February 5, 2020

Coronavirus: J&K under threat with no specialized isolation wards, diagnostic kits

Srinagar: Threat is looming large in Jammu and Kashmir even as no specialized ‘negative- pressure’ isolation wards (airborne infection isolation wards) and medical kits have been made available in the valley despite World Health Organization (WHO) declaring China’s Coronavirus outbreak as an international emergency.

The Divisional Administration has asked district authorities to press surveillance teams on 24X7 jobs to keep a close watch on Coronavirus disease. Divisional Commissioner Kashmir, Baseer Ahmad Khan on February 2 said multi-pronged strategy, including deployment of screening teams with doctors at block level, besides roping in ASHA workers, should be adopted.

The death toll from coronavirus outbreak has continued to climb in China, rising to 490 with new cases surging by double-digit percentages in the past 11 days, with no sign of a slowdown. So far, 24,324 people are known to have been infected by the virus in China.

“No specialized training has been given to doctors or paramedical staff to handle the patients or take samples if the virus manages to sneak into the newly created Union Territory (UT),” experts told UNI.

They said the initial symptoms in the patients are fever followed by cough, but running nose, sour throat was missing in them. “Upper respiratory symptoms were missing in them. In severe cases, they have difficulty in breathing and complication is pneumonia and Acute Respiratory Distress Syndrome (ARDS)… they die because of that,” they said.

As many as 11 Kashmiris, mostly students, who have a travel history of China, have so far not shown any signs of Coronavirus infection though they have been placed under observation at their respective residences in the valley.

However, experts claim that keeping suspected people under observation at their residences was putting other family members and people, who come in their contact, at risk. They further said that there were reports of asymptomatic carriers of the virus, who show no symptoms but can infect other vulnerable people.

“Suspected case is anyone who comes from the affected area, be it China or other countries which has reported Coronavirus cases. If someone comes from these countries he or she is also a suspected case. Suspected person is anyone who has been around a confirmed case or a suspected case. Now, if people have come from China and we are around them, we are also suspected cases even if they are not symptomatic,” they said.

A UNI reporter, who visited hospitals were isolation wards have been designated by the authorities in the city, including SHMS and SKIMS, saw normal rooms (wards) for such patients. They are not ‘negative-pressure’ isolation wards or airborne infection isolation wards hence lack the capacity to curtail the virus if it sneaks into the UT.

Experts said that there were some cases, who were positive, but had no symptoms. “So, we might have asymptomatic people and they may come into community and give it to the vulnerable lot,” they added.

They believe that Coronavirus is going to be pandemic. “It is a droplet infection, it transmits by coughing and sneezing. So virus will be in the air. Human to human transmission is happening through droplets and it is spreading to other countries, so it will be pandemic. We can’t stop it,” they said, adding ‘we can prepare for it’.

“41 initial cases, which were studied in Wuhan, are nothing to gage the disease … but around one-third deaths were of those who had some underline medical condition or hypertension or cardiovascular disease and they were elderly. That means they were possibly vulnerable… but 41-case study is nothing, but we are learning about the disease,” they said.

Experts said that they are not sure for how much time the virus remain in the air. “We know that the period of infectivity is 14 days. But we don’t know for how much time it remains on the surfaces. If somebody coughs it on the surface, be it table, knob of a door, or his hand and then touches the surface it remains there. Then if a uninfected person touches it, he will be infected,” they claimed.

“Once a new virus comes, we do not know anything about it. How it will behave in a human body. Even symptoms… studies so far say it has flue like symptoms… there are fever and cough but there is no running nose. There are some upper respiratory symptoms for flue like sour throat, but it was not found in Coronavirus infected patients. We just found fever and cough. Even some of the flue patients have intestinal symptoms, but during study of Coronavirus patients it was missing in China. So there are some dissimilarity between flue and Coronavirus.

Every fever or cough is not Coronavirus, there is confounding things between different viruses which attack people, particularly during winter… not only flue, but other respiratory viruses which have similar symptoms,” they said.

They said there are two way to fight it. “One is to stop the virus from entering your region or country or state, which is very difficult and the other is curtail it if it manages to sneak in.

“You can’t check only the airport, because people also commute through train and surface transport. We are not checking at Lower Munda or train stations. There is every possibility that virus could sneak in. In the airport also there are no thermo graphic devices so infection can sneak in. So the virus can come anytime,” they said.

They said it is not possible to stop it from entering a region as there are reports of asymptomatic carriers of the virus. “How can you check it? At the airport only temperature of suspected people is checked. So, it is inevitable that the virus will come,” they added.

So, the experts said that the administration needs to take measures to curtail it. “If there is a virus in the community, we have to contain it. The three isolation wards setup by administration in Srinagar are not equipped. The isolation wards have to be negative pressure isolation wards. Suppose you put an infected patient in the ward, if there is no negative pressure the air will go to the other wards,” they said.

“The negative pressure of the room would prevent contaminated air from escaping the room. These rooms should have dedicated ventilators and they should be fitted with HEPA filters that would reduce the risk of transmission of the virus,” they said

They said that the rooms should have separate entrance so that infected patients don’t risk other patients and staff in the hospital. “They (isolation wards) have to be specially designed,” they said.

Government Medical Colleges (GMC), Srinagar has set up 26 beds, S K Institute of Medical Sciences (SKIMS) 25 in Srinagar district. Directorate of Health Services Kashmir (DHSK) has kept 52 beds available across Kashmir Division with Isolation wards and ventilators in each hospital and Public Health Centres (PHCs).

Besides, VTM kits, personal protection gears and dedicated staff of Microbiologist have also been kept in ready mode. The GMC has stored 11,500 triple layer, 7000 N-95 masks while as SKIMS has stored 10,000 N-95. Moreover, 2 lkh triple layer masks will reach valley within a day.

Mr Khan asked the concerned to maintain a travel inventory of students, businessmen and traders in each district, from December 01, 2019 who have been travelling to China and other reportedly infected countries.

He said printing pamphlets regarding do’s and don’ts of Corona Virus disease in Urdu, Kashmiri and English languages should be distributed in these areas, at Airport, Railway Stations, different locations on National Highway and other congested places. He asked the concerned to ply announcement vehicles on highways on daily basis.

“Bio-medical and other wastes related to patients, if any, kept in isolation wards be lifted separately and disposed-off by incinerating as per the advisory of Health & Medical Education department besides, setting up adequate beds at PCR hospital and other district police hospitals with all facilities,” he further added.

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Confirmed: 2,153,010Deaths: 43,379