Inadequate preparedness on part of state's health department to handle "influenza season" in Kashmir is putting lives of people in danger with lack of facilities in hospitals and patchy information about the viral infection in public compounding the problem
In the past one week, three people have succumbed to influenza at two hospitals of Kashmir, two at SMHS Hospital and one at Sher-e-Kashmir Institute of Medical Sciences (SKIMS). With these deaths the toll due to viral respiratory infection this season (since September 2018) has gone up to 12. Last season, at least 30 people lost lives to influenza.
Even though influenza has become an annual seasonal health emergency, causing morbidity and significant number of deaths, Kashmir's health apparatus has once again been caught unprepared, doctors opine.
Two days ago, directorate of health Kashmir issued an advisory for influenza. The advisory directs people to get vaccine against influenza "by October". The advisory, a doctor working at the department said, is too late and too little an effort by the health department, given that the "best time" to get vaccinated is already over. He said that vaccine uptake in Kashmir was very low, exposing people to grave risks, especially the high risk groups.
The lack of awareness about vaccine and the high cost of the injection, another doctor said, was the major factor that most people were not vaccinated against influenza. He alleged that Government's failure to provide vaccines in hospital set-ups on subsidized costs was proving dear to people at risk of getting influenza.
Prof Parvaiz A Koul, head department of internal and pulmonary medicine at SKIMS and an influenza expert agreed that cost factor was proving an impediment in vaccine uptake. "We have for long recommended that influenza vaccines could be provided by government on no-profit no-loss basis. This could help save lives of high risk groups," he said. He added that apart from the cost, most healthcare providers did not educate their patients of the benefits of the vaccine, which he said was their duty.
He further said that vaccination could still be considered, especially by high risk groups. "The immunity usually takes two weeks to develop and given the past experience, we still have about two months of high activity of influenza to go," he said.
Dr Naveed Nazir Shah, head department of pulmonology at Government Medical College Srinagar said that due to the recent "developments", many high risk patients were seeking vaccination. "It is never too late, and all those people who suffer from cancer, diabetes, kidney disease, respiratory issues like asthma or are pregnant or elderly must seriously consider getting vaccinated," he said.
In other departments of health too, influenza preparedness was reactionary rather than pre-emptive, a senior official said.
The RT-PCR machine, installed at Chest Disease Hospital as part of the Rs 5.63 crore funding by State government is not functional at a time when flu activity has been seen peaking in Kashmir, a source revealed. He said the facility could have provided seamless testing for H1N1 and other influenza at Government Medical College Srinagar but due to a "small snag", it was lying unused.
However, a lab is not the only shortfall that the patients reporting to medical college have to bear. At the GMC which administers a network of six major tertiary care hospitals, the first full-fledged isolation ward was opened on Tuesday at Chest Disease Hospital, days after two deaths took place at its general specialty hospital SMHS.
A doctor treating the patients said that although influenza is seen to cause death across the world, in many cases it is the dearth of required infrastructure that worsens the outcomes. "May be, if one of those who died at SMHS Hospital had been provided ventilator on time, the life could have been saved," he said. The inadequate infrastructure for isolating the patients with influenza, a doctor said, had forced the authorities to admit patients in medical ICU, threatening other critical patients with getting infected. "What is the purpose of isolation, if infected patients are admitted along with non-infected ones?" he asked.