CMAAO Update 10th February on Corona
2019 nCoV
Serious cases 6,484,
New 296
Cases: 82% mild, 15% severe, 3% critical, 2% deaths
6484 Serious cases, Mortality in admitted cases
15% ( expected 972 more)
Number of deaths likely to cross 2000
New: masks export lifted, fake news, pathogenesis, daily
statistics,
Dr
KK Aggarwal
President
CMAAO, HCFI and Past National President IMA
Summary
PM Modi writes to Xi Jinping, offers assistance
Kissing
scenes banned in China Movies
DGCA exempts air crew from breath analyser
tests in Kerala
Thousands of people stuck on a cruise ship in
Hong Kong for five days have been allowed to disembark after tests for
coronavirus came back negative.
Behaves like SARS with 2 % case fatality (15%
of admitted cases), time to death 14
days, time to pneumonia 9 days, 3-4
reproductive number R0, has its origin from bats, spreads like large droplets
and predominately from people having lower respiratory infections and hence
universal droplet precautions the answer.
WHO has called on countries not to impose
travel and trade restrictions over the coronavirus, warning that such measures
could increase “fear and stigma” within the international community. Some
countries, including the UK, are advising their citizens to leave China
altogether.
If it behaves like SARS it will not be endemic.
It most likely will be a hit and run just like SARS. Also, if this virus follows the same path as
SARS or MERS it won’t mutate and will burn itself out in about 6 months.
The World Health Organisation (WHO) has warned that
"trolls and conspiracy theories" are undermining their response to
the new coronavirus.
1. Russia's Channel One, the host links the virus to US
President Donald Trump, and claims that US intelligence
agencies or pharmaceutical companies are behind it.
2. Another published in British and
US tabloid media, linked the virus to a video of a Chinese woman eating bat
soup. However, it was filmed in 2016 and was in Palau, in the western Pacific
Ocean - not China.
3. And a now-widely-discredited scientific
study released last month linked the new coronavirus to snakes
4. One such claim advises users in the
Philippines to "keep your throat moist", avoid spicy food and
"load up on vitamin C" . The information is said to be from the
country's Department of Health but it does not match the advice on the DOH
website or its official press releases on the outbreak.
5. Another claim suggests avoiding cold or
preserved food and drinks, such as ice cream and milkshakes, for "at least
90 days". A Facebook page ForChange accompanied the post with a video of a
parasite being removed from a person's lips. Altnews fact-checkers pointed out,
the video is in fact three months old and unrelated to the virus.
6. As the United States reported its first
case several patent documents started to circulate that at first glance appear
to suggest experts have been aware of the virus for years. They shared a link
to a 2015 patent filed by the Pirbright Institute in Surrey, England, that talks
about developing a weakened version of coronavirus for potential use as a
vaccine to prevent or treat respiratory diseases. Sather used the fact that the
Bill & Melinda Gates Foundation is a donor to both Pirbright and vaccine
development to suggest that the current outbreak virus has somehow been
deliberately manufactured to attract funding for the development of a vaccine. But
Pirbright's patent is not for the new coronavirus. Instead, it covers the avian
infectious bronchitis virus, a member of the wider coronavirus family that
infects poultry.
7. Another baseless claim that has gone
viral online suggests the virus was part of China's "covert biological
weapons programme" and may have leaked from the Wuhan Institute of
Virology. Many accounts pushing the theory cite two widely-shared Washington
Times articles both of which quote a former Israeli military intelligence
officer for the claim. However, no evidence is provided for the claim in the
two articles, and the Israeli source is quoted as saying that "so far
there isn't evidence or indication" to suggest there was a leak.
8. Another claim inaccurately linked the
virus to the suspension of a researcher at Canada's National Microbiology
Laboratory. Virologist Dr Xiangguo Qiu, her husband and some of her students
from China were removed from the lab following a possible "policy
breach," according to a report by Canada's national broadcaster CBC last
year. Police told CBC News there was "no threat to public safety".
9. Another report said Dr Qiu had visited
the Wuhan National Biosafety Laboratory of the Chinese Academy of Sciences
twice a year for two years.
10. A tweet claimed without evidence that Dr
Qiu and her husband were a "spy team", had sent "pathogens to
the Wuhan facility", and that her husband "specialised in coronavirus
research". None of the three claims in the tweet can be found in the two
CBC reports and the terms "coronavirus" and "spy" do not
appear even once in either.
11. Different
versions of a "whistleblower" video, alleged to have been taken by a
"doctor" or a "nurse" in Hubei province, have racked up
million views on various social media platforms and mentioned in numerous
online reports. The most popular version was uploaded to YouTube by a Korean
user, and included English and Korean subtitles - the video has since been
taken down.
According
to the English subtitles, the woman is a nurse in a Wuhan hospital. However,
she does not claim to be either a nurse or a doctor in the video at all. The
woman, who does not identify herself, is wearing protective suit in an unknown
location. However, her suit and mask do not match the ones worn by medical
staff in Hubei.
Due
to a lockdown being enforced by the authorities, it is difficult to verify
videos from the province. But she makes a number of unsubstantiated claims
about the virus, making it unlikely for her to be a nurse or a paramedic.
She
also claims the virus has a "second mutation", which can infect up to
14 people. But the World Health Organization has preliminarily estimated the
number of infections an individual carrying the virus can cause is 1.4 to 2.5
Case Definition
1.
Fever (subjective
or confirmed)
OR signs/symptoms of lower respiratory illness (cough or shortness of
breath)
PLUS, any person, including health care workers, who has had close contact
with a laboratory-confirmed 2019-nCoV patient within 14 days of symptom
onset.
2.
[Contact means: Being within
approximately 6 feet (2 meters) or within the room or care area of a 2019-nCoV
case for a prolonged period of time while not wearing recommended personal
protective equipment (gowns, gloves, NIOSH-certified disposable N95 respirator,
eye protection); close contact can include caring for, living with, visiting,
or sharing a health care waiting area or room with a 2019-nCoV case OR having
direct contact with infectious secretions of a 2019-nCoV case (e.g., being
coughed on) while not wearing recommended personal protective equipment.]
3. Fever and signs/symptoms of lower respiratory illness (cough
or shortness of breath) PLUS a history of travel from Hubei Province, China
within 14 days of symptom onset
4.
Fever and signs/symptoms
of lower respiratory illness (cough or shortness of breath) requiring
hospitalization PLUS a history of travel from mainland China within 14 days
of symptom onset.
Continue asking patients with suspected flu or
diarrhoea if they, or someone they have been in contact with, recently returned
from corona affected area. [ in US confirmed case they 2019-nCoV
RNA in a stool specimen collected on day 7 of the patient’s illness.]
Take Home Messages
Virus: Single-strand,
positive-sense RNA genome ranging from 26 to 32 kilobases in length.
Type: Beta corona virus
Family: Corona
virus family. ‘corona’ means crown or the halo surrounding the sun. Heart is
considered crown and hence coronary arteries. In electron microscope, it is
round with spikes poking out from its periphery.
Virus is killed by sunlight, temperature,
humidity. Survive on stainless steel surface for 36
hours. Sunlight cuts the virus ability to grow in half so the half-life will be
2.5 minutes and in the dark it’s about 13m to 20m. The virus can remain intact at 4 degrees or
10 degrees for a longer period of time. But at 30 degrees then you get
inactivation. High humidity the virus doesn’t like it either. SARS stopped
around May and June in 2003 due to more sunlight and more humidity.
The virus may not reach, Indonesia, Africa other
southern hemisphere due to high temperature.
High income countries: Low population density,
higher level of environment control and hygiene. Low mortality
Europe – possibility higher transmission but
environmental care is higher.
The
virus can remain alive on any surface for 3-12 hours
Types of Transmission: Droplet
or direct (Corona); Contact from surface ( Corona), aerosol or nuclei ( TB,
Corona ??)
Link to ACE: 2019-nCoV
might be able to bind to the angiotensin-converting enzyme 2 receptor in
humans.
Origin: Wuhan,
China December 2019
1st case informed to the world by Dr. Li
Wenliang died Feb 6th
Lockdown: 50 million people
Spread: 28
countries and territories
New Cases: On Feb
9, 31 provincial-level regions on the Chinese mainland as well as the Xinjiang
Production and Construction Corps reported 3062 (2618 in Hubei province)
Suspected cases on 9th : 4008 new
cases (2272 in Hubei province)
Serious new cases on 9th : 296 new
serious cases (258 in Hubei province)
Deaths on 9th Feb: 97
deaths (91 in Hubei province, 2 in Anhui province, 1 in Heilongjiang province,
1 in Jiangxi province, 1 in Hainan province, and 1 in Gansu province).
Discharged on 9th : 632 cured (356 in Hubei province)
Freed from medical observation on 9th: 29307
Total cured: 3281
Suspected cases: 23589
Quarantine: 26,359
patients
Serious: 6484
Close contacts: 399487
Medical observation: 187518
Confirmed Cases: National
Health Commission 40,171
Deaths: 908
Feb 9, 64 confirmed infections had been
reported in the Hong Kong and Macao special administrative regions and Taiwan
province: 36 in Hong Kong (1 death), 10 in Macao (1 had been cured and
discharged from hospital) and 18 in Taiwan (1 had been cured and discharged
from hospital).Three
deadly
human respiratory coronaviruses viruses: Severe acute respiratory syndrome
coronavirus [SARS-CoV], Middle East respiratory syndrome coronavirus
[MERS-CoV]) and 2019-nCoV: The virus is 75 to 80% identical to the SARS-CoV
30th January 2010: Emergency: It is
a Public Health Emergency of International Concern (mandatory to report to WHO human and animal
cases).
Prior 5 PHEIC’s:
26th
April 2009 Swine flu: shift toward mortality among persons
less than 65 years of age. 10 August 2010, WHO announced that the H1N1
influenza virus has moved into the post-pandemic period. However, localized
outbreaks of various magnitudes are likely to continue.
May 2014 Polio: resurgence of wild
polio after its near-eradication. Global eradication was deemed to be at
risk with small numbers of cases in Afghanistan, Pakistan, and Nigeria. In
October 2019, continuing cases of wild polio in Pakistan and Afghanistan, in addition
to new vaccine-derived cases in Africa and Asia, was reviewed and remains a
PHEIC. It was extended on 11 December 2019.
August 2014 Ebola: It was the first PHEIC
in a resource-poor setting.
Feb 1 2016 Zika: link with microcephaly and
Guillain–Barré syndrome. This was the first time a PHEIC was declared for
a mosquito‐borne disease. This declaration was lifted on 18 November
2016.
2018–20 Kivu Ebola:A review of the PHEIC
had been planned at a fifth meeting of the EC on 10 October 2019[44] and as of 18
October 2019, it continues to be a PHEIC.
Kerala: state
public health emergency. Three primary cases in North, South and Central
Kerala (Kasaragod district is in north Kerala, Thrissur in central
Kerala and Alappuzha in South Kerala]. Four Karnataka
districts bordering Kerala — Kodagu, Mangaluru, Chamarajanagar and Mysuru have
been put on high alert.
Median age: 59
years (2-74 years)
Male to female ratio: 56%
male
Link to Huanan Seafood Wholesale Market: 55% with
onset before January 1, 2020 and 8.6% of the subsequent cases. The
Chinese government has banned the wildlife trade until the epidemic
passes.
Mean incubation period: 5.2
days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of
the distribution at 12.5 days.
Epidemic doubling time: In its
early stages, every 7.4 days. With a mean serial interval of 7.5 days (95% CI,
5.3 to 19)
Contagiousness or Basic reproductive number: 2.2
(95% CI, 1.4 to 3.9). The reproduction number R0
or “r naught” refers to the number of additional people that an infected person
typically makes sick. An outbreak with a
reproductive number of below 1 will gradually disappear. The Ro for the common
flu is 1.3 and for SARS it was 2.0.
Comorbid conditions: 71%,
deaths in comorbid cases, SARS affected people in their 30 or 50 years. And
MERS affected people with co-morbidity. The China data indicate that it’s those
with the co-morbidity are most at risk like seasonal influenza.
0-15 years age: Just like SARS, it mostly
does not affect children 15 years or less of age
Daily deaths: 73 deaths on 5th
(15% rise), 66 on 4th, 64 on 3rd Feb.
Anticipates: one lac already infected.
Secondary cases: Thailand, Taiwan, Germany, Vietnam, Japan, France and the United
States
Deaths outside China:
Philippines on Feb 2 (44 Chinese man M) and 2nd in Hong Kong ( 39 M, local) on February 4,
both had co-morbid conditions. Both acquired infection from Wuhan.
ICU need: 20% needed ICU care with 15% of them died
Fever: In all (no fever no corona)
Cough: 75% cases
Weakness or muscle ache: 50%^
Shortness of breath: 50%
TLC: low
Liver transaminase levels: raised
Case
fatality:
2% [Dr John Nicholls, University
of Hong Kong} China is only reporting those who come for test, stricter
guidelines, actual mortality may be 0.8%-1% like outside China
Case
fatality in admitted cases:
15%
Time to death: 14 days
Time to pneumonia: 9 days
Origin: Bats
Mode of spread: Large
droplets and predominately from people having lower respiratory infections
Answer: Universal
droplet precautions the answer.
Incubation period: up to 2 weeks, according to
WHO. Mean 5.5 days
Transmission:
Predominantly a large droplet and contact and less so by means of
aerosols and fomites
Once it was disclosed that SARS also spread
through the fecal oral route there was much less emphasis on the masks and far
more emphasis on disinfection and washing hands. HK has far more cleanliness
(than China) and they are very aware of social hygiene. And other countries
will be more aware of the social hygiene (than China). So in those countries
you should see less outbreaks and spreading. [Dr John Nicholls]
Healthcare Workers: In
Hong Kong with SARS there was a lot of infection of healthcare workers as they
are close and doing invasive procedures. But this time around there is not much
evidence of the healthcare workers getting sick or dying (unless China is not
reporting it) so this may suggest that it is not being spread by close aerosol
contact but more by the fecal-oral route or with droplets. So, it may not be as
contagious within hospitals. Makeshift hospitals will help.
Lab
precautions:
BSL 2 or 3
Human
to human contact period: Requires
contact of ten minutes within six feet
Travel preferable seat: Choosing a window seat and staying lowers the risk
Travel advisory: Level 1 in all countries
(Exercise normal safety precautions), Level 2 in all affected countries and states including
Kerala ( Exercise a high degree of caution), Level 3 in all countries with
secondary cases (Reconsider your need to travel) and Level 4 in China ( Do not
travel). Hong Kong has imposed 14 days quarantine on people arriving from
china. The Karnataka government has ordered that anybody arriving from the
23 coronavirus affected countries must stay in isolation at home for 28
days. The home isolation requirement is irrespective of the virus symptoms.
To date, 72 countries are implementing travel
restrictions.
Indian Government:
foreigners who went to China on or after January 15 will not be allowed to
enter India. All visas issued to Chinese nationals before February 5 have been
suspended. These visa restrictions will not apply to aircrew, who may be
Chinese nationals or other foreign nationalities coming from China via air,
land or seaport, including Indo-Nepal, Indo-Bhutan, Indo-Bangladesh or
Indo-Myanmar land borders,
IndiGo and Air India have suspended all of their
flights between the two countries. SpiceJet continues to fly on Delhi-Hong Kong
route.
High viral load: Detection of 2019-nCoV RNA in specimens from
the upper respiratory tract with low Ct values on day 4 and day 7 of illness is
suggestive of high viral loads and potential for transmissibility. [NEJM]
Risk to other Asian countries including India: Currently,
people at risk are healthcare workers caring for 2019-nCoV patients and other
close contacts of 2019-nCoV patients. For the general public, who are unlikely
to be exposed to this virus, the immediate health risk from 2019-nCoV is
considered low at this time.
It is less likely to have the serious illness
in other countries. As patients with breathlessness are unlikely to board and
patients will mild illness or asymptomatic illness are less likely to transmit
infections.
Zoonotic
but unlikely to spread through seafood: It is closely related to several bat
coronaviruses. Bats are the primary reservoir for the virus. SARS-CoV was
transmitted to humans from exotic animals in wet markets, whereas MERS-CoV is
transmitted from camels to humans. In both cases, the ancestral hosts were
probably bats.
The virus has been traced to snakes in China. Snakes often hunt
for bats in wild. Reports indicate that snakes were sold in the local seafood
market in Wuhan, raising the possibility that the 2019-nCoV might have jumped
from the host species - bats - to snakes and then to humans at the beginning of
the outbreak. However, it remains a mystery as to how the virus could adapt to both
the cold-blooded and warm-blooded hosts.
Infectiousness
to humans: 2019-nCoV
grows better in primary human airway epithelial cells than in standard
tissue-culture cells, unlike SARS-CoV or MERS-CoV. It is likely that 2019-nCoV
will behave more like SARS-CoV.
Both
SARS-CoV and MERS-CoV infect intrapulmonary epithelial cells more than cells of
the upper airways. Consequently, transmission occurs primarily from
patients with recognized illness and not from patients with mild, nonspecific
signs. Though NEJM has reported a case of 2019-nCoV infection acquired outside of Asia in which
transmission appears to have occurred during the incubation period in the index
patient but the same has been challenged now.
2019-nCoV
uses the same cellular receptor as SARS-CoV (human angiotensin-converting
enzyme 2 [hACE2]), so transmission is expected only after signs of
lower respiratory tract disease develop.
SARS is high [unintelligible] kind of inducer.
This means that when it infects the lower part of the lung, the body develops a
very severe reaction against it and leads to lots of inflation and scarring.
In SARS what we found is that after the first 10 to 15 days it wasn’t the
virus killing the patients it was the body’s reaction. Is this virus in the
MERS or SARS kind picture or is this the other type of virus which is a milder
coronavirus like the NL63 or the 229. It may be the mild (unintelligible) kind
inducer. [Dr John Nicholls University of Hong Kong]
No sore throat: This new virus attacks the lungs and not just the throat.
Patients so far have not presented with a sore throat, the reason being that the
2019-nCoV launches an attack at the intraepithelial cells of lung tissue.
Asymptomatic transmission: One
report of a small cluster of five cases suggested transmission from
asymptomatic individuals during the incubation period; all patients in this
cluster had mild illness. Another case got infected while using gown, but eyes
not covered. NEJM reported a transmission from asymptomatic case but the same
has been challenged.
Mass Quarantine May Spark
Irrational Fear, Anxiety, Stigma
Evacuation: Tokyo,
Japan, India have evacuated their citizens trapped in China affected areas. All 645 evacuees from Wuhan test negative for
the deadly infection in India. Close to 80
Indian students are still stuck in Wuhan. 70 of the 80 chose to stay behind at
the time of the evacuation operation. 10 had expressed willingness to return to
India but could not board after they failed the screening process at the
airport.
Bangladesh has scrapped plans to bring back its
171 nationals stuck. Refusal from crew members to fly. State-run Biman
Airlines' Boeing 777-300 ER aircraft on February 1 brought back 312
Bangladeshis.
Legal
implications in India: Section 270 in The Indian Penal Code: 270. Malignant act likely to spread infection of disease dangerous to
life.—Whoever malignantly does any act which is, and which he knows or has
reason to believe to be, likely to spread the infection of any disease
dangerous to life, shall be punished with imprisonment of either description
for a term which may extend to two years, or with fine, or with both.
Asymptomatic:
Unlike
SARS, patients were symptomatic at about day 5, some of these cases may be
asymptomatic until about day 7. Asymptomatic is probably the first 5 days.
Case
fatality of coronavirus 2%
Case
fatality of MERS
34% (2012, killed 858 people out of the 2,494 infected)
Case
fatality of SARS 10%
(Nov. 2002 - Jul. 200, originated from Beijing, spread to 29 countries, with
8,096 people infected and 774 deaths)
Case
fatality of Ebola 50%,
Case
fatality of Smallpox
30-40%
Case
fatality of Measles
10-15% developing countries
Case
fatality of Polio
2-5% children and 15-30% adults
Case
fatality of Diphtheria
5-10%
Case
fatality of Whooping cough 4%
infants < 1yr, 1% children < 4 years
Case
fatality of Swine flu <
0.1-4 %
Case
fatality of seasonal flu
0.01%.
Case
fatality of current virus in Wuhan 4.9%.
Case fatality of current virus in Hubei Province 3.1%.
Case fatality of current virus in Nationwide 2.1%.
Case fatality of current virus in other provinces 0.16%.
Number of flu deaths every year: 290,000 to 650,000 (795 to 1,781
deaths per day)
Lab
tests: There are two ways to detect a virus: through
the genetic material DNA or RNA or to detect the protein of the virus. The
rapid tests look at the protein. It takes 8-12 weeks to make commercial
antibodies. So right now, for the diagnostics tests they are using PCR which
give you a turnaround in 1-2 hours.
Treatment:
No proven antiviral treatment.
With SARS, in 6 months the virus was gone and
it never came back. Pharmaceutical companies may not spend millions and
millions to develop a vaccine for something which may never come back.
Evidence of E-coli: Secondary
infection are most likely the cause of deaths of the patients in the
Philippines and HK.
SARS Experience: A combination of
lopinavir and ritonavir showed promise in lab
MERS experience: Combination of
lopinavir, ritonavir and recombinant interferon beta-1b has been tried
Recreation of Virus: Scientists in Australia have reportedly recreated a lab-grown
version of coronavirus.
Chloroquine: had potent
antiviral activity against the SARS-CoV, has been shown to have similar
activity against HCoV-229E in cultured cells and against HCoV-OC43 both in
cultured cells and in a mouse model.
Thai experience: Oseltamivir along with
lopinavir and ritonavir, both HIV drugs.
Experimental drug: Rrom Gilead Sciences Inc., called remdesevir (started on 6th
Feb as a trial)
Russia and China drug: Arbidol,
an antiviral drug used in Russia and China for treating influenza, could be
combined with Darunavir, the anti-H.I.V. drug, for treating patients with the
coronavirus. {the corona virus shares some similarity to HIV virus also)
PVP-I
mouthwashes and gargles significantly reduce viral load in the
oral cavity and the oropharynx. PVP-I has high potency for viricidal activity
against hepatitis A and influenza, MERS and SARS
DCGI Approval: The
Drug Controller General of India has approved the "restricted use" of
a combination of drugs (Lopinavir and ritonavir) used
widely for controlling HIV infection in public health emergency for treating
those affected by novel coronavirus.
Steroids: In
SARS, people were put on long term steroids ending with immunosuppression and
late complications and death. The current protocol is short term treatment.
Universal respiratory droplets precautions
Self-quarantining:
2
weeks
Adherence: Strict
Soap and water: Wash your hands often and for at
least 20 seconds.
Alcohol-based hand sanitizer: if soap and water is not available
Avoid touching: your eyes, nose, and mouth with
unwashed hands.
Avoid close contact: (3-6 feet) with people who are
sick with cough or breathlessness
Stay home: when you are sick.
Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
Clean and disinfect frequently touched objects and surfaces.
Surgical Masks: For patients
N 95 Masks: For health care providers and close contacts
The world is facing a chronic shortage of
gowns, masks, gloves and other protective equipment in the fight.
Ten Common Myths
1. People receiving packages from China are not at risk of
contracting the new coronavirus as the virus does not survive long on objects,
such as letters or packages.
2. There is no evidence that companion animals/pets such as dogs or
cats can be infected with the new coronavirus. However, it is good to wash your
hands with soap and water after contact with pets. To prevent transmission of
common bacteria such as E. coli and Salmonella.
3. Pneumococcal vaccine and Haemophilus influenza type B (Hib)
vaccine, do not provide protection against the new coronavirus.
4.
Regularly rinsing the nose with
saline does not protect people from infection with the new coronavirus or
respiratory infections although it can help people recover more quickly from
the common cold.
5.
There is no evidence that using
mouthwash will protect you from infection with the new coronavirus although
some brands or mouthwash can eliminate certain microbes for a few minutes in
the saliva in your mouth.
6.
Garlic is a healthy food
that may have some antimicrobial properties, however, there is no evidence that
eating garlic protects people from the new coronavirus.
7.
Sesame oil does not kill the
new coronavirus. Chemical disinfectants that can kill the 2019-nCoV on surfaces
are bleach/chlorine-based disinfectants, either solvents, 75% ethanol,
peracetic acid and chloroform. However, they have little or no impact on the virus if you put them on the
skin or under your nose. It can even be dangerous to put these chemicals on
your skin.
8.
People of all ages can be infected by
the new coronavirus (2019-nCoV). Older people, and people with pre-existing
medical conditions (such as asthma, diabetes, heart disease) appear to be more
vulnerable to becoming severely ill with the virus. WHO advises people of
all ages to take steps to protect themselves from the virus, for example by following
good hand hygiene and good respiratory hygiene?
9.
Antibiotics do not work against
viruses, only bacteria. Hence
antibiotics should not be used as a means of prevention or treatment of new
coronavirus unless you suspect bacterial co-infection.
10. To date, there is no specific medicine recommended to prevent or
treat the new coronavirus (2019-nCoV).
Role of CMAAO and other Medical
Associations
1. All countries should be prepared for
containment, including active surveillance, early detection,
isolation and case management, contact tracing and prevention of onward
spread of the virus and to share full data with WHO.
2. All
countries are legally required to share information with
WHO under the IHR.
3. Any
detection of 2019-nCoV in an animal (including information about the species,
diagnostic tests, and relevant epidemiological information) should be reported
to the World Organization for Animal Health (OIE) as an emerging
disease.
4. All
countries should emphasise on reducing human infection, prevention of secondary
transmission and international spread.
PMO Suggestions sent
7th
January: CMAAO Alert: WHO to
monitor China's mysterious pneumonia of unknown virus outbreak
8th
Jan: CMAAO warns Asian citizens
travelling China over mystery pneumonia outbreak
10th
January: I wrote an editorial: Corona virus
strain causing pneumonia in Wuhan, China, It’s a new strain of corona virus in the
china pneumonia
13th January:
China Virus Outbreak Linked to Seafood Market:
China Virus Outbreak Linked to Seafood Market:
15th January:
First Case China Pneumonia Virus Found Outside China in Thailand
First Case China Pneumonia Virus Found Outside China in Thailand
17th January: WHO issues warning after 'mysterious' Chinese
corona virus spreads to Japan
17th Jan: India at threat of Corona. CMAAO urges travel advisory on
coronavirus: http://www.drugtodayonline.com/medical-news/nation/10379-cmaao-urges-travel-advisory-on-coronavirus.html
(18th Indian govt issues travel
advisory as China's mysterious 'Coronavirus' spread in other countries)
18th Jan:
WHO issues warning after mysterious Chinese Coronavirus spreads to
Japan
[http://blogs.kkaggarwal.com/tag/who/]
18-20
Jan: Three countries meet, also discussed Corona virus
22nd
Jan: Still not being declared to be a notifiable disease, N 95 to be included
in the list of essential drugs and prise capped, Oseltamivir, should
also be prise capped, air flights should have available air masks for all
passengers, not declaring flu like symptoms while boarding or landing should be
a punishable offence (23rd India advisory to airports)
24th:
Inter Ministerial Committee needs to be formed on Corona Virus (PMO took a
meeting on 24th evening)
25th
Jan: Indian government should pay for Indians affected with the virus in China
26
Jan: Need of National droplet Infection Control program, Policy to ban export
of face masks, policy to evacuate Indians and neighbouring countries from
China affected areas, Time to collaborate on Nosode therapy (Exports of masks
banned on 31st January by Indian Government) Action: [ Feb
1st: Ibrahim Mohamed Solih thanked India
for the evacuation of seven Maldivian nationals from the coronavirus-hit
Chinese city of Wuhan. India evacuated 647 people]
[ on 30th India banned gloves, PEP
and masks but on 8th lifted the ban on surgical masks/disposable
masks and all gloves except NBR gloves. All other personal protection
equipment, including N-95 and equipment accompanying masks and gloves shall
remined banned.]
27:
History of anti-fever drugs at airports should be taken
28:
Do research on Nosodes
29:
Closure of live markets all over the world, India should take a lead
30:
Paid flu leave, surgical mask at public places, N 95 for health care providers
31:
Respiratory hygiene advisory schools, Pan India task force to be made
1st
Feb: Disaster Budget is the need of the hour
3rd
Feb: 100 crore budget for Corona virus; Private labs to be recognised; one
dedicated corona National help line, MTNL BSNL to have a line of advisory in
their bills, isolation wards to be single rooms or two beds separated with six
feet distance, national insurance to cover cost of treatment, Sea ports to have same precautions, prize caps for masks, and
gloves, National droplet control program, clarification that import of goods is
not risky And suspend AI flights to China and Hong Kong
[Feb 4 Air India on
Tuesday suspended flight services to Hong Kong from Friday until March 28. Earlier,
Air India had cancelled its flight to Shanghai from January 31 to February 14
and on 5th Feb the Ministry of Defence is setting up 10 new laboratories across the country,
primarily to conduct research on viruses]
4th
Feb: Kerala travel advisory needed [The Union Ministry of Health and Family
Welfare issued a fresh travel advisory on Monday urging people to refrain from
visiting China]
5th Feb: PM should talk about Corona in Man Ki Baat
or a special address
6th
Feb: Time to have makeshift bed policy to tackle deaths
in Kota, Muzaffarpur and Corona [Uttarakhand to set up two dedicated hospitals to tackle
coronavirus : https://www.hindustantimes.com/india-news/uttarakhand-to-set-up-two-dedicated-hospitals-to-tackle-coronavirus/story-NYxBOw6XHTbugznTWa3CXK.html]
7th Feb: IPC 269 should be
applicable to corona virus
8th Feb: teleconsultation should be
allowed to flu and corona consultation
Search:
Country
|
Cases
|
Deaths
|
Region
|
China
|
40,171
|
908
|
Asia
|
Japan
|
96
|
0
|
Asia
|
Singapore
|
43
|
0
|
Asia
|
Hong Kong
|
36
|
1
|
Asia
|
Thailand
|
32
|
0
|
Asia
|
South Korea
|
27
|
0
|
Asia
|
Taiwan
|
18
|
0
|
Asia
|
Malaysia
|
17
|
0
|
Asia
|
Australia
|
15
|
0
|
Australia/Oceania
|
Vietnam
|
14
|
0
|
Asia
|
Germany
|
14
|
0
|
Europe
|
United States
|
12
|
0
|
North America
|
France
|
11
|
0
|
Europe
|
Macao
|
10
|
0
|
Asia
|
Canada
|
7
|
0
|
North America
|
United Arab Emirates
|
7
|
0
|
Asia
|
United Kingdom
|
4
|
0
|
Europe
|
Philippines
|
3
|
1
|
Asia
|
Italy
|
3
|
0
|
Europe
|
India
|
3
|
0
|
Asia
|
Russia
|
2
|
0
|
Europe
|
Spain
|
2
|
0
|
Europe
|
Cambodia
|
1
|
0
|
Asia
|
Nepal
|
1
|
0
|
Asia
|
Finland
|
1
|
0
|
Europe
|
Sweden
|
1
|
0
|
Europe
|
Sri Lanka
|
1
|
0
|
Asia
|
Belgium
|
1
|
0
|
Europe
|
Total Deaths of Novel Coronavirus (2019-nCoV)
Date
|
Total
Deaths |
Change
in Total |
Change in
Total (%) |
Feb. 9
|
910
|
97
|
12%
|
Feb. 8
|
813
|
89
|
12%
|
Feb. 7
|
724
|
86
|
13%
|
Feb. 6
|
638
|
73
|
13%
|
Feb. 5
|
565
|
73
|
15%
|
Feb. 4
|
492
|
66
|
15%
|
Feb. 3
|
426
|
64
|
18%
|
Feb. 2
|
362
|
58
|
19%
|
Feb. 1
|
304
|
45
|
17%
|
Jan. 31
|
259
|
46
|
22%
|
Jan. 30
|
213
|
43
|
25%
|
Jan. 29
|
170
|
38
|
29%
|
Jan. 28
|
132
|
26
|
25%
|
Jan. 27
|
106
|
26
|
33%
|
Jan. 26
|
80
|
24
|
43%
|
Jan. 25
|
56
|
15
|
37%
|
Jan. 24
|
41
|
16
|
64%
|
Jan. 23
|
25
|
8
|
47%
|
Daily Deaths of Novel Coronavirus (2019-nCoV)
Date
|
Daily
Deaths |
Change
in Daily |
Change in
Daily (%) |
Feb. 9
|
97
|
8
|
9%
|
Feb. 8
|
89
|
3
|
3%
|
Feb. 7
|
86
|
13
|
18%
|
Feb. 6
|
73
|
0
|
0%
|
Feb. 5
|
73
|
7
|
11%
|
Feb. 4
|
66
|
2
|
3%
|
Feb. 3
|
64
|
6
|
10%
|
Feb. 2
|
58
|
13
|
29%
|
Feb. 1
|
45
|
-1
|
-2%
|
Jan. 31
|
46
|
3
|
7%
|
Jan. 30
|
43
|
5
|
13%
|
Jan. 29
|
38
|
12
|
46%
|
Jan. 28
|
26
|
0
|
0%
|
Jan. 27
|
26
|
2
|
8%
|
Jan. 26
|
24
|
9
|
60%
|
Jan. 25
|
15
|
-1
|
-6%
|
Jan. 24
|
16
|
8
|
100%
|
Jan. 23
|
8
|
0
|
0%
|
Total Deaths of Novel Coronavirus (2019-nCoV)
Date
|
Total
Deaths |
Change
in Total |
Change in
Total (%) |
Feb. 9
|
910
|
97
|
12%
|
Feb. 8
|
813
|
89
|
12%
|
Feb. 7
|
724
|
86
|
13%
|
Feb. 6
|
638
|
73
|
13%
|
Feb. 5
|
565
|
73
|
15%
|
Feb. 4
|
492
|
66
|
15%
|
Feb. 3
|
426
|
64
|
18%
|
Feb. 2
|
362
|
58
|
19%
|
Feb. 1
|
304
|
45
|
17%
|
Jan. 31
|
259
|
46
|
22%
|
Jan. 30
|
213
|
43
|
25%
|
Jan. 29
|
170
|
38
|
29%
|
Jan. 28
|
132
|
26
|
25%
|
Jan. 27
|
106
|
26
|
33%
|
Jan. 26
|
80
|
24
|
43%
|
Jan. 25
|
56
|
15
|
37%
|
Jan. 24
|
41
|
16
|
64%
|
Jan. 23
|
25
|
8
|
47%
|
Daily Deaths of Novel Coronavirus (2019-nCoV)
Date
|
Daily
Deaths |
Change
in Daily |
Change in
Daily (%) |
Feb. 9
|
97
|
8
|
9%
|
Feb. 8
|
89
|
3
|
3%
|
Feb. 7
|
86
|
13
|
18%
|
Feb. 6
|
73
|
0
|
0%
|
Feb. 5
|
73
|
7
|
11%
|
Feb. 4
|
66
|
2
|
3%
|
Feb. 3
|
64
|
6
|
10%
|
Feb. 2
|
58
|
13
|
29%
|
Feb. 1
|
45
|
-1
|
-2%
|
Jan. 31
|
46
|
3
|
7%
|
Jan. 30
|
43
|
5
|
13%
|
Jan. 29
|
38
|
12
|
46%
|
Jan. 28
|
26
|
0
|
0%
|
Jan. 27
|
26
|
2
|
8%
|
Jan. 26
|
24
|
9
|
60%
|
Jan. 25
|
15
|
-1
|
-6%
|
Jan. 24
|
16
|
8
|
100%
|
Jan. 23
|
8
|
0
|
0%
|
No comments:
Post a Comment