However, the latest analysis of swine flu casualties in the city has revealed that 57% of these patients who succumbed to the virus-induced complications were not locals. They were, in fact, referred to hospitals in Pune city from adjoining areas for tertiary care treatment.
“About 57 % deaths occurring in the city are of those who were referred to hospitals in Pune from adjoining rural areas. But since they died here at city hospitals, we have to include them in the city’s swine flu death tally. This practice makes city’s H1N1 death toll seem larger than it actually is,” said Anjali Sabne, the assistant medical officer of health (AMoH), Pune Municipal Corporation (PMC).
A closer analysis also reveals that swine flu killed more locals in the initial years of virus transmission. Elaborating, Sabne said, “Percentage of local residents succumbing to the H1N1 virus induced complications was more in the initial two-three years when the virus had struck because the city was the epicentre for its transmission. Slowly, the virus transmission shifted to the fringes and adjoining rural parts. Now, the percentage of city patients is less compared to patients coming from rural parts.”
Of the 717 people who died of the virus complications in the city between August 2009 and December 2018, 406 patients were referred to hospitals in the city from outside the municipal corporation limits. “The remaining 311 were local residents accounting for 43% of the total H1N1 deaths in the last 10 years,” Sabne said.
Agreeing, health activist Sanjay Dabhade said, “Besides, general awareness among people living in the city about swine flu, its symptoms and seeking medical care is high.”
There has been a tendency among doctors practising in the peripheral areas and adjoining districts to refer swine flu patients to hospitals in Pune, especially when their conditions worsen. “This is true especially for the doctors working in the periphery and rural regions of Pune, Ahmednagar, Satara, Sangli, Kolhapur and Solapur. We have urged the doctors to treat patients at their own hospitals and have provided them with treatment guidelines. But the referrals continue,” said state surveillance officer Pradip Awate.
Senior public health expert Subhash Salunkhe said, “We have asked all practising doctors to administer oseltamivir (Tamiflu or Fluvir) within 48 hours if a patient has swine flu-like symptoms and has no other co-morbid condition. Doctors should administer the medicines within 24 hours if the patient has other co-morbid conditions along with the influenza-like illness. But often the patients are not given the drug, and delayed treatment leads to complications.”