Tuesday, March 24, 2020



Dr K K Aggarwal
President CMAAO, HCFI and Past National President CMAAO

Younger persons are not at risk

More than 40 percent of those who have tested positive for the virus in New York City are between the ages of 18 and 44. Nationally, 12 percent of the intensive care patients were between the ages of 20 and 44. 

Herd immunity is the answer

No. Initially , the U.K. chief science advisor’s statement, that the way out of this epidemic was to get to 60% or more of the population recovered from infection and thus approach “herd immunity” did not provide reassurance.

Much of the public immediately understood that the trade-off appeared to be to accept a large number of deaths soon, to ultimately get the population to a Covid-19–resistant state.

The minister of health however denied that this strategy was the government policy.

Athithi deva bhava had no scientific evidence
Traditional Vedic teaching has been that all guests first are made to wash feet, than hands, mouth, gargles and then made to sit in place while bowing and not shaking hands with them. Visitors means who is not living with you. The same has now come back.

There is nothing like nonessential social contact.
No. All elderly should avoid non-essential contact.

Chanakya said

Yatha Chaturbhi Kanakam Parikshayate Sheelen Chednataaptadane
Tatha Chaturthi Purusham Parikshayate Tyagen Sheelen Guren Karmana

यथा चतुर्भि: कनकं परीक्ष्यते शीलेन छेदनतापताडनै:
तथा चतुर्थि: पुरुषं परीक्ष्यते त्यागेन शीलेन गुणेन कर्मणा।।
Just like the way gold needs to be cut, rubbed, hit and heated to see its actual brightness, in the same way in order to know about a person, what has he sacrificed in life, how he speaks, his qualities and his work needs to be seen.

Before meeting a non-essential contact we need to see his or her hygiene habits.

Risk of transmission is same between age 30-60
No. The risk of symptomatic infection increases with age (for example, at ~4% per year among adults aged 30–60 years). Nature Medicine 2020

COVID patients can share beds in the hospital

The US CDC recommends that patients with suspected or confirmed COVID-19 be placed in a single-occupancy room with a closed door and dedicated bathroom [95]. The patient should wear a facemask if being transported out of the room (eg, for studies that cannot be performed in the room). An airborne infection isolation room (ie, a single-patient negative pressure room) should be reserved for patients undergoing aerosol-generating procedures [Centers for Disease Control and Prevention. Interim Infection Prevention and Control Recommendations for Patients with Confirmed 2019 Novel Coronavirus (2019-nCoV) or Patients Under Investigation for 2019-nCoV in Healthcare Settings. February 3, 2020. https://www.cdc.gov/coronavirus/2019-nCoV/hcp/infection-control.html (Accessed on March 11, 2020).]

Pneumonia means severe case

Mild (no or mild pneumonia) was reported in 81 percent.
Severe disease (eg, with dyspnea, hypoxia, or >50 percent lung involvement on imaging within 24 to 48 hours) was reported in 14 percent.
Critical disease (eg, with respiratory failure, shock, or multiorgan dysfunction) was reported in 5 percent.

Case fatality will be the same in all countries

The proportion of severe or fatal infections may vary by location. As an example, in Italy, 12 percent of all detected COVID-19 cases and 16 percent of all hospitalized patients were admitted to the intensive care unit; the estimated case fatality rate was 5.8 percent in mid-March.

In contrast, the estimated case fatality rate in mid-March in South Korea was 0.9 percent.
This may be related to distinct demographics of infection; in Italy, the median age of patients with infection was 64 years, whereas in Korea the median age was in the 40s.

All will recover or die in 2 weeks

No. According to the WHO, recovery time appears to be around two weeks for mild infections and three to six weeks for severe disease.

In all dyspnoea will develop in 3 days

Some patients with initially mild symptoms may progress over the course of a week. In one study of 138 patients hospitalized in Wuhan for pneumonia due to SARS-CoV-2, dyspnea developed after a median of five days since the onset of symptoms, and hospital admission occurred after a median of seven days of symptoms. In another study, the median time to dyspnea was eight days [
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395:497.

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