NEW DELHI: As the season of vector-borne diseases begin, healthcare workers in the national capital are now faced with a new challenge, which is balancing cases of dengue and malaria along with Covid-19.
Recently, Dy CM Manish Sisodia tested positive for Dengue along with coronavirus. AIIMS has already started getting patients affected with both.
How are hospitals in the national capital preparing to tackle such cases, what are the challenges that lie in treatment and diagnosis and just how fatal can both be together? Dr Ashutosh Biswas, professor, Medicine, AIIMS Delhi and an expert on vector-borne diseases explains.
What is the risk for patients diagnosed with both types of diseases?
Cases will be more severe. Co-infection is a serious condition. However, if a Covid-19 patient is asymptomatic and the dengue symptoms are also mild then there is no fear of fatality. A patient can have both and still be asymptomatic. Complexity in such cases will be mild but the risk of fatality will still remain.
With Dengue season here, how well prepared are hospitals prepared to tackle both cases?
It is indeed going to be difficult to handle both cases now. Most government hospitals are now dedicated Covid-19 facilities. But they need to accommodate both type patients. Cases with co-infection though should be separated.
What is the main challenge in handling such cases?
As the season is changing, clinical diagnosis of dengue or malaria will be a difficult task owing to the overlapping of symptoms. Having similar symptoms, people are likely to undergo the Covid test first. In such cases, even if the person is also simultaneously infected with dengue, it may be detected later. Covid symptoms also can be predominant and the symptoms of dengue can go unnoticed. Pulses may fluctuate, rashes may come or even minor bleeding may happen but all these may not occur in a mild or moderate dengue patient and therefore the diagnosis becomes difficult.
What should be the procedure for treatment?
Both cases need equal attention. We have seen that cases of Dengue in the past have been fatal as well. One needs to follow a symptomatic style of treatment as there is no systematic treatment available in both cases. There is no specific dengue treatment, it all depends on what is the condition of the patient — whether it has organ involvement or minor issues like vomiting, fever among others. Similar is the case with Covid-19, there is no fixed theory of treating a patient infected with this coronavirus. Again the treatment depends upon symptoms that a certain patient exhibits. So, this has to be done carefully, so that there is no further infection along with these two. Patients with comorbidities need to exercise even more caution now. Platelets may fluctuate in case of co-infection and there is a high chance of this happening. In such distinct cases, the transfusion of blood has to be more.
The ICMR said plasma therapy is not a successful model to save critical Covid patients. Can it be helpful in cases of co-infection?
Impact of plasma therapy is not clear yet in terms of treatment.