Is Kashmir prepared for another COVID-19 wave?

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After reporting its first case in March 2020, Jammu and Kashmir witnessed the peak of COVID-19 cases six months later in September with around 1700 cases reported daily but the numbers soon dropped to a hundred daily cases and no deaths reported for days on stretch during February 2021. 

On 1 March, there was 829 laboratory-confirmed infections in J-K, of which 631 were detected in Kashmir — a sudden spike from February. The same day the number of deaths since the outbreak rose to 1,958. Sixteen more deaths were reported till 15 March.

On 1 April the J-K had 2,874 active cases of the infection with just 721 reported in the Jammu division while the remaining 2,150 were concentrated in Kashmir. The Srinagar city with more than a million residents remains the worst-hit in Kashmir. 

While the region witnessed a rise of 1,004 laboratory-confirmed cases of COVID-19 in the first fifteen days of March, it recorded more than twice that number — 2,874 to be precise — in the next fifteen days with a total of forty deaths recorded during the entire month. 

As indicated by the sudden spike in the number of infections and deaths being reported in March, a second wave of the pandemic has begun in Kashmir. Already, health experts warn that cases of COVID-19 may rise up to two thousand daily cases by as early as April, threatening to overwhelm Kashmir’s fragile healthcare system.

Covid, Srinagar funeral
Funeral prayers of a person in Srinagar who died of COVID-19. Photograph by Umer Asif for The Kashmir Walla.

‘Show must go on’

Amid the ongoing second wave, the Department of Tourism organised a musical event at Badamwari in the downtown area of Srinagar on Sunday. The event witnessed huge participation of people including children huddled together around the stage, enjoying the music performances while neglecting social distancing.  

The musical event held at Badamwari was not the first one held recently in J-K. Several music events have been held, many by the Indian Army across Kashmir where public participation was similarly large and without following social distancing or wearing masks.

The Rural Livelihood Mission also held a five-day-long event called Pooshida Hunnar for the promotion of Self Help Groups at Kashmir Haat in Srinagar last week. In Jammu, the tourism department organised the musical festival Fulkari 2021 while a similar tourism promotion event was also held in Rajouri last month.

Back in Srinagar, a six-day “Tulip Festival” began at the famed Tulip Garden on 3 April to celebrate the arrival of spring and for promoting tourism in J-K. The administration itself admitted that it “expected a huge gathering” but went ahead anyway.

The arrival of tourists, particularly from severely hit states, is also a cause of concern. Ten travellers tested positive on 1 March in Srinagar. Twenty more tested positive on 15 March. On 1 April, 55 travellers tested positive, taking the total number of infected travellers arriving in Kashmir to 3,181.

Along with the ongoing arrival of tourists and crowds gathering in parks and during sports and musical events, colleges too were thrown open from 15 February while schools were opened from 1 March and elementary schools were opened from 8 March. Since then many schools were shut down as dozens of students tested positive for COVID-19. 

“During the first peak, we saw around 1700 cases per day. The speed at which the cases are increasing this time, we may even see around 2000 cases per day,” said Mohammad Sultan Khuroo, eminent Kashmiri doctor and chairperson of the Apex Level Advisory Committee on COVID-19 response. 

Yet, Khuroo ruled out recommending a lockdown to curb the disease’s spread. “Proper testing of people at tourist spots and at other places should be done, the tourist season is finally here, we cannot afford one more lockdown,” he said. “The show must go on.” 

Infrastructure scaled down

Prior to the second wave, in January, Kashmir had 2,345 hospital beds – 148 ICU beds and 2,197 isolation beds – for patients infected by COVID-19 but as the daily cases were still dwindling, it scaled down the capacity by shutting down wards reserved for the pandemic.

“When the cases started coming down, the hospitals obviously had to start functioning like before so the COVID-19 wards were shut down,” said Khuroo.

The healthcare infrastructure in Kashmir, home to more than seven million residents as per a decade-old census, currently has 1,570 beds in fifteen hospitals, five of which are in the Srinagar city, reserved for COVID-19 patients.  

On 1 March this year, 77 patients were admitted to hospitals. The number of total isolation beds excluding ICU beds was 1,484 out of which 1,417 were vacant. The number of COVID-19 ICU beds available was 86. Out of these 76 beds were vacant. 

On 1 April, however, 123 new patients were admitted to hospitals. With a sharp spike in cases expected to continue, hospitals are likely to run out of beds quicker than during the first wave of the pandemic last year in March.

Khuroo, however, maintained that hospitals in Kashmir have enough facilities to brace for a second wave since all arrangements were made during the first one, last year. “Doctors are well-equipped now,” he said. “They even have one or two drugs to treat the patients and they also have oxygen supplies available.”

As the number of cases continues to rise, Khuroo said that infected patients should be quarantined at home with the exception of patients who have difficulties breathing or are suffering from other medical ailments, who should be hospitalised.

To further avoid the spread of COVID-19, vaccination should be made compulsory. The vaccination process started in Kashmir in January this year and has reached its third phase in which all the people above the age group of forty-five can get themselves vaccinated.

The advantage of vaccination is that after a person gets a vaccine infection, he will get either mild disease or notice and he will not become sick. So vaccination is important for the sake of protection,” he said.

covid, kashmir
Burying a patient who died of COVID-19 in Srinagar. Photograph by Umer Asif for The Kashmir Walla.

‘Back with vengeance’

“COVID is back, with vengeance,” warned Mohammad Salim Khan, head of the Community Medicine department at the Shri Maharaja Hari Singh (SMHS) Hospital in Srinagar. “Our complacency would pay heavily,” he tweeted. “The number of cases nowadays are increasing manifold as against very slow rise last year same time.”

Speaking to The Kashmir Walla, Khan said that the second wave can either be due to the decrease in immunity or new mutations. “If there is a new strain, then immunity developed initially by the people against a particular strain might not help this time. So they can easily catch newer variants,” he said. 

Khan added that it is important to pick those cases that are symptomatic and contact tracing is most important. “Social gatherings and congregations need to be restricted to a particular number,” he said. “Open places are not a threat but close spaces are. When people are in tourist spaces where there isn’t much rush, there is minimal risk of getting diseases from these people but people need to adhere to the guidelines.”

At schools, Khan said that assemblies and lunch breaks should be avoided for the time being whereas proper sitting arrangements should be made as well as ensuring social distancing in school buses. “There should be no extended school time, proper handwashing, and proper spacing in buses,” he said.

The Doctors Association Kashmir on Friday called for genetic testing of patients infected with COVID-19 to scan for mutated strains of the virus. “We were witnessing a decline in cases a couple of weeks ago, and all of a sudden with the same behavior among people a fresh wave of Covid-19 has erupted in the valley which could be because of a mutant,” said DAK President and influenza expert Dr. Nisar ul Hassan in a statement. 

Hassan said the COVID-19 virus has the tendency to mutate and it can change behavior and become more infectious or even deadlier. “The three foreign strains – UK, South African and Brazilian that have found their way into India spread more easily and research is underway if they can cause more serious disease.”

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