Pulmonologist Dr Naveed Nazir Shah, as head of the Chest Diseases Hospital, is managing the main counter Covid-19 hospital in Kashmir. He tells Khalid Bashir Gura that after they failed to trace the source of the infection in a few cases, they have concluded the spread of virus might be reaching the stage of transmitting locally
Kashmir Life (KL): With each passing day, Kashmir reports an increasing number of Covid-19 positive cases. We are already in the third month of lockdown. How do you see the next few months?
Dr Naveed Nazir Shah (NNS): Lockdown helped us in getting our infrastructure geared up to cope with the challenge of Coronavirus. It enabled us to make people aware and serious about the gravity of the situation. As the virus is going to stay people need to be cautious and we are doing our best to make people aware of the precautions they need to take. Since many people did not reveal travel history, it created a lot of problems. If they had been honest, things and statistics might have been different. Cases and patients who are coming right now are from outside J&K and country.
Lockdown will be eased in a phased manner in future as the cases go down. As the virus will be around and if there will be carelessness and people don’t adhere to advisories and precautions situation may get worse which in turn will impact and overburden health care.
KL: Has lockdown helped in combating and containing the Coronavirus?
NNS: It has helped. We have seen the rise in cases and deaths in the countries where the lockdown was not implemented in the initial phases. But the lockdown benefits need to be carried forward by people who stay put in all these months and remain vigilant against an unseen enemy.
KL: As the government is easing the restrictions, the cases are surging.
NNS: It is bound to happen. As far as lockdown goes, it is an administrative decision to impose, implement and ease it. As a health care official, I see lockdown as delaying the surge of cases. It is people who need to cooperate and follow advisories. Even at this point people are not bothered and can be seen easily roaming around without masks and in groups. All this is there despite so much of awareness and strictness by government and the lockdown! The lockdown should not be enforced by police. It has to be self-imposed and even as it is eased the people should themselves follow advisories for the well being of themselves, family and society.
KL: On the testing front, Kashmir is doing well. But do we have enough resources to manage the situation?
NNS: I think we are among the top when it comes to the number of tests done as the government spokesperson has personally stated. If we see the developed countries and the places where the health care facilities are best even they have been struggling against the virus. Compared to them we stand nowhere! We are fortunate that our cases are mild and we don’t need Intensive Care Units. But once there will be a surge, once the complicated cases will emerge it will be difficult to manage.
KL: Given the way major hospitals were converted into Covid centres, as a doctor don’t you think the normal medical emergencies are being ignored?
NNS: I am on duty beyond my official hours. The emergencies are running at various hospitals. I am also available at hospital anytime but there are administrative commitments and right now our hospital is not running OPD but emergencies are being tackled at other associated hospitals. If they need our support we are ready to help as pulmonologists.
KL: How long can we avoid treatment of other ailments?
NNS: Nobody should avoid treatment of other diseases. They are being tackled and the government has already made experts available on phone on rotation basis because in the hospital only emergencies are tackled.
KL: The doctors, paramedics and other allied professionals have had a tough time with police on the roads. As a doctor what do you have to say?
NNS: Yes, it is a problem. Even my doctors and paramedics were stopped at many places. But the matter was solved only after the intervention of higher officials of the police and they were allowed to travel.
KL: Does that mean the passes were not enough for police personnel who were themselves on the front line?
NNS: Maybe the message and Standard Operating Procedures from higher-ups were not conveyed to those on the streets. The episodes that happened during previous days were isolated ones and I hope they won’t recur. All the essential services need to run smoothly and people associated with enabling the services should allow it. We are interdependent.
KL: We saw pictures of patients being referred from SMHS lying on the roadside. It created a furore. Were the referrals in line with the protocol?
NNS: There are loopholes everywhere and it was a mismanagement and communication gap regarding shifting of patients. They are redressed and resolved promptly. Clicking viral pictures does not convey full story but I also acknowledge the patient should not have been on a staircase. Many patients had come in a short period and doctors couldn’t see them.
KL: The vaccine is unlikely to be available in the near future. As a pulmonologist, how do you see the pandemic panning out?
NNS: Covid-19 has to be taken as a part of life now. Till we get adequate vaccine we have to be extremely careful and look for preventive strategies and how we can limit the spread. We need to save susceptible ones like old age people and also those with weak immunity. People should continue to follow administrative and health care advisories.
KL: Can you please tell us about the status of virus and the type of strain we have here?
NNS: Seeing the effect of the virus in our part of the world it is safe to conclude that we have the immunity system that is coping with it better and has a low mortality rate as compared to other places.
KL: Few pockets of Kashmir have witnessed a large number of cases. Has Kashmir entered into a community transmission mode?
NNS: There are hotspots and the cases where we are not able to track the basic source of transmission. But most of them were traced. I cannot confirm it but it seems we are on the brink of community transmission.
KL: Are doctors and paramedic staff adequately protected?
NNS: Right now all healthcare personnel have been provided with adequate good quality PPEs. The supply and use will continue until the virus is around.
KL: Is there a chance we can eradicate the virus permanently from our lives?
NNS: Permanent solution is to find a vaccine. Besides, we need to boost our immune system. Till then we need to focus more on preventive strategies.
KL: There is a debate about a dead body transmitting or not transmitting the virus. What is reality?
NNS: To establish answers research needs to be done. But while dealing and disposing of the body of a Covid-19 patient one needs to be cautious and adhere to guidelines. There is a possibility that Covid positive dead body can transmit infection by touching it, through secretions coming from the mouth, excreta, etc. If adequate precautions are taken it can be done as per norms while using PPEs.
