CMAAO Update 12th February on NOVEL CORONA 2019
Round table Experts from HCFI and MAMC Draft Document
Dr KK Aggarwal
President CMAAO, HCFI and Past National President IMA
Namaste: Let’s not shake hands
Good News: Total cases increasing, deaths
increasing BUT total daily cases declining
Confirmed cases: 45166, Countries 28, Deaths 1115
Active cases: 39267 (currently infected), 31025 (79%) mild
cases; 8242 (21%) serious cases. 12 serious cases outside China
Closed cases: 5899 (no outcome), 4784 (81%)
Pattern: 82% mild,
15% severe, 3% critical, 2% deaths
Serious or critical mortality 15%
More than 136 cases have been confirmed on a
ship quarantined in Japan
Secondary
cases: Thailand,
Taiwan, Germany, Vietnam, Japan, France, US
Deaths outside China: Philippines on Feb 2 (44 Chinese man M) and 2nd
in Hong Kong ( 39 M, local) on
February 4, both had co-morbid conditions. Both acquired infection from Wuhan.
Likely deaths 1115 +1236 = 2351 with
the present trend and available treatment
Summary
Possibly behaves like
SARS with < 2 % case fatality (15% of admitted serious cases), mean time to death 14 days, mean time to pneumonia 9 days, mean time to
symptoms 5 days, 3-4 reproductive number R0, incubation period 2-14 days- mean
5.5 days, has origin possibly from bats, spreads like large droplets and predominately
from people having lower respiratory infections and hence standard droplet precautions
the answer for the public and air born precautions for the healthcare workers.
{So: RT Experts meet HCFI and MAMC]
CDC Case Definition
1. Fever (subjective or
confirmed)
OR signs/symptoms of lower respiratory illness (cough
or shortness of breath)
PLUS, any
person, including health care workers, who has had close contact with a
laboratory-confirmed 2019-nCoV patient within 14 days of symptom onset.
2. [Contact
means: Being within approximately 6 feet (2 meters) or within the room or care
area of a 2019-nCoV case for a prolonged period of time while not wearing
recommended personal protective equipment (gowns, gloves, NIOSH-certified
disposable N95 respirator, eye protection); close contact can include caring
for, living with, visiting, or sharing a health care waiting area or room with
a 2019-nCoV case OR having direct contact with infectious secretions of a
2019-nCoV case (e.g., being coughed on) while not wearing recommended personal
protective equipment.]
3. Fever and signs/symptoms
of lower respiratory illness (cough or shortness of breath) PLUS a history of
travel from Hubei Province, China within 14 days of symptom onset
4. Fever and signs/symptoms
of lower respiratory illness (cough or shortness of breath) requiring
hospitalization PLUS a history of travel from mainland China within 14 days
of symptom onset.
Continue asking patients
with suspected flu or diarrhoea if they, or someone they have been in contact
with, recently returned from corona affected area. [ in US confirmed case they
2019-nCoV RNA in a stool specimen collected on day 7 of the patient’s illness.]
Public Health Emergency of International Concern 30th
Jan 2020
Mandatory to report to
WHO each human and animal case.
Prior
5 PHEIC’s:
26th
April 2009 Swine flu: 10 August 2010, WHO announced that the H1N1 influenza virus has
moved into the post-pandemic period. However, localized outbreaks of various
magnitudes are likely to continue.
May 2014 Polio:
resurgence of wild polio. October 2019, continuing cases of wild polio in
Pakistan and Afghanistan, in addition to new vaccine-derived cases in Africa
and Asia, was reviewed and remains a PHEIC. It was extended on 11 December
2019.
August 2014
Ebola: It was the first PHEIC in a
resource-poor setting.
Feb 1 2016 Zika:
link with microcephaly and Guillain–Barré syndrome.
This was the first time a PHEIC was declared for a mosquito‐borne disease. This
declaration was lifted on 18 November 2016.
2018–20 Kivu
Ebola: A review of the PHEIC had been planned at
a fifth meeting of the EC on 10 October 2019[44] and as of 18 October 2019, it
continues to be a PHEIC.
Kerala: state public health emergency. Three primary cases in North, South and
Central. Kasaragod
district is in north Kerala, Thrissur in central Kerala and Alappuzha in South
Kerala]. Four Karnataka districts bordering Kerala — Kodagu, Mangaluru, Chamarajanagar
and Mysuru have been put on high alert.
Virus
Single-strand, positive-sense RNA genome ranging from 26 to 32
kilobases in length, Beta corona virus from Corona family.
‘corona’ means crown or the halo surrounding the sun.
Heart is considered crown and hence coronary arteries. In electron microscope,
it is round with spikes poking out from its periphery.
Origin: Wuhan, China
December 2019. 1st case informed to the world by Dr. Li Wenliang
died Feb 6th
Virus is likely killed
by sunlight, temperature, humidity. The virus can remain intact at 4 degrees or
10 degrees for a longer period of time. But at 30 degrees then you get
inactivation. SARS stopped around May and June in 2003 due to more sunlight and
more humidity. Alive on surface: possibly 3-12 hours
Link to ACE: 2019-nCoV
might be able to bind to the angiotensin-converting enzyme 2 receptor in
humans.
Three
deadly human respiratory coronaviruses viruses: Severe acute respiratory syndrome
coronavirus [SARS-CoV], Middle East respiratory syndrome coronavirus
[MERS-CoV]) and 2019-nCoV: The current virus is 75 to 80% identical to the
SARS-CoV
Pathogenesis
High viral load: Detection of 2019-nCoV
RNA in specimens from the upper respiratory tract with low Ct values on day 4
and day 7 of illness is suggestive of high viral loads and potential for
transmissibility. [NEJM]
2019-nCoV
uses the same cellular receptor as SARS-CoV (human angiotensin-converting enzyme
2 [hACE2]), so transmission is expected only after signs of lower
respiratory tract disease develop.
SARS is high
[unintelligible] kind of inducer. This means that when
it infects the lower part of the lung, the body develops a very severe reaction
against it and leads to lots of inflammation and scarring. In SARS what
we found is that after the first 10 to 15 days it wasn’t the virus killing the
patients it was the body’s reaction. Is this virus in the MERS or SARS kind
picture or is this the other type of virus which is a milder coronavirus like the
NL63 or the 229. It may be the mild (unintelligible) kind inducer. [Dr John
Nicholls University of Hong Kong]
Infectiousness
to humans: 2019-nCoV
grows better in primary human airway epithelial cells than in standard tissue-culture
cells, unlike SARS-CoV or MERS-CoV. It is likely that 2019-nCoV will behave
more like SARS-CoV.
Both
SARS-CoV and MERS-CoV infect intrapulmonary epithelial cells more than cells of
the upper airways. Consequently, transmission occurs primarily from
patients with recognized illness and not from patients with mild, nonspecific
signs. Though NEJM has reported a case of 2019-nCoV infection acquired outside of
Asia in which transmission appears to have occurred during the incubation
period in the index patient but the same has been challenged now.
No
sore throat: This
new virus attacks the lungs and not just the throat. Patients so far have not
presented with a sore throat, the reason being that the 2019-nCoV launches an
attack at the intraepithelial cells of lung tissue.
Transmission
Types: Droplet (droplet, contact, fomites) Corona; aerosol, nuclei or ait born e.g. TB
Kissing scenes banned in movies: China
Air crew exempted from
breath analyser tests: Kerala
Burial: China has banned death
ceremonies, people gathering together,
Lockdown: 50 million people in China
Asymptomatic
transmission: One report of a small
cluster of five cases suggested transmission from asymptomatic individuals
during the incubation period; all patients in this cluster had mild illness.
Another case got infected while using gown, but eyes not covered. NEJM reported
a transmission from asymptomatic case but the same has been challenged.
Link to Huanan Seafood
Wholesale Market: 55% with onset before
January 1, 2020 and 8.6% of the subsequent cases. The Chinese government has
banned the wildlife trade until the epidemic passes.
Zoonotic
but unlikely to spread through seafood: It is closely related to several bat
coronaviruses. Bats are the primary reservoir for the virus. SARS-CoV was
transmitted to humans from exotic animals in wet markets, whereas MERS-CoV is
transmitted from camels to humans. In both cases, the ancestral hosts were
probably bats.
The
virus has been traced to snakes in China. Snakes often hunt for bats in wild.
Reports indicate that snakes were sold in the local seafood market in Wuhan,
raising the possibility that the 2019-nCoV might have jumped from the host
species - bats - to snakes and then to humans at the beginning of the outbreak.
However, it is doubted as to how the virus could adapt to both the cold-blooded
and warm-blooded hosts.
Risk to other Asian
countries: It is less likely to
have the serious illness in other countries. As patients with breathlessness
are unlikely to board and patients will mild illness or asymptomatic illness
are less likely to transmit infections.
Legal
Implications India: Section 270 in The Indian Penal Code: 270. Malignant act likely to spread infection of
disease dangerous to life.—Whoever malignantly does any act which is, and
which he knows or has reason to believe to be, likely to spread the infection
of any disease dangerous to life, shall be punished with imprisonment of either
description for a term which may extend to two years, or with fine, or with
both.
Clinical Features (Current trend)
Median age: 59 years (2-74 years); Male to female ratio: 56% male
Mean incubation period: 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with
the 95th percentile of the distribution at 12.5 days.
Epidemic doubling time: In its early stages, every 7.4 days. With a mean serial
interval of 7.5 days (95% CI, 5.3 to 19)
Contagiousness or Basic
reproductive number: 2.2 (95% CI, 1.4 to
3.9). The reproduction number R0
or “r naught” refers to the number of additional people that an infected person
typically makes sick. An outbreak with a reproductive
number of below 1 will gradually disappear. The Ro for the common flu is 1.3
and for SARS it was 2.0.
Comorbid conditions: 71%, deaths in comorbid cases, SARS affected people in their
30 or 50 years. And MERS affected people with co-morbidity. The China data
indicate that it’s those with the co-morbidity are most at risk like seasonal
influenza.
0-15 years age: Just like SARS, it mostly does
not affect children 15 years or less of age
ICU
need: 20%
need ICU care with 15% mortality
Fever:
In
all (no fever no corona)
Cough:
75%
cases
Weakness
or muscle ache:
50%^
Shortness
of breath: 50%
TLC:
low
Liver
transaminase levels:
raised
Case
fatality:
2% [Dr John
Nicholls, University of Hong Kong} China is only reporting those who come for
test, stricter guidelines, actual mortality may be 0.8%-1% like outside
China
Healthcare Workers: In Hong Kong with SARS there was a lot of infection of
healthcare workers as they are close and doing invasive procedures. But this
time around there is not much evidence of the healthcare workers getting sick
or dying (unless China is not reporting it) so this may suggest that it is not
being spread by close aerosol contact but more by the fecal-oral route or with
droplets. So, it may not be as contagious within hospitals. Makeshift hospitals
will help.
Lab
precautions:
BSL 2 ( 3 for viral culture labs)
Human
to human contact period: Requires
prolonged contact ( possibly ten minutes or more) within three to six feet
Travel restrictions
Travel preferable seat: Choosing a window seat and staying lowers the risk
Travel advisory: Level 1 in all countries
(Exercise normal standard hygiene precautions), Level 2 in all affected countries and states including
Kerala ( Exercise a high degree of caution), Level 3 in all countries with
secondary cases (Reconsider your need to travel) done by India and Level 4 ( Do
not travel) done by US. Hong Kong has imposed 14 days quarantine on people
arriving from china. The
Karnataka government has ordered that anybody arriving from the 23
coronavirus affected countries must stay in isolation at home for 28 days.
The home isolation requirement is irrespective of the virus symptoms. To date, 72 countries are implementing travel restrictions.
Travel and trade
restrictions: WHO says no to countries
Leave china all
together: UK, condemned by many countries
Entry to India not
allowed: foreigners who went to
China on or after January 15
Visas Suspended: All visas issued to Chinese nationals before February 5 (not applicable
to aircrew)
Flight suspended: IndiGo and Air India have suspended all of their flights
between the two countries. SpiceJet continues to fly on Delhi-Hong Kong route.
Mass Quarantine May Spark Irrational Fear, Anxiety, Stigma
Evacuation
Many countries
including Tokyo, Japan, India have evacuated their citizens.
Case fatality
Current
Coronavirus 2%
MERS 34% (2012, killed 858 people out of the 2,494 infected)
SARS
10%
(Nov. 2002 -
Jul. 2003, originated from Beijing, spread to 29 countries, with 8,096 people
infected and 774 deaths)
Ebola
50%,
Smallpox 30-40%
Measles 10-15% developing countries
Polio 2-5% children and 15-30% adults
Diphtheria 5-10%
Whooping
cough 4%
infants < 1yr, 1% children < 4 years
Swine
flu <
0.1-4 %
Seasonal
flu
0.01%.
Current
virus in Wuhan 4.9%.
Current virus in Hubei Province 3.1%.
Current virus in Nationwide 2.1%.
Current virus in other provinces 0.16%.
Number of
flu deaths every year: 290,000
to 650,000 (795 to 1,781 deaths per day)
Lab tests
There are two ways to
detect a virus: through the genetic material DNA or RNA or to detect the
protein of the virus. The rapid tests look at the protein. It takes 8-12 weeks
to make commercial antibodies. So right now, for the diagnostics tests they are
using PCR which give you a turnaround in 1-2 hours.
Treatment
No proven antiviral treatment.
With SARS, in 6 months
the virus was gone and it never came back.
Pharmaceutical companies
may not spend millions and millions to develop a vaccine for something which
may never come back.
Secondary infection, E
Coli, are most likely the cause of deaths of the patients in the Philippines
and HK.
A combination of lopinavir and ritonavir showed promise in lab in SARS
Combination of lopinavir, ritonavir and recombinant interferon beta-1b was
tried in MERS
Chloroquine had potent
antiviral activity against the SARS-CoV, has been shown to have similar
activity against HCoV-229E in cultured cells and against HCoV-OC43 both in
cultured cells and in a mouse model.
Thailand: Oseltamivir along with lopinavir and
ritonavir, both HIV drugs.
Experimental
drug: Rrom Gilead Sciences Inc., called remdesevir (started on 6th
Feb as a trial)
Russia and China drug: Arbidol,
an antiviral drug used in Russia and China for treating influenza, could be
combined with Darunavir, the anti-H.I.V. drug, for treating patients with the
coronavirus. {the corona virus shares some similarity to HIV virus also)
PVP-I mouthwashes and gargles significantly reduce
viral load in the oral cavity and the oropharynx. PVP-I has high potency for viricidal
activity against hepatitis A and influenza, MERS and SARS
The Drug Controller
General of India has approved the "restricted use" of a combination
of drugs (Lopinavir and ritonavir) used widely for controlling HIV infection in
public health emergency for treating those affected by novel coronavirus.
In SARS, people were put
on long term steroids ending with immunosuppression and late complications and
death. The current protocol is short term treatment.
Standard Respiratory droplets precautions
Self-quarantine
if sick with flu like illness: 2
weeks
Adherence: Strict
Soap and
water: Wash your
hands often and for at least 20 seconds.
Alcohol-based
hand sanitizer: if soap
and water is not available
Avoid
touching: Eyes, nose, and mouth with unwashed hands.
Avoid
close contact: (3-6 feet) with people who are sick with cough
or breathlessness
Cover
your cough or sneeze with a
tissue, then throw the tissue in the trash.
Clean and
disinfect frequently
touched objects and surfaces.
Surgical 3 layered Masks:
For patients
N 95 Masks: For health care providers and close contacts
Common Myths
1.
People receiving packages from China are
not at risk of contracting the new coronavirus as the virus does not survive
long on objects, such as letters or packages.
2.
There is no evidence that companion
animals/pets such as dogs or cats can be infected with the new coronavirus.
However, it is good to wash your hands with soap and water after contact with
pets. To prevent transmission of common bacteria such as E. coli and
Salmonella.
3.
Pneumococcal vaccine and Haemophilus
influenza type B (Hib) vaccine, do not provide protection against the new coronavirus.
4. Regularly
rinsing the nose with saline does not protect people from infection with the
new coronavirus or respiratory infections although it can help people recover
more quickly from the common cold.
5. There is
no evidence that using mouthwash will protect you from infection with the new
coronavirus although some brands or mouthwash can eliminate certain microbes
for a few minutes in the saliva in your mouth.
6. Garlic
is a healthy food that may have some antimicrobial properties, however, there
is no evidence that eating garlic protects people from the new coronavirus.
7. Sesame
oil does not kill the new coronavirus. Chemical disinfectants that can kill the
2019-nCoV on surfaces are bleach/chlorine-based disinfectants, either solvents,
75% ethanol, peracetic acid and chloroform. However, they have little or no impact on the virus
if you put them on the skin or under your nose. It can even be dangerous to put
these chemicals on your skin.
8. People of
all ages can be infected by the new coronavirus (2019-nCoV). Older people, and
people with pre-existing medical conditions (such as asthma, diabetes, heart
disease) appear to be more vulnerable to becoming severely ill with the
virus. WHO advises people of all ages to take steps to protect themselves
from the virus, for example by following good hand hygiene and good respiratory
hygiene?
9. Antibiotics
do not work against viruses, only bacteria.
Hence antibiotics should not be used as a means of prevention or
treatment of new coronavirus unless you suspect bacterial co-infection.
10. To
date, there is no specific medicine recommended to prevent or treat the new
coronavirus (2019-nCoV).
Trolls and conspiracy
theories: Not validated and are fake news
1.
The
virus is linked to Donald
Trump, and US
intelligence agencies or pharmaceutical companies are behind it.
2.
That
eating snakes, wild animals or drinking bat soup cases corona
3.
Keep
your throat moist, avoid spicy food and load up on vitamin C
4.
Avoiding
cold or preserved food and drinks, such as ice cream and milkshakes, for
"at least 90 days".
5.
Experts
have been aware of the virus for years.
6.
The
virus was part of China's "covert biological weapons programme" and
may have leaked from the Wuhan Institute of Virology.
7.
Linked
to the suspension of a researcher at Canada's National Microbiology Laboratory.
8. China
wants to kill 20,000 coronavirus patients is totally false. The site is linked
to a sex website.
Role of CMAAO and other Medical Associations
Get prepared for containment, including active
surveillance, early detection, isolation and case management, contact
tracing and prevention of onward spread of the virus and to share full
data with WHO. All countries
should emphasise on reducing human infection, prevention of secondary transmission
and international spread. Intensify IEC activities.
|
Country,
Territory
|
Total Cases
|
Feb 11
Cases
|
Total
Deaths
|
Feb 11
Deaths
|
Total
Recovered
|
Total
Severe
|
|
China
|
44,649
|
+2,011
|
1,113
|
+97
|
4,730
|
8,230
|
|
Japan
|
202
|
+41
|
|
|
4
|
|
|
Hong Kong
|
49
|
+7
|
1
|
|
|
|
|
Singapore
|
47
|
+2
|
|
|
9
|
7
|
|
Thailand
|
33
|
+1
|
|
|
10
|
1
|
|
S. Korea
|
28
|
+1
|
|
|
4
|
|
|
Taiwan
|
18
|
|
|
|
1
|
|
|
Malaysia
|
18
|
|
|
|
3
|
|
|
Germany
|
16
|
+2
|
|
|
|
|
|
Australia
|
15
|
|
|
|
5
|
|
|
Vietnam
|
15
|
+1
|
|
|
6
|
|
|
USA
|
13
|
+1
|
|
|
3
|
|
|
France
|
11
|
|
|
|
|
1
|
|
Macao
|
10
|
|
|
|
1
|
|
|
U.A.E.
|
8
|
|
|
|
1
|
1
|
|
U.K.
|
8
|
|
|
|
1
|
|
|
Canada
|
7
|
|
|
|
1
|
|
|
Philippines
|
3
|
|
1
|
|
2
|
|
|
Italy
|
3
|
|
|
|
|
2
|
|
India
|
3
|
|
|
|
|
|
|
Russia
|
2
|
|
|
|
|
|
|
Spain
|
2
|
|
|
|
|
|
|
Finland
|
1
|
|
|
|
1
|
|
|
Cambodia
|
1
|
|
|
|
1
|
|
|
Sweden
|
1
|
|
|
|
|
|
|
Sri Lanka
|
1
|
|
|
|
1
|
|
|
Nepal
|
1
|
|
|
|
|
|
|
Belgium
|
1
|
|
|
|
|
|
Total Cases of Novel Coronavirus (2019-nCoV)
|
Date
|
Total
Cases
|
Change
in Total
|
Change in
Total (%)
|
|
Feb. 11
|
45,170
|
2,071
|
5%
|
|
Feb. 10
|
43,099
|
2,546
|
6%
|
|
Feb. 9
|
40,553
|
3,001
|
8%
|
|
Feb. 8
|
37,552
|
2,676
|
8%
|
|
Feb. 7
|
34,876
|
3,437
|
11%
|
|
Feb. 6
|
31,439
|
3,163
|
11%
|
|
Feb. 5
|
28,276
|
3,723
|
15%
|
|
Feb. 4
|
24,553
|
3,925
|
19%
|
|
Feb. 3
|
20,628
|
3,239
|
19%
|
|
Feb. 2
|
17,389
|
2,837
|
19%
|
|
Feb. 1
|
14,552
|
2,604
|
22%
|
|
Jan. 31
|
11,948
|
2,127
|
22%
|
|
Jan. 30
|
9,821
|
2,008
|
26%
|
|
Jan. 29
|
7,813
|
1,755
|
29%
|
|
Jan. 28
|
6,058
|
1,477
|
32%
|
|
Jan. 27
|
4,581
|
1,781
|
64%
|
|
Jan. 26
|
2,800
|
785
|
39%
|
|
Jan. 25
|
2,015
|
698
|
53%
|
|
Jan. 24
|
1,317
|
472
|
56%
|
|
Jan. 23
|
845
|
266
|
46%
|
Daily Cases of Novel Coronavirus (2019-nCoV)
|
Date
|
Daily
Cases
|
Change
in Daily
|
Change in
Daily (%)
|
|
Feb. 11
|
2,071
|
-475
|
-19%
|
|
Feb. 10
|
2,546
|
-455
|
-15%
|
|
Feb. 9
|
3,001
|
325
|
12%
|
|
Feb. 8
|
2,676
|
-761
|
-22%
|
|
Feb. 7
|
3,437
|
274
|
9%
|
|
Feb. 6
|
3,163
|
-560
|
-15%
|
|
Feb. 5
|
3,723
|
-202
|
-5%
|
|
Feb. 4
|
3,925
|
686
|
21%
|
|
Feb. 3
|
3,239
|
402
|
14%
|
|
Feb. 2
|
2,837
|
233
|
9%
|
|
Feb. 1
|
2,604
|
477
|
22%
|
|
Jan. 31
|
2,127
|
119
|
6%
|
|
Jan. 30
|
2,008
|
253
|
14%
|
|
Jan. 29
|
1,755
|
278
|
19%
|
|
Jan. 28
|
1,477
|
-304
|
-17%
|
|
Jan. 27
|
1,781
|
996
|
127%
|
|
Jan. 26
|
785
|
87
|
12%
|
|
Jan. 25
|
698
|
226
|
48%
|
|
Jan. 24
|
472
|
206
|
77%
|
|
Jan. 23
|
266
|
133
|
100%
|
Total Deaths of Novel Coronavirus (2019-nCoV)
|
Date
|
Total
Deaths
|
Change
in Total
|
Change in
Total (%)
|
|
Feb. 11
|
1,115
|
97
|
10%
|
|
Feb. 10
|
1,018
|
108
|
12%
|
|
Feb. 9
|
910
|
97
|
12%
|
|
Feb. 8
|
813
|
89
|
12%
|
|
Feb. 7
|
724
|
86
|
13%
|
|
Feb. 6
|
638
|
73
|
13%
|
|
Feb. 5
|
565
|
73
|
15%
|
|
Feb. 4
|
492
|
66
|
15%
|
|
Feb. 3
|
426
|
64
|
18%
|
|
Feb. 2
|
362
|
58
|
19%
|
|
Feb. 1
|
304
|
45
|
17%
|
|
Jan. 31
|
259
|
46
|
22%
|
|
Jan. 30
|
213
|
43
|
25%
|
|
Jan. 29
|
170
|
38
|
29%
|
|
Jan. 28
|
132
|
26
|
25%
|
|
Jan. 27
|
106
|
26
|
33%
|
|
Jan. 26
|
80
|
24
|
43%
|
|
Jan. 25
|
56
|
15
|
37%
|
|
Jan. 24
|
41
|
16
|
64%
|
|
Jan. 23
|
25
|
8
|
47%
|
Daily Deaths of Novel Coronavirus (2019-nCoV)
|
Date
|
Daily
Deaths
|
Change
in Daily
|
Change in
Daily (%)
|
|
Feb. 11
|
97
|
-11
|
-10%
|
|
Feb. 10
|
108
|
11
|
11%
|
|
Feb. 9
|
97
|
8
|
9%
|
|
Feb. 8
|
89
|
3
|
3%
|
|
Feb. 7
|
86
|
13
|
18%
|
|
Feb. 6
|
73
|
0
|
0%
|
|
Feb. 5
|
73
|
7
|
11%
|
|
Feb. 4
|
66
|
2
|
3%
|
|
Feb. 3
|
64
|
6
|
10%
|
|
Feb. 2
|
58
|
13
|
29%
|
|
Feb. 1
|
45
|
-1
|
-2%
|
|
Jan. 31
|
46
|
3
|
7%
|
|
Jan. 30
|
43
|
5
|
13%
|
|
Jan. 29
|
38
|
12
|
46%
|
|
Jan. 28
|
26
|
0
|
0%
|
|
Jan. 27
|
26
|
2
|
8%
|
|
Jan. 26
|
24
|
9
|
60%
|
|
Jan. 25
|
15
|
-1
|
-6%
|
|
Jan. 24
|
16
|
8
|
100%
|
|
Jan. 23
|
8
|
0
|
0%
|
CMAAO Suggestions so far
1. 7th January: CMAAO Alert: WHO to monitor China's
mysterious pneumonia of unknown virus outbreak
2. 8th
Jan: CMAAO
warns Asian citizens travelling China over mystery pneumonia outbreak
3.
10th January: Editorial: Corona virus
strain causing pneumonia in Wuhan, China, It’s a new strain of corona
virus in the china pneumonia
4.
13th Jan: China Virus Outbreak
Linked to Seafood Market
5.
15th Jan: First Case China
Pneumonia Virus Found Outside China in Thailand
6. 17th
Jan: WHO
issues warning after 'mysterious' Chinese corona virus spreads to Japan
9. 18-20 Jan: Three countries CMAAO meet, also discussed
Corona virus
10. 22nd Jan: Still not being declared
to be a notifiable disease, N 95 to be included in the list of essential drugs
and prise capped, Oseltamivir, should also be prise capped, air flights
should have available air masks for all passengers, not declaring flu like
symptoms while boarding or landing should be a punishable offence (23rd
India advisory to airports)
11. 24th: Inter Ministerial Committee
needs to be formed on Corona Virus (PMO took a meeting on 24th
evening)
12. 25th Jan: Indian government should
pay for Indians affected with the virus in China
13. 26 Jan: Need of National droplet Infection
Control program, Policy to ban export of face masks, policy to evacuate Indians
and neighbouring countries from China affected areas, Time to collaborate on
Nosode therapy (Exports of masks banned on 31st January by Indian
Government) Action: [ Feb 1st:
Ibrahim Mohamed Solih thanked India for the evacuation of seven Maldivian
nationals from the coronavirus-hit Chinese city of Wuhan. India evacuated 647
people] [ on 30th India banned
gloves, PEP and masks but on 8th lifted the ban on surgical
masks/disposable masks and all gloves except NBR gloves. All other
personal protection equipment, including N-95 and equipment accompanying masks
and gloves shall remined banned.]
14. 27th Jan: History
of anti-fever drugs at airports should be taken
15. 28th Jan: Do research on Nosodes
16. 29th Jan: Closure of live markets all over
the world, India should take a lead
17. 30th
Jan: Paid flu leave, surgical mask at public places, N 95 for health care
providers
18. 31st
Jan: Respiratory hygiene advisory schools, Pan India task force to be made
19. 1st
Feb: Disaster Budget is the need of the hour
20. 3rd
Feb: 100 crore budget for Corona virus; Private labs to be recognised; one
dedicated corona National help line, MTNL BSNL to have a line of advisory in
their bills, isolation wards to be single rooms or two beds separated with six
feet distance, national insurance to cover cost of treatment, Sea ports to have same
precautions, prize caps for masks, and gloves, National droplet control
program, clarification that import of goods is not risky And suspend AI flights to China and Hong Kong [Feb 4 Air India on Tuesday suspended
flight services to Hong Kong from Friday until March 28. Earlier, Air India
had cancelled its flight to Shanghai from January 31 to February 14 and on 5th
Feb the Ministry of Defence is
setting up 10 new laboratories across the country, primarily to conduct
research on viruses]
21. 4th Feb: Kerala travel advisory needed [The Union Ministry of Health and Family Welfare issued a fresh travel
advisory on Monday urging people to refrain from visiting China]
22. 5th Feb: PM should talk about
Corona in Man Ki Baat or a special address
24. 7th
Feb: IPC 269 should be applicable to corona virus
25. 8th Feb: teleconsultation should be
allowed to flu and corona consultation
