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Month after first patient admitted in RML,how is Delhi fighting the flu?

The Delhi government has decided against sending samples of H1N1 influenza cases to the National Institute of Virology...

The Delhi government has decided against sending samples of H1N1 influenza cases to the National Institute of Virology (NIV),Pune,as the institute takes up to 48 hours to report back. Experts say test results should not take more than six hours. Officials say since suspected patients are kept in the same wards as patients confirmed with H1N1 flu,it increases chances of getting infected. Now,the government will send samples only to the Delhi-based National Institute of Communicable Diseases (NICD).

Another change: hospitals designated to treat H1N1 influenza patients will soon get books and plasma-screen televisions with cable connections for its patients to rid them of boredom.

These are the latest steps in a series of on-the-run changes the Delhi government has made since the first suspected H1N1 influenza patient was admitted in the Ram Manohar Lohia (RML) Hospital on June 1.

A month on,Delhi leads the country’s tally of patients with 31 cases,but has the government got its act together and,more importantly,learnt its lessons from best practices followed globally?

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A senior doctor questioned the government’s late reaction in getting books and TVs for patients. “How did they not see it coming?” the doctor wondered. “They knew patients will have to be isolated — these things should have been thought about when authorities sat to chart out a plan.”

Delhi’s Health Secretary J P Singh reasoned this is the first time the state machinery is dealing with a pandemic,so there should be some margin for error. “Things take some time to settle down; in fact we are actually not doing as badly,” he said. “Given the circumstances,we have done well to contain the spread of infections.”

Banking on ‘institutional quarantine’
As per the World Health Organisation,the flu comes in waves,and history has it that the second and the third waves are more dangerous.

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“We are expecting another wave and it is difficult to comment about the virulence,” Singh said. “As against the international concept of social distancing,we have been relying on institutional quarantine — this has worked very well in containing the infection.”

Social distancing means closing schools,malls,workplaces and other public places to control the virus from spreading.

Health Minister Kiran Walia agreed the strategy might delay the spread but cannot altogether prevent it. “We have never been under any illusion that we would be able to prevent the spread indefinitely,” she said. “We will modify our policies to suit the situation and address the problem at hand. “Right now,our focus is containment and institutional quarantine has given better results than home quarantine.

“But when cases increase,we will rethink the decision.”

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‘Learn from US,Mexico’
Experts say the government needs to learn lessons from countries that have tackled more H1N1 influenza cases. “The government needs to learn what the US or Mexico did and modify those strategies to suit Indian conditions,” Dr Bir Singh,professor of Community Medicine at AIIMS,said.

“Keeping in mind the congestion in our cities,there is little doubt the spread will be far higher in India. So it’s important to adapt quickly by learning from other countries.”

At govt’s end: confusion,late decisions
* At RML,getting information was so difficult that even Health Minister Walia had to visit the hospital at 11 pm on June 10 to get an update on the number of patients
* The government had initially designated only three hospitals — RML,Lok Nayak and Airport Hospital — to treat patients.
But as cases started trickling in,the authorities designated 11 hospitals
* After saying only government hospitals would handle swine flu cases,government recently approached private hospitals to increase “bed capacity”. Barring Max Healthcare,all private hospitals refused
* Helpline numbers for suspected patients was changed from 1075 to 23921401. No reason was offered
* Bed linen and bathrooms of isolation wards were cleaned at RML after protest from patients admitted there
* While it is considered a good practice to start prophylactic (or preventive) treatment while waiting for the test results,patients in many cases were not given Tamiflu until results came in,which took up to 48 hours for NIV,Pune

First published on: 01-07-2009 at 05:33:25 am
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