What should we do?

These are unprecedented times. We are worried, confused and distrustful. The
world is struggling to cope with the COVID 19 pandemic. There is no health system
in the world which can face the wrath of this unseen force. More than 760, 000 are
already infected and about 35, 000 deaths already and the numbers are increasing
day by day. The whole world has come to standstill, economies are crashing, people
losing livelihoods, and in some places, chaos is already setting in. Lots of rumours,
misinformation, fake news, and conspiracy theories, religious and other curses are
making rounds. Mankind is at war with himself. Countries which have far advanced
health systems and resources like the USA, Italy, the UK, and Iran are finding it hard
to provide appropriate treatment to everyone. What should we do in a place where
there is hardly any system and a makeshift administration? In times of such chaos,
you need a leader who people trust and listen to. We don’t have that either.

We need to be realistic. The health infrastructure, number of doctors, nurses and
other allied staff is nil to nothing when we look at the magnitude of this pandemic.
We cannot build hospitals like China did and even if we get some ventilators, there
are no intensive care facilities in most districts and who will operate them when we
do not have any trained nurses or paramedics available. The things are more
complex with COVID 19. Usually first port of call is a doctor or hospital when we
become unwell. Here if you go to the hospital, you can spread it to others including
the healthcare staff. There is no evidence that going to the hospital will help even if
you are tested positive. For those who do become severely unwell and need oxygen
and ventilator support, the prognosis is poor. In our setting, with a dearth of nursing
care, usually, families stay in the hospital, feed, nurse and buy medications from the
market. But here family members are likely to be infected if not symptomatic and if
not already infected, a hospital stay with an unwell patient will infect them. This
raises the question over who will nurse COVID 19 patients as there are not enough
nurses to do that job in Kashmir valley.

The authorities have just focused on testing and tracing people who had travelled
from outside state and this went to the level of propaganda, creating fear and
worsening preexisting stigma. Many people did not come forward with a travel
history and those put in so called quarantine, fled citing justifiable reasons like lack of
basic hygiene and putting dozens of people in the same room that feared likely to get
infected from each other. Even entire extended families of patients who died
because of COVID 19 are being put under alleged quarantine. This is not only
inhumane but hardly based on any scientific facts. Even in such pandemics, people
will need to grieve their dead.

Overall no one seems to be in-charge. One could have thought either director health
services or some other senior specialist from the public health or community

medicine will take the lead. Here we have different officials from the administration
trying to overdo each other without any thought or strategy. Demonizing people,
talking them down and then chasing them like criminals is not going help. There is no
focus on education; information sharing and making sure people don’t get inundated
by rumours through WhatsApp groups only. Can one fight a pandemic using the
decades’ old strategy of managing a political conflict with force and guns? No

What can be done?
It is time to be realistic keeping in view the infrastructure, healthcare staff and
magnitude of the pandemic which is only going to get worse. Everyone cannot be
tested or treated in a hospital. The virus has already spread in the community and
just focusing on anyone with a history of travel is not going to work. About 50 percent
infected do not show any symptoms but are contagious and carry on infecting others.
About 80% only have mild symptoms. So it is the asymptomatic people walking
around you who are spreading it as we speak. Everyone cannot be put in quarantine
or hospital and if we assume only 4 million will get infected out of 8 million; there is
no way of managing this pandemic in the hospital setting. If people are educated
and informed with clear guidelines with sincerity, most can stay home if having mild
to moderate symptoms of cough, fever, malaise and other symptoms. It is ideal to
test people to reduce contact and stress on self isolation in homes, but are there
enough resources to do mass testing.

Training and educating faith healers, peers, imams, and teachers and then using
them to propagate the message at the grass root level. Social distancing and self
isolation is the key to break the chain of spread from one to other. We know the
elderly and those with comorbid medical conditions are vulnerable with bad
prognosis. We have to buy time and protect the vulnerable in a hope that some
treatment or vaccine may be in available in the near future.
The healthcare staff and doctors need personal protective equipment (PPE),
otherwise we many lose may of them to illness and even death and if that happens,
we cannot deal with the pandemic for even few weeks. It is not enough to call them
god or bang plats for them unless there is an investment in healthcare and that
needs to be done now. Just focusing on buying new ventilators would hardly make
any difference if the healthcare staff is not protected in first place. The administration
needs to move on from the attitude of a police state to one of supportive to doctors,
rather than harassing them on the streets and beat them if they try to reach
hospitals.

Finally, people need to take responsibility. In this age, there is no dearth of
information. The internet is only partially restored but enough to know what to do and
what not to do. The infection is spread by droplets- coughing, sneezing, close
contact, hands, and aerosols in closed spaces. The virus lives on surfaces for hours
if touched and retouched. Washing your hands, not spitting in public, covering nose

and mouth when coughing, washing hands regularly, and keeping a distance from
each other is the best solution until we find a treatment. It is time to suspend
mosques, parties, weddings, offices, and any gathering completely. Funerals need to
be managed by professionals in full PPE as the virus is remains alive. These are not
easy times, people may not have food to eat, no jobs and income, so we have a
collective responsibility to look after each other and defeat this monster of a virus. As
Camus writes in his famous book Plague, ‘What’s true of all the evils in the world is
true of plague as well. It helps men to rise above themselves’, and I am sure we will
overcome this current age plague and be human again. Do not rely on hospitals,
doctors, peers, it is your life and only you can protect it for now by staying in your
homes and following the rules.

https://www.greaterkashmir.com/news/opinion/what-should-we-do/