Why dengue is not the devil
The high number of dengue cases in many states around the country has grabbed headlines as the national tally of cases this year is near twice the number recorded during the same period last year.
While the burden of this disease is higher in southern states, the outbreak in Delhi is being seen as the result of poor preparedness on the part of the administration. The rapid progression of the disease has taken many by surprise as the high incidence is unseasonal compared to earlier trends. The dengue virus usually strikes the city only after the end of the monsoons in October.
The reason for the temporal shift, say, experts, is the erratic weather and rainfall that the country has witnessed this year. Many scientific studies in the recent past have drawn connections between weather variables and the incidence of dengue. Many scientists are in agreement that a combination of higher mean temperature in a region and high humidity fosters higher rates of dengue transmission and incidence.
A C Dhariwal, director of National Vector Borne Disease Control Programme (NVBDCP), agrees with the correlation cited in the studies. However, he adds that the prime reason for the unseasonal susceptibility of the country to multiple dengue outbreaks this year has been the unusual monsoon. Characterised by intense wet spells followed by long dry spells, the monsoon season was unusual this year.
“Usually when it rains, the rainwater flushes away stagnant pools that act as sites for mosquito breeding. This year, we saw rainfall early in the season that was followed by long dry spells during which there has been high humidity, especially in Delhi. This has enabled a shift from the usual trend of dengue transmission that we have observed, and the virus has struck parts of the country earlier than usual,” he says.
Dengue in Delhi—A management crisis
The dengue epidemic in the national capital is making national and international headlines. As many as 16 people have died, and over 2,000 have been affected from dengue in Delhi so far. Initial media reports have blamed the high-handedness of doctors, with at least two deaths (that of young boys Avinash and Aman) being caused because they were turned away by hospitals. Many accounts have also blamed the city’s creaky health infrastructure, which has not been able to adjust to the flood of patients.
Our ground check shows that the stories about the high-handedness of doctors are true in that patients are visiting smaller, mostly private doctors and hospitals that treat them for a few days and then send them to bigger, usually state-run hospitals. Also, the government hospitals are getting overburdened, being forced to accommodate more than one patient on a bed. And far from complaining, the patients and their relatives are, in fact, satisfied.
For instance, take the case of Balwant Ram from Gurgaon. His wife, 40-year-old Vimal Devi spent four days in Metro Life Line Hospital in her locality. Nearly Rs 12,000 was spent on her treatment. But, her condition continued to deteriorate. Balwant Ram then rushed her to the All India Institute of Medical Sciences (AIIMS), where his wife is now being treated and said to be normal.
Like Ram, Shafique Ahmad too struggled to get proper treatment for his 12-year-old daughter Shahana. A resident of Raju Park in South Delhi’s <g data-gr-id="81">Deoli</g> neighbourhood, he went to a local government dispensary four days ago when his daughter complained of fever. The doctor there gave some medicine and told him to go somewhere else. He then took his daughter to a private doctor for four days. When her condition worsened, he rushed her to AIIMS.
Narendra Kumar, a resident of Badarpur, took his mother, who had been diagnosed with dengue, to some places, before finally turning to Safdarjung Hospital. She is sharing a bed in the hospital with another woman. Narendra Kumar says he is feeling relaxed now that his mother is admitted.
Experts offered their piece of advice on how to tackle the crisis. “If you get a fever, don’t panic.
Immediately report to the doctor,” said Anil K Rai, Medical Superintendent of Safdarjung Hospital and Vardhman Mahavir Medical College. He added that the best treatment for the disease was hydration.
Rai said that the problem of lack of beds that would be dealt with soon, at least at Safdarjung. “We are accommodating all patients coming to hospitals. There is a lack of beds, which will be augmented in the coming months.”
The city and Central governments have both sprung into action since the deaths of the two boys.
The Delhi government has asked state-run hospitals to increase the number of beds by 1,000 by Sunday. Even private hospitals have been asked to buy more beds and hire more doctors, nurses and paramedics.
The Central government has organised a meeting with all stakeholders including senior officials of the ministry and heads of central government hospitals to review the situation on Tuesday.
Union Minister of Health and Family Welfare, J P Nadda has informed that there has been a decrease in the number of dengue cases detected at the national level. He cited the data of three years including 75,808 cases in 2013, 40,571 cases in 2014 and nearly 21,000 cases in 2015 up to the second week of September.
However, this is not the case in Delhi, which has seen a sharp increase in dengue cases this year, compared to last year. While the number of cases detected in Delhi last year was 995, the number detected this year, up to the second week of September was 1,872.
Concerned the sharp surge in dengue cases, the Delhi High Court on Thursday asked the Centre, the state government and civic bodies to explain the steps being taken to check the crisis.
(The views expressed are personal)