Dearth of test facilities, ventilators, trained manpower in Kashmir

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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 on Tuesday, two had no history of travel to foreign countries. However, they were considered for testing only on Sunday, after Indian Council of Medical Research changed testing criteria. Sans the changed guidelines, their samples would not have been taken by the labs in Kashmir, and not just these two, but the whole chain, including the 4 contacts who tested positive on Wednesday would have been missed, and let out.

Prof Parvaiz A Koul, influenza expert and head of internal and 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  our community now. We are not just testing for it,” he said. He expressed concern over the “hundreds of asymptomatic or mildly symptomatic cases” out there and their potential to cause a blow-up of cases. “I fear we are heading towards very ugly phase,” he said.

The limitation in Kashmir’s testing capacity, he said, was a concern. As per SKIMS, 90 samples can be run at the Institute’s Viral Research and Diagnostic Lab, now a designated COVID19 lab, in a day. At Government Medical 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 a single day.

In addition, the dearth of testing kits is also holding the labs back from taking samples of all suspected cases. As per an official at GMC Srinagar, 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 Naveed Nazir Shah, in-charge COVID19 at Chest Disease Hospital said the capacity to test was “adequate for now” but expressed concern over “growing requirements”. “Testing is not just about kits and machines. We need trained manpower as well,” he said.

On the other hand, the lack of preparedness in terms of ventilator support in Kashmir as well as trained manpower to provide critical care is also being flagged as a weak link in the system. “Experience from other countries shows that out of every 100 positive patients, three need ventilator,” Prof Koul said. He said, no country’s ventilator and manpower resources were able to suffice the need created by COVID19. “Ours is a very grim scenario that ways,” he said.

Although over 90 ventilators are available in Kashmir, these are always occupied due to the burden of other diseases. There are at least 80 additional ventilators that Kashmir’s tertiary care hospitals are in the process of procuring. However, the timeline for the procurement, an official said, was dicey given the “huge demand of ventilators” across India.

Prof Koul said the next few weeks were crucial. “Our preparedness will be put to test soon,” he said.