Srinagar: octors and critical care health workers have raised concern over the preparedness of government hospitals of J&K to fight the novel coronavirus.
They have appealed to the government to keep dedicated Intensive Care Unit (ICU) facilities available with ventilators to tackle any escalation of COVID 19 cases.
“We need as many ventilators as we can to set up dedicated ICU for critical patients infected with coronavirus. Our system can get overwhelmed. We have seen what happened in Spain, Italy, China, etc,” said Dr Parvaiz Koul, Professor and Head, Internal and Pulmonary Medicine, SKIMS.
“Besides, the ICU in our hospital needs testing kits, personal protection equipment, designated quarantine facilities,” he said. “There must a strong backup plan for any spike in cases.”
He added, “Infection control practice awareness should also reach the masses so that they cooperate with the administration in following simple hygiene practices and strict measures like lockdown.”
A leading gynaecologist of the valley, Dr Rizwana Habib, said if there is an eruption of coronavirus cases, the health department may need 400 to 500 ventilators to save lives.
“We need insurance of ventilators, meaning we should have many more of them to prevent an Italy-like situation,” she said.
Dr Habib appealed to patients having suspected COVID 19 infection to call helpline numbers and not go directly to hospital, so that they can be transferred in ambulance to reduce community spread.
“Pregnant women, if having COVID 19 symptoms but are not in labour, should not come to maternity hospitals like LD but go to designated hospitals like CD or SKIMS. They can come to maternity facility only when they are in labour. It is their responsibility that they inform in advance, so that isolation can be done at reception only,” she said.
Dr Habib also asked the government to make enough kits available for testing, adequate PPE (personal protective equipment) for medical and paramedic people, adequate respirators, and abundance of masks and sanitisers for the public.
“Most of all, we need honesty from people. Those who have travelled to affected areas should self-quarantine themselves to break the chain,” she said.
President of Doctors Association Kashmir (DAK), Dr Suhail Naik, said that many patients don’t get desired ventilator support in Kashmir even in normal times.
According to Dr Naik, the health department needs a 1,000-bed COVID 19 hospital with 1,000 ventilators to tackle any emergency.
“There is looming threat of COVID-19 as one case is already positive from Khanyar, Srinagar. For one positive case there might be as many as 20 undetected cases in the community, because disease spectrum ranges from asymptomatic to respiratory failure and most cases abort with only mild respiratory illnesses,” he said.
Dr Naik said that the administration had taken proper measures by imposing timely restrictions that enforce social distancing.
“This is going to break the communicability chain of the infection and clustering of cases. The restrictions will also give ample time to the administration to prepare on war footing to upgrade gadgets, infrastructure, and staff,” he said.
Dr Masood Rashid, a critical care specialist, said that the ICU setup must have defibrillator, oxygen supply, beds suction disposal items, protection equipment, and monitors.
“We can’t just procure ventilators and install them without other equipment,” he said.
Similar points were raised by Dr Salim Khan, the Nodal Officer for COVID 19 in GMC Srinagar. He said the health and medical department has already requested the government to give at least 100 ventilators on immediate basis to augment the ICU facilities at various hospitals.
However, Dr Khan said, the department must have the supporting staff and gadgets to run the dedicated ICUs for coronavirus patients.
“For every ventilator bed we need at least three dedicated persons round the clock, including the ventilator technician,” he said.
Principal GMC Srinagar Dr Samia Rashid said the college held a detailed meeting with MoS in Prime Minister’s Office, Dr Jitendra Singh, to discuss preparedness. “We highlighted the issue of shortage of ventilators with him and the Director NHM. We have been promised 40 high-end ventilators by the end of this month,” she said.
Government-run hospitals in Kashmir have less than 100 ventilators and all of them are occupied.
“It means we have no surplus facility for coronavirus patients if there is spike in cases and complications,” said an administrator in the health department.
The situation is similar in Jammu hospitals. As per official sources, the 20 district hospitals of Jammu and Kashmir have just 61 ventilators, including six BIPAP machines, which are not enough.
“Apart from ventilators, the ICUs require ECG machines, defibrillators and oxygen supply plant,” said a biomedical engineer.
He said the government must augment facilities as soon as possible to tackle the possible emergencies.

Manzoor ul-Hassan