The outbreak of the novel coronavirus (nCoV) in China and its subsequent spread to other countries, including India, has thrown a challenge to the medical fraternity. The strain in this virus is new and mutated and there is no vaccine as of now. The only immediate remedy in sight is isolation and symptomatic treatment.
Cities such as Visakhapatnam are vulnerable as it has an international airport and two major ports, including a private port.
The question is whether the city, and more importantly, its medical fraternity, is prepared to handle an eventual outbreak of the disease.
‘Inadequate arrangements’
Medical practitioners say that immediate arrangements are in place, but they are temporary and inadequate if there is an outbreak.
Fortunately, no cases have been reported so far. Isolation wards have been earmarked with a limited number of beds but what is required is a long-term sustainable plan to handle such eventualities, said Dr. C.V. Rao, former Vice-Chancellor of NTR University of Health Sciences.
"Merely setting up of temporary wards in existing hospitals will not suffice. What is needed is a permanent isolation ward, and preferably a dedicated hospital with trained staff," Dr. Rao said.
Doctors opine that such a ward must have exclusive staff who are highly trained to handle such cases. The wards should have all facilities, including ventilators and emergency medicine, and the staff should be trained to handle the patients as well as themselves. Fumigation should be part of the infrastructure and the staff should be given body suits and other safety gear, doctors said.
Andhra Medical College principal Dr. P.V. Sudhakar said that there should be a standard operating procedure (SOP) in place to handle the patient, right from the entry point such as the airport all the way to the ward. "Along with a battery of medical tests, what is important is to know is the travel history of the suspected patient and his future itinerary," Dr. Sudhakar said.
Doctors also feel that the government should set up at least one virology centre in Visakhapatnam on the lines of the one in Pune. The centre can be converted into a research and study centre, said Dr. Sudhakar.
Measures in place
A thermal scanner was installed at the Visakhapatnam International Airport on January 30. A help desk was opened and all international passengers with symptoms of cough, cold, running nose and fever are being screened by doctors.
"We have opened isolation wards at all government teaching hospitals in the State as per the guidelines of the Union Health Ministry. A doctor has been appointed as the nodal officer for nCoV at each of these hospitals to collect data and report to me on a daily basis," said Dr. K. Rambabu, Professor of Medicine, Andhra Medical College (AMC), who has been appointed the State Nodal Officer to check the spread of the disease.
"We have all the required basic testing and safety equipment including N95 masks, protective suits, goggles and disposable kits at our disposal. Samples like throat swabs of suspected persons will be sent to the Microbiology Department of AMC/KGH for scientific packing. Couriers have already been identified for quick and safe delivery of the samples," Dr. Rambabu explained.
"Though the symptoms of swine flu and nCoV appear similar, there are two basic differences. While a swine flu patient suffers from a blocked nose, difficulty in breathing and gets wet cough early after the onset of the disease, an nCoV patient suffers from a running nose and gets dry cough two to three days after the onset of the disease. An isolation ward will be opened near the port in view of the threat of crewmembers arriving from foreign shores," Dr. Rambabu said.
Airport on vigil
Self-reporting forms are being handed out to passengers at the city airport in which they will have to answer queries on whether they have visited China, particularly Wuhan, or have come into contact with Chinese nationals on their trips abroad. Details will be taken at the immigration counter. A team of doctors is on standby round the clock, Airport Director M. Raja Kishore said.
Airlines have also been advised to look out for visible symptoms and direct any suspected passengers to the doctor on duty at the airport on arrival.
