Tamiflu will now also be given to patients with acute pharyngitis accompanied with fever, those with acute respiratory distress and other serious ailments.
The rising numbers of H1N1 cases in India — 1,283 as on Thursday — has forced the government to alter its strategy. Its focus will now be on cure rather than containment, the health ministry announced on Thursday. Sample testing, the administering of Tamiflu and hospitalisation will be limited to acute and high-risk cases. Tamiflu will now also be given to patients with acute pharyngitis accompanied with fever, those with acute respiratory distress and other serious ailments. For others, the treatment will include home quarantine along with medication.
Ninety H1N1 cases were reported on Thursday, Pune remaining the worst-hit with 43. While Mumbai reported 18 cases, Kolhapur had 2, Delhi 16, Bangalore 9, Mangalore 1 and Gurgaon 1. The death toll went up to 20, with Pune reporting 2 more fatalities and Bangalore recording its first. Pune (12) has the highest number of deaths, followed by Mumbai (2), Nasik (1), Ahmedabad (1), Chennai (1), Thiruvanthapuram (1), Bangalore (1), and Vadodara (1).
Experts feel that it is now neither necessary nor feasible to keep testing samples on such a widescale. Henceforth, testing will be done only in cities or areas where the infection is not widespread, and for serious and high-risk patients. Patients in Pune, Mumbai and Delhi will be directly put on treatment. “Now that the disease is established in places like Pune, Mumbai and Delhi, there is no need to test every person,” said Dr RK Srivastawa, director general of health services (DGHS), Union health ministry. “Unnecessary testing will be stopped and the focus will be on treatment.”
Dr Srivastawa, director general of health services (DGHS), Union health ministry, said:
“People are advised not to rush to hospitals and fight with doctors to test them compulsorily. There is a limit to the number of samples our labs and microbiologists can handle. Hence, samples will be tested only in certain circumstances.”
He said testing will be limited to children, elderly persons and those suffering from serious ailments like asthma, bronchitis, cancer and diabetes. A similar policy will be followed for hospitalisation. Hospitals have been instructed to admit only high-risk patients while those with mild symptoms can be treated at home. “There are three categories of patients: Those with mild fever and sore throat are advised to go home and watch out for more severe symptoms. The second category is of acute pharyngitis accompanied by fever. We will give Tamiflu to these patients but put them on home quarantine. In the third, and most serious, category, where the patient is suffering from acute respiratory distress, has high fever and other complications, the doctors have been instructed to admit the patient immediately to a hospital and administer Tamiflu,” said D Shiv Lal, director of National Institute of Communicable Diseases (NICD), Delhi.
Health experts also believe that though the disease is spreading in the Indian population, it is also slowly moving towards herd-immunity. “The viral load will create immunity among people and after a certain level, the body will fight back and the population will become immune to the H1N1 virus,” said Srivastawa.
According to a study being conducted by the All India Institute of Medical Sciences (AIIMS), 90% of swine flu patients do not even need medicines and are getting fine on their own. “There is no possibility that a wave will come and grip the whole population killing many. All the deaths so far are because of late reporting and late treatment,” Srivastawa said.
Swine flu came up for discussion during the cabinet meeting in which prime minister Manmohan Singh expressed a need for more effective social communication. But the PM also said there was no need for panic and the government has adequate medicines to tackle the situation.
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