The Centre on Friday said that all hospitals – private or public – should take in suspected COVID-19 patients. They must notify the National Centre for Disease Control and the Integrated Disease Surveillance Programme of all such patients, the advisory said. All pneumonia patients must also be notified to the two health agencies so that they can be tested for the disease caused by the novel coronavirus, the Ministry of Health and Family Welfare said in its latest advisory.

The advisory came amid reports that some patients have been turned away from hospitals in places such as Jalgaon in Maharashtra, and Chhattisgarh’s Raipur. It is unclear whether the Centre’s advisory is enforceable until state governments issue orders, since health is a state subject in India.

The health ministry’s advisory saying pneumonia patients must now be notified so that they can be tested indicates that the government will now begin to test patients who do not have travel or contact history. Till now, India’s conservative protocol limited coronavirus testing to only those who have travelled to coronavirus-affected countries in the last 14 days or those who have come in contact with confirmed cases and have symptoms of the disease.

The Indian Council of Medical Research, the testing agency for coronavirus, however, has not yet made any formal announcement revising the testing criteria. The last formal revision was made on March 16 to include that healthcare workers “managing respiratory distress or severe acute respiratory illness patients should be tested when symptomatic with acute respiratory illness”.

The ICMR on Friday confirmed that over 50 more people have tested positive for COVID-19 since the previous day, taking the total number of cases to 236. This is the largest single-day increase in cases in India so far.

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The health ministry’s latest advisory has also told hospitals to postpone non-essential elective surgeries and mobilise additional resources such as masks, gloves, ventilators and personal protection equipment. “Healthcare personnel should be trained for dealing with any foreseeable emergencies,” the advisory said.

Each hospital, whether public or private, must set apart some beds to prepare isolation facilities, it said. “All doctors, nurses and support staff in different specialities, including pre and para clinical departments, should be mobilized and trained in infection prevention and control practices,” it said, adding that hospitals must ensure “stable patients are discharged as early as possible” and make sure that new admissions of stable patients is restricted.

It added: “Number of patient attendants should be strictly restricted to ‘one’ only.” All hospitals must provide free treatment to any medical personnel who picked up the infection while treating patients, the Centre has said.

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