Doctors in Indian administered Kashmir believe the authorities could have facilitated the spread of deadly coronavirus by refusing to carry out tests. Dr Tsering Angchuk, the Medical Superintendent in Sonam Norboo Memorial Hospital (SNM) in the city of Leh, received three patients he suspected of having contracted coronavirus in late January. One patient, a 54-year-old man from the village of Phyang, was admitted on January 27. “He was having breathing difficulties and running a high fever at the time of admission. All these symptoms fit with the criteria of coronavirus,” said Dr Angchuk. Dr Angchuk immediately sent a letter, seen by The Telegraph, to the Chief Medical Officer (CMO) in Leh. The letter, titled ‘report regarding the patients who show coronavirus-like symptoms’, instructed that samples should be immediately sent to India’s only coronavirus testing facility in the city of Pune.

“When you get several patients with the same symptoms, you obviously inform your higher ups to ascertain the cause of their illness,” said Dr Angchuk. “I had coronavirus in the back of my mind and that is why I asked my seniors to send samples for further laboratory investigation.” However, the hospital authorities refused to send samples arguing it would be impossible for coronavirus to have infected anyone in Kashmir. This was despite India recording its first three cases while the patient was in hospital. The hospital said it had also not been sent pre-sterilised kits from the Health Ministry in Delhi needed to collect samples despite the confirmed cases. The 54-year-old’s symptoms gradually worsened and he died on February 5. The hospital authorities recorded that he suffered from pulmonary tuberculosis and died from pneumonia. However, the district tuberculosis officer in Leh, Dr Nurzin Angmo, said the deceased patient was never medically diagnosed with the disease.

Misdiagnosis of the cause of death in India is extremely common and less than one quarter of deaths are medically certified, according to the Registrar General of India. Indian hospitals are some of the most chronically underfunded in the region and overworked staff often do not have time to diagnose sick patients. Speaking on condition of anonymity, health workers in Kashmir said the misdiagnosis of deaths was common and would extend to coronavirus. “We have never worked on that [medical certification] and hospital staff have never been trained to ascertain the correct cause of death,” an anonymous regional health official admitted. “You will see hospitals record the mode of death as a heart attack rather than its underlying causes like hypertension,” echoed an employee at SNM Hospital. “These incorrect methods can have implications on estimates of coronavirus deaths also.” Doctors believe the hospital authorities refused to send samples because they didn’t want to create panic but that an outbreak in Kashmir is only a matter of time, thanks to government inaction.