Challenges of Covid Vaccination-2021


If 2020 was consumed by Covid Virus ,  the next year 2021 will be  for Covid vaccination.

All over the world, billions of people are going to get vaccine.

Corona vaccination is one of the most anticipated events in every country. in coming weeks, multiple vaccines   are likely to get regulatory approval. 

    However, while making a good vaccine was the difficult part, earning  trust of public in vaccine is going to be another one. Especially the hurried development at Pandemic speed  and lack of awareness about safety issues will be areas of concern.

  The adverse events, which are unexpected medial problems that occur with drug treatments, are unavoidable part of any treatment, including vaccine science.

    The system need to be in place to identify  the causal relationship between vaccine agent and  the adverse event.  The objective criteria have to be in place to identify and treat, as the population to be vaccinated is also very large.

 The main hurdles equally challenging will be sourcing, distributing and giving the actual vaccination doses.

The preparation for mammoth exercise will also be a herculean task. It may take months to get ready to supply and build the chains and preparation for this need to begin now.

A systematic approach needs to be ready, so that the process of vaccination gets on smoothly and quickly, as soon as the doses are available. For example, the need for transport vehicles and the storage facilities for billions of doses at distant places will be one of challenges.

It will take mammoth number of healthcare workers, who will vaccinate people at different towns and cities.  

This exercise, if not done in a well-planned manner, could result in chaos.   The failure to set up a system will not only result in suboptimal vaccination but also non uniform supplies. Maintaining the cold chain will be crucial for effectiveness.

 People should get it based on needs rather than black marketing or money power.   The issues which look insignificant like the financial complexity among various stake holders or customer clearances need to be settled first, as they may become significant hurdles for smooth distribution.

    Most important would be to safeguard citizen’s faith in vaccine and clinical trials. As for the future science to develop, would   require people’s co-operation, faith and participation.

     Government regulators and Vaccine makers need to recognize the utmost importance of the communication about the true results of trials and effective communication with the public.  The misinformation and distrust should not  undermine the good work of medical science and advancements.

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Authorities mum on Adverse Event at Covid Vaccine Trial


Safety data of Covid Vaccine- need disclosure

   There are two important aspect of a successful vaccine,

1. Efficacy  for the prevention

2. Safety

       Given that the Covid vaccine is needed urgently and will be developed within a years’ time, some doubts about the safety aspect are natural. But safety can be assured, if the data about side effects is made public.

   All  the  companies  in a bid to rush their  vaccine into the market, are eager to  create an hype. But a caution need to be exercised against such hyping, especially when long term safety data is not available.

  Even the sparse details of the severe side effect,  that leak into the public domain, may be just tip of the iceberg, as far as long term safety data of a vaccine is concerned.

   All the side effects, mild or severe, need to be made known  and  in public domain, rather than exposed later after the use.

More than a month and a half after an adverse event occurred in a clinical trial in India of the AstraZeneca vaccine, the Central Drug Standard Control Organisation (CDSCO), the regulator for vaccine trials, has not issued any statement on the occurrence. It also did not respond to queries about whether it has completed its investigation to determine if the trial participant’s illness was related to the vaccine. Serum Institute, which is partnering the pharma MNC and Oxford University for producing the vaccine in India, has also refused to comment. This is in sharp contrast to AstraZeneca and Oxford University going public when one of the trial participants in the vaccine trial in the UK fell ill and halting the trial till an independent safety monitoring board and UK’s regulatory authority gave safety clearance. Information about the occurrence of the serious adverse event (SAE) during the vaccine trial in India came from the family of the trial participant, which has sent the company and the regulators a legal notice. Serum Institute merely stated that it would issue an official statement next week. AstraZeneca had issued a statement within days of the trial participant in UK falling ill and halted the trials across the world in the UK, Brazil and South Africa. The trial was resumed within a week after the independent safety review committee and national regulators gave clearance. The Indian Council of Medical Research is a co-sponsor of the trial along with Serum Institute.

According to the ICMR, it is for the DCGI to take a call on whether or not to halt the trial. The DCGI heads the CDSCO.

The 40-year-old trial participant, a business consultant with an MBA from New Zealand who says he took part in the trial deeming it his duty to help such an important venture, was administered the vaccine at SRMC on October 1. Eleven days later, he woke up with a severe headache, and progressively lost his memory, showed behaviour changes, became disoriented and was unable to talk or recognise his family members, according to the legal notice. As soon as he fell ill he was admitted to the ICU in SRMC.

“Though the legal notice we have served talks of a compensation of Rs 5 crore, our focus is not on monetary compensation. It was sent just last week, more than a month after the occurrence when we saw that none of the authorities was making the adverse event public. They ought to have warned other participants so that they could watch out for similar symptoms. We want to know why the occurrence of the adverse event has been kept under wraps and why the trial was not halted like it was done in the UK. Is an Indian life of less value than that of an UK citizen?” asked a close family friend who has been helping the family cope with the illness.

WHO says more data needed on AstraZeneca dose

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Ayurvedic Surgery: 10 Technical Questions? About safety concerns


      If there are certain doubts about the safety of the patient, the apprehension needs to be addressed.

      The government has issued a notification which authorises post-graduate practitioners in specified streams of Ayurveda to be trained to perform surgical procedures such as excisions of benign tumours, amputation of gangrene, nasal and cataract surgeries.

    The notification by the Central Council of Indian Medicine, a statutory body under the AYUSH Ministry to regulate the Indian systems of medicine, listed 39 general surgery procedures and around 19 procedures involving the eye, ear, nose and throat by amending the Indian Medicine Central Council (Post Graduate Ayurveda Education) Regulations, 2016.

     Any  Surgery, how-so-ever simple it may look to the people sitting on fence, carries some  risk and needs  some kind of precautions and regulations to make it risk free.  Therefore if there are certain doubts about the safety of the patient, the apprehension needs to be addressed. If the service of surgery by Ayurveda surgeon has to be availed by public, a certain confidence needs to be generated about the safety and quality assurance. Mere push by an enforced law will not lead to genesis of trust and confidence. So there needs to be technical analysis of some kind, whether  it is a genuine original  strategy or merely  an imposed law.

     If it was an accepted practice till now, there was no need for such notification. So apparently,  if the need was felt  to be said in a forceful manner, there has to be something unusual about the practice.

      No doubt, ancient Ayurvedic text referred to surgical practices. But  in present era of consumerism, patients need to know, how it was being practiced for last 200 to 300 years. What are the results and data about complications.

  There are two main categories for the purpose of discussion.

A. Existence of a robust system

B. Individual competencies.

    Firstly, there should be basic robust system  that will generate Ayurvedic surgeons.

To start with, the  CCIM need to  satisfy on following questions. Following are the basic requirements of surgery.

1. What  kind of Anaesthesia  will be used in surgeries by Ayurveda surgeons? Who will be the anaesthesiologist?

2. What are post op pain killers be used in surgeries by Ayurveda surgeons?

3. What antibiotics  will be  used;. Allopathic or ayurvedic?

4. What are principles of pre-op evaluation?

5. How surgical techniques are different. Are they same used in allopathic surgery or different ones described in Ayurveda?

6. How the post op complications are being managed. Is it by using allopathic medications and investigations?

7.  Data of surgeries done in last decade or two in all of  Ayurvedic medical colleges, especially those done by Ayurvedic surgeons.

8. Who is teaching Ayurveda doctors about the  surgeries? Are there ayurvedic teachers  or being taught by allopathic surgeons?

9. Will  the people in higher positions and government  officials be availing such facilities or it is only for the  poor people? 

10. Will the patients be given enough information or an informed consent about such Ayurvedic surgeons before  surgery?

         More than a law, the whole exercise   will require a trust building   in public  along with quality assurance and something unique to make such surgeries practically happen.

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Potential Ray of Hope: Highly effective coronavirus antibodies


        Identification of highly effective antibodies, will not only provide a passive immunity, but can be helpful in developing vaccine as well. This discovery may be a potential ray of hope against Covid war.

Highly effective coronavirus antibodies discovered may lead to passive Covid-19 vaccine

     BERLIN: Scientists have identified highly effective antibodies against the novel coronavirus, which they say can lead to the development of a passive vaccination for Covid-19. Unlike in active vaccination, passive vaccination involves the administration of ready-made antibodies, which are degraded after some time. However, the effect of a passive vaccination is almost immediate, whereas with an active vaccination it has to build up first, the researchers said. The research, published in the journal Cell, also shows that some SARSCoV-2 antibodies bind to tissue samples from various organs, which could potentially trigger undesired side effects. The scientists at the German Center for Neurodegenerative Diseases (DZNE) and Charite – Universitatsmedizin Berlin isolated almost 600 different antibodies from the blood of individuals who had overcome Covid-19, the disease triggered by SARS-CoV2. By means of laboratory tests, they were able to narrow this number down to a few antibodies that were particularly effective at binding to the virus.  Highly effective coronavirus antibodies identified, may lead to passive Covid-19 vaccine The researchers then produced these antibodies artificially using cell cultures. The so-called neutralising antibodies bind to the virus, as crystallographic analysis reveals, and thus prevent the pathogen from entering cells and reproducing, they said. In addition, virus recognition by antibodies helps immune cells to eliminate the pathogen. Studies in hamsters — which, like humans, are susceptible to infection by SARS-CoV-2 — confirmed the high efficacy of the selected antibodies. “If the antibodies were given after an infection, the hamsters developed mild disease symptoms at most. If the antibodies were applied preventively — before infection — the animals did not get sick,” said Jakob Kreye, coordinator of the research project. The researchers noted that treating infectious diseases with antibodies has a long history. For Covid-19, this approach is also being investigated through the administration of plasma derived from the blood of recovered patients. With the plasma, antibodies of donors are transferred, they said. “Ideally, the most effective antibody is produced in a controlled manner on an industrial scale and in constant quality. This is the goal we are pursuing,” said Momsen Reincke, first author of the research. “Three of our antibodies are particularly promising for clinical development,” explained Harald Pruss, a research group leader at the DZNE and also a senior physician at Charite – Universitatsmedizin Berlin. “Using these antibodies, we have started to develop a passive vaccination against SARS-CoV-2,” Pruss said. In addition to the treatment of patients, preventive protection of healthy individuals who have had contact with infected persons is also a potential application, the researchers said. How long the protection lasts will have to be investigated in clinical studies, they said. “This is because, unlike in active vaccination, passive vaccination involves the administration of ready-made antibodies, which are degraded after some time,” Pruss said. In general, the protection provided by a passive vaccination is less persistent than that provided by an active vaccination, the researchers said. “It would be best if both options were available so that a flexible response could be made depending on the situation,” Pruss added.

Plasma therapy- life saving for Covid?


  Few months ago, there was a hope and  presumed scientific reason to believe that plasma therapy will be a wonderful option in Covid pandemic. But the said belief needed to be strengthened by robust trials. As trials continue, the belief that plasma therapy will save lives, have not been proved  clear. Now again there is a doubt in the mind of doctors, whether it will save lives or it may not. What ever future may hold, it is clear that it needs more trials, more evidence. Covid virus has again proved to be more smart.

Delhi: Plasma therapy’s life-saving abilities in question, doctors caution on its use (Times of India)

NEW DELHI: A day after TOI reported about an ICMR study that showed administering convalescent plasma to Covid-19 patients did not reduce death risk, top doctors of AIIMS, Institute of Liver and Biliary Sciences (ILBS) and Lok Nayak Hospital stressed the need to rethink who should get the therapy. In the trial by Indian Council of Medical Research, which involved 464 hospitalised, moderately-ill Covid-19 patients, researchers observed that some participants had higher antibody positivity than their plasma donors. “The difference in age and severity of illness, with donors being younger and having milder disease, could have driven this difference. While all Covid-19 survivors were encouraged to donate plasma, an overwhelming majority of the donors were only mildly sick, young survivors. Recovered patients who had moderate or severe disease were generally reluctant to return to hospitals for plasma donation,” the ICMR study noted.  Earlier the institutes  did not check the level of neutralising antibodies in the donor, which led to poorer outcomes. “The ICMR study re-affirms our assessment based on a trial conducted on 29 patients who received plasma therapy at ILBS. It showed no mortality benefit. However, there was significant benefit in terms of clearing of viral load in those who received the therapy in addition to standard care compared to who received only standard care,” he said. The ILBS director added that only patients with mild-to-moderate illness should be given convalescent plasma. “The therapy has to be given within 24 to 48 hours of diagnosis. Also, detailed assessment of presence of sufficient levels of neutralising antibodies in the donor should be mandatory,” Dr Sarin said. At least 100 Covid-19 patients at the state-run Lok Nayak Hospital have been given plasma therapy till date. Dr Suresh Kumar, its medical director, said larger studies might be needed to assess its benefits. “Remdesivir did not show significant benefit in Covid-19 treatment in some studies. Still, the drug is being used in select patients because it has certain benefits and there is no other known cure. Similarly, plasma therapy may not help reduce death risk but our experience shows it does help in faster recovery in a small subset of patients,” he said. ILBS and Lok Nayak Hospital are conducting a study involving 400 Covid patients to assess the benefits of plasma therapy. Rajiv Gandhi Super Specialty Hospital is also taking part in the study. The ICMR study was conducted at 39 tertiary care hospitals — 29 teaching and 10 private — across the country. According to the study, released on MedRXIV, a preprint service for medicine and health sciences, mortality was documented in 13.6% patients who received plasma therapy in addition to standard care and 31 (14.6%) patients who received only standard care. The trial results also indicated that there was no difference in progression to severe disease among moderately ill patients treated with convalescent plasma along with the best standard of care.

The Visionary princess who built AIIMS :Rajkumari Amrit Kaur


The pages of history celebrates Amrit Kaur’s determination to drive out the British, her feminist zeal, and also the many contributions she had made to the health infrastructure of the country.

Most of people know about the OPD block of AIIMS (premier Institute of India) named after Rajkumari Amrit Kaur, but how the vision of having an institute of excellence was converted into reality is largely unknown. The Indian Express carries a beautiful report about how the visionary Princess and Health Minister of India turned a dream into reality.

On February 18, 1956, the then minister of health, Rajkumari Amrit Kaur, introduced a new bill in the Lok Sabha. She had no speech prepared. But she spoke from her heart. “It has been one of my cherished dreams that for post graduate study and for the maintenance of high standards of medical education in our country, we should have an institute of this nature which would enable our young men and women to have their post graduate education in their own country,” she said.

The creation of a major central institute for post-graduate medical education and research had been recommended by the Health survey of the government of India, a decade ago in 1946. Though the idea was highly appreciated, money was a concern. It took another 10 years for Kaur to collect adequate funds, and lay the foundation of India’s number one medical institute and hospital.

Kaur’s speech in the Lok Sabha sparked a vigorous debate in the house over the nature of the institute. But the bill moved fast, gaining the approval of members of both the houses, and by May that year, the motion was adopted.

The All India Institute of Medical Sciences (AIIMS) was born. “I want this to be something wonderful, of which India can be proud, and I want India to be proud of it,” said Kaur, as the bill was passed in the Rajya Sabha.

In the past few months, as India has been battling a global pandemic, the role of the country’s apex medical body has come under discussion on several occasions. Significantly, it is the first prime minister of the country, Jawaharlal Nehru, who is credited for the heights reached by AIIMS. It is true that AIIMS came to be under the Nehru government. However, the real driving force behind it was Kaur.

A princess of the Kapurthala princely state, a student at Oxford university, a devout follower of Mahatma Gandhi, and an important member of the Constituent Assembly, Kaur was all of this and much more. Members of her family like to remember her as someone who believed in simple living and high thinking. The pages of history, on the other hand, celebrates her determination to drive out the British, her feminist zeal, and also the many contributions she had made to the health infrastructure of the country.

The Kapurthala princess

As a member of the Kapurthala princely family, Kaur had an interesting history. Her father, Raja Sir Harnam Singh, had converted to Protestant Christianity after a chance meeting with a Bengali missionary named Golakhnath Chatterjee in Jalandhar. Singh went on to marry his daughter, Priscilla, and had ten children with her. Kaur, the youngest among them was born on February 2, 1889.

Kaur, therefore, was brought up as a Protestant Christian. After spending her early years in India, she was sent off to England for her education. “Princess Amrit Kaur was as much a product of Edwardian England as she was of India,” suggested her obituary in the New York Times in 1964. She completed her schooling from the Sherborne School for Girls, in Dorset, and then went to study at Oxford University. Thereupon, she returned to India in 1908 at the age of 20, and embarked on a life of nationalism and social reform.

The Gandhian and social reformer

Upon her return from England, Kaur was immediately drawn towards the ideas of nationalism, as she interacted with leaders like Gopal Krishna Gokhale and Mahatma Gandhi. She was mesmerised by the teachings of Gandhi, and shared an enduring, special friendship with him, as is evident from the collection of letters shared between the two, that have been compiled in the book, ‘Letters to Rajkumari Amrit Kaur’.

“What drew me to Bapu was his desire to have women in his non-violent army and his faith in womankind. This was an irresistible appeal to a woman in a land where women were fit for producing children and serving their lords as masters,” she is quoted as having said by American philosopher Richard Gregg in his introductory note in ‘Letters to Amrit Kaur.’

Though she wanted to join the naionalist movement soon after she returned, her family was against her involvement in the struggle, and therefore she kept away till her father passed away in 1930. During this period though, she was actively involved in social reforms particularly those related to women. Consequently, she waged a battle against the purdah system, the devadasi system, and child marriage. In 1927, she helped in the founding of the All India Women’s Conference and later served as its president.

By 1930, as she joined the Gandhian movement, she was imprisoned for her participation in the Dandi march. She gave up all her princely comforts to join Gandhi at his ashram in Sabarmati. “I remember Rajkumari sitting at the spinning wheel and eating along with other ashramites, the simple fare prescribed by Gandhiji,” wrote political activist Aruna Asaf Ali about her fondest memory of Kaur. “Rajkumari Amrit Kaur belonged to a generation of pioneers. They belonged to well- to-do homes but gave up on their affluent and sheltered lives and flocked to Gandhiji’s banner when he called women to join the national liberation struggle,” she added.

In her battle for a free India, she became one of the few women members of the Constituent assembly. She along with Hansraj Jivraj Mehta were the only female members to be ardently in support of the uniform civil code in the constitution.

The passionate health minister who created AIIMS

Nihar Mahindar Singh, the 58-year-old grand niece of Kaur, recalls that as a child she would visit Kaur’s house in New Delhi frequently, as she was getting treated at AIIMS. “I never received any preferential treatment for being her family member. I remember spending hours at a stretch on the corridors of AIIMS. I didn’t even know back then that aunt B (as Kaur was referred to in her family), had created the hospital,” she says, adding that it was much later, and by word of mouth from her family members that she learned of her grand aunt’s contribution in building AIIMS.

As an institute of healthcare and medical research, AIIMS had to have some unique features. To begin with, it was the first of its kind in Asia to prohibit doctors from private practise of any kind. Secondly, the doctors at AIIMS were to devote their time not only to treating patients and teaching, but also to carry out research. “All the staff and students were to be housed in the campus of the Institute in the best traditions of the Guru-Sishya ideal to stay in close touch with each other,” writes V. Srinivas, the deputy director of administration at AIIMS in his article, ‘The making of AIIMS: The parliamentary debate’.

As health minister, Kaur was the pivotal force in ensuring the unique status enjoyed by AIIMS. Yet, it is worth noting, that she was in fact not the first choice of Nehru to be part of the cabinet. “In August 1947, for the woman member of the cabinet, Nehru thought of Hansa Mehta, but took Rajkumari Amrit Kaur at Gandhi’s insistence,” writes author Sankar Ghose, in his book, ‘Jawaharlal Nehru – A Biography’. Writing about why Kaur was not preferred, he explains, “she was sometimes indiscreet and intemperate in her criticism of Congressmen.”

source –The Indian Express

What is plasma therapy for Covid-19


 

As the world is suffering from pandemic by Covid-19, the effort to find an effective treatment is on a war footing.  Few drugs like HCQS, Remdesvir, and Tocilizumab are being tested, vaccines are being developed. A vaccine may be a mainstay in the future , but till that time, how to control mortality.  Convalescent plasma therapy has been found to be useful in China.

Convalescent plasma is an antibody-rich plasma product prepared from the blood donated by the patients, who have recovered from Covid-19 infection recently. These patients are tested twice negative and ELISA can also be done to check for antibodies. The antibodies are proteins with the capability to fight infection in the body and are important component of the immune system

  Antibody rich plasma can be taken after two weeks after  the patient has recovered. The plasma of such patients has the potential to treat or lessen the severity of Covid -19. Plasma taken from one patient may help three to four patients. A donor can again donate after one week. The subsets of patients who may benefit are sick patients in ICU, on the ventilator and are having a risk of death.

The plasma therapy was used for diphtheria and tetanus  about 120 years ago and  used for viral infections like EBOLA

ICMR has permitted  for clinical  trials  of plasma therapy for Covid -19

FDA  has also permitted to pool the donor volunteers.

Reclaim of Lost Territory by Mighty Nature #COVID-19


 

         For thousands of years, humans have achieved tremendous progress and evolution, which was reflected in advancement and modern science. The evolution was used to acquire natural wealth and the environment to the materialistic advantage of mankind. From butchering animals to control sea waters and skies, humans tried to control everything around. Modern medicine was discovered to attack the germs, bacteria, and viruses in a pursuit to prolong life and interfered severely in natural processes of nature without knowing the bigger picture. A sense of holding masterly gained by possessing superior intelligence prevailed in the modern world.  Except for humans, everything living or non-living was being considered as a captive resource to be exploited and consumed. Animals and birds were farmed, tormented and mercilessly killed in uncountable numbers.

        In a few weeks of invasion by COVID-19, the world looked changed. Greener plants, no air pollution, transparent waters, and clear sky looked, no traffic on roads, as if nature claiming back the lost territory without being even seen.

         All living and non-living elements form an ecosystem. Birds, animals, plants, sea life, the environment on earth, non-visible germs and bacteria form an ecosystem and form a balance. How we have affected this balance, that is still unknown.  Germs have been there before humans and are armed with strange powers to mutate and attack humans if balance is disrupted. The real barriers between deadly nano predators and human beings are still undiscovered. When we pollute and destroy the hills and jungles, deserts and oceans, icy glaciers and lush rain forests, use antibiotics to kill micro- and nano-life for our evolved requirements, we force the barriers to be broken.

     The rapidly recurrent coming pandemics may be warning for the behavior of the human race, and point towards a need for more sustainable evolution. The mighty nature deserves more respect to be kind to humans.

     Human beings need to prove that they are truly evolved. Considering that the current invasion by COVID -19 is not the last one that befell us, there can be many more in future, we need to check our pattern of choices to suit the nature and not vice-versa.

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Myths about medical-Ventilator; Corona may help to burst


Unfortunately, celebrities and media have most of the time fuelled the myths and common allegations against the medical profession and ventilator. The myths have been propagated rather than disseminating the truth. This is no truth in such projected and perceived hearsay.

Someone who is drowning, a small boat can save his life, till sea storm settles or the victim reaches a safe land. The boat will not settle the sea storm, but enough to save a person from catastrophe. In reality, a ventilator is the invention, which should be worshiped. But contrarily, due to wrong projections and misguided perceptions, it has been hated despite saving lives.

Although doctors and ventilators are in a similar situation, projected in the wrong way, hated in spite of doing good work and saving lives. They are hated and despised, despite the only ones of help in life and death situations. The following are a few myths and facts about the ventilator.

  1. Myth: Once on a ventilator, patients do not survive: the common myth is that once the patient is placed on a ventilator, he will not survive. The human body, when it gets severely diseased or under stress, heart and lungs need to be supported for saving the life, till ailment So, when the battle for saving a life is ongoing, almost all the patients will have to be placed on the ventilator. It is a last-ditch attempt made to save the patient’s life. However when the patients do not survive people feel that it’s the ventilator that has caused death, rather than a rational thought about the severe disease as a cause.

In reality, it is the severity of disease and the possibility of death, when the ventilator is required. It is necessary to support life.

  1. Myth: Ventilator is a modality for the mere prolongation of life: every disease has a spectrum. Every disease can progress from a reversible to an irreversible state. As an effort is ongoing while waiting to reverse the process, the patient will need ventilator to sustain life. Unless the disease reaches a stage of irreversibility, the ventilator is indispensable for an absolute need to maintain life. Since in serious condition, it is an uncertain prognosis. In retrospect, combined with the application of average wisdom, the time of uncertainty and institution of the ventilator can be interpreted as a mistake. As the whole exercise is labeled as futile and expensive by relatives. it’s a grey area and the negative thoughts are fuelled because of retrospective wisdom in hindsight. The real prognosis cannot be predicted in real-time.

In reality, Ventilator is a machine which just supports respiration and not responsible for heart beating. Therefore it buys time for healing and treatment of primary disease.

  1. Myth: Ventilator will cause death:

one can understand this simple logic on the basis that patients are placed on dialysis when kidneys fail. Patients are placed in the cast when bones are fractured for a fixed predefined period of time. Similarly, patient is placed on a ventilator when the lungs fail. The ventilator is used till the time lungs recover and become fully functional.

In reality; Risk is because of disease, which needs ventilator and not vice versa. Ventilator is a friendly machine which helps people who have failed lungs.

  1. Myth : Doctors and hospitals keep dead patients on ventilator for financial gains

Fact: placing patient on ventilator is a very critical decision, taken in best interest of patient to buy time, to so as to treat the disease. A patient needing on ventilator is actually so sick, that not instituting ventilator will risk the patient’s life. Knowing all these facts, doctors take a decision to keep the patients on a ventilator.

Once the patient is on ventilator, it is a stress for the doctor to take the patient off the ventilator. As such ventilator is a SANCTUM SANCTORUM lifesaving machine, to be used only in life and death situations.

  1. Myth : Its a miracle if the patient placed on ventilator survives.

Given the fact that placing the patient on ventilator on scientific facts. There are clear indications for putting the patient on ventilator. A much larger patients put on ventilator are actually saved and go home.

Fact: Everyday thousands of patients are placed on ventilator and sent home to lead a normal life: Any patient who is given general anesthesia is placed on ventilator in the operation theater and then taken off the ventilator at the end of the surgery. In these cases patients are placed on ventilator so as patient can be put to deep sleep (called anesthesia) during which surgery on desired part can be carried out. Soon after the surgery patient are taken off the ventilator and soon thereafter discharged for home after few days of healing.

  1. Myth :Doctors place patients on ventilator at their own will:

Fact: there are scientific parameters which decide when the patient should be placed on the ventilator and when the patient should be taken off the ventilator. So the decision to place the patient is scientific and based on objective parameters.

Contrary to this popular myth, it is a compulsion for the doctor to put patient on ventilator to prevent death in serious situations. Doctors are usually thinking several steps ahead of lay person about medical science.

  1. Myth :All patients placed on ventilator are unconscious:

Fact: this is not necessary. Usually patients are sedated for their comfort. they can be made to walk, write and even perform small tasks when on ventilator, depending upon their lung condition.

Patients are also put on ventilator in case of airway failure when unable to protect their airway for various reasons. Another reason why patients are placed on ventilator is inability of the patients to protect his or her airway. Conscious and alert patients can swallow normally formed mouth secretions. When patients consciousness level is dulled the ability of the patient to protect his airway is lost or compromised. This causes secretions from mouth to enter into the lungs through the airway i.e. trachea causing infections in the lungs. The only way to prevent this and protect the patient’s lungs is to place a tube in his airway and then place them on the ventilator.

  1. Myth: Patients can be kept alive by placing on the ventilator:

General masses have a feeling that patient can be kept alive by keeping them on the ventilator. Even a dead person can be kept alive by placing on the ventilator, which is not true.

In reality: It is machine used only for breathing and not heart and brain.

  1. Myth : Ventilating the dead patients:

this is a common allegation on medical profession. This is no truth in this projected and perceived hearsay.

Facts: Assumptions are based on thoughts of lay persons. Patients on ventilator, may look like dead, because of the disease, sedation and paralyzed by drugs. But their heart and brain are working, so they cannot be declared dead.

If there is some incident, it needs to be proved by medical personnel. In reality, it can be a very rare and remote exception. These untrue projection are creating lots of mistrust about life saving machine.

The problem is about correct projection and majority of people without knowledge of medical science do not even know the large number of lives been saved by the ventilators.

In nutshell: serious conditions and life threatening situations need higher technical interventions, to save a life. If correct projections are made, ventilators are lifesaving machines.

About ventilator

History of ventilator

History of Major Pandemics


Disease and illnesses have always been  catastrophe to  humanity since ancient times. The magnitude of the illnesses and death rates have shown a  marked shift. The more civilized humans became – with larger cities, more exotic trade routes, and increased contact with different populations of people, animals, and ecosystems – the more likely pandemics would occur.

Despite the persistence of disease and pandemics throughout,   one trend that has emerged over time is the gradual reduction in the death rate. As the germ theory is discovered and there is a better understanding of the causative agents has led to better control. Healthcare improvements and control of infections have been powerful tools in mitigating their impact.

In many ancient societies, people believed that spirits and gods inflicted disease and destruction upon those that deserved their wrath. This unscientific perception often led to disastrous responses that resulted in the deaths of thousands.

Brief timeline for the major known pandemics :

165  AD  –  Antonine plague-  thought to be small pox or measles  and caused

around   5 million deaths.

735 AD –     Variola major virus–  Japanese smallpox  –     around 1 million deaths

541  AD-     Plague of Justinian – Yersinia pestis/ rat, fleas –   30- 50 million deaths

1347 AD-    Black death (Plague) –- Yersinia pestis/ rat fleas –   200 million  deaths

1520 AD-   Smallpox —                  Variola major virus—                  56 million deaths

1665 AD  Great plague of London–- Yersinia pestis/ rat fleas –     One lac deaths

1629 AD-         Italian plague          Yersinia pestis/ rat fleas –     death 30- 50 million

1817  AD– Cholera pandemic (6) – vibrio cholera: over 100 years-death one million

1850 AD – Third plague     –         Yersinia pestis/ rat fleas –              death –12  million

1880 AD-  Yellow fever –           Viral /     mosquitoes                    death 1 lac to 1.5 lac

1889  AD-        Russian flu-                   H2 N2 (bird)                           deaths    10 million

1918 AD–      Spanish flu  –                 H1 N1 (Pigs)                          deaths 30-50 million

1958 AD  –         -Asian Flu                                  H2 N2                                        1 million

1968 AD  –     Hong Kong flu                        H3 N2                                              1 million

1981 AD- continued -HIV/AIDS               viral/  chimpanzees                     30 -40 million

2002 AD-            SARS–                         corona virus  Civets / Bats-                     770

2009 AD              Swine Flu                        H1N1 – (pigs)                                     200,000

2014 AD –           EBOLA                                 Ebola virus  –                                       11000

2015 AD-            MERS                          Corona virus/ bats, Camel         death count 850

2019 AD           -COVID -19                         Corona virus                            -still continued

 

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