Friday, August 14, 2009

Swine Flu - Dont Panic, Take Precautions

The spread of swine flu has brought the Union health ministry under the scanner. Dinesh Trivedi, minister of state for health, who belongs to the Trinamool Congress, has remained in the shadows even as his senior Health Minister, Ghulam Nabi Azad faces the fire over government inaction on the issue.

Trivedi gives his take on the issue and a lot of advice as well. Even though he doesn't say it in enough words, Trivedi wants people to take the H1N1 pandemic in their stride and not go by the coverage in electronic media.

Q: What is the real picture of spread of swine flu in India?

A: Since the outbreak of swine flu in the western countries, the health ministry's team -- under the guidance of Ghulam Nabi Azad -- is working round the clock. Honestly speaking, it is due to the hard work of doctors, scientists and officers of the health ministry in the last two months that we have been able to contain the disease to this extent.

To answer your question I would say so far, so good. But, do we have infrastructure to tackle the disease if it spreads? The answer is yes and no; because, every day things are changing and every day the ministry changes its strategy. So far, we have done very well, but now the common flu season is on. We will have to increase collection centres; we will have to increase the number of beds for isolated cases. And, if the patients go beyond certain numbers, then we will have to do something dramatic.

Q: What is the biggest challenge before the ministry?

A: The major challenge is educating people. Without running down any particular section of the media, I would say that a section of electronic media is trying to create a sensation without knowing what this disease is all about, how does one counter it and the right treatment is. I somehow think a section of the television media has not covered the disease maturely. They have mishandled it. I am not saying all, just few of them.

Some of the channels were asking me angrily why are you not increasing testing centres or why are you restricting it to the government. The answer is very simple. These laboratories are very sophisticated. It requires investment and one has to have what is called BSL level 3. It will require four to five months to set up such a lab.

These labs require trained technicians, doctors and staff. It is like handling a nuclear power plant where waste management is an equally big job. These labs have to manage the waste of the virus. These labs don't have many people inside. If somebody goes in, they are covered from top to toe. If any lab does the test and is not well equipped to manage the waste management, then you can create more problems than solutions.

The maintenance of such a lab even without testing could be more than one lakh rupees a day. The private sector is not into social service; they want to make money. The government has 12 functional labs in the country; on paper there are 16 labs!

In Kolkata, I have visited one such lab, which has state-of-the-art technology. We as countrymen should be proud of it. Doctors told me that they can test 92 cases per day. Another machine is coming, so they will be able to conduct 180 tests.

If you read any European or American medical journal, most of them have praised the way India has controlled swine flu. We are screening 100 per cent of passengers at international airports. If an infected passenger is found, we go through the list of passengers, track down and contact each and every passenger sitting around that patient in the aircraft.

Since the government contacts them, they are bound to respond and tell us if they have caught swine flu or not. We have visited so many air-passengers' houses. You have to understand that in India more than lakh patients die due to viral flu, malaria and TB. But, nobody gives it in headline news. I am also, not trying to distinguish between rich and poor. Swine flu has suddenly become disease of high society because it has come through people flying abroad. Rich patients are scared to do anything with the government. They may have justification. They are scared to be in isolated beds in government hospitals. Many of them have never seen government hospitals.

When blasts occur in a middle class locality there is not as much coverage as it was in case of the November 26 attack on the Taj hotel. We already have serious diseases and that too requires attention of the people and the media.

Q: So, do you mean there is no reason to panic?

A: There is no reason to panic for one simple reason that there is a cure for swine flu. One has to see that when there are symptoms, go to the government laboratory and get the test done. Now, we don't even insist that they should be quarantined in hospital. We give a choice to patients if they have the infrastructure at home to live in isolation. We give the medicine (Tamiflu).

The unfortunate incident in Pune involving that little girl was sad. She had no reason to die this way. Her parents went to a place, which was not equipped to test H1N1. Her test result came out negative. So, obviously she was not treated for swine flu. She didn't get the right medicine at the right time. Then the family panicked and rushed her to a government hospital with the sample. She tested positive. But by then it was too late.

I am again saying that do not panic. Have faith in the system. Go to registered laboratories. If you test positive, then take medicines as per the doctor's advice and you will be cured. The masks are not important for ordinary citizens; handkerchiefs will do.

Masks are a must for medical people or people who are vulnerable. Take personal caution. Greet people with a 'namaste' instead of shaking hands. Take care of hygiene. Avoid kissing and hugging for some time. Cover yourself with a handkerchief. Don't be shy of it.

Q: Even as we talk, television channels are showing that Mumbai has been shut down. Why?

A: I have just come from Mumbai. I had gone to Bali, Indonesia on an official visit. It's quite amusing to see Mumbai. Mumbai panics very fast and normalises very fast as well. I think it's strange on part of the government to ask parents to SMS their opinion. How do you expect them to react one way or the other on diseases they have no knowledge about? The authorities should have taken their own decision.

However, Mumbai is alright and functioning. The intensity of panic is more on television than in real life. Do you have any idea when you hype more than what is real how much the country loses in terms of business? Do we know what the spread of swine flu in America is? In the western world, there are over one million cases. They are not panicking; they are taking care to cure.

I am sorry to say that some channels are adding to the panic. People watch it and panic more. I have gone to many studios and I have seen that the interviewer has no idea about the disease. We have enough stock of medicines. Companies have given us manufacturing schedules to ensure supply. Somebody in the world will quickly crack the solution and make vaccines soon. Few companies are doing clinical trials.

We have enough centres for testing; enough isolated beds. Why panic? I see that the print media is much more responsible. They are analysing it and telling people without spreading panic. See, few days back a friend of mine called from Kolkata. His nephew Rishabh tested positive. They didn't want to enter a government hospital but were worried about how to tackle the 11-year-old boy's flu. I strongly advised them to go to a government hospital. These are all psychological fears. I went to see the boy. He was in an isolated area with all sides covered with glass. I could not enter that place, but he wrote on a piece of paper in bold handwriting 'Uncle, You saved my life'. I was so touched.

Q: Still, what are your fears?

A: My fear is that we are entering the flu season. We have no control over the atmosphere. While we are talking, it is quite possible that the virus is somewhere around in the air around us. I won't say fear but my concern is that if the virus really spreads, I am afraid we may not have capacity to treat everybody. In that case, we will have to change our strategy.

In US, the issue has gone beyond testing time. There, in many cases, they are skipping the testing and going by symptoms.

We have relaxed the system where in we are doing away with keeping patients in quarantine area of government hospitals. It is quite possible that a situation may arise when we may have to allow certain things and may have to further liberalise. We are updating our website. The government is bearing the cost of Rs 5,000 for a negative test and Rs 10,000 for a positive one. The government is not concerned about money. We give free test and medicines. But I wish the private sector will chip in. There is no bar on private investment in laboratories that can test swine flu and on curing patients.

Q: What will happen if swine flu spreads to the villages?

A: I am not ruling that out, but I would not panic. There are more serious medical issues and diseases that we already face. Nobody is talking about it, but it doesn't mean they are not there. The same way, we will fight against flu. People don't necessarily die of flu but in some cases when patients also have lung disease, diabetes or obesity, those issues get aggravated if not treated on time.

I am hopeful that as it happened in Mexico, the virus would become weak as it passes on from one person to another person to another and so on. Swine flu started in Mexico but the deaths are decreasing there. We will have a graph of infected patients that will go up but it would come down soon. Sorry to repeat myself, but there is nothing to worry. If you get it, you get it. All cases are not terminal. It can become terminal if you run away from it. If you get any symptoms, go to the government doctor. Get the test done if he advises. Take medicines and let life go on.
The Indian government tried to stop the flu from coming to India. We requested western countries to try screening passengers. But, you know this is a unipolar world. The western countries would have stopped flights from India, Pakistan or Bangladesh in a similar case. This flu is imported. It's difficult to guess how the disease will mutate. But the silver lining in the current situation is that in a couple of months we are definitely going to have the vaccine. Importantly, the virus weakens as it is passes on from person to person. So, we will have to withstand this storm for a while.


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