Karo na panic

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Karo na panic

Sunday, 08 March 2020 | Shalini Saksena / Musba Hashmi

Karo na panic

Coronavirus aka COVID-19 is raging world over and has recently breached the Indian borders too. For a high population density nation like India, this could be catastrophic. However, experts feel this is no time to panic but just to be cautious. SHALINI SAKSENA and MUSBA HASHMI find out how the upcoming warm weather, staying out of big gatherings and simple hygiene can help save the day

Delhi-NCR is in panic mode. More so, since it has been raining for the past two days and Delhiites have been taken up by the idea that the virus doesn’t live if the temepratures rise abover 26-27 degree C. However, the truth of the matter is that there is no need for panic or rush to hoard masks which is a must only for caregivers  and the patients themselves. Then there are the numbers that point to the fact that there is no need of fear. Unlike SARS that had a mortality rate of 10 per cent, for COVID-19 is just 3.4 per cent.

It started when a pneumonia of  unknown cause detected in Wuhan, China was first reported to the WHO Country Office in China on December 31, 2019. The outbreak was declared a Public Health Emergency of International Concern on January 30, 2020. Since then 96,251 cases have been detected golbally; 3,303 people have died and 53,708 have recovered. The coronavirus (COVID-19) has affected 86 countries and territories around the world and one international conveyance — the Diamond Princess cruise ship harbored in Yokohama, Japan). This cruise ship has 16 Indians onboard.

Back in India, there was a calm till the first three cases came to light in Kerala. Fortunately, they recovered. But it made the country vulnerable and rightly so. The first case of COVID-19 in the Capital came to light on March 2, 2020. The fallout? Two schools in Noida were shut even as new cases continue to come to fore, the latest being a Gurugram PayTM employee who had recently been to Italy, one of the worst hit countries.

While some are comparing this virus to SARS, doctors have a slew of measures and advice for the people. According to Dr Om Shrivastav, director, Infectious Diseases, Jaslok Hospital and Research Centre, Mumbai tells you the situation is being evaluated in the country. “There have been some people who have tested positive. There are a few simple things that people need to follow to prevent the spread of this disease. First, be adequately hydrated. Drink at least three to four litres of water every day. Make sure that you wash your hands at regular intervals with soap and water. Those who can’t wash hands, they can simply rub an alcohol-based hand sanitizer or wipe. If a person is tested positive, it is important that the tissues and handkerchiefs are disposed of responsibly in order to prevent the spread,” Shrivastav explains.

Dr Hirenappa Udnur, Consultant Pulmonologist, Columbia Asia Hospital,  Hebbal, Bengaluru, tells you that one of the simplest ways of disposing of the tissues used by infected patients and anybody displaying signs of infection is by throwing it in a closed bag and into a closed dustbin.

Shrivastav tells you that sanitisers have a very important role to play; to keep the hands as clean as possible. He also tells you that any surface that one touches is a potential source of givng one an infection hence the need for frequent handwashing. This is because the COVID-19 settles on surfaces for a limited period of time. “In needing to ensure that one is cleaning the hands every time you touch that may or may not be infected; this can include any surface from a tray to a table to a door knob and even elevator buttons — all of these are likely to carrying the virus and hence clean the hands,” Shrivastav says.

He strickly advises people against wearing a mask unless one is a caregiver to a sick patient. There is, he says, no scientific evidence that mask is going to act as a protection against the virus.

Dr Ron Diskin, Department of Structural Biology, Weizmann Institute of Science in Israel tells you that the new SARS-like coronavirus (SARS-CoV-2) that emerged in China in December is rapidly spreading and efforts for stopping or slowing down the spread of the virus could have a substantial impact on our everyday life routines.

“Like in any other infectious disease, isolating individuals who contracted the virus is the most effective way of achieving control. However, some people that contract SARS-CoV-2 will develop only a very mild sickness or will not become sick at all, an attribute that substantially complicates the effort of controlling the spread of the virus, as these individuals may go unnoticed and unintentionally transmit the virus to others. Hence, high personal hygiene is needed to reduce the risk of contracting the virus — specifically, frequent washing of the hands and avoiding touching our mouth, nose, eyes, and ears,” Diskin opines.

But he tells you that while such changes in personal behaviour could make a real impact on the spread of the virus, it will not be feasible to maintain them for a long period of time adequately. A more fundamental solution is required, and the most desired one would be an effective vaccine. “Many vaccine platforms and technologies were previously developed and could now be adapted to combat SARS-CoV-2. One promising approach is to use a replicating unrelated viral vector that will be engineered to display a protein of SARS-CoV-2 on its surface. This approach was utilised to design Ervebo, the first anti-Ebola vaccine that was recently approved for use. Besides vaccines, there is a great effort to test off-the-shelf drugs like Remdesivir (Gilead Science) for treating patients, as well as to develop more targeted therapeutics. While such therapeutics will almost certainly become available, it will take an unknown amount of time until they could be usedin our fight against this virus,” he says.

To give a sigh of relief to the people, Ministry of Ayush has come up with a drug, Arsenic Album 30, to tackle the virus. However, there is no proven evidence to show the drug’s effectiveness.

Dr Kushal Banerjee from Dr Kalyan Banerjee’s Clinic, says that since this is a novel virus, there is an absence of strong evidence demonstrating specific efficacy of any drug in any system of medicine for the treatment or prevention of COVID-19. “Homeopathic prescriptions work on the analysis of symptoms and Arsenic Album 30 was arrived at by the study of the symptoms that this virus produces. At our practice we are advising the use of Eupatorium Perfoliatum 30 and Lycopodium 30, once a day for two weeks. It is important to remember that in the absence of any evidence supporting the treatment or prevention of COVID-19, these medicines are being advised based on their efficacy in the management of other similar viral infections. It is also important to emphasise that consumption of any homeopathic medicines should not be taken as assured protection from infection. It is also irresponsible for anyone to suggest this. As in any other infection, we must remember that all other protective measures must be taken. Any behaviour that may increase risk of infection must be strictly discouraged under all circumstances,” he tells you.

What I’m doing for the COVID-19 pandemic: Molecular virologist

Dear Colleagues, as some of you may recall, when I was a professor of pathology at the University of California San Diego, I was one of the first molecular virologists in the world to work on coronaviruses (the 1970s).

I was the first to demonstrate the number of genes the virus contained. Since then, I have kept up with the coronavirus field and its multiple clinical transfers into the human population (eg: SARS, MERS), from different animal sources.

The current projections for its expansion in the US are only probable, due to continued insufficient worldwide data, but it is most likely to be widespread in the US by mid to late March and April.

Here is what I have done and the precautions that I take and will take. These are the same precautions I currently use during our influenza seasons, except for the mask and gloves:

NO HANDSHAKING! Use a fist bump, slight bow, elbow bump

Use ONLY your knuckle to touch light switches, elevator buttons. Lift the gasoline dispenser with a paper towel or use a disposable glove.

Open doors with your closed fist or hip, do not grasp the handle with your hand, unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors.

Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.

Wash your hands with soap for 10-20 seconds and/or use a greater than 60 per cent alcohol-based hand sanitizer whenever you return home from any activity that involves locations where other people have been. Keep a bottle of sanitizer available at each of your home's entrances. and in your car.

cough or sneeze into a disposable tissue and discard. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!

What I have stocked in preparation for the pandemic spread

Latex or nitrile latex disposable gloves for use when going shopping and all other outside activity when you come in contact with contaminated areas.

Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! But all the surfaces where these droplets land are infectious for about a week on average - everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon.

This virus only has cell receptors for lung cells. The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.

Stock up now with disposable surgical masks and use them to prevent you from touching your nose and/or mouth (We touch our nose/mouth 90X/day without knowing it!).

The mask will not prevent the virus in a direct sneeze from getting into your nose or mouth it is only to keep you from touching your nose or mouth.

Stock up with zinc lozenges. These have been proven to be effective in blocking corona virus from multiplying in your throat and nasopharynx. Use as directed several times each day when you begin to feel any "cold-like" symptoms. It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx. Cold-eeze lozenges is one brand available, but there are other brands available.

I, as many others do, hope that this pandemic will be reasonably contained, But I personally do not think it will be. Humans have never seen this snake-associated virus before and have no internal defence against it.

Tremendous worldwide efforts are being made to understand the molecular and clinical virology of this virus. Unbelievable molecular knowledge about the genomics, structure, and virulence of this virus has already been achieved. But there will be no drugs or vaccines available this year to protect us or limit the infection within us. Only symptomatic support is available.

The advisory is by James Robb, Coronavirus expert and former professor of pathology at the California University, San Diego

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