Interview: Happy we could rise to the challenge

HAPPY WE COULD RISE TO THE CHALLENGE

Dr. B. Padmakumar The deadly Corona virus (subsequently named ‘Covid 19’ by the World Health Organisation) outbreak in China’s Wuhan city, which claimed over 2700 lives and infected more than 80,000 people globally, had its ripple effect on Kerala too. The State was the only one in the country to report positive cases of the epidemic as three students, who had all returned from China, were detected with the virus infection for which there is no specific treatment.

The State, especially its health machinery, didn’t succumb to panic and defeated ‘Coronavirus’, just as it did with the ‘Nipah’ virus onslaught nearly two years ago. The three patients from Alappuzha, Thrissur and Kasaragod districts have fully recovered from the infection and have been discharged from hospitals.

‘Medical Tourism’ spoke to Dr. B. Padmakumar, who had treated the patient admitted to the Government Medical College Hospital, Alappuzha, in south Kerala. Excerpts:

Can you share the experience, especially the fight against a completely new virus strain?

The youth was detected with the virus strain and admitted to the hospital on January 30. The novel Corona virus infection had by then assumed dimensions of an epidemic. The biggest challenge was to treat a

We don’t have any clearly defined protocol for treating Corona virus infection and we could not wait for that. We followed the general guidelines of the WHO (World Health Organisation) and the Indian Council of Medical Research (ICMR) for handling such situations.

A medical team led by the medical college hospital superintendent was formed with a nodal officer, four medical officers, 12 post graduate Doctors, 9 house surgeons, eight staff nurses, six nursing assistants and nine housekeeping staff.

Since there’s no specific drug to treat the condition, we focused on supportive care (monitoring vitals such as temperature, blood pressure and oxygen, among others, and ensuring that the vital organs functioned normally) for the following two weeks. The symptoms were similar to serious flu infections that affect the lungs. We managed to contain the infection from turning severe and finally cured the patient fully. He was discharged on February 13 after repeated laboratory tests of samples returned negative readings for the presence of the virus.

What were the precautionary measures adopted by the medical team?

We knew the new virus strain is quite dangerous and that it would not be possible to tackle it without adequate precautionary measures. We all used disposable Personal Protective Equipment (PPE), specialised clothing with masks and gloves that cover the whole body.

A high standard of personal hygiene was followed by each one of us once out of the room. Separate vessels were used to serve food for the patient and the same was disposed-off post use every time. The select nursing staff was redeployed every three to four hours and continuous care was ensured for the patient.

People were asked to avoid unnecessary hospital visits, especially to wards. Strict instructions were given against crowding. All were asked to cover mouth and nose with handkerchief, wash their hands frequently and avoid shaking hands. But, when doing so, we were careful not to trigger panic among the general public.

What was the main measure taken to prevent the virus from spreading?

The patient was co-operative and courageous. We identified the secondary level contacts (family members and other close relatives with whom the patient had interacted) and subjected them to close medical examination. Tertiary level contacts (friends and others who had come into contact with the patient at least once) too were identified and put under home quarantine for 28 days. Their health was also monitored closely.

Did the patient and his relatives face any difficulty, especially social boycott, when information about his having contracted Corona virus spread?

I didn’t feel so during my interactions with them, though some social media posts with his picture were uploaded by someone, and that hurt the family. They filed police complaints on a couple of occasions. Otherwise they did not complain about anything.

Obviously, given this experience, we should have a state-of-the-art virology institute in the State. Now we are sending the samples, hundreds of them, to the Pune NIV (National Institute of Virology) for testing which results in delay?

The State government is taking all measures necessary for this. A laboratory has been set up at the Alappuzha Medical College itself. After the first two days of the patient admission, we began to test the samples here itself. The government has also started the construction work of Virology Institute at Thiruvananthapuram, the State capital.

No new Corona virus case has been reported and the State government has withdrawn its declaration of the virus outbreak as a ‘State disaster’. What is your advice to people?

There is no need for panic. However, we should continue to take precautionary measures like covering one’s face while sneezing and washing hands frequently with soap. We should also maintain high standards of personal hygiene. Unnecessary visits to hospitals should be avoided. The virus strain will be active in a carrier for 28 days. Follow directions of the State Directorate of Health and do not trust social media posts about the infection or related topics from unauthorised persons or groups.

Dr. B. Padmakumar Professor of Medicine, Medical College, Alappuzha