Friday, March 20, 2020



Dr KK Aggarwal
President CMAAO, HCFI and Past National President IMA

Yoga is not helpful to tackle Corona Respiratory Illnesses

No. Yoga (mind body stillness) is nothing but unison of mind with the body or a shift from sympathetic to parasympathetic mode. It can make one calm during illness and prevent acute anxiety.

Doing Pranayama (para sympathetic breathing) every day can build your respiratory reserve which can help during illness.

Social distancing means one can sleep with his or her partner?

Social and self-distancing are if one of the persons is having cough and fever. If both the partners do not have fever and cough, they can live a normal married like.

Regarding after how long a person can sleep with his partners after recovering from COVID 19 is not known. Science only knows about Zika and Ebola where the virus can stay in the testes and secrete the virus for months.

Breathlessness mean you are in the severe category of COVID 19

No.  Mild means a positive test, fever, shortness of breath, and possibly even pneumonia, but not so bad that you need to be hospitalized or needs oxygen. Severe is once you need oxygen, then you move into the severe category.        

Corona is nothing but more contagious flu

No. It’s not flu: It’s a lung disease, not a stuffy nose disease. Clinically all have fever, 75% have cough; 50% weakness; 50% breathlessness with low total white count and deranged liver enzymes; runny nose only shows up in 4% cases; 20% need ICU care and 15% of them are fatal.

Absence of fever at admission can rule out COVID19

No. Guan W NEJM 28 Feb 20: Fever on admission is present only in 44% and the mean incubation period of 4 days. Overall, 89% have fever, 68% cough, 34% sputum production, 14% sore throat, 55 nasal congestion and 4% diarrhoea.

Ground-glass opacification/opacity in CT is diagnostic of COVID 19
GGO or an area of increased attenuation in the lung on computed tomography (CT) with preserved bronchial and vascular markings is seen in 56% of the cases [Guan W NEJM 28 Feb 20]

You can protect yourself from COVID-19 by swallowing or gargling with bleach, taking acetic acid or steroids, or using essential oils, salt water, ethanol or other substances.
FALSE. None of these recommendations protects you from getting COVID-19, and some of these practices may be dangerous.

Elbow touch is the best new way to greet people

No. Greeting people by namaste or bowing are the best. Elbow
touch is not recommended as we often ask people to cough or sneeze over the sleeves.

Phase of mitigation will not come after Chins has stopped getting cases
No.  Better to be overprepared than underprepared. This phase will work more for damage control and saving lives. Commercial labs need to pitch in for testing. The testing criteria may change to testing only symptomatic cases and admitting cases only with breathlessness.

Face to face meeting at 3 feet distance is the best

No ideal is six feet distance face to face of 3 feet face to side meeting.

All severe cases need ventilator

No. as per Dr Claudio Colosio from Italy WHO, 5% patients are critical and need mechanical ventilation; 15% are severe and need oxygen, 40% are moderate with pneumonia with no oxygen requirement and 40 % are mild.

It is not possible to estimate the required hospital beds.

Hypothetical number of people requiring hospitalisation with current estimate of outbreak are based on the formula that 20% will require oxygen or ventilation

1. Italy (27980 cases) 5596 beds
2. Iran (14991 cases) 2998 beds
3. Spain (9942 cases) 1988 beds
4. Korea (8320 cases) 1664 beds
Germany (7272 cases) 1454 beds

You cannot estimate the number of deaths

The formula is simple
1.     Number of deaths as on today
2.     Add 15% of cases with serious illness
For example, at 5 PM today
Number of deaths 10405
Serious 7451
15% of 7451 = 1118
Estimated minimum deaths: 11523

The above formula is accurate

No. It estimates todays deaths and todays serious cases. Time to death is 14 days. So, the correct formula will be todays deaths and 14 days back serious cases X 15%.

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