Sunday, April 12, 2020



Dr K K Aggarwal
President Confederation of Medical Associations of Asia and Oceania

471:  Is there a link with long term pollution and COVID mortality
A new study was made public this week that sheds light on the connection between COVID-19 health impacts and air pollution.
Dr. Francesca Dominici, author and Director of the Data Science Initiative at Harvard’s T.H. Chan School of Public Health : People living in counties in the US that have experienced a higher level of air pollution over the past 15–17 years have a substantially higher COVID-19 mortality rate. One unit increase in long-term average exposure to fine particulate matter is associated with a 15% increase in COVID-19 mortality rate on average in the analysis.
A one unit increase in long-term exposure to PM2.5 leads to a 15% increase in COVID-19 mortality rate with a magnitude that is 20 times that of PM2.5 and all-cause mortality (which is 0.7%).
So, in the Medicare study [Di et al, 2017], we report that a one unit increase in long-term exposure to PM2.5 is associated with a 0.7% increase in all-cause mortality. In this study, we have that one unit associated with a 15% increase in COVID-19 mortality so the relationship between PM2.5 and COVID mortality is 20 times stronger than the relationship between PM2.5 and all-cause mortality.

472: What is the mortality in India

473: Can this be linked to high pollution ratews in the air
One can only postulate

474:  when will social distancing end

When the following conditions are met:
  • When the number of new infections in states and regions start go down over time
  • When we have a massive ability to diagnose cases through testing
  • When proper equipment, like masks and other personal protective equipment are fully available for doctors, nurses, and hospital staff so that the sick can be cared for safely and effectively
  • When hospitals have all of the equipment they need like beds, ventilators, and are fully prepared for new cases
  • When a robust public health infrastructure is in place to identify new cases and trace contacts to prevent spread and contain new outbreaks
475: Are there phases of social distancing
 Yes there are four phases

476: What is phase 1
Social distancing is the Phase One, to buy us time to accomplish the conditions described above.

477: What is phase 2
Phase 2: If cases do not increase over a 2-week period.

478: What are the components of phase 2

Phase 2 allows businesses and schools to reopen with appropriate physical distancing measures and increasing disinfecting and cleaning of public spaces. Large gatherings will likely still need to be limited. High risk people like the elderly and those with medical problems may still need to limit time outside of the home until there are validated treatments available. They stress, however, that if at any time cases go up in an unmanageable way, we would probably need to go back to social distancing.

479: What is phase 3

Phase 3: Would be a time when we can lift almost all physical distancing restrictions. This would depend on whether or not our country has a strong COVID-19 surveillance infrastructure in place to stamp out any new cases quickly, readily available drug treatments, and potentially a safe and effective vaccine.

480: What is phase 4
Phase 4: Is a time when we use all of the lessons learned from this pandemic to expand public health and health care infrastructure, along with developing strong emergency preparedness plans to “rebuild our readiness.” This will help protect us from future threats without the same severe conditions we have faced during this pandemic.

481: how to tackle future pandemics
Aggressively implementing Phase Four would probably allow us to respond to future threats similar to the way South Korea responded to COVID-19.

482: What is the time line for each phase
It’s not clear what the timeline would be to move from one stage to another, some stages could take weeks – others make take months to years.

483: what is happening in Italy
It is now being estimated that they will have virtually eliminated new COVID-19 cases by May 16th, 10 weeks after the entire country went into lockdown.

It took them 4 weeks after lockdown to reach their peak and then show a sustained decline in the number of cases. It’s still not clear when they will start easing up their restrictions.

484: what is circuit breaker

Its term sued by Singapore for lock down.
in Singapore On Apr 3, Prime Minister Lee Hsien Loong announced significantly stricter measures to curb the COVID-19 outbreak in Singapore. He likened this to a “circuit breaker”.

485: What is Janta Karphew
India used this term for lock down on 22nd March

486: What is Movement Control Order (MCO)”
 This is a term sued by Malaysia for lock down

487: What is   Shelter-in-Place and Stay-at-Home Orders
These are the US terms for lock down

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