Abstract
Abstract
 
 On 11th March 2020, the World Health Organization declared Severe Acute Respiratory Syndrome COVID-19 as a pandemic and hence lockdown imposed in India resulted in a significant depletion in surgical practices even after unlock down. There were some guidelines for patient care in general surgical practice have been published, overall, publications focusing exclusively on guidelines on starting surgical outpatient departments (OPD) after the COVID-19 lockdown amidst the on-going pandemic are lacking. We hereby propose the evolving knowledge in changes in OPD management practices for general surgeons in the COVID- 19 era. The priority on online registration (e-registration) should be given impetus and become the new norm supplemented by telephonic and spot registration for the uneducated patients. 
 The article also mentions the duties of the help desk, OPD hall supervisor and the new norms of air conditioning, ventilation, safe use of elevators, sanitization of OPD premises and biomedical waste disposal. The optimum and safe utilization of human & material resources DO’s and DON’Ts for patients & health staff have also been proposed. 
 In Ayurveda, a concept similar to the epidemic is narrated by Acharya Charak under a broad heading ‘Janapadodhwamsa’. The word ‘Janapadodhwamsa’ comprises of two words Janapada (large population) & Udhvamsa (destruction) which means the diseases affecting & causing damage of a large number of people. Factors which are familiar to the people under a particular community like air (Vayu), water (Jala), habitat (Desha) and seasons (Kala), Sinful acts (Adharma) in the form of war, affliction by attacks of monsters, demon, alliants (Rakshas) etc. & curses (Abhishap) are responsible for ‘Janapadodhwamsa. . These diseases can be considered as either airborne or waterborne infectious diseases or diseases occurring due to soil contamination or conditions arising due to weather or seasonal hazards. Further, under the heading of Adidaivika Bala Pravritta Vyadhi (diseases arising due to such causes that cannot be controlled by human intelligence), terms such as Sansargaja and Upsragaja are mentioned which indicate that there are certain diseases which can be transmitted directly from infected persons to healthy persons such as contagious diseases or certain diseases can be transmitted by respiration/air borne
 Keywords: COVID 19, Outpatient, general surgery, Corona virus, OPD, Janapadodhwamsa’
Highlights
The 2019 novel corona virus (2019-nCoV) or the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) as it is called, is rapidly spreading from its origin in Wuhan City of Hubei Province of China to the rest of the world [1]
Healthcare workers are at the higher risk of contamination by COVID-19 especially at the early stage of outbreak when they are not aware of the risks of COVID-19 and the personal protections are suboptimal (2)
All hospital staff should strictly stick to the infection prevention rules, highly dedicated to hand hygiene and using the personal protective equipment (PPE) (2)
Summary
The 2019 novel corona virus (2019-nCoV) or the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) as it is called, is rapidly spreading from its origin in Wuhan City of Hubei Province of China to the rest of the world [1]. India and the rest of the world are going through a difficult, decisive and stressful phase of existence due to novel Severe Acute Respiratory Syndrome- SARS CoV2 (COVID-19) pandemic. In these unprecedented circumstances where COVID-19 pandemic has indiscriminately engulfed the world and as social distancing and limitation are essential tools to contain its spread; the outpatient healthcare model needs rebooting to prevent it from spreading further. The high infectivity rate of COVID19 has created a health emergency in most parts of the world but overwhelmed the existing health system of all countries alike To avoid such a situation, physical distancing being practiced by India and remaining world is probably the best precautionary measure. Samshamana chikitsa: Proper administration of Rasayana therapies advised in the effective management of communicable diseases which is described in Janapadodhwamsa. [22]
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