187 CMAAO CORONA FACTS and MYTH COVI Update
Dr K Aggarwal
1053: Update on Covid-19
Minutes of Virtual Meeting of CMAAO NMAs on “Asian countries update – part 2”
15th August, 2020, Saturday
Dr KK Aggarwal, President CMAAO
Dr Yeh Woei Chong, Singapore Chair CMAAO
Dr Alvin Yee-Shing Chan, Hong Kong
Dr Marie Uzawa Urabe, Japan
Dr Sajjad Qaisar, Pakistan
Dr Prakash Budhathoky, Nepal
Dr Russell D’Souza, UNESCO Chair in Bioethics, Australia
Dr S Sharma, Editor IJCP Group
Key points from the discussion
- The Covid-19 virus has six antigens: E, S, N, ORF 1a, ORF 1b and RDRP antigen. E antigen is common to corona viruses; if negative, no corona. The rest five are specific to Covid-19.
- RT PCR antigen has been reported for up to 40 days. But, there is no data available as to how long any of these antigens last in the body.
- The RT PCR tests the antigen; it does not detect the virus. If only one antigen is tested, the sensitivity is low. Testing for 2 or more antigens incurs higher cost.
- In cold, frozen foods, the virus can survive for much longer.
- The virus becomes non-replicable inside the body after 9 days.
- We need to have studies to find out how long these antigens remain inside the body.
- The virus is present in skin. The Lancet has published a case report where RT PCR was negative, but the skin biopsy samples from rash, were positive for the virus.
- Covid-19 causes immune hyperreaction in the body. It is a multisystem disorder, especially in children and also now in adults. Skin could also be involved.
- It is the duty of the treating doctor to decide after Day 14, whether his patient is infectious or not.
- The certificate stating simply positive/negative status has no value. The doctor should mention if the patient is infectious or not.
- For instance, a doctor should be able to give a certificate that the patient is non-infectious under following conditions: the patient demonstrates the presence of IgG antibodies with or without presence of antigens, the patient is asymptomatic after 10 days without doing antigen test, the patient is positive for 2 weeks, his ESR and CRP are normal.
- We should know which antigens are being tested. A person detected negative in one country may test positive in another country. This depends on the antigen/s being tested.
- It was suggested that a survey could be conducted in the member countries to find out which country is testing which antigen.
- In Singapore, chip machines check for N, ORF and S antigens at the airports.
- In Japan, the quarantine period has been reduced from 14 days to 10 days. It is a recommendation and not a law.
- Regarding the strike in South Korea, it is risky to issue a statement without knowing all facts as had been discussed in the last meeting.
- Melbourne has reached the peak; the cases are now coming down in the last 3-4 days.
- Masking and social distancing will only prevent the infection. So, prevent as long as you can and as much as you can.