Amid Covid-19 crisis, where have other contagious diseases gone this monsoon?

File: A test for dengue is being performed.

Every year around this time, the number of patients of other infectious diseases would have risen. If the coronavirus pandemic had not occurred, I would have been treating patients with contagious diseases. However, the number of patients of diseases such as diarrhoea and scrub typhus visiting any hospital this year so far is almost zero. Where have they gone?

Earlier, 99.7 per cent of Covid-19 cases were asymptomatic. But, now, the number of cases with symptoms are rising. That raises the question of whether there is a connection between the rise of symptomatic patients and the disappearance of diseases that used to be seen in the past. The symptoms of these diseases are similar to those of Covid-19. So maybe it would be better to test Covid-19 and other infectious diseases together.

Even, India does not seem to consider this. I mention India because infectious diseases seem to appear at the same time between the two countries. For example, when there is flu, we also see flu cases here. Looking at the past experience, the number of patients of the contagious diseases should have increased in India at this time.

I would like to share an experience while living in Bangladesh as a visiting researcher. There, diarrhoea patients were infected with E-coli, and shigella whereas three to four types of infections were found in each cholera patient. I asked the professor there which infection caused the patient to be admitted. They had no answer. I later wrote about that in The Lancet Journal.

What happens, in this case, is that the bacteriologist would admit the bacterial patient and the viral doctor would be treating the patient as the virus patient. Thus, there would be no accurate data.

There are more than 24,000 Covid-19 infections in Nepal. Maybe, it overlaps somewhere with others because now is the time that the infectious disease is seen every year.

Media in yesteryears would report the number of scrub typhus and flu patients. But, why are there no such reports this year? Yes, that is my question. Did such contagious diseases stop appearing or did we not test them?

Shukraraaj Tropical and Infectious Disease Hospital in Teku of Kathmandu

Or, are other contagious diseases yet to come? The United States and the United Kingdom have said the rainy season is prone to other infectious diseases. If we look at the data of our National Influenza Centre for the last five years, most cases of contagious diseases are seen in August. According to journal articles, such diseases are more prevalent in July-August.

Almost all the symptoms of Covid-19 and other infectious diseases are similar except for the loss of smell and loss of taste. It is important to separate them as there are cures for other infectious diseases. For example, there is a flu vaccine. Children with the flu and the chronically ill can be saved. If mortality can be reduced, why should not we research it?

Meanwhile, the attitude of society is also different for Covid-19 and other diseases. In the past, people used to be afraid of the flu. However, after the insurgence of Covid-19, they seem to have stopped worrying about other diseases.

Shukraraj Tropical and Infectious Disease Hospital used to treat infectious diseases at this time in previous years. As it has been made a Covid-19 hospital now, there is no question of patients coming here for other communicable diseases. But, I have personally received calls from people suffering from cold and diarrhoea.

If a patient with the flu comes to the hospital for testing and the person’s Covid-19 report came negative, my question is: what is the patient suffering from? We have not thought that way, but that is my concern. Had the Covid-19 not come, we would have been looking for the causes of the symptoms at this time.

Earlier, snakebites were also treated in hospitals. We are now referring such cases to Bir Hospital and Patan Hospital. The doctors there also consult me regularly.

Recently, a person contracted scrub typhus and visited me. Maybe others would have been afraid to treat him because of the fear of Covid-19. I treated him and he recovered in two days.

Now if a patient with fever visits a hospital, it will create panic and chaos. However, the reality is that the death rate from other infectious diseases is higher than that of Covid-19 till this date. Therefore, I emphasise we should not ignore this issue. Like before, let’s test the patients who have symptoms of diarrhoea, and whether they have cholera. If the disease is diagnosed, the right patient can get the right medicine at the right time and the risk can be reduced.

The Lancet Journal also reported that it was difficult to distinguish between Covid-19 and dengue. It seems that dengue is also seen in September-October.

Symptoms such as fever and headache are common in contagious diseases. Thus, we used to test two or three of the most common diseases in Nepal. But now, our whole attention is centred on Covid-19. I hope that no person would die with a disease that could have been identified and treated.

If such tests do not show any diseases, it should definitely be Covid-19. We have been testing people for infectious diseases in the past. But now, needless to say, Covid-19 has completely overwhelmed and overshadowed other diseases. By only focusing on Covid-19, another disease should not become more complicated and a patient should not die.

(Based on a conversation with Dr Sher Bahadur Pun, Research Coordinator, Shukraraj Tropical and Infectious Disease Hospital)

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Dr Pun works at Shukraraj Tropical and Infectious Disease Hospital, Kathmandu.

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