Why Is Karwar Opposing Admission Of New Coronavirus Patients Despite Treating 11 Successfully

Misinformation and our inability to think a level down the surface are going to kill us before the virus does. Karwar which recently treated 11 coronavirus patients and discharged them successfully is about to see it manifest before its eyes. Misplaced fear and paranoia spread through news channels and Whatsapp University are consuming us. Would they devour us completely before we wake up remains an open-ended question. Karwar has zero Covid-19 positives. The 11 patients it treated were not from Karwar but many km away from it. If that makes you applause Karwar for its altruism then you must hold your hands some meters apart.

Uttara Kannada district in total, by the time of writing this, has recorded 39 cases of COVID-19 positives of which 11 were earlier treated and discharged from INHS Patanjali Hospital in Karwar which is an Indian Navy hospital meant for its staff. It admitted this initial batch of positives on request of Uttara Kannada District Commissioner Dr K Harish Kumar. The rest 28 were tested positive in the last four days and are now being treated at District Hospital situated in Karwar itself. The Patanjali hospital allegedly refused to admit this new batch of patients resulting into their being admitted into the civilian hospital of Karwar. But why Karwar? Uttara Kannada district is made up of twelve talukas (or units); of which Karwar and Bhatkal are but just two units. All the 39 cases mentioned above are from Bhatkal alone which is situated 139 km away from Karwar. This might make you think of Karwar as some special place in the district which is both true and false. There is one particular reason why patients are being ferried to Karwar from far-away Bhatkal. A reason which section of people from Karwar and surrounding area seems to forget, and instead are now gearing up to resist the movement of COVID-19 positives from Bhatkal to Karwar, which along with other units (talukas) have registered zero positives of their own. They fear that this movement of patients would result in the spread of disease to other parts of the district.

Three Goa’s would fit into one Uttar Kannada. It’s no small district by its size and Karwar which shares its boundary with Goa is Uttara Kannada district’s administrative centre that houses many important government offices including district commissioner’s office, Zilla panchayat office, Indian Navy and the district hospital which has special equipment, labs and also special surgeons unlike any other public hospital in the district. The upside of this is, most in Karwar for even their minor ailments get to visit this hospital and get their medication for free or on very low prices. Most have got their surgeries done free-of-cost too. Although there is catch there — most of the surgeons (and other doctors) from the civil hospital (the name by which it is mostly known here) also have their private practices in Karwar. Some even have very specialized and big hospitals of their own which all charge high prices. Those who have these private hospitals happen to prescribe special tests for their patients when they visit them in the civil hospital with explicit instructions on where those tests are to be conducted. The coordinates of which always seem to lead to their private centre. And in case you get operated, the surgery that should have been free gets charged albeit you are asked to pay, a proportion of the price of the same operation if it was done in a private hospital, by visiting their private centre. Otherwise, they don’t write the discharge date due to which everyone ends up paying them the charges (hello corruption). Doctors are courteous though. They charge different prices based upon your economic condition. But despite all these small ills, having a district hospital in Karwar has been a boon for local people of Karwar. Many don’t realize how much money they are saving by not visiting private hospitals which just for consultation alone charge around Rs. 500 (200 if it’s a small clinic) — it’s free for BPL families in the district hospital and Rs. 5 for others (was Rs. 2 before). X-rays, blood tests, etc are done free-of-cost in district hospital too — all of whose cost would push someone into a level down in poverty ladder if done from a private one.

Location wise INHS Patanjali is situated in the outskirts of city limits while the civil hospital is at the centre of the city surrounded by all the crowded places including residential complexes. On top of it, people who work in the district hospital come (and go) from all parts of Karwar. Some even travel into nearby talukas of Ankola and Kumta. Two of the cleaning staff from the civil hospital, for instance, travel to and fro on the road before my house. At least once in a day, I greet them. My mum probably greets both of them every day. And this seems to have rattled people. They were initially agitated with Patanjali admitting patients from far-away Bhatkal but they made peace with it when it dawned on them that staff and doctors of Patanjali mostly stayed inside the compound of Indian Navy. A relative of mine, an old lady whose husband worked in Navy, a pensioner who gets ration and medicine at subsidised prices at Navy stalls have stopped visiting the same since they admitted Covid-19 patients. Same must have been the attitude of others. 

If district administration had isolated district hospital and its staff like Patanjali, perhaps by housing its staff, doctors, nurses and other support workers in lodges and hotels, then people would have had fewer reasons to fear. It is the sight of seeing two women walking by, before your own eyes in hospital dress that agitates and animates them. I hear everyday people saying “these women must be stopped” just after they walk by. Both women are dropped to the hospital in the morning by their sons. One of them used to go on a local boat here. Other seafarers objected to his presence and so from yesterday, he has been stopped from going on the boat. Whatever he used to earn from that source is stopped now. People whenever pushed to the wall, here they are thanks to misinformation and paranoia from news channels and Whatsapp, try to find easy targets. People do not like inaction when they face danger. Doing nothing in dire situations rattle people. They want to do something. It doesn’t matter if what they are doing is adding to the misery or cutting from it. They simply want to do something, anything. So I hear, some want to gather before district commissioner’s office to protest. I’m a huge fan of citizen’s protests but I cannot approve of this nonsense now.

The most successful and important deterrent to spreading of the virus is social distancing (rather physical distancing is the apt-term) and frequent hand-washing. These protests would only violate the first weapon we have against the virus’s evolutionary goal. And why are they planning to protest? To not have patients from Bhatkal in District Hospital situated in Karwar. Because this increases their chance of catching the virus. But do they realize by protesting (arranging such a social gathering) they are only increasing their chances of getting the virus? Probability of their catching virus in a protest is higher than their catching same from safe indoors of their houses even when district hospital continues to treat Covid-19 patients from Bhatkal. Ever since the lockdown restrictions have been lifted partially, people have started to crowd markets. Some are even travelling with their small kids with them. In these times every one of us has a responsibility to reduce unwanted movements. Are kids required to be brought to market? Some are travelling to their sister’s places and they’re in turn coming to their houses. I see this every now and then. All these movements are dangerous and can aid into spreading of the virus.

Why does this happen? This paranoia, fear and irresponsible behaviour, are all caused by mass-scale misinformation spread by the news channels and Whatsapp University clubbed with the absence of credible information and easily available resources from the government that would explain the virus, how it spreads, how it does not and what happens when you catch the virus. I have written in past here and here about these topics so I won’t dwell on them any further. There are two things I would suggest to the District Commissioner. One, to make it public knowledge the steps taken inside District Hospital to avert any tragedy of spreading the infection. What steps doctors, nurses and other staff (cleaning and likes) are taking in protecting themselves and their family members. I would suggest if this is not already being done, that hospital staff who are treating the Covid-19 patients be isolated and work in batches like Victoria Hospital in Bangalore does — which is Karnataka’s largest public hospital and also the main hospital set up to treat Covid-19 infected in Karnataka. They work in batches. The batch that treats Covid-19 stays and sleeps in the hospital itself for a week and then they are isolated for 14 days in specific hotels. Karwar can follow this method or come up with a better solution. Indian Railways had converted their train coaches into COVID-19 treating wards with seats turned into isolation wards with ventilators and other medical equipment. Bhatkal and Karwar are both connected via train route. Can we not have these patients treated on a train? It is possible if administration so desires. To sum, the first step is to release more information along-with making sure that doctors and staff are isolated from the general public. The second suggestion to district commissioner is conditional in case protests are to happen or a delegation comes seeking a ban on bringing patients from Bhatkal. Explain to them why patients from Bhatkal are being brought here. They are not brought here to Karwar but to District Hospital in particular which incidentally for good or bad happens to be situated in Karwar. By saying no to patients from Bhatkal, which happens to be part of the Uttara Kannada district, protesters are saying no to the district hospital in Karwar. Ask them if they do not want district hospital in Karwar. Would they like it to be situated in, say Sirsi, which is anyhow the demand of Kageri and Anant Kumar Hegde, two popular politicians hailing from Sirsi. In that case, patients from Bhatkal would have been taken to Sirsi and not Karwar.

District Commissioner with surgeon (in pink) of District Hopsital

Indian Railways coach converted into Covid-19 isolation ward

Deccan Herald on March 28 had said — Uttara Kannada Deputy Commissioner Dr K Harish Kumar announced on Saturday that a COVID-19 unit would come up at a cost of Rs 1 crore on the premises of the Karwar Institute of Medical Sciences within a week (before April 3). The 150-bed unit would have an isolation centre and an oxygen supply facility. There will be 50 quarantine beds and 25 isolation beds. The ICU will be a 10-bed facility, the DC said.

If this has indeed been done then DC must release a bird’s eyeview of the new structure showing the separation if any of the old and new one.

Images as above where DC is standing beside the doctor, both without any gloves or other safety kit along with some curious bystanders on left does not imbibe confidence. This is exactly what needs to be addressed and acted upon on immediate footing. We can’t afford carelessness and laziness at this moment. District Commissioner and other administrative units must think about all the pieces of this corona puzzle including repercussions of the steps they take. If he and others think District Hospital cannot handle COVID-19 patients efficiently if they think the staff cannot ensure safety and precaution so as not to spread the virus where it does not exist then he must request Indian Railways to send their special train that can treat these patients away from the crowded city centre that is District Hospital.

In the end, we need more and more information that is real and factual which will evade fears, paranoia and fight misinformation. The only way to stop rumours spread from WhatsApp University is to provide credible and frequent information from official channels which will shorten the spread and kill the rumours.