CHENNAI: Tamil Nadu is grappling with a heatwave and at least 100 patients are treated for heat-related illnesses at government hospitals each day, yet the state has not reported a single case or death of heat-related illness on the Union Health Ministry portal under the National Programme on Climate Change and Human Health.
The state health department was only able to confirm a single case to TNIE. A 35-year-old man was admitted to Chennai’s Rajiv Gandhi Government General Hospital with heat-related illness on Saturday. He was diagnosed with heat cramps and rhabdomyolysis, a condition that causes muscle to disintegrate leading to muscle death. The patient’s condition is said to be stable.
Meanwhile, a 25-year-old man from Uttar Pradesh, employed at a construction site near Sriperumbudur, died allegedly due to heat stroke on Sunday. Sanjay had collapsed on Saturday at his home and was rushed to Saveetha Hospital in Thandalam. He was diagnosed with heat stroke and referred to RGGGH early Sunday morning. Doctors there said he was brought dead.
Reporting cases vital for precautions: DPH
Government hospital doctors see such cases daily but, despite a March 7 advisory from the Directorate of Public Health, the institutions do not report them to the DPH.
The doctors told TNIE that their hesitancy in officially recording such cases stems from the difficulty in making a diagnosis. “A case can only be diagnosed as caused by heat-related illnesses if other causes of illness have been ruled out,” a doctor said.
A doctor at the Government Stanley Medical College Hospital in Chennai gave an example of a patient who came for treatment last week. The patient, a Central Reserve Police Force (CRPF) personnel, came with heat exhaustion with symptoms of tiredness and fatigue. “He recovered after receiving fluids. His illness presented as a case of stroke but all the tests were normal. So we were able to diagnose it as a heat-related illness. The very next day another CRPF personnel came in with the same condition.”
“Then we realised they were exhausted due to their physical activities and advised them to stay hydrated and finish their workouts before sunrise. Similarly, we are seeing cases among people who work in the sun from 11 to 3pm,” the doctor added. Asked if the cases were reported, the doctor said they reported such cases to their seniors.
However, the reluctance to report the cases may affect preventative measures that the DPH could undertake.
“The reporting will help us to locate the cases to see where they are coming from and take precautions or issue advisories. If the cases are coming from a construction site, then we can instruct the construction site owners to take precautionary measures and protect the workers. Reporting of cases will help the health machinery to stay alert,” Director of Public Health Dr T S Selvavinayagam told TNIE.
According to the DPH, minor heat-related illnesses include heat rashes, heat oedema, heat tetany, heat cramps, heat syncope, while major heat-related illnesses are exertion-associated collapse, heat exhaustion, heat stroke.
In its advisory on March 7, the DPH had instructed all the district health officers to start heat-related illness surveillance from March 1, 2024 on the Integrated Health Information Platform under the NPCCHH . The NPCCHH division of the National Centre for Disease Control (NCDC) had conducted a video conference with state nodal officers on February 21, and requested the district nodal officers to report the heat-related illnesses on the IHI P-NPCHH portal from March 1.
Meanwhile, the Directorate of Medical Education in its circular to all deans and directors of institutions on April 29 instructed them to take precautionary steps to handle heat-related emergencies and to create public awareness to manage the situation.
The Director of Medical Education Dr J Sangumani told TNIE that all medical colleges were instructed to have a separate ward for treating heat-related illness cases and many medical colleges have earmarked beds to treat such cases.
Peak summer sees the light of the day
Be alert
Listen to the radio, watch TV, read newspapers for local weather news, get latest update of weather on IMD website
Stay indoors as much as possible
Stay in well ventilated and cool places
Block direct sunlight and heat waves. Keep windows and curtains closed reign the day, especially on the sunny side of the house.
Open them up at night to let cooler air in
If going outdoors, limit outdoor activity to cooler times of the day, morning or evening.
Do outdoor activities during cooler parts of day, Try to remain on lower floors during the day, Use fan, damp cloths to cool down the body
Stay hydrated
Drink sufficient water whenever possible, even if not thirsty. Thirst is not a good indicator of dehydration
Carry drinking water when travelling
Use Oral Rehydration Solution (ORS) and consume homemade drinks like lemon water, buttermilk, lassi, fruit juices with some added salt
Eat seasonal fruits and vegetables with high water content like watermelon, muskmelon, orange, grapes, pineapple, cucumber, lettuce or other locally available fruits and vegetables
Stay protected
Don’t go out from 11 am to 3pm
Wear thin loose cotton garments, preferably light coloured
Cover heat, use umbrella, hat, cap, towel, other traditional headgear during exposure to direct sunlight
Wear shoes or chappals while going out in sun
For vulnerable population
People at greater risk who need additional attention: Infants and young children, pregnant women, people working outdoors, people who have a mental illness, people who are physically ill, especially with heart disease or high blood pressure, people coming from cooler climates to a hot climate. These people should allow one week of time for their bodies to acclimatize to heat and should drink plenty of water
Precautions while at work
Duration of exposure to a hot environment should be minimised
Avoid strenuous physical activity under hot sun
There should be periods of rest in between work in hot climates. The frequency and length of rest breaks should be increased
Cool drinking water should be provided near the working place
Water should be consumed every 20 minutes or more frequently to stay hydrated
If signs such as headache, and dizziness appear. Should remove the person to a cooler environment, and the necessary treatment including adequate fluids should be given