Uncategorized

By Dr. Neeraj Nischal Associate Professor, Department of Medicine , AIIMS & Dr. Sujay Halkur Shankar,Department of Medicine, AIIMS

The festive season is here, and so is winter. With all of us stranded at home for most of the year, the desire for celebration and social gathering is climbing. We are all eagerly waiting for the distribution of COVID vaccines, so we may gain immunity and go about our lives as in the pre-COVID era. Vaccine development and immunization is, however, time-consuming. Thus, while the scientific community works on a biologic solution, we must continue to take part in the practice of the ‘social vaccine’. The COVID-19 social vaccine includes social distancing, hand hygiene, face masks, and isolation. Since the discovery of the mode of spread of the SARS-CoV-2 virus, these measures have been widely popularized. Over the last 9 months, COVID fatigue has set in in all of us, and there has been a laxity in the practice of the laid down COVID appropriate behavior. Without reinforcement, this will only worsen.

We are currently in the unlock process after a long lockdown phase. At this time, the number of cases in certain parts of India are again on the rise. The disease is just as, if not more rampant in its spread and has not heeded to our efforts of lockdown. Social vaccination is still the only way to safeguard ourselves. The virus will enter our homes if we falter and permit it. It is up to us to keep ourselves and those around us safe and healthy.

To elaborate the measures yet again, social distancing includes a physical distancing of individuals by at least 6 feet. We do not have to be socially or emotionally distant in these times, just physically distant. We have been blessed with technology to bring the world closer. Utilization of these online platforms will help us socialize when we have to practice social distancing. Washing your hands with soap and water (or alcohol hand rubs) for at least 20 seconds, frequently, will keep you from spreading the virus by touch. Let us strengthen the Indian tradition of ‘Namaste’ and say no to handshakes. Face masks will not only protect you from COVID, but other winter viruses like the common cold and influenza. Most importantly, remember to be socially vigilant and isolate yourself if you are symptomatic.

A vaccine is not a magic bullet to end the pandemic. The introduction, logistics, and effects of vaccination is a drawn-out process. Even with a sound biological vaccine, social vaccination is still the most important aspect of disease prevention. The two should go hand-in-hand to control the disease, and are not mutually exclusive. Both the above would need staggering community participation, with the social vaccine requiring full and conscious effort of the entire population, without which it is bound to fail. The fate of the pandemic rests in the hands of each and every one of us. Here’s to celebrating the festive season the way it was meant to be; with lamps and good will.

The writer is Dr. Neeraj Nischal, Associate Professor, Department of Medicine , AIIMS and Dr. Sujay Halkur Shankar,Department of Medicine, AIIMS

The National Centre for Disease Control has warned Delhi that Delhi needs to be prepared for fresh 15,000 cases of Covid-19 per day during the winter season. Delhi may go for another lockdown as a surge in Covid-19 positive cases.

In a statement given by Delhi CM Arvind Kejriwal has said that if required then Delhi Govt can implement shutting down markets for few days that have a “potential of becoming hotspots” .

“Since cases are rising in Delhi, we are sending a general proposal to Central Govt, that if required, Delhi Govt can implement shutting down those markets for few days, where norms are not being followed & they are becoming a local Covid-19 hotspot.”

The Delhi govt has also significantly ramped up testing in the past few days.

Delhi CM Arvind Kejriwal has also appealed to people to take necessary precautions “I appeal all to wear masks & follow social distancing.” said Arvind Kejriwal,CM,Delhi

Now the gathering in marriages have been also reduced from 200 people to 50.

India reports 29,164 new COVID-19 cases in last 24 hours. The total cases mounts to 88,74,291 and total number have deaths reported in last 24 hours is 449 .According to the Union Ministry of Health and Family Welfare the total active cases are 4,53,401 .

Total number sample tested – ICMR

According to Indian Council of Medical Research (ICMR) the total number of samples tested in 24 hours are 8,44,382.

According to the data given by the Government of Delhi India reports 3,797 new positive cases and 99 deaths are reported in Delhi in the last 24 hours. The total number of COVID19 cases in Delhi stands at 4,89,202 that includes more than 40,000 active cases i.e 40,128 active cases and 7,713 deaths form the time of outbreak of Coronavirus(COVID-19).

Delhi has crossed earlier more than 8,000 COVID-19 positive cases that has raised serious concern and many challenges for the government of Delhi. As per Data Delhi is taking 4 lives every four hours.

India is in dialogues with all the vaccine-making companies Modera, Pfizer, Serum, Zydus Cadila, and Bharat Biotech over the progress on clinical trials, safety, immunogenicity, and efficacy, official sources.

After Pfizer and BioNTech , Moderna a U.S. giant drug maker company has announced that the independent,NIH – appointed Data Safety Monitoring Board (DSMB) for the phase – 3 study of mRNA-1273 has shown to have an efficacy of 94.5%.This study is known as the COVE study and enrolled 30,000 participants in the U.S.

“This is a pivotal moment in the development of our COVID-19 vaccine candidate. Since early January, we have chased this virus with the intent to protect as many people around the world as possible. All along, we have known that each day matters. This positive interim analysis from our Phase 3 study has given us the first clinical validation that our vaccine can prevent COVID-19 disease, including severe disease,” said Stéphane Bancel, Chief Executive Officer of Moderna

According to the sources India is in dialogues with all the vaccine making companies Modera, Pfizer, Serum , Zydus Cadila and Bharat Biotech over the progress on clinical trials, safety , immunogenicity and efficacy .

Bharat Biotech starts Phase III trials for COVAXIN.Bharat Biotech’s Phase-3 trials will involve 26,000 volunters from 25 centres in India.It’s the largest clinical trial that will be conducted in India .The volunteers will receive two intramuscular injections in a gap of 28 days.
According to Sushitra Ella , Joint Managing Director of Bharat Biotech “The development and clinical evaluation of COVAXIN™ marks a significant milestone for vaccinology in India, for a novel vaccine. It is important for Indian companies to innovate and develop indigenous vaccines, especially during a pandemic. COVAXIN™ has garnered interest from several countries worldwide for supplies and introduction.”
The 25 centers where phase – 3trials will be conducted are as follows

1. Bhubaneswar IMS SUM hospital
2. New Delhi Guru Tej Bahadur Hospital
3. Mumbai Grant Government Medical College and Sir J.J. Group of Hospitals
4. Guntur Guntur Medical College
5. Bhopal Gandhi Medical College
6. Ahmedabad Gmers Medical College and Civil Hospital
7. Uttar Pradesh Aligarh Muslim University
8. Hyderabad Nizams Institute of Medical Sciences
9. Rohtak Pandit Bhagwat Dayal Sharma University of Health Sciences
10. Goa Redkar Hospital and Research Centre
11. Guwahati institute of medical sciences
12. Faridabad ESIC hospital
13. New Delhi AIIMS
14. Mumbai Lokmanya Tilak Municipal General Hospital And Medical College (Sion Hospital)
15. Nagpur Rahate hospital
16. Patna AIIMS
17. Pondicherry MG Medical College, Sri Balaji Vidyapeeth
18. Bangalore Vydehi institute of medical sciences
19. Vizag King Gorge Hospital
20. Bhopal People’s University
21. Kolkata ICMR-National Institute of Cholera and Enteric Diseases
22. Chennai Directorate of Public Health and Preventive Medicine, Teynampet

At the time of crisis when people are losing jobs, not getting salaries timely and students who want to go for medical education are forced to change their field in the middle of all this crisis due to Covid-19 the decision by the Karnataka government to allow an increase of fees for medical and dental seats has raised serious concern for aspiring students. The fees for medical seats in Private and colleges will be increased by 15% for dental seats also.

The total hike of fee for government quota in private colleges is raised from Rs 1,11,952 to Rs 1,28,746 that means total hike will Rs 16,794 for MBBS seats and from Rs 72,484 to Rs 83,356 for dental seats.

For institutional seats the fee hike will be raised by 25% that means from 7,85,565 to Rs 9,81,956 hike of Rs 1,96,391 for MBBS.

According to the Union Health Ministry in last 24 hours India has reported 30,548 new COVID-19 cases. India has total rise to 88,45,127 Covid-19 cases and 435 new deaths have been reported.

Total number of sample testing for COVID-19 – ICMR

The data shared by Indian Council of Medical Research(ICMR) for COVID-19 up to 15th November is 8,61,706.

As per Union Health Ministry Indian is reporting lowest cases per million population.

In a review meeting on Delhi increasing Coronavirus (COVID-19) cases Union Home Minister has said that some of the hospitals that come under MCD will get converted into the COVID hospitals, Doctors, Paramedics, and paramilitary forces will be deployed in the hospitals, and National capital to deal with the shortage of manpower. He also said that to deal with the increasing Covid-19 cases number of ICU beds and health equipments will also get increased hospitals to save lives.

The high-level meeting was attended by Union Health Minister Dr.Harsh Vardhan, LG Anil Baijal, and Chief Minister Arvind Kejriwal. The RT-PCR tests to be doubled, Mobile Testing Vans to be deployed at vulnerable spots of Delhi and retired nurses, docs to be employed in Covid-19 dedicated hospitals.

By Dr.Abhishek Shankar, Assistant Professor in the Department of Radiation Oncology at Lady Hardinge Medical College & SSK Hospital, Delhi,

Clear blue skies in Delhi was not a usual expectation but viewing it during lockdown, was the most positive side of this pandemic. According to World Health Organisation (WHO) latest report Air pollution kills 7 million people every year and most of them are from developing nations.

India is suffering severe ambient air pollution in recent decade and particulate matter (PM) has become the major pollutant, which have highly raised doctors, researchers and policy-makers attention in last few years. The highest values are observed in winter among in many cities of the country. People have started knowing and noticing value of air pollution indicators to understand the severity of air pollution. An air quality index (AQI) is used by Government to communicate to the general population how polluted the air currently or how polluted it is forecast to become. There is a major impact on human health if AQI is on rise and the exposure is for longer duration. Different countries have their own air quality indices, corresponding to different national air quality standards like, Air Quality Health Index in Canada, the Air Pollution Index in Malaysia, and the Pollutant Standards Index in Singapore.

The proposed National AQI in India take eight pollutants (PM₁₀, PM_2.5, NO₂, SO₂, CO, O₃, NH₃, and Pb) into consideration. PM 2.5 and 10 refer to atmospheric particulate matter (PM) that have a diameter of less than 2.5 and 10 micrometres respectively.

As per the severity, AQI has been categorised into 6 categories like, good (between 0 and 50), satisfactory (51 and 100), moderate (101 and 200), poor (201 and 300), very poor (301 and 400) and severe (400 and 500). The air quality of Delhi-NCR region is continuously falling in severe category as per the Central Pollution Control Board (CPCB) data and is showing no signs of abating. Delhi has been recording PM2.5 particles value at 14 times over the World Health Organisation safe limit in winters.

This severe air quality is contributed by stubble burning in neighbouring states, vehicular pollution, pollution from construction sites and factories festive fireworks and low wind speed conditions. We have been debating on very similar issues for last many years and intervention like odd and even vehicle pass have been tried but nothing worked. might experience symptoms like wheezing, coughing, chest tightness, and difficulty in breathing when PM_2.5 levels are high and this is more profound in people with heart or lung conditions.

COVID-19 symptoms are overlapping with symptoms associated with air pollution, adding more worries, confusion, fear and anxiety to general population. In addition to it, air pollution has significantly worsened the Covid-19 outbreak leading to more deaths. One recent study by Harvard University found that even small increases in fine particulate matter, known as PM2.5, have had an outsized effect in the US.

Long-term exposure to chronically high PM2.5 levels weakens the ability of the lungs to clear off infections due to compromise in immunity, making general population more prone to acquire COVID-19. In addition, traces of SARS-CoV-2 RNA, the genetic material of the virus, can be found on pollution particles, meaning that increased air pollution may act as a vehicle to increase Covid-19 transmission in highly polluted places.

The most effective long-term approaches are directed towards better ventilation and air purification to ensure better air quality at home. Air Purifiers must cross everyone mind, when shopping for the festive season in India keeping air pollution and its effects in mind but there are not enough evidence to support  

.

Delhi is witnessing a severe air quality these days and this situation is worst news for fight against COVID-19. There is a need for strict regulation and enforcement for protection of air quality to prevent worst outcome from COVID-19 and air pollution as there is growingg evidence of the linkages between poor air quality and negative health outcomes.

The writer of article is Dr.Abhishek Shankar, Assistant Professor in the Department of Radiation Oncology at Lady Hardinge Medical College & SSK Hospital, Delhi,