‘It’s already very late’: Kashmir under shadow of pandemic

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On 1 April, New Delhi’s chief minister Arvind Kejriwal called an emergency meeting as the COVID-19 pandemic’s resurgence became evident. 

“Compared to other states, the situation in Delhi is under control,” Satyendra Jain, the health minister had said. “As of now, there is no possibility of another lockdown… for me, lockdown is no solution.”

Kejriwal urged people to follow safety protocols and that all shall be fine. Fast-forward to three weeks later: patients have died in lines outside hospitals, turned away to crematoriums and cemeteries. The land is falling short to bury the dead, firewood exhausted. Bodies keep piling up. A lockdown has been enforced and extended. New Delhi has turned into a ghost town.

SOS cries on social media have amplified the trauma of a helpless death in Kashmir’s spaces too. But Divisional Commissioner Kashmir Pandurang Pole is confident that there is no need for a lockdown. “Situation in Kashmir is not as bad as in outside states,” Pole said on 20 April. 

As he spoke, Jammu and Kashmir (J-K) recorded the highest-ever spike in a single day:  2,030 confirmed cases and eight deaths. The record that was beaten over the next week, again and again.

The doctors have rung alarms of the unprecedented second wave of the coronavirus that continues to rattle the Valley and endanger its ailing healthcare infrastructure. With cases piling up at a record pace, is Kashmir’s descent into another COVID-19 crisis inevitable?

Cases are piling up

SMC Covid, srinagar covid
SMC worker sanitizing Srinagar’s Jamia Masjid. Photograph by Umer Asif for The Kashmir Walla.

Gasping for breath as bilateral pneumonia hijacked her lungs, a teenager was rushed to a hospital in Srinagar on 15 April. The coronavirus, which she contracted five days ago, had already damaged her kidney beyond recovery. The next day, she was moved onto a ventilator. 

Despite the best efforts, the doctors said, the teenager, who had no comorbidities, died at Shri Maharaja Hari Singh (SMHS) hospital.

A month ago, the erstwhile state reported a record-low sixty-three COVID-19 cases. Then, the situation upended drastically: within twenty-five days, the infections rose ten times, from 100 to 1,000 per day, and spreading four times faster than the first wave.

Signs of a second wave emerged in other parts of the country but when cases ebbed in Kashmir, the guard was lowered and carpets were rolled out for tourists. The worst was yet to come. Not only have COVID-19 cases shot up exponentially but doctors have found themselves overwhelmed with young patients coming in with severe conditions.

“Situation is very scary, the cases are piling up together,” said Mohsin Bin Mushtaq, president of Resident Doctors’ Association (RDA) at SMHS. He explained that in this spell, unlike the first wave, a larger number of young patients are coming in. From his personal experience of treating COVID-19 patients, he said: “Last year, if we saw five young patients out of 100, now it has increased twenty-five.”

J-K has been recording a near-constant 2,000 cases daily for the last week. Deaths have hovered just over two digits. Several experts have credited the abrupt rise in the cases across India to new variants of the coronavirus, including the UK variant and the double-mutant. “The UK variant’s prevalence in genomes sequenced nearly doubled from the second to the last week of March,” said India’s National Centre for Disease Control (NCDC) on the Delhi crisis. 

In Kashmir, local media reported that a lesser-known variant N440K of SARS-CoV-2 was detected on 23 April. The administration said twenty-eight variant cases were detected in the Jammu division.

But there are apparent signs of mutant’s wider presence in Kashmir, doctors told The Kashmir Walla. “There are three clear signs of a mutant’s presence that no one should overlook,” said epidemiologist Nisar Ul Hassan. “There is a sudden surge; people who are testing negative in RT-PCR are dying with COVID-19 symptoms; and this wave is very aggressive.”

Last week, a 40-year-old masked man with teary eyes knocked on his door, pleading for help, recalled Mushtaq. “I recognised him from his voice; he was my teacher in middle school,” the doctor said. “He was very disturbed, not even able to recognise me.”

Mushtaq admitted his former teacher’s wife into the hospital’s COVID-19 ward. “Next day was horrible,” he said. “The woman, who was also 40, kept telling me that she was not feeling good. Her X-ray was horrible… By the morning, she was dead.”

Mushtaq was shocked, not because he could see the fire reaching his home “but seeing young women dying within hours is horrifying. They are dying with no comorbidities.”

At the current rate, Kashmir Valley might reach a “sustained peak” in the next two weeks that threatens to bring the healthcare infrastructure to shambles. 

“[At the peak] things will be bad, very bad,” said Mushtaq. “Eventually, it will come onto people and they need to understand this: follow protocols if the administration doesn’t impose a lockdown.” 

Tulip garden
A view of Asia’s largest Tulip Garden. Photograph by Bhat Burhan for The Kashmir Walla.

Rising challenges, missed opportunities

A groundbreaking assessment by The Lancet said it has consistent, strong evidence to prove that the SARS-CoV-2 virus is predominantly transmitted through the air. In other words, it could stay in the air even when the infected person has left the vicinity. Other researchers have found it to be fast-spreading in indoor setups and the possibility of transmission drop drastically with proper ventilation. 

This has thrown a lot of challenges to the healthcare infrastructure. “It is urgent that the World Health Organization and other public health agencies adapt their description of transmission to the scientific evidence so that the focus of mitigation is put on reducing airborne transmission,” Jose-Luis Jimene, a US-based scientist said.

Kashmir’s hospitals were never designed for this, claimed Hassan, in anguish. “And it is already very late.”

The doctors that The Kashmir Walla spoke with said that the second wave of the coronavirus was inevitable. The Indian variant, which has caused worries across the globe with the country becoming the new epicenter, has been spotted in at least twenty-one countries, prompting Canada, the UK, and UAE to bar flights from India. 

When the mutant was first detected in India — searingly downplayed by the government — the J-K administration rather threw open the gardens for tourists and staged cultural events for locals. 

Nearly 35 percent of the total infections detected in J-K in the first three weeks of April were travelers and tourists. After this, the Div Com of Kashmir underlined that around 40 percent of Kashmir’s economy relies on tourism and allied sectors.

At the start of the first wave, the central government imposed a draconian lockdown, and roads were deserted when Kashmir had just ten cases. “Today, it is 2,000 when markets are full. Gardens are full,” Mushtaq lamented. “People have not learned anything, the admin has not learned anything. Nobody had learned anything.”

The recklessness will ravage Kashmir, warned Hassan. “Nobody used the time between the first wave and second wave to improve the infrastructure and our capabilities,” he added. “We are not prepared for a Delhi-like situation at all. We will crumble in a nudge like [Delhi].”

Meanwhile, another major concern for health experts is the allegations that several states are fudging COVID-19 stats of tests and deaths that will impact the policy decisions.

“The Kashmir administration is saying 2,000 persons are positive; they aren’t saying that we are not even testing now,” Hassan said. “It is an underestimate of the real picture where the numbers have to be much higher.”

Simultaneously, a crisis is brewing underneath the Valley. “The pinnacle of the first wave is the start of the second wave,” Mushtaq reiterated, in urgency. “

On Saturday, a man reached the office of Athrout, a non-governmental organisation, looking for an Oxygen concentrator for his mother. The NGO said that his entire family, except him, had tested positive for the virus. “Life is no less than a nightmare when seven of your family members need oxygen supply,” the man told the NGO.

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