Monday, August 17, 2020





Dr K Aggarwal

President CMAAO


1053:  Update on Covid-19


Minutes of Virtual Meeting of CMAAO NMAs on “Asian countries update – part 2”


15th August, 2020, Saturday






Member NMAs


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.


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