Srinagar, Feb 5: Threat is looming large in Jammu and Kashmir, even as no specialised 'negative-pressure' isolation wards (airborne infection isolation wards) and medical kits have been made available in the valley, despite the World Health Organisation (WHO) declaring China's Coronavirus outbreak as an international emergency.
The Divisional Administration has asked the district authorities to press surveillance teams for a close 24x7 watch on Coronavirus disease. Divisional Commissioner of Kashmir, Baseer Ahmad Khan on February 2 said that a 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 the Coronavirus outbreak has risen to 490 in China, while new cases are 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. However, experts told UNI that no specialised training has been given to doctors or paramedical staff to handle the patients or take samples, if the virus manages to sneak into the recently-created Union Territory (UT).
They said the initial symptom in the patients was fever, followed by cough, however, running nose and sour throat were missing. '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,' the experts added. 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 have 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,' added the experts. A UNI reporter, who visited hospitals with isolation wards designated by the authorities in the city, including the 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 the community and give it to the vulnerable lot,' they added. They believe that Coronavirus is going to be a 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, but we can prepare for it.
'The 41 initial cases, which were studied in Wuhan, are nothing to gauge the impact of 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, however, we are learning about the disease,' they said. Experts said 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 on the surface, be it a 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 flu-like symptoms… there is fever and cough, but there is no running nose. 'There are some upper respiratory symptoms, including flu-like sour throat, but it was not found in Coronavirus-infected patients. We just found fever and cough. Even some of the flu patients have intestinal symptoms, but during the study of Coronavirus patients, it was missing in China. So, there is some dissimilarity between flu and Coronavirus.
Every fever or cough is not Coronavirus, there are confounding things between different viruses, which attack people, particularly during winter… not only flu, but other respiratory viruses, which have similar symptoms,' they said. They further said that there are two ways 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 to curtail it, once it enters the place.
'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. The experts said that 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 the 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 the rooms should have separate entrance, so that infected patients don't risk other patients and staff in the hospital. 'The (isolation wards) have to be specially designed,' they added. The Government Medical College (GMC), Srinagar has set up 26 beds, while the SK Institute of Medical Sciences (SKIMS) has set up 25 beds in Srinagar district.
The 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 Microbiologists have also been kept in ready mode. The GMC has stored 11,500 triple layer, 7000 N-95 masks, while SKIMS has stored 10,000 N-95 masks. Moreover, two lakh 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 1, 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 added. (UNI)