Dr Parvaiz Koul, Head of Internal and Pulmonary Medicine, SKIMS Soura, tells Kashmir Reader correspondent Junaid Nabi Bazaz that he expects a drastic surge in the number of Covid-19 cases in May and June.

KASHMIR READER (KR): Based on how the novel coronavirus has so far behaved in the population, what change do you see in the time to come? Would there be a drop or a spike in positive cases and deaths due to Covid-19?
PARVAIZ KOUL: I pray that what I am going to tell you turns out to be wrong. I believe we are in the first level of local transmission of the disease. In May and June there is going to be drastic surge in numbers of patients we need to isolate and treat. But the good news is that out of total patients tested positive, there was only a miniscule percentage which required treatment and device support. Covid-10 deaths have also been only of old people who had underlying illnesses.

KR: What is the blueprint for managing Covid-19 keeping in view a given time frame?
PARVAIZ KOUL: Rapid testing, isolation, contact tracing, while at the same time ramping up infrastructural capacity and waiting for a vaccine to come. It is difficult to give a time frame right now.

KR: We have not done rapid testing yet. Can we afford it?
PARVAIZ KOUL: We are a poor union territory of a very poor country. World’s leading health systems have collapsed before the disease, so one can easily imagine what our health system’s response will be. But we need to know the depth of the virus penetration in the population, which only testing can do. We have to do it.

KR: Is there any creative or innovative technique you can suggest for testing?
PARVAIZ KOUL: At present we are doing individual testing, but given the situation we are in and the resources needed, this cannot be the way. We have deficit of resources but that is the case everywhere in the world. The challenge is how to utilise the resources available in an effective way. The mini pooling method can obtain laboratory results of equal validity as of individual testing. This can get us a lot of people tested in less time with limited use of resources. There are limitations to this method but I believe it will work for us, given how the virus is appearing to behave so far in the population.

KR: What about other infrastructure needed, say ventilators, oxygen cylinders, and manpower?
PARVAIZ KOUL: As I have said, the world’s best health care systems have collapsed before the disease, which means any amount of resources can fall short. But we must get as much as we can in this situation.

KR: If the government does not have the resources, then can philanthropic organisations come forward? If yes, in what way do you suggest them to contribute?
PARVAIZ KOUL: They can be a big help in this situation. They need to work with the administration to know what is needed, and where.

KR: How do you see the government’s lockdown measures for containing the disease?
PARVAIZ KOUL: It is dicey situation. As a doctor, I would suggest going for the lockdown. But at the same time, it would have an economic cost beyond our imagination. Economies have shattered. If food cannot reach the needy, then there will be people dying without food, too. That is as scary.

KR: Why is more testing a must? Does it mean that there is hidden viral infection in the population and deaths due to Covid-19 are happening without being reported?
PARVAIZ KOUL: Yes, that is a possibility.

KR Desk