Ahmedabad: A panel of expert senior doctors in their interaction with media made it clear that exact reason of high mortality rate in Gujarat is still unknown and the way out for doctors is to focus on patient care. The doctors concluded that the condition of Cytokine Storm and impact to multiple organs triggered by Covid-19 infection remain great challenges for doctors involved in the treatment.

Addressing the press, Padma Shri Dr. Tejas Patel said, more than 200 countries are affected by Covid-19 infection spread. Since the month of March, the problem started here and our Prime Minister announced lockdown-1-2-3 to slow down the infection spread and curb it to some extent. We have benefited from it as much as we can. But this virus is new for all countries and therefore no expert has complete knowledge of this virus. And therefore periodically, we learn from our experience and find ways. Gujarat has more hospital fatality rate. We are worried same way as you are. We are finding scientific reasons and wherever lapses are found we are fixing them. We are in touch with global experts and whenever we get something, we give our efforts. Exact reason of mortality will be known only after this pandemic ends and data analysis is done. There’s no permanent remedy for this virus at present.

Dr. Patel said, ‘infected lung and related clot formations in organs including vascular result into Cytokine Storm. Cytokine Storm can happen in all persons including a child, a young person and an old person. The situation in simple words occurs when messenger cells in response to infection of virus, send message to immune system and antibody are created, but antibody along with fighting the virus, also starts fighting own body.’

Dr. Patel said, co morbidity and issues with multiple organs make patients vulnerable to exposure of any disease. Age also has to be considered as a factor because growing age results into reduced immunity. Late admission to hospital increases the risk.

Dr. Ami Parikh said, weekly review of death analysis covers each death, and it has been found that case goes out of hand when complication is involved in multiple organs. Lungs are predominantly affected due to Covid-19 infection, later Cytokine Storm condition affects all organs including kidney, lever and heart. Third thing that worsens the situation is virus endothelium due to which, internal lining of blood vessels is attacked. Thus the fight in such cases is on three fronts. There’s no medicine for Covid-19 and doctors treat whatever are the complications. In treatment of Covid-19, case to case focus is very important. Each case demands extreme focus and lot of discussions. Doctors should focus on clinical work so that at least patient care part is taken care of.’

She said, it can’t be predicted that whose immune system would react how. Bulk of chemicals are released from cell and affect organs. This creates ARDS pattern in lungs triggering clotting and then there’s no way left to give external oxygen because external oxygen would have no path to reach blood. In this case, doctors feel helpless.

She said, the experience to deal with indoor patients show that condition if deteriorate, it deteriorates in 7 days. Regarding testing, she in reply to a question suggested Serosurveillance for asymptomatic patients.

Addressing the media Dr. Maharshi said, the focus remains on appropriate care to each patient. Interstate or regional variation in terms of death rates should not be a focus.

Dr. VN Shah in his address explained that protein molecule’s multiplication rate as per patient’s immune system. Immunity compromise people such as those who have asthma, blood pressure, obesity, cancer, kidney etc may suffer attack on lung’s last portion, following which fluid will start. Multiplication rate in such cases is so much that exchange of Co2 and Oxygen stops.

Dr. Shah suggested people to keep pulse oximeter and test by themselves that if oxygen is at below 94 level, the patient is critical. He should go to hospital immediately. He said 85% Covid-19 patients have no problem, 15 to 20% need simple oxygen supply while 5% are vulnerable to develop Cytokine Storm and other problems.

Speaking to media persons, Prof. Dileep Mavalankar said that as per available data, Ahmedabad district has more dense population and more co-morbidity conditions, and these two could be major contributing factors for higher rate of Covid-19 cases in Ahmedabad district.

He said, every month around 30,000 deaths are witnessed in Gujarat normally including 125-150 deaths in Ahmedabad. With this 20-30 more deaths are being witnessed due to Covid-19. So mortality in Ahmedabad has increased by 15-20% during this pandemic. It is not the case that death rate in Ahmedabad has doubled due to Covid-19. The loss due to unavailibility of other medical services needs to be think about now.

DeshGujarat