With the number of COVID19 positive cases rising in Kashmir, meagre testing as well as dearth of ventilators and trained manpower, requirement for which is expected to rise steeply in coming days, is a concern, experts believe.
Out of the three people who tested positive in Kashmir onTuesday, two had no history of travel to foreign countries. However, they wereconsidered for testing only on Sunday, after Indian Council of Medical Researchchanged testing criteria. Sans the changed guidelines, their samples would nothave been taken by the labs in Kashmir, and not just these two, but the wholechain, including the 4 contacts who tested positive on Wednesday would havebeen missed, and let out.
Prof Parvaiz A Koul, influenza expert and head of internaland pulmonary medicine at Sher-e-Kashmir Institute of Medical Sciences (SKIMS),said too little testing was taking place, not just in J&K but entire India.”I am pretty sure we have COVID19 in ourcommunity now. We are not just testing for it,” he said. He expressed concernover the “hundreds of asymptomatic or mildly symptomatic cases” out there andtheir potential to cause a blow-up of cases. “I fear we are heading towardsvery ugly phase,” he said.
The limitation in Kashmir’s testing capacity, he said, was aconcern. As per SKIMS, 90 samples can be run at the Institute’s Viral Researchand Diagnostic Lab, now a designated COVID19 lab, in a day. At GovernmentMedical College Srinagar’s COVID19 lab too, the capacity is 90 tests.
The total capacity of 180 tests is a serious constraint,considering 88 contacts of just two positive cases needed to be tested in asingle day.
In addition, the dearth of testing kits is also holding thelabs back from taking samples of all suspected cases. As per an official at GMCSrinagar, only 350 test kits were available with the lab, while as SKIMS,another official revealed, had a stock of just over 200 testing kits. Dr NaveedNazir Shah, in-charge COVID19 at Chest Disease Hospital said the capacity totest was “adequate for now” but expressed concern over “growing requirements”.”Testing is not just about kits and machines. We need trained manpower aswell,” he said.
On the other hand, the lack of preparedness in terms of ventilatorsupport in Kashmir as well as trained manpower to provide critical care is alsobeing flagged as a weak link in the system. “Experience from other countriesshows that out of every 100 positive patients, three need ventilator,” ProfKoul said. He said, no country’s ventilator and manpower resources were able tosuffice the need created by COVID19. “Ours is a very grim scenario that ways,”he said.
Although over 90 ventilators are available in Kashmir, theseare always occupied due to the burden of other diseases. There are at least 80additional ventilators that Kashmir’s tertiary care hospitals are in theprocess of procuring. However, the timeline for the procurement, an officialsaid, was dicey given the “huge demand of ventilators” across India.
Prof Koul said the next few weeks were crucial. “Ourpreparedness will be put to test soon,” he said.