The disease which probably started with asingle patient in the city of Wuhan in China, became a global catastrophe andcaught the world unawares. Everyone is distressed. We at the same time areblessed to have got a breather to prepare ourselves to combat this disease. Wemust not let this blessing go in vain. It took more than 2 months to reachfirst one lakh patients worldwide and just 11 days for the second one lakhpatients to develop, 4 days for another one lack, and just 2 for another. If wefail to understand this basic statistical analysis and fail to act right nowthen no one will be left to tell our story
We are sitting on a volcano. We have tolearn lessons from the mistakes committed by the countries where the diseasegraphics surged vertically and also from the countries which were able to nipthis evil in the bud and have successfully flattened the curve. Since thedetection of first hundred cases, countries like Hong Kong, Japan, Singapore,South Korea acted swiftly by adopting a slew of measures strictly andconscientiously which resulted in flattening the curve leading to less numberof cases, ultimately saving hundreds of lives.
Among the various measures two strategiesare indispensable; one centered around the masses in general and the otherrelated to the preparedness of our hospitals. Regarding the first strategyalmost every one of us is aware of, as is being regularly advertised by the Government. We all have toco-operate and co-ordinate with the administration. This includes socialdistancing even at our homes (where we may have to keep a room earmarked forisolation as recommended by CDC USA), frequent hand washing, coughing andsneezing etiquettes etc.
The human touch has to be eliminated but atthe same time a Special Task Force (STF) of emergency services personnel has tobe formed for the essential needs of the people like delivery of food,medicine, ambulances services coordinated through various call centers/controlrooms which must be established in every district, and each tehsil.Administration should make various Whatapp groups of different specialtieswhere are all the non-emergent complaints of patients can be addressed byvarious enlisted specialist after being forwarded to them by a single nodalWhatsapp number. Hotels, preferably large ones must be acquired for the purposeof isolation of people in separate rooms.
Second strategy which is equally or evenmore important is to look into the preparedness of our hospitals to deal withthe overwhelming number of patients. We are a resource limited nation, if wefail in the first strategy, the second is bound to fail. Here is the list ofmeasures which I humbly request our Government to adopt on war footing.
Ensuring immediate and adequate supply ofpersonal protection equipment which includes respiratory masks, googlessanitizers, medical gowns etc. it is apt to mention here that since the firstoutbreak of Covid-19, many doctors and paramedical staff have lost their livesin fighting this disease which includes the 29 year old whistle-blower Dr LiWenliang who was initially punished inappropriately and later apologized forposthumously
A larger tertiary care hospital with enoughof space and bed strength has to be exclusively designated for the treatment ofCovid-19 patients. This is highly recommended albeit a difficult decision atpresent but has to be taken as smaller hospitals neither have the capacity norare having the necessary equipment and staff to deal with this pandemic.
All the doctors and paramedics have to haveshort term training courses under proper protection and guidance in themanagement of patients on ventilators, ICU management and infection control. Asthe number of patients increase, requirement of the trained medical personnelwill also increase proportionately.
With only less than a hundred ventilatorsavailable in total throughout the valley having a population of more than 70lakhs we are going to face shortage of such equipment and it is my earnestappeal to the government to purchase and procure the same well in advancebefore it is too late. Till the time we get additional supplies of theventilators and other necessary equipment I, would suggest to pool all theavailable ventilators of whole valley at the designated hospital for thetreatment of Covdi-19 keeping some for other non Covid-19 emergencies.
All the Private Hospital may be annexedwith the Government temporarily till the crises is over to deal with other nonCovid-19 related emergencies. This is needless to emphasize to compensate themfor the losses and the salary of their employees.
Lastly, we have to be prepared for theworst possible outcome. Separate teams have to be kept ready for giving properfuneral and burial to the deceased at designated places otherwise it is goingto add chaos to the already chaotic situation.
Dr G M Naikoo is Assisstant Professor,Department of Surgery , Government Medical College Srinagar