Friday, March 20, 2020



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

Health Care Workers cannot get asymptomatic infections?

No in a study presented by Dr Prof Colosio and ICRH team from Italy 4142 workers are employed in two public hospitals in South Ovest Milan, both university hospitals. 709 percent women with Mean age 46.
In San Paolo hospitals 537 swabs were tested and 19 were positive amongst workers.
In San Carlo hospital 349 swabs were tested and 17 were positive.
90 percent of positive were asymptomatic.

Mosquitos also can transmit coronaviruses
To date there has been no information nor evidence to suggest that the new coronavirus could be transmitted by mosquitoes. The new coronavirus is a respiratory virus which spreads primarily through droplets generated when an infected person coughs or sneezes, or through droplets of saliva or discharge from the nose.

Hand dryers can kill coronaviruses?
No. Hand dryers are not effective in killing the COVID 19 virus. To protect yourself against the new coronavirus, you should frequently clean your hands with an alcohol-based hand rub or wash them with soap and water. Once your hands are cleaned, you should dry them thoroughly by using paper towels or a warm air dryer.

Why shouldn’t I use ultraviolet disinfection lamp to kill coronaviruses?
UV lamps should not be used to sterilize hands or other areas of skin as UV radiation can cause skin irritation.

COVID-19 virus can be transmitted in areas with hot and humid climates
WHO: From the evidence so far, the COVID-19 virus can be transmitted in ALL AREAS, including areas with hot and humid weather. Regardless of climate, adopt protective measures if you live in, or travel to an area reporting COVID-19.

Thermal scanners can detect Corona Viruses?
No, Thermal scanners are only effective in detecting fever. Also, it takes between 2 and 10 days before people who are infected become sick and develop a fever.

I must keep my nose clean and moist?
There is no evidence that regularly rinsing the nose with saline has protected people from infection with the new coronavirus but there is some limited evidence that regularly rinsing nose with saline can help people recover more quickly from the common cold. Also people with allergy with this may touch their nose on less occasions ( nose hygiene)

Taking a chlorine bath will help
No. Spraying or bathing with chlorine will not kill viruses that have already entered your body. Spraying such substances can be harmful to clothes or mucous membranes (eyes, mouth). Chlorine can be useful to disinfect surfaces, but they need to be used under appropriate recommendations.

I must take a hot bath daily
Taking a hot bath will not prevent you from catching COVID-19. Your normal body temperature remains around 36.5°C to 37°C, regardless of the temperature of your bath or shower. Actually, taking a hot bath with extremely hot water can be harmful, as it can burn you.

For Asian countries COVID 19 is very fatal
Measles 10-15% developing countries. More than one third of all measles deaths worldwide are among children in India.
MERS 34% (2012, killed 858 people out of the 2,494 infected)
SARS 10% (Nov. 2002 – Jul. 2003, originated from Beijing, spread to 41 countries, with 8,096 people infected and 774 deaths).
Ebola 50%
Smallpox 30-40%
Diphtheria 5-10%
Whooping cough 4% infants < 1yr, 1% children < 4 years
Swine flu < 0.1-4 %
Seasonal flu 0.01%
Number of flu deaths every year: 290,000 to 650,000 (795 to 1,781 deaths per day)

Numbers have no value in COVID 19

No, they help understanding its course.
56% are males
Deaths rate males 2.8% females 1.7%
Causes mild illness in 82%, Severe illness in 15%, Critical illness in 3%, Death 3.4 % (March 3)
Deaths: 15% severe disease, 5% require ICU care, 2% require ventilators,
Deaths 71% with comorbidity
71% deaths are in patients with comorbidity due to cytokine storm. [72,314 Chinese cases, largest patient-based study, JAMA)
CAD patients most at risk [CAD 10.5%, Diabetes 7.3%, COPD 6.3%, HT 6%, Cancer 5.6%, no pre-existing disease (0.9%)
Health care provider infections China 3.8% 0.3% deaths. Singapore Nil
Deaths 10% in Iran (under reporting)
Deaths S Korea (1%)
Affects all sexes but predominately males 56%
Age; 87% (30-79), 10% (< 20), 3% (> 80)
Mean time to symptoms 5 days
Mean time to pneumonia 9 days
Mean time to death 14 days
Mean time to CT changes 4 days
3-4 reproductive number R0 (flu 1.2, SARS 2)
Epidemic doubling time 7.5 days
Doubling time in Korea 1 day probably due to super spreader
Tripling time in Korea 3 days
Positivity rate% (UK 0.2, Italy 5, France 2.2, Austria 0.6, USA 3.1)
Incubation period days 2-14 days
Mean Incubation period: 5.2 days
Recover time Mild cases 2 weeks
Recovery time sever cases 4-6 weeks
Case fatality 80 + 14.8%; 70-79 = 8%; Case fatality 60-69 = 3.6%; Case Fatality 50-59 = 1.3%; Case fatality 40-49 – 0.4%; Case fatality 10-39: 0.2%; Case fatality < 9 years: nil

Corona can spread through semen after recovery.

No, there is no evidence. But we do know that in patients infected with Ebola, the virus may persist for months in the testes or eyes even after recovery and can infect others and keep the epidemic going.

Environmental disinfection is not  important.
No. CDC states routine cleaning and disinfection procedures are appropriate for COVID-19 virus. Products approved by the Environmental Protection Agency for emerging viral pathogens should be used.

Viruses can stay on the surfaces. Human coronaviruses can be efficiently inactivated by surface disinfection procedures with 62-71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite" or bleach within one minute.

According to the CDC, the flu virus can live on some surfaces for as long as 48 hours and potentially infect someone if the surface has not been cleaned and disinfected.

People can get reinfected

·       The Japanese government reported that a woman in Osaka had tested positive for the coronavirus for a second time, weeks after recovering from the infection and being discharged from a hospital. Combined with reports from China of similar cases, the case in Japan has raised some questions. Reinfections are common among people who have recovered from coronaviruses that cause the common cold.

·       Reinfection in a short time is unlikely. Even the mildest of infections should leave at least short-term immunity against the virus in the recovering patient. More likely, the “reinfected” patients still harboured low levels of the virus when they were discharged from the hospital, and testing failed to pick it up.

·       Even if there were occasional cases of reinfection, they do not seem to be occurring in numbers large enough to be a priority at this point in the outbreak.

COVID 19 behaves the same way in every country?
No. Japan and S Korea have slowed it, Hong Kong and Singapore have contained it. India and African countries are less impacted by the COVID 19. Most Western countries are on the same coronavirus trajectory.

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