Valley prepares for the next wave

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Valley prepares for the next wave

Monday, 03 May 2021 | Bisma Bhat

Valley prepares for the next wave

Doctors and non-government organisations in the union territory of Jammu & Kashmir are gearing up to fight the new strain of Covid-19, says Bisma Bhat

The second wave of Covid-19 has caught the entire country unprepared. Alerted by the extreme situation in states like Delhi, Gujarat, Maharashtra and Kolkata, medical practitioners, and heads of non-profit organisations in Jammu and Kashmir have started preparing for it in the newly formed Union Territory (UT) as well. They have appealed to the people on social media to strictly follow all the precautionary measures. They have also requested them to arrange oxygen cylinders and concentrators at the local Mohalla Committee level to be prepared for future emergencies.

On April 21, the Superintendent of North Kashmir's Baramulla district's Government Medical Hospital requested the people of the valley to follow the SOPs both in letter and spirit. He suggested that social organisations and religious groups should act proactively and must prepare to deal with the second wave of COVID-19 which can possibly overwhelm the health infrastructure of J&K in the same way which it has in other states of the country.

“All Masjid/Mohalla Committees should arrange oxygen facilities in their respective areas. A disastrous wave is on its way. This little time should be utilised to build these small domiciliary facilities which will help the system from overloading,” Syed Masood, Superintendent Government Medical College (GMC) Hospital posted on social media.

On April 25, J&K reported 2,382 fresh positive cases of Covid-19 — the biggest single-day spike and around 20 deaths. Till April 24, 2,030 positive cases were recorded with 15 fatalities while on April 23, 1,937 cases and 19 deaths were reported. Compare this with April 1, when there were only 461 positive cases. It was from this week onwards that a surge was seen in the number of cases in the UT. On April 30, a total number of 14,5441 cases were reported while more than 2,283 patients had died of the deadly virus.

After medical practitioners raised the alarm, many local voluntary organisations that were already providing medical facilities to the people across Kashmir valley, have stepped up their work. They have started keeping stock of necessary equipment that might be needed in the coming days.

Mohammad Aafaq Syed, Project Director, Oxygen — which is run by Social Reform Organisation (SRO) Kashmir, a Srinagar-based non-government organisation —  informed that they have been arranging for various essential medical equipment to fight the second wave of this deadly pandemic.

"We have around 250 oxygen cylinders, 220 oxygen concentrators, 30 Non-Invasive Ventilator (NIV), and 120 oxygen tanks of 25 LPM. Besides, we are planning to procure small ICU set-ups which can be used at home. These can monitor the five parameters of a patient including blood pressure, oxygen saturation, temperature, pulse, and ECG. The plan is to provide a bed, an oxygen concentrator, one high-flow oxygen cylinder to each patient who would also be visited by medicos assigned to them twice a day or as per requirement. This plan is in the pipeline and hopefully, we will be able to execute it, shared Aafaq.

At present, he said, they have enough infrastructure to deal with the virus, but if the cases rise at a rate similar to Delhi, then it would not be enough. “Precaution is better than cure. It is better to take early precautions to save our people from succumbing to this virus,” said Aafaq whose organisation is operating round the clock and is currently receiving more than 50 calls for oxygen.

One of the volunteers at Srinagar-based Athrout — another non-government organisation, committed to assisting vulnerable communities in this crisis — said that they have more than 200 oxygen concentrators of which 125 have already been provided to the people in need.

“Currently, we have around 75 concentrators in stock. We have 37 auto BIPAP and CPAP machines which we are supplying to the patients as per requirement. All our 10 litre concentrators are with patients as the demand is quite high and the availability low in the market,” the volunteer informed. They have also donated 54 oxygen concentrators to different NGOs across J&K and Ladakh.

Apart from this, the managing body of Athrout is planning to set up an ‘Oxygen Baitulmaal’ at their head office in Srinagar’s old city. Here, they will provide oxygen to the patients in a dedicated space that will have proper beds and will be supported by paramedical staff.

“We will be offering PPE kits to the families with Covid-19 positive members. We will also offer oximeters to those in need. The caretakers of the patients admitted in a hospital can also avail this facility at our office,” he added.

Medical practitioners are anxious about the next three weeks which, they feel, will be crucial in deciding the intensity of the second wave of Covid-19 in J&K.

Dr Syed Mudasir Qadri, Consultant and Associate Professor, Internal Pulmonary Medicine, Sher-I-Kashmir Institute of Medical Science (SKIMS), while speaking to the writer over the phone said, “Doctors are noticing a considerable difference in the second wave of the pandemic. This year, we are seeing patients who are as young as 19-, 20- and 30-year-olds infected with the virus, which is quite disturbing.”

Kashmir is witnessing 2,000 positive cases every day. As per Dr Qadri, these are the registered cases. There are hundreds of people, he believes, who are Covid-19 positive and opt for home consultation without informing the authorities. They conduct self-tests (RAT) at home and do not report them, so the actual numbers may be more.

“We have a good supply of oxygen and our infrastructure is also better. As the Covid-19 burden is increasing, we need to strengthen the peripheral hospitals and make them fully functional to take care of patients with mild to moderate symptoms and not refer them to tertiary care. This will avoid overburdening of the tertiary hospitals with referral cases. This can help us handle the situation in a better way,” Dr Qadri suggested, adding that doctors at tertiary care should redistribute patients to the peripheral hospitals after treating them in the acute stage.

Peripheral hospitals have everything in place, he said, including infrastructure, medical equipment, and specialists. What needs to be strengthened is the regular supervision of these hospitals and quick response to their requirements which can act as a roadblock for patient management.

Dr Irtifa, spokesperson of resident doctor's association, Shri Maharaja Hari Singh Hospital — another tertiary care hospital in Srinagar — said that seeing the sudden spike in the cases, the hospital authorities immediately shut the outpatient department to avoid patients with other ailments.

“Keeping in mind the situation we faced last year, it was decided to activate the isolation wards for Covid-19 positive patients and allocate staff for Covid-19 duty. As far as availability of oxygen is concerned, we have three oxygen plants here and the fourth one is in the pipeline and an adequate number (more than 1,000) of large oxygen cylinders are available. Kashmir is in a better situation than other states. What is helping us is that several people are opting for home management and only severe cases are coming to the hospital,” shared Dr Irtifa.

He added that several NGOs are helping people to get oxygen concentrators at home. “I would suggest that people should consult with the doctor over the phone and if there is a need to visit a hospital, please be proactive. Don't play with your lives and with that of others," he said.

“We are in a better situation but with the number of cases increasing every day and people not taking proper precautions, we are bound to register a spike. As predicted by the senior epidemiologists, there will be a big wave in early or mid-May. There is a need to have systematic lockdowns that can save the lives of thousands. You cannot have markets closed while keeping the gardens open, which makes no sense. There should be a proper mechanism in place which can take people into account for violating Covid-19 guidelines,” Dr Irtifa noted.

The UT is under complete lockdown till 7 am on May 3.

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