The battle to save lives amid scarce resources

Karnataka community health experts and microbiologists suggest second wave was not unexpected, but quantum was not properly assessed in state

A new 6 kiloliters medical oxygen plan installed at Chamarajanagar district hospital by the government of Karnataka. Photo: @mla_sudhakar / Twitter

The magnitude of the second wave of the novel coronavirus disease (COVID-19) in Karnataka was not expected, estimated or assessed by anyone in the state, even though all signs were pointing to it, experts from the health.

The number of COVID-19 positive cases as well as deaths in the state and its largest urban area, Bengaluru Urban, peaked from January to April 2021.

On January 1, Karnataka reported 877 new cases of COVID-19, including 464 in Bengaluru Urban and six related deaths. On February 1, four people died from COVID-19, while 522 new cases were reported.

On March 1, 58,206 RT-PCR tests were performed and 349 new cases of COVID-19 were reported in Karnataka, including 210 in Bengaluru Urban. As of April 1, there were 4,225 new cases (the highest peak so far), including 2,928 new cases from Bengaluru Urban. The statewide daily test positivity rate rose to 3.89%.

As of April 15, 11,265 new cases were reported in Karnataka and Bangalore recorded 8,155 new infections. On April 30, the new positive numbers rose to 48,296 and there were 217 deaths statewide.

A Bengaluru-based community health expert working with the state government said:

We were happy that COVID-19 was apparently gone. There were political rallies, weddings and religious events from January to March and we are feeling the repercussions now. It is a natural tip. It is not unexpected. Any virus will take three to four years to mutate and disappear. There could also be a third and a fourth wave.

The expert added that such an exponential surge had probably not been estimated: “The proportion and the quantum were not guessed. General beds are always available in hospitals. But the demand for intensive care units, oxygen beds and ventilators is on the rise. ”

The wave has left physicians in an ethical dilemma due to the acute scarcity of resources. Vivek Gundappa, Assistant Medical Superintendent and Assistant Professor of Respirology, Rajarajeswari Medical College and Hospital, Bengaluru said:

I had only seen these real ethical dramas in the movies. It’s so overwhelming when a group of 15-20 patients – all with 30-40% oxygen saturations – together come to us, requiring the assistance of a ventilator. Who should we give a fan? Will it be on a first come, first served basis? When I did this the first time, I had to deny a ventilator to a 30 year old man versus a 73 year old man. The elderly person died within hours. I sulked then. I should have given the 30-year-old a chance. But why choose? Who should I choose? Everyone has the same right to live. Tears still flow from my eyes; I will always feel guilty that I couldn’t save any of them.

Microbiologists and community health experts suggest that vaccination and herd immunity are the only way to fight the pandemic.

“A lot of people are infected, so we should develop herd immunity. The second tool would be the massive vaccination campaign. Once 70-80% of the population is vaccinated, it will reduce cases, ”said Asima Banu, professor of microbiology at Bangalore Medical College and nodal manager of the Covid Center at Victoria Hospital.

As of April 7, some 5,016,695 people have been vaccinated in Karnataka. 3,537,949 others were vaccinated from April 10 to 30. Up to May 3, some 3,824,765 people aged 45 to 60 have been vaccinated and 3,574,682 people over the age of 60 have been bitten.

However, there is currently a severe shortage of vaccines in the state. Authorities say many vaccination centers are temporarily closed due to unavailability of vaccines.

“My in-laws took their first dose of Covaxin on March 27 at Blossom Hospital. After 28 days, on April 23, they were to take the second dose. We tried to call the hospitals. But the numbers were constantly busy or we were told that the stock was not available ”, Venkatagiri GR whose stepmother Shantha MN is 68 years old and her stepfather Krishna Rao AS is 72 years old.

He added that the family tried to go to the primary health centers but they were already full because the slots were reserved. The centers were also unsure whether Covaxin was available or not.

“I even tried to contact Bharat Biotech International Limited to understand where they gave the vaccines, but they said they gave them to governments,” Venkatagiri said.

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