INTERVIEW | ‘HMPV is just another annual virus, there’s no need to worry’

The HMPV we are talking about right now in India, according to the genomic surveillance we did, is not the strain that’s found in China.
Dr Asima Banu
Dr Asima Banu
Updated on
7 min read

Amid the HMPV scare, Dr Asima Banu, Professor and HoD of the Microbiology department and Principal of Bangalore Medical College and Research Institute (BMCRI), and Nodal Officer for Trauma Care Centre, has a reassuring message: that there is absolutely no reason to worry.

In an interaction with the TNIE editorial team, she shared her views on multiple issues such as healthcare in Karnataka, why people choose private hospitals and what needs to be done to strengthen the medical care system.

Excerpts...

Could you tell us about the Human Metapneumovirus (HMPV) and how dangerous it is?

Every time, ever year, we have some viral outbreaks in the world. This is a respiratory virus. These are common viruses which cause common seasonal cough and cold. There is nothing to worry about. Covid-19 became a problem because of the mutations. The HMPV we are talking about right now in India, according to the genomic surveillance we did, is not the strain that’s found in China.  

Is HMPV just another viral infection?

Yes, it was always there. It comes every year. We saw HMPV in 2001. We have the avian metapneumovirus from 1970s. After that, there have been regular bouts of infections and we don’t bother about them.  

The stress is again on wearing a mask. Should we continue to do that?

I always recommend masking. If you have influenza A/B or H1N1, or are visiting a healthcare setup, or have a cough and cold, it is better to wear a mask so it doesn’t spread to others.

How is HMPV different from other viruses in causing kids to be hospitalized? 

It is not a severe cough but a prolonged one, often persisting over an extended period. Children, in particular, are experiencing prolonged illness, which is prompting testing. Regarding the two cases reported at Baptist Hospital, I am unsure why they were admitted. However, no casualties have been reported anywhere in Karnataka linked to this issue.

What advice would you give to parents, especially since children are among the primary targets of this illness? How can they manage or prevent it at home?

The two cases involved infants aged three months and eight months, so it’s likely they were infected either by a parent, another family member, or during an outing. Parents and caregivers must strictly adhere to preventive measures such as masking and maintaining hand hygiene. While masking infants is not feasible, it is essential to isolate them from others, if necessary. 

What message would you like to share regarding the current HMPV scare?

There’s no need to fear a pandemic, epidemic or virus, but it’s important to stay vigilant. Be aware without panicking. Follow basic precautions like hand hygiene, masking, and proper cough etiquette. If you are infected, isolate yourself to prevent spreading the illness.

Is there a possibility of this virus mutating? At what point does it become a concern? Are we actively monitoring its progression?

Every virus mutates, especially as we encroach on zoonotic areas and disrupt habitats meant for animals. This particular virus, seen in turkeys and poultry, is domestic rather than wild. To address this, the government has implemented the ‘One Health’ approach, focusing on the surveillance of pathogens across humans, animals and even marine life. 

How has the health machinery improved post pandemic?

Covid-19 taught us that it can happen anytime. Our generation had only read about pandemics in books. For the next 40-50 years, we are there to handle this and are equipped. It will be a novelty for the next generation. We are doing a lot of robust surveillance and diagnosis. During Covid-19, we procured many things, now we just have to pick up a PCR and start. We have become vigilant. We can detect viruses three weeks in advance using water samples, and prevent outbreaks. We are equipped with beds and manpower to handle emergencies. We didn’t know how to handle respiratory emergencies during Covid-19, but now we can. People are also aware of etiquette like mask, hand hygiene etc.

Is there a shortage of manpower in the health sector?

We follow the National Medical Council (NMC) guidelines in medical colleges for the required manpower. Yes, there is attrition and transfers, so in sectors like nursing, there will be a shortage.

Why do some lose interest after getting into the medical field?

After 12 years of struggle to get a medical seat, they tend to relax. They become euphoric, there is also pride and arrogance.  

You said diagnosis is very specific now. But while testing for respiratory illnesses like HMPV, do you think there could be cases of false positives?

No. We have very strict quality assurance. ICMR has designated only BMC lab to do the testing in Karnataka. We are doing positive and negative quality analyses, matching the results and then sending them to the Indian Council of Medical Research (ICMR) and National Institute of Virology (NIV).

BMCRI is the only designated lab in Karnataka for this type of surveillance. How many cases are typically being reported on a regular or weekly basis?

There are only five cases allowed per week for children under five years, and five cases per year for adults above 65. These samples must first test negative for influenza, RSV and Covid-19. If the patient still exhibits severe symptoms and is either under five or over 65, the sample is sent to BMCRI. 

Post-Covid, has there been an increase in demand for studying virology among medical students? 

There hasn’t been a significant increase in the demand to specifically study virology. This year too, there has been little interest, possibly due to delays caused by the Covid batch. Once exams return to a regular schedule, we expect more students to take it up. 

Which medical courses currently have the most takers, and are in highest demand?

Dermatology, cosmetic dermatology, has gained significant popularity. It offers a more predictable schedule with no emergencies, making it an attractive and financially viable option. Radiology is also in demand for similar reasons — no night shifts or emergencies.

What are your thoughts on the one-year rural stint that doctors are required to serve after completing their course?

In government colleges, rural postings are mandatory. Most new government colleges are located in districts, so doctors are posted there. The exposure they get in rural areas is different from what they would experience in urban settings, and I believe it’s valuable. 

Any words of encouragement for young doctors considering rural service?

It’s about the rural bond. Whatever bond they have signed, they should complete it and move on. Some doctors choose rural service, especially if they come from rural backgrounds. They feel a strong connection to their roots and want to give back to their village or taluk. If they are from urban areas, they may not choose to go to rural settings.

Whenever there is some virus, a lot of panic is created on social media. What do you have to say about it?

I can’t say they’re doing it purposefully. After Covid, people have become more paranoid and panicky about these situations. 

People choose private hospitals over government hospitals, even if treatment is free. Why so?

Maybe because of the high load of patients, people prefer private hospitals. Government hospitals get over 1,000 outpatients, 150 emergencies and 100 deliveries, all in a day. Which private hospital has this much of load on a daily basis? Government hospitals are always overcrowded.

Those who want quick treatment, without waiting, choose private hospitals and we don’t have any say on this. On the other hand, there are many who prefer government hospitals, especially for normal deliveries. Many women, private doctors, bureaucrats and others get admitted to government hospitals for normal deliveries as they fear that if they go to private hospitals, they may have to undergo C-section delivery.

Why do people always complain about the service and treatment in government hospitals?

The number of beds and visitors in government and private hospitals are not comparable. In government hospitals, for one patient, as many as ten attendants barge in. People spit in the hospital, they eat and litter the premises. Is this done in private hospitals? There people follow the rules, stand in queues and follow discipline. Why can’t the same behaviour be followed in government hospitals?

As per government regulations, we can only have a specific number of staff, whereas private hospitals can have any number of doctors. It’s no wonder private hospitals spend more time with patients and talk nicely to them. Private hospitals also charge accordingly. 

Are government doctors paid less than private doctors?

Government doctors are paid well, much higher than those in private hospitals. There is huge competition among doctors to get into government hospitals. As selection is based on merit, only a few get a chance.

Isn’t it the responsibility of the government to increase the number of hospitals to match increasing population?

Karnataka has the maximum number of medical colleges in India. It has one of the best infrastructure. The health minister is trying to have a medical college in each district. Compared to the healthcare scenario in North India, Karnataka is heaven. Post-Covid, even a Primary Health Centre is equipped with oxygenated beds. 

Many rely on the internet for medical treatment these days. Isn’t it harmful?

The trend of checking the internet, post Covid, to know one’s medical condition and treatment has become an addiction now. Many have landed up with health anxiety disorder as they don’t know what should be taken seriously and what not, and end up with complications.

What are the challenges to making healthcare more robust, accessible and affordable?

There needs to be massive awareness about schemes and facilities, and what we can offer. Many don’t even know how to read and write. When they come to hospital, they don’t know much about government schemes or whom to approach. At Vani Vilas Hospital, everything is free. There is a strong midwifery unit which pampers mothers and pushes for normal child delivery. This is not reaching the grassroots. Forget the population from outside the city, even Bengaluru’s population is not very aware.

What do you have to say about maternal deaths in Ballari?

Maternal deaths are not reported only in Ballari, they are everywhere and we are investigating. The committee is conducting a death audit and once they give the report, we will come to know. We need to know the reason as Karnataka was doing well in containing maternal mortality.

Is BMCRI introducing Artificial Intelligence (AI)?

We need to have simulation skills as per National Medical Council (NMC) guidelines. When we started training, we had to see and learn and practice and now a module has been introduced by NMC. We have not taken any robotics yet. When we have manpower, there is no need for AI.

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