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What are Ventilators and Why are they needed in Kashmir?

What are Ventilators and Why are they needed in Kashmir?
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If the number of patients increases and ventilators are just not enough, those who could have recovered will simply die.

Shakeel Maqbool

Amid the growing coronavirus pandemic, health facilities around the globe are facing the tough task of saving lives. This happens at a time when the available medical infrastructure is far less than what is needed to meet this unprecedented challenge posed by the novel virus. Among other supplies in high demand like gloves, masks and Personal Protective Equipment, the most badly needed, experts say, are ventilators. But why are ventilators so important in this crisis? The answer lies in what they are and how do they work.

Ventilators and the way they work

Ventilators are mechanical breathing devices employed to save patients with severe lung attacks. Since COVID-19 is a highly infectious respiratory disease, a considerable fraction of patients get their lungs damaged. This makes it difficult for them to keep the oxygen delivering to their blood, leading to respiratory failures.

According to World Health Organisation, one in six patients becomes serious and needs a ventilator to keep breathing. In some cases, it can develop Pneumonia and acute respiratory distress syndrome resulting in damage to other organs. A ventilator feeds oxygen into the patient’s lungs through a tube inserted down the upper respiratory tract. It also adds heat and moisture to the air to keep it in sync with patient’s body temperature. In patients with milder symptoms, non-invasive ventilation works well. This simply uses face masks, nasal masks, mouthpieces, hoods and oxygen tanks. But this is not always the option. Patients with severe respiratory issues often require well-trained medical staff like anesthetists to perform invasive surgical procedures before they can be put on ventilators. The machines too are not much easy to operate. More precautions are needed to ensure when dealing with such a contagious disease.

According to John Hopkins University, India may need 1 million ventilators. But what we know is that the country lacks an official figure on the number it has. Rough estimates peg it at around 40,000.

What is the world doing?

 Countries around the world are racing against time to procure ventilators. Even car manufacturers and rail manufacturers are trying to manufacture ventilators. In United States, Ford Motor Company, in cooperation with General Electric’s healthcare, is said to be producing 50,000 ventilators over the next 100 days and 30,000 per month afterwards. General Motors Company plans to produce 10,000 ventilators per month by mid-2020. Even in India, the Integral Coach Factory (ICF) in Chennai, the makers of Train 18 (India’s first electric semi-high speed train), is attempting to manufacture ventilators. AgVa Healthcare, a Noida-based manufacturer, is working to manufacture 20,000 units in the next month.

Where do we stand and what is the need?

 According to John Hopkins University, India may need 1 million ventilators. But what we know is that the country lacks an official figure on the number it has. Rough estimates peg it at around 40,000. This is around 1 ventilator for 32,000 people. In UK, they have around 7,000 ventilators for 70 million people. 1 ventilator per 10,000. They have just ordered for 10,000 more ventilators. Even Pakistan next door has declared that they are procuring 10,000 more to take the total to 12,000 which make roughly 1 ventilator per 16,000 people. New York City has a population of 8 million and its city mayor Bill de Blasio says he needs 15,000 more units. Kashmir valley has a population of 7 million and it has 97 ventilators. 1 ventilator per 70,000. The government is procuring around 100 more. Once it is done it will be 1 per 35,000. If we want to reach the level of UK, we need 2,300 ventilators. Even to reach the capacity of Pakistan, we need roughly 450 ventilators. The situation is desperate and the comparison tells a scary story of the sorry state of affairs.

According to most experts, COVID-19 is here to stay till we get the vaccine which looks at least one year away. Personal Protective Equipment, lockdowns and hygiene awareness are all golden measures but they may only delay the spread.

Ventilators, we are told, are in short supply. Even if available, they take at least a month to deliver and get installed. This means we need some contingency planning for acquiring, installing and operating them; in case there is an explosion of COVID-19 in the community and that is not far-fetched at all. If the number of patients increases and ventilators are just not enough, those who could have recovered will simply die. One of the most obvious ways to avoid a shortage of ventilators is to reduce the numbers of people catching the disease in the first place. That means following all the health advice including social distancing and lock downs. But we need to be prepared for the worst. Community transmission has already been observed in the Kashmir valley and often the viral spread explodes in a few weeks.

According to most experts, COVID-19 is here to stay till we get the vaccine which looks at least one year away. Personal Protective Equipment, lockdowns and hygiene awareness are all golden measures but they may only delay the spread. We need to focus on the curative aspects besides the preventive measures. Like it or not, ventilators are going to be the lynch-pin of curative efforts. Lastly, a ventilator alone cannot do anything. It needs an ICU ecosystem to operate. Be that as it may, there is no going away from the fact that we need ventilators and we need more and more of them desperately. We also need to put the rest of the pieces in their ecosystem in place in order for them to function.

 

Shakeel Maqbool is a Civil Servant

Disclaimer: Views expressed are author’s own and do not reflect the stand or policy of Oracle Opinions.

 

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