People embarking on the Char Dham pilgrimage should undergo a medical checkup to reduce health risks during the strenuous journey to the high-altitude shrines, the Uttarakhand government said on Sunday, citing recommendations of an expert panel that analysed the reasons for over 100 deaths since the pilgrimage started on May 3.

The health risks were found to be specially high among the elderly and those with prior medical conditions by the committee led by Hem Chandra Pandey, vice-chancellor of the Hemwati Nandan Bahuguna Uttarakhand Medical Education University.

“In the suggestions given by the expert committee on June 5, it has been said that the elderly, the Covid-affected and pilgrims suffering from other diseases should come on the journey only after a health examination and medical consultation,” the state’s health secretary Radhika Jha said in a media briefing.

As much as 60% of the deaths so far were of people with co-morbidities, and 60% of were above 50 years of age, the committee found, according to Jha.

The pandemic may have also played a role in the high mortality, Pandey said. Various scientific research has shown that the adverse effects of Covid-19 is heightened at high altitudes, he said. People should undertake the pilgrimage only after a medical examination, he recommended.

Many people infected with Covid-19, which can have long-term impact on the lungs, may face breathing troubles at higher altitudes and suffer from hypoxia – an absence of enough oxygen in tissues to sustain bodily functions.

A higher number of pilgrims are going on the pilgrimage this year, said Radha Raturi, additional chief secretary. All state departments are working in coordination with each other to ensure that pilgrims are provided with adequate facilities, Raturi said.

Till June 4, the number of pilgrims to the four shrines has surpassed 1.6 million, according to Ashok Kumar, Uttarakhand’s director general of police. His men have been able to reunite 920 pilgrims who got separated from their families, the police chief said.

“Three hundred pilgrims were rescued during the journey, 80 were admitted to hospitals and 54 injured were provided with medical assistance,” Kumar said. Over 4,500 police personnel have been deployed for Char Dham pilgrimage, he said, adding that an additional 47 police posts and 57 tourist police centres have been established.

Adequate arrangements have been made by the health department for the safe travel of pilgrims, health secretary Jha said. “For the first time, specialist doctors have been posted in major hospitals located on the yatra routes,” she added. “For the first time, training for the treatment of high-altitude sickness has also been given to doctors posted in the yatra route through AIIMS Rishikesh.”

Some pilgrims have not been allowed to proceed after they were found to be medically unfit, Jha said. “So far, 87 passengers have been returned after screening. All the passengers above 50 years of age are being screened,” she said. “So far, health screening of more than two lakh patients has been done. Thirty patients have been successfully treated at AIIMS Rishikesh using helicopter ambulance.”

The state’s tourism department has also for the first time set up a toll-free help line and call centre, said Dilip Jawalkar, tourism secretary. “Everyday, about 400 people are calling the call centre and getting various types of information regarding the yatra,” he said.

“For the first time, surveillance cameras have been installed to maintain continuous vigil along the yatra routes,” Jawalkar said. “In addition, headcount cameras have been installed at the Char Dham shrines to accurately assess the number of passengers.”

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