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.

Covid pandemic to infected plastic pandemic


Now, while we are fighting the COVID-19 pandemic, plastics use is increasing again. But, while the pandemic is just temporary, plastic pollution will be long lasting.  

For our current battle to fight the COVID-19 pandemic, we see a dramatically increasing demand for personal protective equipment (PPE) which comprises various plastic and rubber items. Moreover, there are many other fresh, clean plastic items widely used in medical applications for creating a sterile environment, such as pill casings, disposal syringes, catheter, and blood bags. These items are also made of synthetic polymers such as polyvinyl chloride (PVC) and PP, which are not biodegradable. Therefore, it would be not surprising to see that the COVID-19 pandemic is generating tons of medical waste.

dumping Covid-19 infected waste in public places

               The Biomedical Waste Management Rules, 2016, define biomedical waste as“any waste that is generated during the diagnosis, treatment or immunisation of human beings or animals or research activities pertaining thereto or in the production or testing of biological or in health camps.” Therefore, broadly, any waste generated from treating patients comes under the ambit of biomedical waste.

As per available data, India produced approximately 600 tonnes of biomedical waste per day before the coronavirus first hit.

However, ever since Covid-19 showed up on our shores, the amount of biomedical waste produced in India has increased exponentially. This is mainly due to two factors:

  • Medical facilities themselves are producing far more biomedical waste as they battle the virus. As of August 30th, more than 4.14 crore tests to check for the virus had been conducted in India. Further, with over 36 lakh persons having tested positive for the virus, medical facilities have also been producing a lot more medical waste as they treat these patients. Therefore, all of the cotton swabs, samples, injections among other medical inputs necessary to test and treat these patients become highly contagious bio-medical waste that needs to be treated and disposed of with utmost caution.
  • Due to the infectious nature of the coronavirus itself and the strategy of home quarantining of asymptomatic COVID-19 Positive patients, adopted by the country, a major part of affected household waste has now become biomedical waste. The amount of waste that is hazardous is large due to the fact that India has some of the worst waste segregation numbers in the world. This forces infrastructure that is already burdened beyond capacity to handle mixed waste that it is not equipped to handle.


Treatment facilities and growth in biomedical waste

A factor that infinitely complicates India’s fight against Covid-19 is that as per available data, India, a country of more than 1.3 billion people, has only 198 Biomedical Waste Treatment Centres (BMWTCs) and 225 medical centres in the country with captive waste treatment facilities. Simple maths tells us that India’s infrastructure to process biomedical waste was already inadequate during pre-Covid times. However, post-Covid, India is truly staring at a disaster of alarming proportions if it does not rapidly increase its biomedical waste treatment capacity.

There have already been multiple instances of Covid-19 infected waste being dumped in public places including in Delhi and Vijayawada. In addition to this, due to the rapid and sustained increase in biomedical waste due to Covid-19, most BMWTCs are running out of capacity to handle the waste. For instance, the two BMWTCs in Delhi have a combined capacity of handling 74 tonnes of biomedical waste in a day.

However, a report submitted by the Environment Pollution (Prevention and Control) Authority to the Supreme Court of India showed that Delhi’s biomedical output had risen from 25 tonnes per day in May to 349 tonnes per day in July. Similarly, Covid-19 related waste in Mumbai rose from 12,200 kg per day in June to 24,889 kg per day in August, essentially doubling in three months. A similar situation has arisen in West Bengal as disposal facilities there too have reached maximum capacity.

Proper waste segregation and disposal is need of the hour. Disease burden may keep on rising, if proper steps are not followed.

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

Immunity business in corona times


About the medicines and substances, that  are consumed by masses under a false hope of immunity enhancement. Every substance, which claims to alter human physiological functions should undergo strict international neutral trials and not allowed to be sold by mere advertisements.

Tremendous misguidance is propagated by giving a false hope to people of doing some treatment.

Every day we read in media the various pronouncements claiming to enhance the immunity especially in the  days of Covid-19. It automatically implied  or interpreted that the said product will save  the people from Corona and hence a brisk business starts. No one has studied the real effectiveness, correct  doses or side effects of preparation in real sense.

 

A myth, that any plant extracted drug is useful, free of side effects, is a belief ingrained deep in the minds of people. Such unscrupulous  advice is followed blindly without even verifying the authenticity of the source. A hope of miracle is flashed to patients who perceive  a “no hope” by scientific medicine, are an  easy prey for such fraudsters.

Another major problem  is that medicines and syrups distributed in such manner often  are without name of drug, contents and doses. It is not uncommon to get lethal substances like steroids, hormones and heavy metals in dangerous doses.   Such acts  are  real crime to society, done with an intention to cheat rather than treating them.

Any one selling  medicines in name of alternative medicines, food supplements or medical advice of any kind, has to be registered with a council, for those particular medicines. advertisement of such drugs or products should be on some scientific basis and neutral trials.

 

Most of these are not validated at all by international or national authorities, not even considered as drugs. No impartial, neutral trials conducted about effects, side effects or toxicity. Mere media or social media words, which are paid, are considered as  Gospel  Truth  and substances are consumed by masses under a false hope of immunity enhancement. Most of them marketed as herbal or alternate medicines, which are advertised as harmless but beneficial. They are sold by propagated words of benefit  and advertisements rather than a solid proof.

Slowly these medicines become part of conventional wisdom rather than  considered as drugs and chemicals or heavy metals.  In reality, being a settled medical science issue, it remains a fake news at the basis.

There is no dearth of quacks, who sell unknown and unlabelled substances, merely  to earn money, but the dangers of such products are high and unassuming consumers remain oblivious to side effects.

   Any substance is considered effective only after rigorous testing through randomised clinical trials  and additional laboratory analyses.  The substances that are merely propagated on social media or claims of company or advised by quacks will not help and merely remain as part of immunity business. They provide a false hope and thereby earn money  because of fear in the minds of masses.

Times of India carries a report about the brisk business being done, while people are looking at ways to enhance their immunity.

Any substance which claims to alter the physiology of a person or patient, cannot be consumed  without undergoing rigorous, neutral and international  safety trials. If found to be good, all  homo sapiens in the world should be benefitted. If not,   let the gullible masses not be misguided and trapped into a false hope. There has to be a strict Government  control about the products to be consumed, which claim to alter human physiology.

Balancing immunity in Corona times

 

Who will treat people in next Pandemic?


Pandemic has unmasked the real risk to doctor and nurses. The occupational risk of being among the diseases, that was known to them, has been unveiled to everyone. That should have generated respect for health workers in a civilized society. What was actually desirable, was the encouragement and psychological support to these warriors. Good administrators were supposed to give some moral boosting and financial support, so that health staff should work willingly and inspire next generation for future catastrophe like this. Instead of armchair preaching to health care staff, there should have been robust rules and guidelines to protect health care staff and health systems as doctors and nurses are working under tremendous psychological pressure.

More importantly, among this chaotic situation, whether rules are being followed or not, how administrators are doing can be at the most a guess work, rather than following a uniform system. The possibility of chaotic management due to economical compulsions or just trying to be projected as an outstanding administrator may be a real possibility rather than exception.

Health care workers can be easily subjected to moral and legal blackmail or pressure to perform their duties in sub-optimal and below par conditions. They can be subject to moral, legal, financial or even pressure of physical assaults. Such pressures can be tremendous in health sector because of financial complexities.

Is the payment made to them is commensurate to the risk to their life and work they do? Who will pay them and how much in case harm or death of health care worker, every one refrains to discuss?

Are they given the real respect, what they deserve and are worthy of?

Every day when doctors and nurses, while going to work have this thought in mind. But still they continue to work amid their own tensions, worries about families. While it is clear to them that administrators refrain to discuss the issues, which matter to them the most.

Times of India carries a report that the interns will be punished, if they become positivefor Covid, while doing duties. Although possibly the circular is withdrawn, but it reflects the deep seated and hidden mental frame of administrators, about the intention, how they wish to behave with doctors. Why such punishments are not for other Government functionaries or officials or even public, who test positive. It is just an example, but there are numerous examples of such kind.

MUMBAI: The department of community medicine at KEM Hospital issued a circular on Thursday asking interns to give a written explanation on how they had been exposed to the Covid-19 infection, after an increasing number of interns went into quarantine. It further said they will be liable to repeat their internship for the duration period of the quarantine if there was any negligence in following “Covid-19 discipline”. The circular was withdrawn within a few hours, after it faced criticism from many. Doctors and students termed the circular “insensitive” and “unwarranted” during a pandemic. Dr Sagar Mundada, psychiatrist and former president of Maharashtra Association of Resident Doctors, called the circular insensitive. “It is a pandemic. Why medical interns should be asked about the source of the infection?” An intern said some of them have been working for three months without stipend while their duty hours have been increased to 12. They collect swabs, blood and insert IV. 6/6/2020 Mumbai: KEM questions interns over quarantine, then backs off – dean Hemant Deshmukh said he had not signed the circular and it will not be implemented. Dr Gajanan Velhal, who signed it, said it was misunderstood. “No such action will be taken against any interns,” he said. Rajvi Bheda, a representative of the Association of State Medical Interns at KEM, said it seemed to be an attempt to ensure interns stay safe. “But it was unfair to the interns too, as it is difficult to identify the source of infection.

As Corona has unmasked the real risk to health workers and society has dealt with heath workers shabbily. Next younger generation of aspiring doctors, who is a witness to the cruelty shown towards health staff, may be forced to think about their decisions to become health workers. Possibly the administrators need to ponder now, who will treat people in next pandemic.

Corona unmasks the risk to doctor and nurses, administrators refrain

Altruistic professions are not cherished in present era

21 occupational risk to doctor and nurses

Being doctor or nurse- a disadvantage in present era

Plight of nurse in Covid ward

Balancing Immunity in Corona Times


Any substance is considered effective only after rigorous testing through randomised clinical trials with Covid-19 patients, and additional laboratory analyses.  The substances that are merely propagated on social media or claims of company or advised by quacks will not help and merely remain as part of immunity business. They provide a false hope and thereby earn money  because of fear in the minds of masses.

  As there is no definite treatment or prevention against Covid-19, people need to depend upon their own body resistance and preventive strategies. There are advisory in respected papers about the same in The Hindustan times and The Wall Street Journal, that may be helpful.

 

 

Scientists bust myths about ‘immunity-boosting’ substances in fighting Covid-19

Indian scientists on Thursday released a statement against the promotion of “immunity-boosting substances” to protect oneself from being infected with the novel coronavirus. Citing lack of scientific evidence, scientists said consuming mustard oil or tea, homaeopathic solutions or ayurvedic preparations, or modern medicines like hydroxychloroquine that are claimed to provide either immunity or cure “do not provide any known and/or validated protection against Covid-19”.

Additionally, drinking cow urine, wearing talismans, exposure to ultraviolet light or injecting disinfectants are harmful to the human body, while excess consumption of supplements such as zinc or datura seeds can prove to be fatal.

Aniket Sule, astrophysicist at Homi Bhabha Centre for Science Education and one of the signatories, said, “Since the beginning of Covid-19 epidemic, several statements have propagated ‘immunity-boosting’ substances. Some assertions were also supported by a few government functionaries at the Centre and in various states; and we, therefore, wanted to place scientific facts in the public domain.”

The most severe cases of Covid-19 are made worse by an overreaction of the immune system. So trying to boost general immunity using untested methods may be risky.”

Facts (and Myths) About Boosting Your Immune System

It’s crucial to stay healthy as the threat of coronavirus spreads. Here are the best strategies.

As the new coronavirus continues to spread across the country, having an optimally functioning immune system is more important than ever.

Medical professionals say it is important not to rush to buy supplements and vitamins that promise to enhance your immune system; there isn’t much evidence that such products do any good. Instead, they say, stick with the more mundane, but proven, approaches:

  • Keep your stress levels down.It’s a bit of a vicious cycle, of course: The more you stress about the virus, the more likely you are to suffer from it. “Stress can certainly hurt your immune system,” says Morgan Katz, an assistant professor of infectious diseases at Johns Hopkins University. “Do not panic, try to minimize stress.”

Andrew Diamond, chief medical officer of One Medical, a nationwide network of primary-care providers, says the stress hormone cortisol turns off cells in your immune system. He recommends engaging in activities that people find relaxing, such as meditation.

  • Exercise.Low- and moderate-intensity exercise naturally lowers cortisol levels and helps with immune-system function, says Dr. Diamond. One Medical recommends 30 to 60 minutes of exercise a day. If you’re apprehensive about germs in the gym, walk or run outside.

But it is important not to go overboard. A recent study found high-performance athletes have an increased risk of infection, says Elizabeth Bradley, medical director of the Cleveland Clinic’s Center for Functional Medicine. “Exercise helps boost the immune system, but we have to be careful not to overexercise because it can weaken your immune system,” she says.

  • Get adequate sleep.For adults, that means getting seven to eight hours of sleep a night. Children should get more, depending on their age.
  • Make sure your vaccines are up-to-date, especially the flu vaccine.
  • Eat plenty of plain yogurt every day.“It’s really an easy way to boost your probiotics and help support your microbiome,” Dr. Katz says. “It helps to support the good bacteria that live in your body, which help to fight bad bacteria or viruses.”

Dr. Katz also suggests avoiding antibiotics unless you must take them because they deplete the good bacteria in the system, leaving you more vulnerable to other infections.

Other foods that can help support the microbiome include garlic, onion, ginger, sauerkraut and fermented foods, says Dr. Bradley.

 Watch your diet. Stick to a healthful, balanced diet filled with lots of colorful fruits and vegetables to ensure you’re getting enough zinc and vitamin D and other important vitamins and minerals. Most experts say you should be able to get enough of these vitamins and minerals through your diet, and extra supplementation isn’t necessary. But because vitamin D deficiency is relatively common, experts do recommend supplementation if levels are low.

Dr. Bradley recommends eating lots of dark green, leafy vegetables and berries, as well as nuts and seeds, and to minimize foods with sugar and trans fats, which aren’t as nutrient-dense.

Your immune system needs fuel, so avoid ultralow-carbohydrate diets, experts say. In addition, drink lots of water and reduce alcohol consumption, which can disrupt your sleep.

  • Stop smoking or vaping.Smokers and those with respiratory disease have a higher rate of serious illness and complications from coronavirus. “Anything that is challenging to your lungs is going to work in the wrong direction,” says Dr. Diamond.

 

 

 

Disbelief to grief & hypocrisy# Doctor’s death in Mumbai #Covid-19


 

Covid-19 has unmasked the real danger to medical professionals, doctor and nurses while doing their duties. But it has also laid bare the hypocrisy, the denial of dignity by society to doctor and nurses, even to those who lost their lives in service of patients.  Medical professionals had signed for the occupational hazard willingly, but not to be an object of violence, undignified, and ignoble behaviour.

At this time, if anyone is there and surrounded by patients, with or without appropriate PPE,  it is the only doctors, nurses, and front health care workers. Even in non-COVID hospitals or outdoors, it is impossible to differentiate which one patient is carrying the deadly virus.

There were countless reports of health care workers being assaulted, all over before Covid-19, as well.  It was being taken as a routine. Covid-19 has not only helped to unmask the real danger to doctors and nurses but also sounded them of being an object of the undeserving ignoble attitude and hypocrisy of the society.

Mumbai: 36-year-old doctor dies of multiple organ failure, samples test positive for Covid-19

A 36-year-old general physician, who consulted at two private hospitals in Mumbai’s Govandi, succumbed to the novel coronavirus infection on Thursday. He is likely to have contracted the virus from a patient at the hospital.

“My brother had to be shifted on oxygen to Raheja as no cardiac ambulance was ready to transport a Covid-19 patient,” said the doctor’s brother.

The doctor did not have any co-morbid conditions and died of Acute Respiratory Distress Syndrome due to Covid-19 along with multiple organ failure. He was declared dead at around 1:55 am on Thursday at SL Raheja Hospital. The doctor started showing symptoms such as loose motions and breathlessness on April 13.

He was admitted to the Sion Hospital in the wee hours of April 15 where he was tested for Covid-19. As his condition was deteriorating and an ICU bed was not available at Sion, he was shifted to Somaiya Hospital in Vidyavihar. At Somaiya hospital, his breathing improved but he needed dialysis.

As he was a suspected Covid-19 patient, Somaiya hospital administration said that he will have to be shifted to Raheja hospital as they have dialysis for Covid-19 patients.

“My brother had to be shifted on oxygen to Raheja and no cardiac ambulance was ready to transport a Covid-19 patient. He was on a ventilator. After looking at his deteriorating condition, we shifted him using a normal ambulance. His samples have returned positive for Covid-19,” said the deceased’s brother who is also a doctor.

The doctor’s condition kept deteriorating. He had a multi-organ failure with deranged liver function test, acute renal failure, and bleeding disorder. His condition further worsened on Wednesday night. Despite multiple efforts of resuscitation, he could not survive and was declared dead.

“We did not get a chance to speak with him to understand how he contracted the virus. Before going to Sion, we tried to get a bed at Kasturba hospital, but we were told no beds are available,” the doctor’s brother added.

“This is something we need to be very careful about. If healthcare workers are infected like this, we should be able to provide them with the best of care,” said Epidemiologist Dr Om Shrivastava.

21 occupational risk to doctor and nurses

Covid-19 unmasks the risk to health workers

Noble doctor-ignoble death

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.

21 occupational risk to doctor and nurses

reel heroes vs real heroes

Lock-down essential to prevent knock-down


Imagine what would have happened if religious functions, social functions, conferences, marriages and birthday functions,  social gatherings or normal transport would have continued for many more days.

Social distancing is the key element to prevent the Coronavirus spread.  But not everyone among the masses has the ability to understand the urgency from the very beginning and own up responsibility for social distancing. It is the responsibility of each and every human being to prevent the spread. But a significant number of people failed to do it from the time that was crucial. The time for basic understanding and wisdom to prevent at individual level varies from person to person.

Social distancing to be successful has to be strict and imposed in a totality. Police patrolling, drone surveillance, camera surveillance may be needed for a longer duration in view of the current crucial phase that may lead to community transmission.

Online consultation or teleconsultations need to be strengthened to avoid unnecessary contact.

Doctors and nurses need to be protected as they can be crucial links for treatment.

As it is a totally preventable disease, so lock-down has to be more complete and strict. It cannot be left to individual wish to quarantine. Once it happens, doctors can not treat it, whereas people can prevent it from happening.

So strict Lock-down is much needed to prevent Knock-down from community spread.

How to implement strict lockdown

Global clap-doctor and nurses

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