J&K Covid hospitals ‘overburdened’, doctors want asymptomatic patients in home quarantine

Struggling with limited hospital beds for Covid patients, doctors in Jammu and Kashmir want the administration to change its policy.

People stand at one meter distance in a queue while waiting to shop at a medical store, in Srinagar (Representational image) | ANI

Srinagar: A woman admitted to Srinagar’s Jawaharlal Nehru Memorial (JNLM) hospital for Covid-19 tried to escape Sunday after she tested positive for a fifth time. An asymptomatic case, she was first brought in on 2 May along with her husband and three children, who were also asymptomatic.

While her family eventually tested negative and were discharged, she tested negative once before testing positive again. It’s been nearly 40 days since she’s been in quarantine centre.

Her case isn’t the only such case at Srinagar’s Covid-designated hospitals and wellness centres. Doctors estimate that more than 90 per cent of the total 4,987 cases in J&K are asymptomatic. This has caused a problem for health facilities which have a limited number of beds.

Doctors say there’s a need to revise the current guidelines. According to the Indian Council of Medical Research (ICMR), the country’s apex medical research body, a Covid patient can be certified as recovered only after testing negative twice.

However, to mitigate the situation given the volume of cases, many states have opted for keeping asymptomatic cases, i.e. patients who don’t show any symptoms of infection, in home quarantine.

The Jammu and Kashmir administration is considering doing the same as it begins easing out of the lockdown. But doctors say that decision can’t come fast enough.

Covid wards over flow

A doctor at one of the city hospitals said that due to the Covid wards already running at full capacity, some patients have taken to dragging their beds out into the hospital corridor to keep some distance from other patients.

“They thought their chances of recovery will reduce and they too will test positive repeatedly because they are continuously staying in a ward filled with infected patients,” the doctor said.

The union territory witnessed the highest single day spike of Covid-19 cases Sunday with 621 new cases. Since 1 June, over 1,500 people tested positive for the virus. Of the total number of cases, 2,830 cases are active and includes 230 pregnant women and over 60 health staffers. So far, 1,216 have recovered but 41 have died — five in Jammu and 36 in Kashmir.

Doctors are worried that the easing of lockdown measure will likely see a spike and the current health infrastructure might not be sufficient to handle the new load.

In Srinagar, Covid-19 patients are treated at the Chest and Disease (CD) hospital and Sher-i-Kashmir Institute of Medical Sciences (SKIIMS Bemina) apart from JNLM hospital. However, hotels and other buildings have been turned into quarantine centres.

Between the three hospitals, there are 381 beds designated for Covid patients — 92 in CD hospital, 139 in JNLM hospital and 150 in SKIIMS Bemina. According to government sources, all beds are occupied, except for 10 at SKIIMS Bemina and three at CD hospital.

Policy adds to stress on healthcare facilities

The administration has thus far preferred sending all Covid positive patients, asymptomatic or otherwise, to government-run facilities.

Talking about the JNLM hospital patient who tried to escape, a doctor requesting anonymity said, “While the rest of the family tested negative twice and were allowed to go home, the woman tested positive four times. She tested negative the fifth time on 4 June. On 6 June, she was tested again because a patient can only be released after testing negative twice. The woman however tested positive. In the evening, she became violent and tried to escape. She had to be sedated.”

Health officials have come across multiple such cases where patients have tested positive more than five times and but were asymptomatic.

“These include a 29-year-old male who tested positive five times. Ideally, we would have recommended home quarantine to free up the space, but we do not have clarity on discharge policy despite specific ICMR guidelines. There are also multiple cases of toddlers aged between 2-4 who have tested positive repeatedly,” said another doctor, requesting anonymity.

Dr Naveed Shah, the head of CD hospital who is in quarantine after contracting the virus, said, “According to ICMR guidelines, patients with mild symptoms or asymptomatic cases should be kept in home quarantine. We should be adopting the guidelines because given the speed at which the cases are increasing, I don’t think any hospital can cater to the cases. Our hospital is almost full, rest of hospitals are also full. It will be impossible to handle them.”

Dr Suhail Naik, paediatrician and president of Doctors Association Kashmir, said if asymptomatic patients or those with mild conditions weren’t sent home, “we will end up infecting doctors and paramedical (staff), and that is why you are witnessing a spike in infection among medical staff”. The government strategy has to be modified, he said.

“If a person is tested positive, not only he is put in hospital or administrative quarantine, but all the contacts of his or her are bundled into these facilities by the police. Now, you have a situation where our hospitals are full and the government will suddenly decide to send everyone to home quarantine, this will create chaos. Instead, authorities should create awareness among the masses as well as the patients about home isolation. What Delhi is doing is what we need to follow,” Naik added.

Doctors say that administrative officials need to consult with more experts to determine protocols to tackle Covid-19 more effectively.

Pointing out that hospitals can’t deny admission, Dr Shah of CD hospital said, “It is for policy makers to decide whether they want to keep patients in hospitals and administrative facilities or home isolate them. I personally think home quarantine is a option we must explore.”

ThePrint contacted Financial Commissioner, Health, Atal Dulloo, Kashmir Divisional Commissioner P.K. Pole and Samir Matoo, director, health services, Kashmir,  through multiple calls and text messages, but did not receive a response until the time of publishing this report.