First death in India The case calls for implementation of IPC 270 and Epidemic Disease Act
Severe violation of epidemic guidelines in the first death
Dr KK Aggarwal
President CMAAO, HCFI and Past National President IMA
First death in India: The case calls for implementation of IPC 270 and Epidemic Disease Act
In an epidemic one needs to follow one protocol, police should be informed for left against medical advise, suspected COVID can not be shifted to other state hospital. Suspected cases should be treated as positive case unless tested negative. One such case with pneumonia ( LRTI has high viral load) can make all the difference in the country and spread the disease like a wild fire.
As per India Today Report
· 76-year-old who died in Karnataka
· The necessary contact tracing, isolation and other measures as per protocol are being carried out. Telangana government has also been informed since he went to a private hospital there.
· From Kalburgi
· Visited Saudi Arabia from January 29 to February 29.
· Reached in Hyderabad on February 29 and went to Kalaburagi in Karnataka.
· Man had gone to a private hospital in Hyderabad earlier.
· Asymptomatic on his return (from Saudi Arabia)
· Developed symptoms of fever and cough on 6th March.
· One private doctor visited him at his home and treated him there.
· On 9th March, the symptoms got aggravated and he was shifted to a private hospital in Kalaburagi.
· Provisionally diagnosed as 'mid-zone viral pneumonia' and 'suspected Covid-19'
· Sample was collected on March 9
· Without waiting for the test results, the attendees insisted and the patient was discharged against medical advice and the attendees took him to a private hospital in Hyderabad
· The patient was admitted to a private hospital in Hyderabad and treated.
· He died on Tuesday when he was being brought back to the Gulbarga Institute of Medical Sciences (GIMS) in Kalaburagi.
· Apart from the deceased, Karnataka has confirmed five other positive cases of the novel coronavirus. The fifth case, confirmed on Thursday is of a 26-year-old man who recently returned from Greece.
Expected cases in India
Based on per million current infection rate
i. Average 17.3 / million population = 22100
ii. Italy like situation: 250 per million = 325,000
iii. China scenario: 56 per million: 72800
iv. Iran scenario: 120 per million, 156,000
v. US scenario 5.2 per million: new6760
vi. New Zealand scenario: 1 per million 1300
vii. Best scenario: 0.1 per million 130
Out of them
82% will be mild
15% will be severe
3% will be critical
3% will die or 15% serious cases will die
71% deaths will be in patients with comorbidity
How to early diagnose severe cases
1. Do resting SPO2 levels, if low needs oxygen
2. Do walking SPO2 and if falls by 4% within 1-2 minutes, is a severe case
3. Resting tachycardia
4. Early oxygen