As Spring sets in, Kashmir and the World is looking at a much unchanged picture – rising cases, more fatalities and an uncertainty about what is to come. However, the scenario of pandemic is very different from what it was last year, around this time.
The biggest difference in the two years is the availability of the vaccine. Much said about this only effective weapon against SARS-COV2, it still remains partly effective, primarily due to the negative publicity surrounding its efficacy and safety. In India, the parallel debut of Bharat Biotech's Covaxin and Serum Institute's CoviShield created a stir, for the former's "skipping" of access to Phase 2 trial data. If CoviShield has a technology and data of Astra-Zeneca and Oxford to boast of, the latter was a solely indigenous entity. Many saw the two vaccines in the same light and thus started the trend of vaccine hesitancy as reports of adverse reactions started to crop up. The Phase 1 of India's vaccination drive aimed to cover health care workers, and in Kashmir, this group has been the most difficult to cover and get vaccinated. As this phase ended technically, only about half of the targeted 60,000 HCWs had got the shot, a miniscule of this population doctors. Many reported coercion by officials for getting the jab. Today, as about 80 percent of the target in this group achieved, many doctors are still reluctant to get the vaccine in Kashmir, as is evident from the continuous featuring of them in the list of positive cases. The hesitancy is infective – targets continue to lag behind.
However, with the new wave of infections set in, many officials believe, a selective group is worried about getting infected and this may alter the fashion of vaccine avoidance. Meanwhile, another jolt to the vaccination is the increasing number of people, vaccinated, testing positive.
The lack of understanding about testing positive and safeguard provided by the vaccine may be another battle that needs to be won by the Government paraphernalia now.
In April 2020, when more and more people were piling up as the fresh cases of infection, Kashmir and entire India was under a strict and stringent lockdown. By just 100 cases, the fear of the unknown had elicited responses such as resorting to hand hygiene, masking up and social distance in a select group. In April 2021, the N95 masks, real and fake, have been mostly replaced by the fashionable and convenient cloth masks. The Virus has remained unchanged in its size, but it's entry has been made easier with the fanciness of the protection. The new guidelines about masks, every quarter of the year is a challenge that needs to be addressed and that is being ignored conveniently by the official messages. 2021 will remain a year of masks. Whether they succeed in bringing down the rate of transmission will essentially depend on what is being said to people. Images of leaders with a scarf around their noses has and will only brew dangerous complacency about the purpose at hand.
Although a lockdown is not viable, as Government has reiterated over the past month, control over crowding has also been a casualty. Hospital settings are the live examples of this failure. Any OPD, registration counter and ward in any hospital of Kashmir will show how easy it is to have buzzing hotspots of COVID19. Hordes, not queues of people struggling to get a card, get into a doctor's chamber or struggling to get space in around a hospital bed must be looked into by hospital administration. Financial Commissioner Health and Medical Education J&K, Atal Dulloo said, the load of patients other than COVID is much more and needs to be catered to. He said, while speaking to Greater Kashmir, that hospital's could switch to online registration and a timeslot system could ease the crowds in hospitals. "We are issuing directions for better crowd management across hospitals," he said. In 2020, healthcare had become inaccessible to patients. COVID19 did not spread among patients and attendants in healthcare settings but health care took the hit as patients missed life saving diagnosis and interventions. In 2021, the challenge is double – to prevent the spread and make-up for a missed year of healthcare.
Last month, in a phase wise manner, schools started opening up to students, almost 20 months after they had shut in Kashmir, post August 05 2019 events. However, with Government closing them down once again this week, the act itself is fraught with dichotomy. At schools, the numbers allowed to attend per class per day, as per reports was miniscule, and adherence to SoPs could be supervised. There are hundreds of schools in Kashmir where the total enrollment is lower than the number allowed by Government for social gatherings. Such schools dot the rural Kashmir, and many are in parts of urban Kashmir as well. The decision to close down these schools is unjustified. For many students, these schools are the only mode of education they can access.
However at tuition centers and coaching centers, which have been running through 2020 and 2021, there is no cap on the number of students attending, no check on the space between students, no stress on adherence to the protocols and no monitoring of child health status. If the Government wishes to avoid "spread" through schools and passage of the virus to homes from education centers, then a stricter monitoring of tuition centers should have been the first step. It is not. Not even in 2021.
The real "game-changer" in COVID19 in 2021 perhaps is the easy and wide availability of testing facilities. With 100 tests a day around this time last year, to over 20,000 a day now, early detection is a reality and can really help in breaking the chain. However, that would require a more robust contact tracing paraphernalia, which has technically fallen low in a year. A year ago, it was possible and realistic to tap the contacts of a known case, isolate them and get them tested before the infection would spread to those who may be at risk. Now, the complacency that has crept into people about the effects of the virus and the fatigue that has set into the human resource is the biggest challenge for the pandemic. The future would depend on what is done about this shared callousness in Kashmir.