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State’s epidemiologist Dr Pradeep Awate said, “As per our analysis, 600-1,000 patients of the thousands that may contract H1N1 till December may need ventilatory assistance.” A patient receiving treatment within the 48-hour window has little chances of suffering complications, he added.

The 42-year-old patient was initally admitted to Chembur’s Sushrut Hospital, where he tested positive for the virus. He developed pneumonitis and was put on ventilator. On June 19, he was shifted to Jaslok Hospital with complaints of breathlessness, fever with chills and cough. He was also coughing blood in his sputum.

“The most advanced interventions were made, but we couldn’t save his life,” said Dr Tarang Gianchandani, CEO of Jaslok. She added that this case shows the monetary burden that complications of H1N1 can pose. The patient needed ventilator support on admission. While most patients respond to ventilation, he showed no improvement. Also, the oxygen concentration in his blood continued to be low. “The only option was to put him on extracorporeal membrane oxygenation (ECMO),” she said.
He remained strapped to the ECMO machine for 65 days. Bypassing the functioning of the lungs, the machine pumps a patient’s blood with oxygen and removes carbon dioxide before pumping it back into the body. But, doctors self-admittedly, use it as the last resort as affordability remains a constraint. “It comes with a daily cost of Rs 35,000-Rs 45,000 and very few hospitals in the city have the facility. There has to be a dedicated nurse and a perfusionist to monitor the patient. Additionally, tests need to be conducted every day to gauge the patient’s improvement and whether there is any evidence of internal bleeding,” said Dr Gautam Bhansali, consultant physician at Bombay Hospital.