177 CMAAO CORONA FACTS and MYTH COVID Informed Consent
Dr K Aggarwal
President CMAAO
With inputs from Dr Monica Vasudev
1043: Minutes of Virtual Meeting of CMAAO NMAs on “Asian
Countries Update – Part 1”
1st
August, 2020
9.30am-10.30am
Participants
Member
NMAs
Dr
KK Aggarwal, President CMAAO
Dr
Yeh Woei Chong, Singapore Chair CMAAO
Dr
Marthanda Pillai, Member World Medical Council
Dr
Alvin Yee-Shing Chan, Hong Kong
Dr
Subramaniam Muniandy, Malaysia
Dr
Marie Uzawa Urabe, Japan
Dr
Ashraf Nizami, Pakistan
Dr
Prakash Budhathoky, Nepal
Invitees
Dr
Russell D’Souza, UNESCO Chair in Bioethics, Australia
Dr S Sharma, Editor IJCP Group
Dr
Marthanda Pillai spoke about Covid situation in the Gulf countries. Dr KK
Aggarwal analysed the Covid data in South Asia and Dr Yeh Woei Chong gave an
update on Covid in China, South Korea and Singapore. Dr Alvin Yee-Shing Chan
spoke on the current scenario of Covid in Hong Kong.
Covid in
Gulf countries
Dr Marthanda Pillai
- Many of Gulf countries have been
proactive in response to Covid-19 launching tremendous efforts to control
the infection prior to detecting the first case.
- Iran was the first country to be
affected; it continues to be a hotspot.
- Saudi Arabia: Spread from Iran;
disease detected in Jan/Feb, quick to implement measures to control the
infection.
- UAE reported four cases on 29th
January. Subsequently, Bahrain, Kuwait, Oman, Iraq and Qatar reported
their first case in late February. These cases were either Iranians or
citizens of Gulf countries who had recently visited Iran.
- Lockdown has been implemented,
schools/religious places have been closed, no public transport in
operation.
- There is a good system of
testing.
- The entire treatment is free,
especially Covid-19 treatment, for all citizens.
- Overall, total cases are around
2.3 lakh; the cure rate is around 45-50%. Mortality is less than 1% except
in Iran, where mortality is 3.2%.
- Non-Covid patients are restricted;
e prescriptions are being given, which has helped to control the
infection.
- Restrictions are in place; there
is no international travel except chartered flights for people who wish to
go back to their country of origin. Their status is checked.
- The status of these countries has
an indirect impact on the situation in our countries.
Covid-19 in
South Asia
Dr KK Aggarwal
- The south Asian region includes 8
countries: Afghanistan, Bangladesh,
Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka.
- If the population density is
more, the number of cases will be more in the first wave. If density is
more than 1000, the number of cases is higher. Among the 5 countries,
Bangladesh is the most densely populated at 1174/sq km. In all the rest,
the density varies between 200 and 400.
- India has the maximum number of
cases in the South Asia region.
- India, Pakistan and Bangladesh
are almost the same in terms of total deaths per million population
(20-25) and also same case fatality rate, which is around 2%. The total
deaths per million population is 2 in Nepal; this may be because Nepal is
yet to peak and spread is not yet seen.
- The situation in Sri Lanka is however
different despite similar population density. The case fatality rate is
low (1%) as is the total number of cases.
- Analysis of the indicators of
health infrastructure shows that all five countries have almost similar
number of physicians per 1000 people. But in terms of hospital beds per
1000 population, Sri Lanka has the highest number (3.6); in India,
Pakistan, Nepal and Bangladesh, this number if 0.5-0.8.
- Sri Lanka and India reported
their first case of Covid-19 at nearly the same time; 27th
January and 30th January, respectively.
- All five countries implemented
lockdown around the same time, but Sri Lanka extended the lockdown much
longer.
- More than 10% positive rate
practically means community transmission and if less than 5%, then
lockdown can be lifted. India, Pakistan and Bangladesh have more than 10%
positivity rate
- Reasons for low mortality in Sri
Lanka: First in the region to eliminate malaria, better hygiene index,
educated population, better infrastructure, extended lockdown.
- Kerala has similar mortality as
that of Sri Lanka (0.3%); total cases are 23,000 cases and only 74 deaths.
The seroprevalence is less than 10%. The seroprevalence in Delhi and
Mumbai and Pakistan is around 20-30%. In Bangalore, seroprevalence is
10-12%.
Covid-19 in
China, South Korea & Singapore
Dr
Yeh Woei Chong
- China: Confirmed cases
84292 (discharged 78974, deaths 4634); cases have been rising from last
one week. From 11th June to 23rd June, there were
256 cases in Beijing. Prior to this, there were no cases for 55 days. The
trigger is a seafood market like in Wuhan and the source of infection
apparently is contaminated chopping boards. China has a huge testing
capacity; it is testing people in large numbers – half million tests
daily. Outbreaks in Dalian and Xinjiang in the last week; the new outbreak
in Dalian has been linked to a seafood company and contamination from
packaging is suspected. On 30th July, there were 11 cases in
Dalian and 112 in Xinjiang.
- South
Korea:
There are more than 14,000 confirmed cases; 13183 have been discharged and
around 300 have died due to the infection. There is a second wave in South
Korea. The number of cases is increasing. There were 113 cases on 30th
July (Friday). South Korea has done 1563796 tests. Their clusters are nightclubs,
door to door sales, churches, ports, and nursing homes.
- Singapore: There are around
52,000 cases. Majority of cases in the country are in dormitories housing
migrant workers (around 50,000), while the community are only around 2000
cases. Last week there were 400 cases in dormitories and 5 in the
community. Around 5400 cases are in isolation. Since February, there are
128 ICU cases; this number has been zero since last 2 weeks. Number of
tests performed is 1.23 million. There are 323,000 migrant workers in
dormitories. Of these, 262,000 have recovered or cleared of the virus. Efforts
are on to clear all the dormitories of Covid-19 by 7th August. Migrant
workers are swabbed every month towards this end. 975 factory dorms + 64
blocks in 17 purpose built dorms have been cleared. Everybody is swabbed
and if there are any cases, swabbed again after a week. 13000 swab tests
are done in a day.
Hong Kong
Update
Dr Alvin Yee-Shing
Chan
- Hong Kong is experiencing the
third wave (July) with 3271 cases and 27 deaths, which is serious; up to
end of June, there were 1200 cases and 8 deaths; in 2nd wave in
April, the maximum number was only 65.
- Origin of the third wave is from
sea men and air crew who were exempted from quarantine and routine testing
together with relaxation of rules of social gathering and fatigue set in.
- No capacity for en masse testing
; bottleneck of testing 13,000 daily; now screening started for high risk
groups – people working in restaurants, catering, sellers etc. No
exemption now from testing and quarantine.
- Manpower is adequate; 6219
doctors in public hospitals, only half of public hospital beds are
occupied in the past two months as all elective surgeries have been
postponed in public hospitals.
- T614 gene mutation was found in
cluster of sailors entering Hong Kong from Kazakhstan and Philippines;
this DNA expression is similar to that seen in many people in Hong Kong
infected in the third wave. Patients became more serious and more
infectious.
- Virology Dept in the University
of Hong Kong is working on research to produce a vaccine against Covid-19.
- Holiday homes/villages/resorts
have been modified as isolation and quarantine centers for mild cases to
prevent cross infection to family members.
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