Witnessing the Valley in pandemic

Dal Lake Srinagar [Photo: Prof Upendra Kaul]

The flight to Srinagar had mainly security forces and only a handful of Kashmiris, all with masks and face shields. The first person after getting down whom I saw was a friendly porter Mr Manzoor. He gave me an artificial smile with his facial impression looking very worried and prematurely aged. He took me out through the formalities and I had a COVID rapid antigen test before being allowed to move out. The roads were deserted with the news of an impending lock down because of spiralling number of cases. In order to keep my commitment of providing healthy heart care at our newly commissioned Gauri Heart Centre and helping my medical and paramedical colleagues I spent 3 full days in the centre despite my wife being treated for COVID in a Delhi Hospital. This was the period of fasts during the Ramazan Kareem. This was also the period of escalating number of COVID 19 cases in Srinagar and neighbouring districts with increasing number of deaths. All the Covid appropriate measures were being observed as per our SOPs and the appointments given to the patients were respected despite the lock down which had been announced. The lock down had exempted the essential services like Health Care.

The people whom I saw during this visit were really scared of the spreading of this highly infective virus. Appropriate use of masks, hand sanitizer and avoiding social gatherings during the prayer times and Iftar hours is becoming a rule, unlike in the year 2020. People who in the initial months after the availability of the vaccine were very hesitant to get the jab are now asking for it. Most families have seen the ravages of this pandemic affecting a few of their near or distant relatives – and seeing is believing. The hesitancy is getting rapidly converted to dependency, a very good sign. The doubts in the minds of a large number of patients with high BP, Diabetes, existing heart disease and those on blood thinners need to be handled with providing them scientific answers and not dictates.  In fact, several news items quoting the makers of COVAXIN even before it was launched erroneously cautioned the people using blood thinners. This needs to be refuted by Bharat Bio-Tech effectively. In fact, patients who need drugs like aspirin who have had a heart attack or procedures like bypass surgery and angioplasty with stenting are high risk individuals and need the vaccine on a priority rather than avoiding it.

Now that people are looking for the vaccine, it has gone into short supply. The problem has got compounded by the announcement of vaccines for all above the age of 18 years. It is hoped that this shortage because of premature announcements will eventually get over. In a large population like ours such decisions should be taken after a cohesive planning in consultation with scientific minds and epidemiologists and not as populistic slogans. The lessons learnt from the Delhi experience should alert the administrators, who need to take bold decisions of containing the pandemic and also increase the facilities of treating sicker lot of patients in appropriate facilities. The oxygen supplies need to be diverted to these centres, with a sufficient reserve. Constant vigilance of the areas with higher density of population like the old city and backwaters of Dal with treatment advocacy regarding home isolation wherever feasible. The lock down announced in the UT is a decision in the right direction to prevent the spread and breaking the cycle. It has to be remembered that praying at home should be the rule as mosques with limited ventilation can be a source of spread since aerial spread of the infection has been proven convincingly. Cleanliness and praying 5 times at home, nevertheless helps fight COVID besides bringing sanity and solace. Feeding the poor by sending packed food and utilizing Zakat for helping the needy as preached in Quran should be practised.

During my stay, and patient interactions, my team instructed all the patients to have the vaccine and both the doses at specified time intervals. In addition, I did an interview on GKTV highlighting the importance of the vaccine and removing the myths which somehow have got into the minds of the population and also being circulated on the social media. There is actually no contra indication to the administration of COVID vaccination including pregnancy and lactating females. Only subjects who developed severe allergic reactions like acute shortness of breath (anaphylaxis) with the first dose of vaccine, need to be cautioned and need to be seen by specialist before going for the second dose. The miniscule number of cases of clots associated with marked reduction in platelets in the circulation leading to strokes, and heart attacks are very rare. These have been reported, studied and remedial measures worked out. Platelet anti body administration and avoiding platelet transfusions for this rare complication associated with low counts of platelets is the treatment. It should be remembered that the benefits of the vaccine far outweigh its risks.

During this period, I did sneak out for some time after the day’s work. This was in the form of a short drive towards Boulevard. The weather and the ambience were beautiful and nature was at its best with very few people, mainly security personnel around.  The Shankaracharya hill and the Hari Parbat were looking spectacular as the shadows were lengthening. Bakarwals (nomads), who usually don’t take these routes were seen in plenty with their sheep and horses interspersing the silence. This time of the year is the tourist season of the valley, which has been unfortunately not happening for the last 3 years. It has severely affected the economy of the UT. First it was the aftermath of the abrogation of article 370 and then the COVID which has been coming wave after wave.

We are passing through difficult times and needs a unified action to overcome the dreadful situation. It is not a time for denials but it needs acknowledging the very serious situation at hand. No point in talking about the omissions, but to have experts join together and take rapid action based upon science and to take help from all the quarters wherever needed. All of us need to unite like in a war. It is worse than any war faced by our people in the living memory.

Prof Upendra Kaul Founder Director Gauri Kaul Foundation. A recipient of Padma shri and Dr B C Roy award.