KASHMIR ON EDGE! Lung failure, bilateral pneumonia cases flood hospitals as COVID continues to kill

Srinagar: Two weeks ago, when a 70-year-old man was diagnosed with bi-lateral pneumonia and tested COVID positive, his family went into utter shock. That a person, who never went outdoors in two consecutive lockdowns hardly interacted with the relatives and kept to his room mostly, could get severely sick, was something they could not fathom. 

“He had underlying conditions of diabetes and came to us with symptoms of respiratory distress (in common language: breathlessness), and high fever, at SMHS Hospital, Srinagar,” the doctor examining him said.

On examination, it came to be known that his oxygen saturation was very low, around 80 percent. Oxygen saturation refers to the extent to which haemoglobin is saturated with oxygen.

 Haemoglobin is an element in your blood that binds with oxygen to carry it through the bloodstream to the organs, tissues, and cells of your body. Normal oxygen saturation is usually between 96% and 98%. Any level below this is considered dangerous and warrants urgent oxygen supplementation and/or treatment for your lung condition

“It indicated that he had respiratory failure. We did his X-ray and it showed bi-lateral infiltrations,” the doctor said.

Following this, the patient was put on oxygen via nasal prongs. “After 48 hours, his test reports came back COVID positive. Accordingly, he was shifted to Chest Diseases Hospital,” he said.

Similarly, another baffling case of pneumonia was reported to SMHS Hospital. A 26-year-old, who had a travel history came to the hospital with symptoms of fever and cough.

“He was a medical student in Kazakhstan and had undergone all quarantine procedures. Even his initial COVID test was also negative. However, on returning home, he developed symptoms of fever and cough,” the doctor said.

As a routine, his X-ray was conducted. Much to the surprise of doctors, it was worse than the X-ray of the elderly patient.

“However, there was a difference: he was clinically better than him and was not a respiratory failure. His oxygen saturation was 94 percent,” the doctor said.

Accordingly, he was shifted to Kashmir Nursing Home instead of Chest Diseases Hospital.

However, within 72 hours of admission at the nursing home, his oxygen saturation dropped below 80 percent. He was immediately shifted to CD Hospital.

Official figures reveal that since Friday, 110 people have been admitted to SMHS Hospital against 30-40 admissions per casualty on a usual day.

Among them, 90 percent are pneumonia patients.

 “The isolation ward created in Drug De-addiction Centre, Department of Psychiatry, SMHS Hospital is packed with patients. The new wards created are also full. Even the general medicine wards are full. The COVID tests of these patients are awaited and will come by evening,” a senior resident at SMHS Hospital said. 

Figures from Chest Diseases Hospital show that around 48 patients are on oxygen. The majority of them suffer from bilateral pneumonia.

In layman terms, Pneumonia is filling up of lungs by fluid which is normally filled with air. Pneumonia may be the result of infection (bacterial, viral, or fungal) or other diseases like toxic gas inhalation, etc. Pneumonia is easily diagnosed by a chest X-ray or CT scan.

The coronavirus affects the lungs and sometimes it causes pneumonia too. Since there is no strong medicine against coronavirus, pneumonia may take a very long time to heal. That is when patients may require a ventilator. The patient’s immune system plays an important role in the outcome.

President, Doctors Association of Kashmir Dr Suhail Naik said that during summer, such an alarming level of respiratory illnesses or bilateral pneumonia and patients requiring oxygen was never observed before.

“Such an epidemic level of clinical presentation vividly depicts that the virus has spread and propagated in the community. It implies that people did not follow the protocol as well as safety measures and allowed this lethal virus to propagate in community,” he said.

Dr Naik pointed out that this is scientifically proven and research-backed that 10 percent of patients will land to severe pneumonia. “No age is immune to virus and anybody can succumb to illness. Not following health advisories increases disease burden in the community and serious patients finally land at dedicated COVID hospitals with breathlessness, fever, and fall in oxygen saturation,” he said.

In another worrying development, there are fears of a more fatal respiratory disease that has sprung up. The Chinese embassy in Kazakhstan has issued a warning about unknown pneumonia sweeping through the central Asian countries after more than 600 people died of pneumonia in June.

In an advisory issued for its citizens living in the former Soviet Bloc country, the Chinese embassy said the new disease has a fatality rate “much higher” than Covid-19.

Emerging pneumonia in Kazakhstan is similar to COVID in the sense that both are viral. However, the potential of that virus is still unknown.

“There is no widespread community transmission of that virus. It is localized in Kazakhstan and that too in some parts. It is neither pandemic nor endemic. It can be called an epidemic. We need not worry about it as there are strict travel restrictions in place and very less movement of international travellers. But we have to be cautious. If it has emerged in one part of the world, then it can prop up in other parts of the world as well,” a senior doctor at SMHS said, wishing anonymity.

He noted that in cases of pneumonia, the condition of the patient irrespective of the age group can worsen within no time.

Dr Shahnawaz B Kaloo, a Kashmiri doctor based in Delhi said new pneumonia reported by the Chinese embassy and refuted by the Kazak government may or may not be due to a new bug.

“We don’t know yet. But mostly such new diseases are localized and it is very uncommon for them to go pandemic. As more information becomes available our understanding of this will also improve,” Dr Kaloo said.