validation of these promising markers is ongoing in a fresh cohort of patients
  • Long term doxycycline as a possible therapeutic option for COPD is being explored
  • Robust serum biomarkers have been identified in early stage endometriosis; fabrication of a minimally invasive multiplexed point-of-care diagnostic device for detection of these markers is underway

 What is the future of this research?

Our research is translational and interdisciplinary in nature. We have active collaboration with clinicians and faculty members of various departments within the Institute. The aim of our team is to carry out ‘omics’-driven translational health research which will provide the ideal platform to diagnose diseases early in a non/minimally invasive and cost-effective manner.

How will the upcoming Dr B.C. Roy Institute of Medical Science and Research hospital help this work?

  • Large patient cohort is needed to generate error free data for biomarker discovery studies. The 400 bed hospital will provide the ideal set-up for such high-throughput data generation.
  • Integration of metabolomic data with metabolic imaging (PET-CT) and molecular imaging will be possible, which will provide a more holistic view to the perturbations caused by the disease
  • Discovering new drug targets, understanding drug mechanism of action at the proteome (pharmacoproteomics) and metabolome level (pharmacometabolomics), and the potential to investigate drug toxicity and resistance will become possible

IIT Kharagpur’s Healthcare Ecosystem

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The superspecialty hospital of IIT Kharagpur, Dr B C Roy Institute of Medical Science & Research, is expected to start the outdoor patient department by the end of this year. The indoor facilities in the first phase with 400 beds are scheduled to start next year.

In a recent interaction with Officiating Director Prof. Sriman Kumar Bhattacharyya, he confirmed that once the hospital is operational, the MBBS programme will be rolled out for 50 students in phase I. The course curriculum will be as per MCI guidelines.

Phase II Development

There is a further plan to extend the number of seats to 100 with the scaling up of the hospital to 750-bed in phase II. Postgraduate degrees will be introduced eventually. Health care data sciences and data analytics would also be among the primary thrust areas as IIT Kharagpur ventures deeper into medical research.

Hospital Management

While the MBBS and postgraduate degrees along with the academic affairs will be managed by IIT Kharagpur,  the day-to-day hospital management will be run by the special purpose vehicle floated under Section 8 of the Companies Act, 2013. The hospital’s board of directors will be headed by the IIT Kharagpur director and will include senior IIT faculty.

Societal Outreach

A key initiative of the hospital would be to cater to the huge community who are currently away from the reach of superspecialty healthcare services either due to distance or affordability.

The hospital will be run on a cross-subsidy model in a not-for-profit mode. While 10% of the beds would be free, 65% of the beds would be charged as per the rates in the central and state health insurance schemes ~ said Prof. Bhattacharyya.

Anticipating a heavy influx of patients, the Institute has decided to set up mobile healthcare units to cater to the healthcare needs in the immediate neighbourhood.

Basic diagnostics and treatment will be done by these mobile units, which will reduce the patient load in the hospital ~ said Dr Satadal Saha, project director and visiting faculty at IIT Kharagpur.

The Healthcare Ecosystem

Health ecosystem and not just a hospital, as Prof. Saha calls Dr B C Roy Institute of Medical Science & Research, it  will cover the entire spectrum of tertiary healthcare, high-quality medical education (undergraduate and postgraduate), allied health education (nurses, allied health professionals), inter- and multi-disciplinary research that brings all three stakeholders – doctors, engineers and patents –together; rural primary care and public healthcare, technology innovations that work in the resource-constrained environment of extreme-point-of-care, and a sustainable model that holds the entire elements together in a synergistic manner.

Collaborations

The Institute has already formed collaborations with All India Institutes of Medical Sciences, Tata Medical Center, South Eastern Railway Hospital. The Institute has also set up a Common Research & Technology Development Hub supported by DSIR to promote healthcare technology innovation and supporting manufacturing by MSMEs.

What are the faculty members saying?

I am very excited to know that the hospital is being set up next to IIT Kharagpur campus with a key focus on education and research which will help us a great deal to attain our goals. Without any active collaboration between clinicians and scientists, we will never reach the higher goal of serving our society by alleviating the disease burden ~ said Prof. Ritobrata Goswami, Assistant Professor, School of Bioscience at IIT Kharagpur.

This will lead to the development of better therapeutics and possible early detection devices that will be affordable to all. Such collaboration will fetch competitive research grants and will potentially lead to high-quality research publications and patent applications. This will definitely fulfill the aspirations of a lot of faculty members like me on the campus.