Fear of Community Spread Shadow J&K’s Strained Healthcare Sector

On Friday, 5 June, five more doctors were among 182 fresh cases of COVID-19 in Jammu and Kashmir.

Fear of Community Spread Shadow Jammu and Kashmir Strained Healthcare Sector. 

(Illustration: Shruti Mathur)

In recent weeks, the Jammu and Kashmir administration has been scrambling for answers to explain the sudden jump in the number of pregnant women who are testing positive for COVID-19, especially in Kashmir.

On Wednesday, 3 June 2020, 26 pregnant women were among 139 persons who tested positive for the virus. On Thursday, another 20 women were found COVID-19 positive. According to a doctor, close to 150 pregnant women have tested positive for the virus in Kashmir so far.

“Initially, there was a spurt in such cases in south Kashmir’s Anantnag district but we are now seeing its repeat in Baramulla. Interestingly, barring some exceptional cases, these women come from places that are not red zones. It all points to community spread,” a doctor at Chest Disease Hospital, a COVID-only facility, said.

To ally these fears and check the prevalence of the virus in the population, officials said that a team of doctors and healthcare workers, backed by Indian Council of Medical Research, has carried out random sampling of 400 persons in south Kashmir’s Pulwama district.

“The results will be out in a day or two,” Dr Mohammad Salim Khan, a senior epidemiologist of Jammu and Kashmir told The Quint.

Shrinking Human Resource

A top pulmonologist in Kashmir has become the latest addition to the growing number of healthcare professionals in Jammu and Kashmir who have contracted the novel coronavirus in the line of duty.

On Tuesday, 2 June, Professor Naveed Nazir Shah, the face of Jammu and Kashmir government’s efforts to stem the spread of the virus who heads the Department of Pulmonary Medicine at GMC Srinagar, was reported to have tested positive along with another doctor from the same hospital.

On the next day, two more healthcare professionals, including a doctor, tested positive. On Friday, five more doctors were among 182 fresh cases of COVID-19 in Jammu and Kashmir. According to official data, the virus has led to the isolation of close to three dozen healthcare professionals, most of them doctors and nurses.

Close to hundred of them in Jammu and Kashmir have tested positive so far.

In the newly created union territory which has one of the lowest patient per doctor ratio among the UTs and states of the country, experts say the shrinking number of trained healthcare professionals and steadily growing number of cases may shadow the efforts to curb the spread of the virus, especially in the Valley.

Following the National Trend

According to sources, Professor Shah is believed to have contracted the virus at a lodge in Srinagar where he has been staying since the pandemic broke out. An infected and unwary man, whose mother needed immediate surgical intervention, paid him a visit for his opinion.

The WHO guidelines lay down that all the patients undergoing surgeries should be tested for COVID-19. “When the woman’s test returned positive, Dr Naveed got himself tested on the very next day as a precaution and he unfortunately had contracted the virus,” sources said.

As the lockdown is easing now and the hospital OPDs in Kashmir are slowly and steadily returning to normal, the risk of the virus rendering more healthcare professional ‘useless’ is only going to increase in coming days.

“The government should immediately cap the number of patients at OPDs because almost all of them are non-emergency cases. It will also reduce the risk of infection to healthcare professionals,” a senior doctor at the premier SKIMS hospital in Srinagar, said.

There are already complaints by the doctors that the administration was pushing them into the harm’s way by not procuring adequate Personal Protection Equipment (PPE). Many doctors say they procured safety gear out of their own pocket to minimise the risk.

Army Steps In

There are around 220 beds with ventilators in hospitals across Jammu and Kashmir and more are on the way but few active cases have actually required ventilation. At SKIMS, just two COVID patients are on ventilator.

Officials say instead of ventilation, direct oxygenation of the COVID-19 patient’s blood throws up better results by reducing chances of internal injuries during intubation and thereby improving survival rates.

Around 2,000 hospital beds have been identified each in Jammu and Kashmir regions for handling COVID-19 patients. Stepping into the battle as part of Op-Namaste, the Army has set up a 250-bed centre in Srinagar and another 100-bed facility in Jammu, in a record 15-day time.

The Jammu and Kashmir administration had also deployed its own human resource and life-saving electro-medical equipment for the patients at the facility, said Dr Zakir Hussain, in-charge of the centre located near the old airfield military station in Srinagar.

According to reports, Jammu and Kashmir LG, GC Murmu, has said the Army’s help may be sought again in case the need for more beds arises.

“This will be one of the many initiatives of the Army to bring succour to the lives of people of Kashmir and it will go a long way in bolstering the capability of the joint efforts in combating the pandemic,” Col. Rajesh Kalia, a defence spokesperson in Srinagar, said.

Shadow on Healthcare

The curve of COVID-19 in Jammu and Kashmir is consistent with the national trend. Merely four cases on 21 March in the entire Valley plodded to over 650 on 5 May and within another month, showed a five fold jump totalling nearly 3,000 cases.

According to official data, 89,456 persons have completed surveillance period in Jammu and Kashmir but over 43,000 persons remain in quarantine. The virus has killed at least 35 patients so far, most of them having underlying morbidities.

The Niti Aayog’s 2019 report shows the healthcare index of Jammu and Kashmir is nowhere close to the better performing states such as Rajasthan and Haryana. Private healthcare sector caters to 90 percent healthcare needs in Jammu and Kashmir, according to Dr Suhail Naik, who heads a key fraternity of doctors.

“Hospitals in Kashmir are already hugely understaffed. Doctors and other healthcare workers lack adequate protective equipment. The rising trajectory of the curve can translate into a catastrophe if corrective steps are not taken and a change of tack is not effected immediately,” a doctor at SMHS hospital said, wishing anonymity.