APadma Bhushan awardee, DR K K TALWAR is a renowned cardiologist and a former chairman of the Medical Council of India. A former director of the Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh, Dr Talwar is the Punjab government’s health adviser and head of the state’s Covid-19 Expert Committee.
In an interview with RANJEET JAMWAL, Dr Talwar spoke at length about the Covid surge in Punjab, one of the worst coronavirusaffected states in the country, and steps being taken to curb its deadly spread.
Q. What are the reasons for the fresh Covid surge in Punjab?
A. It was in the middle of February this year that we (Punjab) started realising our (Covid) cases which had come down to 400 a day started going up to 800 a day. We found 40 per cent of these cases were people below 30 years of age. It worried us as it was the young population getting affected. So, we suggested closure of schools and colleges as well as to limit the number of people in social functions, restaurants, and shopping malls because youngsters visit such places.
We took these steps in March and by the end of the month, the number of new cases virtually stabilised. So these steps have certainly helped us. We have been sending our samples to designated labs since December (2020) but then in March we got the result that 80 per cent Covid cases in Punjab were infected with the UK strain of the virus, which is more contagious and virulent. Younger people may have milder symptoms, but they are superspreaders.
These two factors – younger people getting more affected and the UK strain of the virus – are main reasons for the Covid surge. Punjab has its own issues of (political) rallies (with Assembly polls slated for early 2022). Such factors have also contributed to this surge. If people don’t wear a mask at such rallies, it becomes a spreading place.
Q. Punjab’s Covid case fatality rate (CFR) is the highest in the country. What are its reasons?
A. The number one reason for it is that our people come late (for treatment). They don’t go for test early (for Covid). They go to a local doctor, take medicines and avoid testing. In this, there is one phenomenon we call hypoxia (low oxygen in the blood).
Patients don’t initially see any symptom, only when it (oxygen level) falls very badly, do they become symptomatic and rush for treatment when the golden period of required medical help has already been crossed. So this is one factor. And the second factor has been our (Punjab’s) comorbid situation.
Punjab has a high prevalence of non-communicable diseases like diabetes, hypertension, coronary artery disease, cancer, liver disease, kidney disease. I also admit that in health facilities and medical colleges earlier we had a problem but now we have upgraded them significantly. If you look at deaths in this surge, it’s half of the deaths we saw in August and September (2020). The UK variant virus, we have documented, is more virulent than the original virus. These are the reasons that we have a high mortality.
Q. A Central team has highlighted the gaps in testing, contact tracing, and slow pace of vaccination. Are these factors also hampering Punjab’s battle against Covid-19?
A. As for contact tracing, I agree we had a problem in July-August. This time our contact tracing is better than before but it’s not been that good. The problem is people in small towns don’t want to get tested. We have to accept the limitations of our cultural mindset.
People think they are healthy, so what’s the need to get tested for Covid. So we face this issue. But the effort has been to educate people. As for slow vaccination, initially health workers were not co-operating for vaccination. At the moment, our vaccination is fairly okay.
Q. What’s your assessment of the second Corona wave?
A. As far as Punjab goes, it may peak in the middle part of April and then go down. Other states should also get virus sequencing done so that the picture becomes clear and that may help in taking more steps to control the spread of the virus.
Q. Punjab has imposed night curfew to curb Corona spread.Is it effective?
A. Night curfew is only to educate people and curb late evening activities. The people who go out in the evening are mostly youngsters. They visit places like restaurants which are closed places. In summer, the air-conditioners are on at such places and youngsters don’t wear masks there, so the virus spreads much more. So night curfew is to curb late evening activities. There is no economic loss from it.
Q. Given the Covid surge,is lockdown a possibility?
A. Personally, I think there should not be any lockdown. There should be some restrictions to control some activities like in a lockdown. Lockdown was done earlier because we wanted to prepare our health services. Now, I personally feel we should not go for lockdown.
Of course, we must effectively control the assembly of people and the use of masks should be enforced strictly. If people follow these restrictions and don’t defy these, I am sure in the next three-four weeks, things will change. But I think complete lockdown will only make people suffer more.