Monday, April 13, 2020



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

517: What are ICMR testing results

ICMR was earlier testing only suspected patients — those who had travelled overseas, those who were in contact with them and were symptomatic — and only 3 per cent of them tested positive for coronavirus.

ICMR, then, began a sentinel surveillance programme from 15 February to 19 March at more than 50 major hospitals in India. They picked up representative samples of all cases of Severe Acute Respiratory Infection (SARI), like pneumonia. In this study, two out of 965 samples tested positive for Covid-19.

On 20 March, the testing criteria changed and they started testing all SARI cases across India. A total of 4,946 samples were tested and 102 out of them were positive for Covid-19. This means out of 5,911 cases tests in total, only 104 have tested positive. Even though testing is targeted, only 1.8 per cent have tested positive.

The study indicates that 38 per cent of coronavirus cases do not have a history of foreign travel.

Private labs have only tested suspected cases till now. Out of the 16,000 tests that private labs have done, only 320 have tested positive for Covid-19.

The Indian Council of Medical Research (ICMR) said on Saturday that a total of 1,79,374 samples from 1,64,773 individuals have been tested in India as on April 11 9 p.m., and 7,703 of them have tested positive.

518 : The virus not politics, will set the terms

It leaves us with three options: Continue sheltering at home until there is a vaccine, which could take a year or more; simply open the floodgates of activity and then face a repeat explosion of cases; or prepare vigorously, expanding our public health capacity so we can gradually lift restrictions and safely loosen the tap of activity, instead.

519: The CDC reports that cloth face coverings should:

Include multiple layers of fabric.

Allow for breathing without restriction.

Fit snugly but comfortably against the side of the face.

Be secured with ties or ear loops.

Be able to be laundered and machine dried without damage or change to shape.

Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used

Cloth  coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.

The recommended cloth face coverings are not surgical masks or N-95 respirators. Surgical masks and respirators are in short supply and must continue to be reserved for medical first responders.

This CDC recommendation does not replace – but rather, it complements – our social distancing efforts

It is critical that we continue to wash our hands regularly, cover our coughs, stay at home whenever possible and maintain 6-feet social distancing in order to slow the spread of COVID-19.

520: What is the dose of Ivermectin

12 mg single tablet

521: Can two people in the same family behave differently with COVID 19

A physician couple who both had COVID-19 had very different responses — one ending up in intensive care, the other asymptomatic. This tells us how much is still to be learned about COVID-19, says Noopur Raje, MD, professor of medicine at Harvard Medical School and director of the Center for Multiple Myeloma at Massachusetts General Hospital (MGH) in Boston.

Raje says that she wants clinicians to know how symptoms can evolve both quickly and suddenly. She recalls how for 10 days, she cared for her COVID-19–positive husband at home, separated from him by a floor in their Boston townhouse and wearing a surgical mask and gloves to bring him food and fluids, as he was too weak to help himself.

Despite the high fevers, chills, extreme fatigue, and dramatic weight loss, Raje says she felt reasonably confident that her husband was getting better. His temperature had dropped from around 103 to 101, his heart rate was in the 80s, and his blood pressure was "OK," she recalls. But then Jag Singh, MD, an otherwise healthy 55-year-old Harvard professor and cardiologist, started to cough — and everything suddenly changed. The cough sounded chesty, and he was weak and unwell. They decided that he needed medical help. "I was planning on driving him to the hospital, but I ended up having to call 911, although we literally live across the street," she said. Singh was admitted straight to the medical intensive care unit (MICU) while his wife waited at home.

522: Look for Red Flag

Raje wants physicians to warn their self-isolating patients and caregivers to look for red flags. "There are primary care physicians who reached out to me and said 'when someone calls me and says it's been 5-7 days and I am still not feeling well, I am going to look at that more seriously.

523: What is a State lockdown:

As per the Constitution, subjects of law and order and public health lie with state governments, which means states can take steps related to the two. Additionally, the Epidemic Diseases Act of 1897, which many states have invoked to order a lockdown, empowers them to prescribe temporary regulations to prevent the outbreak and spread of a disease.

524: What is a Centre’s lockdown

The central government had cited a possible "lack of uniformity in the measures adopted (by states) as well as in their implementation" as a reason for ordering a nationwide lockdown on March 24. The lockdown was ordered through the National Disaster Management Authority (NDMA), which is headed by the prime minister, under section 6(2)(i) of the Disaster Management Act, 2005. The Union home ministry, in compliance with the NDMA's order, issued orders for the 21-day lockdown under Section 10(2)(l) of the DMA.

525: Which has more powers state or central

Article 254 of the Constitution says that if there is an inconsistency between a law made by Parliament and those made by states, the Central law prevails.

526: Can the President intervene

The President also has emergency powers to make states and center work together.

527: Can the states say no the central lock down

No. States can announce their own lockdowns but can’t say no to a lockdown mandated by the Centre.

528: what is Xenophobia

From the Greek xenos, meaning "stranger" or "foreigner", and phobos, meaning "fear" is the fear or hatred of that which is perceived to be foreign or strange. It is being seen more and more during this COVID era

529:  Can Crohn’s disease increase the risk of COVID 19

Having IBD does not appear to increase the risk of SARS-CoV-2 infection or the development of COVID-19.

530: How long the virus stay in CT scan center

Imaging equipment used to scan patients can be contaminated with the COVID19 virus for up to nine days if the machines aren't properly cleaned.

The virus can stay active on metal, glass, or plastic surfaces. And, according to recent research from the University Medicine Greifswald and Ruhr University Bochum in Germany, the best way to decontaminate these areas is by using a solution comprised of 62 percent-to-72 percent ethanol, 0.5 percent hydrogen peroxide, or 0.1 percent sodium hypochlorite within one minute of possible contamination. Their findings were published in the Journal of Hospital Infection (JHI).

531: How to clean the equipment

After each contact with potential coronavirus patients, staff should disinfect all CT and MR machine gantries, noninvasive ultrasound probes, blood pressure cuffs, and mouse and keyboards at imaging stations. Such surfaces should be washed with soap or decontaminated using low- or intermediate-level disinfectants. Imaging professionals should contact their vendors to determine which solutions are best for each machine.

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