Dengue, Malaria are all set to join COVID-19 to rain more trouble this monsoon. MUSBA HASHMI looks at what can be done to curb this fearsome threesome
Prolonged fever, chills, nausea and diarrhea, the symptoms which once were considered normal are now sufficient to give someone a miny heartattack. Come fever, and one is horrified by the thoughts of having suffering from the dangerous flu — COVID-19. The mere thought of catching the infection is enough to make you feel sick.
However, these symptoms are common in the Monsoon season, when other killer diseases, though not as lethal as the Coronavirus, still capable of claiming many lives like dengue, malaria, jaundice and typhoid are a part and parcel of the heavy showers.
Given that the healthcare facilities are already struggling with the pandemic, these diseases are going to add further pressure on the hospital staff. While some of the big players in the healthcare sector are well-equipped to battle this double fight, the pressure will be the most on the Government hospitals.
More so, because people these days have turned a blind eye towards these diseases.
“With the onset of monsoon, dengue and malaria cases are going to rise in the months of August, September and October. On the sidelines of coronavirus pandemic, dengue and malaria are going to be the most difficult diseases to treat. All these diseases are going to put a lot of pressure on our healthcare ecosystem,” says Dr P Venkata Krishnan, Internal Medicine, Paras Hospital, Gurugram.
The healthcare system, he says, is going to crumble if too many cases of dengue and malaria are going to come.
“Other than these two, some other common diseases are chikungunya and leptospirosis, which also arises during this time. These diseases are caused by mosquito bite and contaminated water respectively. Even the cases of jaundice and hepatitis rise in the monsoon, they all can be equally dangerous like malaria, dengue and chikungunya. Management of these diseases needs holistic views and especially if the patient is COVID-19 and acquires one of these. Co-managing these infections is going to be very painful and is going to put a lot of pressure on the healthcare system to take care of these patients and give them best care possible,” Krishnan says.
He adds that in order to eliminate any risks involved mosquito bite prevention is important. “One needs to wear such clothes that cover the body in the maximum way and use mosquito repellent creams. Keep your environment clean, don’t let the water stagnate in any place be it in the cooler, flower pot or any vessel. Moist places are the best breeding ground for mosquitoes. Not only the house, one needs to keep the society and nearby locations clean too,” he tells you.
Dr Manjeetha Nath Das, Internal Medicine, Columbia Asia hospital, tells you that the hospital hasn’t reported any dengue or malaria case till date.
“There is no reported case of dengue or malaria in our hospital so far. However, these are common diseases in monsoon until October due to water accumulation. We must be careful because in case of any co-infection of dengue or malaria and COVID, managing the patient will become far more challenging now,” Das tells you
She says that in certain diseases where the symptoms are similar to COVID-19, the hospital has a fever protocol to distinguish the disease. “Also the COVID and non-COVID areas are separate and staff are dedicated to one unit at a stretch — all members of the staff working in COVID ward are tested and quarantined for the stipulated period as per the protocol,” Das says.
Dr Suranjeet Chatterjee, Senior Consultant, Internal Medicine, Indraprastha Apollo Hospitals tells you that dengue and malaria patients need to visit hospitals and there’s no escaping from that.
“From day one, even when COVID-19 was at its peak in Delhi, we have maintained that non-COVID conditions should not be ignored. A lot of people are dying of non-COVID issues because of delayed or no treatment. In such a case, if a patient has dengue or malaria there is no way he can be treated at home. It is there but that doesn’t mean one wouldn’t seek medical help. So my first advice for a person who is sick is to consult a doctor and seek professional help. Because most of the times, people do teleconsultations and things are superficial in there. A physical examination is a must when it comes to such health issues. We would have saved a lot of non-COVID patients if they would have come to us on time,” he tells you.
Though last year Delhi saw less number of Dengue cases because a lot was done to curb the disease that is at times just as killer as COVID-19, if not more. However, keeping in mind the current scenario people have to be more careful because all the attention these days is towards fighting the pandemic.
Dr Chatterjee denies the fact that the rising cases of dengue and malaria could pose a challenge on the health infrastructure of the country, especially for the big hospitals.
“All big hospitals are built in a way to tackle the surge in patients. However, what needs to be done is that a patient should first consult his local physician and when he advises the patient to get hospitalised then the patient should turn to the big hospitals. Having said that, all big hospitals have their COVID and non-COVID wards. At Apollo, we have 300 beds for Corona patients, out of which some are vacant. The credit goes to the people who have understood the disease and those with mild symptoms are treating themselves at home. But yes, if you talk about 20 days back, we had 70 patients waiting for beds. Also, the 400 non-COVID wards are all empty these days, the reason being people not wanting to visit any healthcare facility because they have a fear of catching infection. As compared to last year, during this time we had all 700 beds full of patients with several diseases. You take any big hospital for that matter, they have quite a few beds vacant for patients. But this doesn’t mean, all the patients should rush to hospitals, that would be an unnecessary stress for the hospital staff, their local physician stays relevant in this case,” he tells you.
People learning about Corona, he says, is a good thing but he fears that people would become complacent about the disease.
He agrees that there might be risks involved with people suffering from dengue and malaria visiting the hospitals, given the Corona situation. “But this doesn’t mean that dengue is any less of a disease. We have seen three years back how people died of it. Therefore, it is important to get proper treatment. As far as Corona risks are concerned, we have seen that the fatality rate is very low, hence it is advisable that, if needed, people should visit the hospital,” Chatterjee says.
Apart from dengue and malaria, there are gastroenteritis viruses too which cause similar havoc and can be a matter of confusion. “Diarrhea, vomiting and in some cases mild fever are some of the symptoms of the gastroenteritis virus, which is prevalent during the Monsoon. This could create a bit of confusion because these symtoms overlap with Coronavirus. Unfortunately, the patients have to be tested for COVID-19 as well,” he tells you.
To curb these diseases, he says, one needs to keep an eye on the kind of water he drinks. “Gastroenteritis diseases occur mainly because of drinking contaminated water, therefore, it is important to keep a check on the kind of water you are drinking, especially in the monsoons — July to September. Go for packaged bottled water. Stopping for a chilled glass of water at the roadside vendor is a big no. Staying hydrated is of utmost importance,” he tells you.
Dr KK Aggarwal, , President CMAAO, President HCFI, and Editor in chief — Medtalks.Cmaao — Confederation of Medical Associations of Asia and OceaniaHCFI- Heart Care Foundation of India, however, denies the fact that there can be a surge in dengue or malaria cases, given the pandemic situation. “There is an unwritten law: Ek mayaan mein do talwarein nahin rehti. It is very unlikely that we can see a dengue or malaria outbreak. Two epidemics can’t happen together. Therefore, I don’t anticipate any rise in malaria or dengue cases,” he explains.
Moreover, about 30 per cent population of Delhi has already been affected by COVID-19, the antibodies in these people won’t allow any new infection to enter the body for the next three months.
“We don’t expect these patients to suffer from dengue or malaria. For those who haven’t suffered from Corona, can only get one disease — dengue, malaria or Coronavirus itself. Therefore, there will be added pressure either on the Government or the hospitals. If malaria or dengue outbreak is there, then Coronavirus will disappear,” he says.
The reason behind this, he says, is the innate immunity that is developed by a disease and is like plasma therapy. “This is a natural plasma therapy. If someone gets dengue, the antibodies will then act as a shield against Coronavirus too, for about three months,” Aggarwal tells you.
He tells you that there is no possibility of a dengue or malaria patient catching Coronavirus during his hospital visit. “Dengue or malaria is a mosquito-borne disease. There is no relation of immunity in such a case. It’s all about mosquito bites. Therefore, it is out of question that a dengue or malaria patient can catch infection from a hospital. Even if he gets in contact with the virus, like I said before, his antibodies will prevent him catching infection,” he tells you.
He goes on to explain that an area can only see either a dengue outbreak or a malaria one. “It is like mosquitoes too have their designated areas. The one which causes dengue breeds in a different area than the one which is responsible for spreading malaria. Such is the case with viruses. But yes, those parts of India, which are now don’t have as many cases of Coronavirus or are free from it, might see a dengue or malaria outbreak,” he tells you.
But this doesn’t mean that one can live in oblivion and become complacent about the two diseases. Precautions are a must. “We have been telling people since eternity about the preventive measures. To be on the safer side, all the safety measures should be followed with utmost care. Surroundings should be kept clean and hygienic at all times,” he tells you.