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Global clap for Doctors-Nurses; ‘God in only Corona-times’==Looks opportunistic & temporary


 

In times of Corona- war, what doctor and nurses really wish and need is uniform applause all times, genuine legal regulations,  freedom from industrial enslavement and sensible or true projection from media. Much needed are PPE’s,  good protective gear and an environment, where the voice of “every worker with patients” is heard.

An applause or clap for a specific and short time under the shadow of Corona looks opportunistic and temporary. The continued attacks on doctors, even on the doctors looking after Corona patients, just indicate, how deeply disrespect and hatred for saviours have been encrypted in the minds of people, especially by insensible statements from media and celebrities. The hatred and instigation had come from the people, who have not treated a single patient in their lifetime.

Before Corona episode exploded, doctors and nurses continued to work with the burden of mistrust, legal complexities and hurt. They were working and saving lives before as well. Despite doing good they were on receiving end of imposed consumerism, battling legalities, subject of public violence without much support from any quarter. The insult and assault on doctors were considered business as usual. The ridiculous attitude and beating of doctors were thought of as natural reactions of emotional mobs.

Most of Media and Celebrities earned applause, fame, money,  for themselves by spewing venom and citing stray incidents as generalization against the medical community.   Hence instigating and turning the opinion of masses against health workers.

Although it was good to see an overnight change in the attitude of people and media, as Corona-war was declared. But at the same time, continued episodes of violence against doctors gave an indication that it may be a temporary satisfaction for doctors and claps or applause may live only till Corona fear.

If it was a true applause, why it was not done before Corona exploded. After all,  doctors were doing their work before as well.   Sudden applause comes now in view of the risk to their life as a professional obligation, without proper PPE’s and deficiencies in protective gear.

Doctors and nurses just need PPE’s, good protective gears and a  safe environment.  Children of today, who inspire to be doctors, are watching with anxiety, the treatment given to saviors. An opportunistic or temporary applause without any concrete support will  not inspire good doctors or nurses in the future.

 

 

Reel Hero vs Real Hero

Blaming  doctors for the death of coronavirus patient family members attacked them Hyderabad 

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

How to achieve “Effective Lock-Down” to prevent community spread @Corona pandemic


  To identify communities at  risk

“Battle of Corona” Only people can win this war, not doctors or Governments

         Preventing Community spread at this time  is the key to  control  the  Corona pandemic.  Strict  Lock down needs to be effective to achieve the desired objectives. Therefore it is necessary to identify the communities at  risk, where lock-down is not complete and hence these may be need to identify the weak points to achieve effective lock-down.

   These communities can be:

  1.    Surveillance in high population density zones: India  and specially large cities have areas with thick population density.  There is a tendency to come out of houses for  informal chatting.  People need to understand that effective lockdown is more than just not attending to the office work.  Such collections of people can be  prevented by strict enforcement:

A.   Police patrolling in thickly populated residential or good administrative control.

B.   Drone surveillance

C.   Camera surveillance and administrative control

  • Medical needs: people may come out of houses for medical needs. This can be minimized by
  1. Online consultations
  2. Telephonic consultations

These tele-consultations to be used  to differentiate whether it is an emergency or not. The emergencies should be guided to attend hospital, that may be different from Covid 19. So these consultations will help to segregate these patients from  Covid patients.

3.Strengthening of Ambulance service- Network of ambulances can be used to assess at homes and hence  the need for hospitalization may be minimized.  Besides it may help in preventing gathering of relatives and guiding the patient  to appropriate hospital.

4. Providing PPE’s to doctors to prevent loss of work force.

  • Need for essentials: System for community delivery  or   decongestion at market places need to be checked and gathering to be discouraged.

                   Effective Lock-down  can be a key  for winning the “Battle of Corona”. Only people can win this war, and not doctors or Governments.

“Battle of Corona”-Win or loss in People’s hand: not doctors or Governments


 

This is a disease that people can prevent, but doctors cannot treat.

Prevention is better than cure

In this era with knowledge of modern medicine, we know how to prevent the infection from Coronavirus. This is a completely preventable infection and everyone has enough knowledge about it. Heads of Governments requesting people to follow rules of prevention. Strangely these rules are not difficult. Hon’ble Prime minister Mr. Modi has himself requested people to follow simple precautions. Imagine if just by following simple rules can prevent a catastrophe in countries, world and families,  there should be no reason to not follow them.  If it happens, it shows the sheer carelessness and irresponsible attitude of people.  The success or failure or winning the battle against Coronavirus will not be of doctors, but people themselves.

This is a disease that people can prevent, but doctors cannot treat.

India Ahead News Video

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

 

#Nurse/doctor/soldier vs Filmy superstar: Reel Heroes or Real Heroes. what does the society Need/deserve?


 

     In the current era of media domination where media projection shapes the perception and may defy reality.  Media has dominated our lives and can sway the opinion formation of masses.  Written media, television, social media can collectively influence the mass opinion.

   A reel hero who acts like a soldier is famous and richer and than the actual soldier, who dies unnamed and in penury.   Children of today’s times will strive to become, who is worshiped and paid respect by society and therefore will prefer to become the ‘Reel heroes’.

Even a junior doctor saves many lives in a  day in emergencies as compared to the work of a superstar in films.  A teacher, nurse or scientist have a contribution which is more fruitful to our generation. Also, the scientists, who contribute immensely and bring about the real change in our lives. Their contribution is huge to our society and much more than doing just acting on screen. The reel actor merely imitates the real-life lived and actual work done by real heroes like a soldier, doctor or teacher. Someone who only acts and  behaves like one, is respected and paid thousand times or more than the real one. In reality, people need  more than mere entertainment and reel role models and actors in their real lives.

       A  society truly needs the real people, who work and act for them, more than just entertainment. It will need a total change in the attitude of people to deconstruct their perceptions, which are based on mere projections and are away from reality.

21 occupational risk to doctor and nurses

The naivety of masses to perceive the projected character as real one  goes beyond a reasonable thought process and imagination.

These roles played in films are  not  really acts of   inspiration  in real life as the actual purpose accomplished at the end of a movie  is entertainment of society and business for themselves.

   At the best, a particular projected character  (and not individual acting star) may be a  role model. An actor or superstar, is simply doing his work of “acting” in  the end. This work of acting may bring an entertainment of few hours at the most.

One  cannot stray away from the wisdom to  choose between what we consume merely for our entertainment and  what we believe or face in real life. One needs to differentiate between rational truth behind the celebrity gimmicks in the media and exaggerated sensationalism. Sensation created merely for a commercial successful venture should not be allowed to overpower the judgments of real life.

 

But the problem starts, when these false perceptions created merely   by a projected  glimmer    takes the shimmer  away from the real worthy. The real  professionals and people who are worthy of glory become invisible behind  the glittery mist, a haze, which is unreal and unhelpful in real life.

  Compare the trivial  amount of  remuneration, fame  and respect the real worker  gets  as compared to the film stars, who merely imitate their actions. Reel projection for the purpose  of entertainment is more easier to enact and more profitable  than actual performance  in real life.  It is easier to become a reel hero, as it requires little hard work or just connections to get an opportunity.  Some one can be a reel hero just  by  dynastic factor  easily. Hard work is definitely required but that may or may not be prerequisite.

In present era, real contributions by people, who are saviours of human life and  the real heroes, remain unappreciated. People are so besotted by  fame and money that they fail to appreciate the sacrifices made by real heroes. Filmy super hero  just imitates  a doctor, soldier,  dacoit or a street hooligan and just pretends to be one on the screen.

     But there are  real life heroes that exist around us. Doctors awake at night saving lives every minute or soldier in freezing cold are worthy  of more respect and are real heroes.  And it is up to the society  to look beyond the superficial and reel story, and focus on the real life actors. There has to be an true effort to make, respect and appreciate  real heroes.

Point to  ponder  is that whether society needs people  just  acting like   doctors,  soldiers  and not the  actual and real ones, who saves lives. Does Society need  only  entertainment, because respect  which is paid to someone who is  just  an   actor, is  not extended to real doctors, soldiers or other altruistic professions.

         It is time to recreate and worship real heroes, who have become invisible behind the glittery mist.

Society needs to envisage the bigger real picture, and should not be mistaken for another projected story.                          

The perception of the projection will decide, what does the   society actually  need- or desire-or deserve , “Reel Heroes or Real Heroes”.

Whistle-blower Doctor who informed about Corona-sacked in Kerala


 

The ease with which doctors can be punished for doing even the right has finished the independence of the medical profession. The harassment of Chinese whistleblower doctor and now  sacking of the doctor who informed authorities about the coronavirus patient in Kerala are just an example of day to day troubles doctors are facing in every day working. These incidents are just the tip of the ice-berg. The evolving systems in the present era have made it difficult to deliver health care in the right way, as a consequence to routine harassment of doctors. Who will be the ultimate sufferer does not need an Einstein brain to predict.

 

 Kerala: Doctor who informed authorities about patient with coronavirus symptoms sacked by clinic.. Adoctor in Kerala on Tuesday alleged that she was sacked by the management ofthe private clinic she was working with for informing authorities about an NRI patient who reportedly declined to undergo the mandatory check for coronavirus. Dr Shinu Syamalan said the patient had come to the clinic recently with suspected symptoms of the virus. “When he was asked whether he had visited any foreign countries, he said he was coming from Qatar. But he had not reported to the health department about his foreign trip,” she said. When he was directed to inform about his foreign travel to the state health department, which has been monitoring people coming from abroad for the virus, he refused and said he was going back to Qatar, she told reporters. Concerned over the health of the person who had a high fever, Syamalan informed health and police authorities. “Officials who let the patient go abroad do not have any problem, but I have become jobless,” she posted on social media. 3/10/2020 Kerala: Doctor who informed authorities about patients with coronavirus symptoms sacked by the clinic – Times of India https://timesofindia.indiatimes.com/city/kochi/kerala-doctor-who-tipped-authorities-about-patient-with-coronavirus-symptoms-sacked-by-clinic/articleshowprint/74564864.cms 2/2 She alleged she was sacked by the management of the clinic for reporting the matter to police and informing the public about the incident through social media and through television. “The argument of the management is that no one would turn up for treatment in the clinic if they come to know that it was visited by patients with suspected symptoms of Coronavirus,” she said. There was no immediate reaction from the management of the private health clinic. Official sources said the district medical officer (DMO) at Thrissur has complained to the collector against Shinu Syamalan accusing her of defaming health officials. Sources said the DMO informed the collector that health officials had tried to prevent the patient from traveling abroad immediately after getting information from Syamalan.

corona virus unmasks risk to doctor and nurses

21 occupational risk to doctor and nurses

Antibiotic for resistant super bugs discovered by machine learning (AI) for first time


 

An important breakthrough   towards  discovering new antibiotics, that has potential to change  the ways, new molecules are discovered,  Team at MIT says HALICIN  kills some of the world’s most dangerous strains. Discovery  has been possible using artificial intelligence.  It also signifies the role of artificial intelligence in medicine, in future.

Antibiotic resistance arises when bacteria mutate and evolve to sidestep the mechanisms that antimicrobial drugs use to kill them. Without new antibiotics to tackle resistance, 10 million lives around the world could be at risk each year from infections by 2050.

To find new antibiotics, the researchers first trained a “deep learning” algorithm to identify the sorts of molecules that kill bacteria. To do this, they fed the program information on the atomic and molecular features of nearly 2,500 drugs and natural compounds, and how well or not the substance blocked the growth of the bug E coli.

A powerful antibiotic that kills some of the most dangerous drug-resistant bacteria in the world has been discovered using artificial intelligence.

The drug works in a different way to existing antibacterials and is the first of its kind to be found by setting AI loose on vast digital libraries of pharmaceutical compounds.

Tests showed that the drug wiped out a range of antibiotic-resistant strains of bacteria, including Acinetobacter baumannii and Enterobacteriaceae, two of the three high-priority pathogens that the World Health Organization ranks as “critical” for new antibiotics to target.

“In terms of antibiotic discovery, this is absolutely a first,” said Regina Barzilay, a senior researcher on the project and specialist in machine learning at Massachusetts Institute of Technology (MIT).

“I think this is one of the more powerful antibiotics that has been discovered to date,” added James Collins, a bioengineer on the team at MIT. “It has remarkable activity against a broad range of antibiotic-resistant pathogens.”

Once the algorithm had learned what molecular features made for good antibiotics, the scientists set it working on a library of more than 6,000 compounds under investigation for treating various human diseases. Rather than looking for any potential antimicrobials, the algorithm focused on compounds that looked effective but unlike existing antibiotics. This boosted

the chances that the drugs would work in radical new ways that bugs had yet to develop resistance to.

Jonathan Stokes, the first author of the study, said it took a matter of hours for the algorithm to assess the compounds and come up with some promising antibiotics. One, which the researchers named “halicin” after Hal, the astronaut-bothering AI in the film 2001: A Space Odyssey, looked particularly potent.

Writing in the journal Cell, the researchers describe how they treated numerous drug-resistant infections with halicin, a compound that was originally developed to treat diabetes, but which fell by the wayside before it reached the clinic.

Tests on bacteria collected from patients showed that halicin killed Mycobacterium tuberculosis, the bug that causes TB, and strains of

Enterobacteriaceae that are resistant to carbapenems, a group of antibiotics that are considered the last resort for such infections. Halicin also cleared C difficile and multidrug-resistant Acinetobacter baumannii infections in mice.

To hunt for more new drugs, the team next turned to a massive digital database of about 1.5bn compounds. They set the algorithm working on 107m of these. Three days later, the program returned a shortlist of 23 potential antibiotics, of which two appear to be particularly potent. The scientists now intend to search more of the database.

Stokes said it would have been impossible to screen all 107m compounds by the conventional route of obtaining or making the substances and then testing them in the lab. “Being able to perform these experiments in the computer dramatically reduces the time and cost to look at these compounds,” he said.

Barzilay now wants to use the algorithm to find antibiotics that are more sekills only the bugs causing an infection, and not all the healthy bacteria that live in the gut. More ambitiously, the scientists aim to use the algorithm to design potent new antibiotics from scratch.

“The work really is remarkable,” said Jacob Durrant, who works on computer-aided drug design at the University of Pittsburgh. “Their approach highlights the power of computer-aided drug discovery. It would be impossible to physically test over 100m compounds for antibiotic activity.”

“Given typical drug-development costs, in terms of both time and money, any method that can speed early-stage drug discovery has the potential to make a big impact,” he added.

Antibiotic resistance

 

 

Reverberations of the slap #CMRI-hospital-Kolkata;whether to choose medical profession?


The consequence and reverberations of the slap landed on the doctor, subsequent to the death of patient in CMRI hospital  Kolkata,    are  more than  routine.  Media and celebrities usually   have proudly  projected on screen and television that doctors can be beaten and assaulted, in case there are unexpected results or in case of dissatisfaction. But the news is viewed by medical community anxiously and is definitely a poor advertisement for younger generation to take medicine as profession. As incidents are widely publicized and masses following their “Reel Heroes” depicting violence against the doctor is seen as a routine and looked as an   easily do-able  adventure  due to  non-willingness of  authorities to take stringent action.

doctor assault is like corona virus

In such cases, everybody seems to get falsely satisfaction  by the fact that the doctor must have been the culprit, who was   unable to save the patient. Medical community becomes anxious as the fear of more brazen attacks as the incidents can trigger   many more. As patients will continue to get treatment in hospitals and few cannot be saved, so every death declaration may be a harbinger to such attacks in future.

Doctors will be scared and avoid risky patients   or difficult surgeries may be avoided.

There can be complications or genuine poor prognosis. Even mistakes and errors are part of treatment.  The problem is that soft skills, deep knowledge and polite behavior is now been taken as weakness of doctors and not helping them   anymore. A notion  that   assaulting a doctor under emotional  outburst is taken as normal and should not be punished.

Brutality against doctors reveals a deep prejudice and lawlessness, merely on the basis of perceived negligence. Government is either unwilling to act and establish a strong culture of deterrence, so justice been elusive for medical professionals.

Even murderous assaults on doctors are not enough to shake administrators, courts  and doctors’ body out of slumber.  Definitely such violence, if unabated will be   poor advertisement for   next generation to take medical profession as a first choice.

female doctor assault 

#Choosing-to-be-doctor in lawless society: A self inflicted disaster #uncivilized-society #Govt-apathy serving an uncivilized society

21 occupational  risk to doctor and nurses

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