Wuhan Coronavirus Resource Thread

Guddu · Post by **Guddu** » 30 Mar 2020 00:34

putnanja wrote:From Anand Ranganathan on twitter. Gives link to a paper claiming that mortality rates are lower in countries where compulsory BCG was practised for a long time

Anand Ranganathan
@ARanganathan72
·
6m
Preliminary evidence but I congratulate
@dasgobardhan
dada, India's top immunologist. He told me the exact same TWO weeks ago.

Paper just out today (non-peer-reviewed) establishes a correlation between CoVID19 cases/deaths and BCG vaccination.
MUST-READ. https://medrxiv.org/content/10.1101/202 ... 1.full.pdf

Looks like a case of correlation is causation. There could be several other factors, sunlight, temperatures etc. Have to see where the study gets finally published after peer review.

sanjaykumar · Post by **sanjaykumar** » 30 Mar 2020 00:43

One can postulate latent TB, previous TB exposure may also be protective.

saip · Post by **saip** » 30 Mar 2020 01:00

Looks like it is common in India to administer BCG vaccine and others like polio in the hospital itself at the time of birth. Let us hope BCG DOES give protection and India dodges the bullet.

nam · Post by **nam** » 30 Mar 2020 01:28

Is BCG the reason for lower effect of the Chinese virus on kids?

I always wondered how immune system of kids seems to be able to contain the virus better than a grown up? where as technically their immunity is not as "experienced" compared to a grown up.

vijayk · Post by **vijayk** » 30 Mar 2020 01:44

http://misiones.minrex.gob.cu/es/articu ... oronavirus
Interferon alfa 2B: The Cuban medicine used in China against coronavirus.

The medicine is one of about 30 drugs chosen by the Chinese National Health Commission to cure the respiratory condition and, according to statements on Cuban television by Dr. Luis Herrera Martínez, scientific and commercial advisor to the President of BioCubaFarma, his selection It is due to the effectiveness shown previously against viruses with similar characteristics.
"It has the advantage that in situations like these it is a mechanism to be able to protect itself, its use prevents patients with possibilities of aggravating and complicating from reaching that stage, and finally having death as a result," said the specialist.
Herrera Martínez said that a technology transfer was made to Jilin province years ago, from which the Chinese-Cuban ChangHeber plant, in the town of Changchun, emerged. In this factory “the same product as us is made, with exactly the same technology, and that responds to the quality standards that were approved by the Chinese and Cuban regulatory authorities”.
«The Chinese-Cuban Changheber plant in Jilin has been producing Interferon alpha (IFNrec) from the first day of the Lunar New Year with the use of Cuban technology. The Health Commission of China has selected our product among those used in the fight against coronavirus, ”confirmed the Presidency of Cuba on its Twitter account.
According to the Cuban ambassador to China, Carlos Miguel Pereira, the Changheber mixed plant began the preparation of the Cuban drug since January 25, taking into account "its potential to cure the respiratory condition."

Karan M · Post by **Karan M** » 30 Mar 2020 01:51

http://www.newsonair.com/News?title=DRD ... &id=384143
DRDO to soon equip frontline Health personnel with advanced ventilators, face masks, PPEs to fight Corona

In a force multiplying move, the Defence Research and Development Organisation (DRDO) will soon equip the frontline Health personnel of the country with advanced ventilators, face masks and Personal Protection Equipments in their fight against spread of novel Coronavirus.

DRDO Chairman Dr G Sateesh Reddy informed our Hyderabad Correspondent that many of them will be made available in next couple of days to health professionals. Stating that many technologies have been transferred to the industry, he said, the DRDO has developed a technology to use one ventilator for multiple patients.

He further informed that the DRDO is helping the Industry to produce certain components and large number of ventilators will be produced in next few weeks with Bharat Electronics limites (BEL) and a couple of other Industries.

Dr Reddy said, the DRDO has developed five layered N-99 masks and offered technology to the Industry to produce in large scale. He held a meeting with 800 industry representatives through Video Conference. He further said the technology relating to the PPEs has also been offered to Industry for production in large quantity.

Stating that the DRDO has produced surgical face masks in emergency and distributed to Delhi police, Mr Reddy said, 3D printing face masks will be produced for police and health workers.

Dr Sateesh Reddy also informed that Sanitizing Vans will also be produced soon in considerable numbers and they will be supplied to major cities and towns for sanitizing people who enter the van. Similarly, he said, technology relating to Oxygen Tubes is also being worked on among other technologies and they also will be produced soon.

Karan M · Post by **Karan M** » 30 Mar 2020 01:54

Livemint

India’s leading passenger vehicle manufacturers, Maruti Suzuki India Ltd and Hyundai Motor India Ltd on Saturday announced their plans to help scale up the production of ventilators and testing kits available to fight the coronavirus (COVID-19) outbreak.

Maruti Suzuki has decided to manufacture 10,000 ventilators in collaboration with AgVA Healthcare, an existing approved manufacturer of ventilators.

Hyundai, on the other hand, will import testing kits from South Korea to help 25,000 patients. “AgVa Healthcare would be responsible for the technology, performance and related matters for all the ventilators produced and sold by them.

Maruti Suzuki would use its suppliers to produce the required volume of components and use its experience and knowledge to upgrade systems for the production and quality control of the higher volumes. Any other assistance required would also be provided,” said Maruti in a press release issued on Saturday. Maruti will also help in providing financial aid for such operations.

Some of the its suppliers like Bharat Seats Ltd and Krishna Maruti Ltd will also help in production of masks and protective clothing for state and central government employees.

The Indian government, on March 24, reached out to the five automobile manufacturers – Tata Motors Ltd, Mahindra and Mahindra Ltd, Hyundai Motor India Ltd, Honda Cars India Ltd and Maruti Suzuki India Ltd – to explore the possibility of manufacturing ventilators at the factories of these companies in collaboration with nine existing ventilator manufacturers.

Hyundai, through its domestic corporate social responsibility (CSR) arm, Hyundai Motor India Foundation, has given an immediate order to import COVID-19 advanced diagnostics testing kits from South Korea which will be shared with hospitals in different states. “Hyundai as a caring brand has been at the forefront in community services. As part of our global direction ‘Progress for Humanity’, Hyundai is committed to support Government of India’s spirited fight against COVID-19 crisis. Our contribution towards advanced diagnostics testing kits will help over 25000 patients,” said S S Kim, managing director, Hyundai India.

Karan M · Post by **Karan M** » 30 Mar 2020 02:01

https://www.tribuneindia.com/news/drdo- ... eces-62789

The Defence Research and Development Organisation (DRDO) has designed a casualty evacuation bag to evacuate persons infected with coronavirus. The bag is water and air-proof and designed to deal with biological agents.

“The design of the bag was finalised this week and DRDO will be procuring an initial lot of 500 such bags,” a senior DRDO official said.

“We are looking at the private industry, which has expertise in this field, to manufacture them,” he added.

DRDO’s Defence Bioengineering and Electromedical Laboratory (DEBEL), which researches aero-medical engineering and life support equipment and Nuclear Chemical and Biological (NBC), protection systems, has developed this bag.

According to DRDO sources, the bag, in the shape of a rigid cylinder, is made of non-woven, water-repellant fabric with air and waterproof zippers as well as a ventilator. It is coated with a film to cater to a Chemical, Biological, Radiological and Nuclear (CBRN) environment with requisite protection against blood and viral penetration.

The size and shape of the COVID casualty evacuation bag is akin to a fabric chamber developed by DEBEL in the aftermath of the 1999 Kargil conflict to manage patients affected with High Altitude Pulmonary Odema (HAPO). The chamber is airtight and simulates air pressure that is prevalent at lower altitudes while evacuating patients from high altitude.

DRDO has been tracking the spread of COVID-19 since the first reports of its outbreak in China’s Wuhan Province. It took a call in the first week of March to enhance efforts for creating counter-measures and creating a mass supply solution of critical medical requirements if COVID-19 becomes a crisis.

A protective body suit developed earlier by DRDO’s Institute for Nuclear Medicine and Allied Sciences for medical and paramedical staff to manage and evacuate causalities in the event of CBRN emergencies, has now been adapted for use by medical staff and health workers engaged in combating COVID-19. Over 10,000 such suits are being produced every day by private manufacturers and production is expected to be ramped up further with more private players joining hands.

Critical care ventilators, advanced, 5-layer N-99 face masks and hand sanitizers are other products developed by DRDO laboratories are now being mass-produced by the industry to mitigate the COVID-19 threat.

Karan M · Post by **Karan M** » 30 Mar 2020 02:02

DRDO HAPO chamber
http://rakshapolycoats.com/products-and ... o-chamber/

Army ordered 3000 and as a result High alt sickness issue in Siachen etc has more or less been addressed completely
http://forcebharat.blogspot.com/2008/04 ... fight.html

Karan M · Post by **Karan M** » 30 Mar 2020 02:09

http://theshillongtimes.com/2020/03/29/ ... i-scanner/

SHILLONG: Indian researchers including an associate professor from NEHU are working actively in developing an Artificial Intelligence (AI)-based T-Ray scanning unit to address the limitation of infrared thermal scanner in accurate and early detection of COVID-19 patients.
Dr. Moumita Mukherjee, Associate Dean, Adamas University (Kolkata), & formerly associated with DRDO centre and Dr Dinesh Bhatia, Associate Professor- Biomedical Engineering Department of North Eastern Hill University (NEHU), Shillong and their collaborative research group are working on a product which will be cost-effective, allowing quick diagnosis with accurate in screening and monitoring of mass population.

As per Mukherjee & Bhatia, the unique absorption fingerprint of T-Ray radiation in lungs and the contrast thermal image of affected and healthy lungs will help the doctors and paramedical staff to identify such cases at an early stage, when the patient is apparently asymptomatic and not showing any symptoms.

Their extensive research is showing a ray of hope in easy identification followed by safe monitoring of COVID-19 patients worldwide. They acknowledge the support of their respective institutions for providing desired support to carry out this research.

Since Terahertz is non-ionizing in nature, its repetitive use in scanning / imaging for screening and monitoring will be harmless to the population and its users such doctors, paramedical staff and other security staff in the vicinity in comparison to using X Ray or CT scan device as both are considered to be ionizing in nature and can cause cancer if repeatedly used for testing on COVID-19 patients in future.

The use of terahertz (THz) device will be more effective in getting desired reliable information compared to the existing thermal scanners and is considered as the most exciting application offered by the THz technology due to its size, ease, cost-effectiveness, and portability of terahertz-imaging unit.

IndraD · Post by **IndraD** » 30 Mar 2020 02:52

some information re testing in India
~ 18 / million tested (we need to test more)
There is no state or city wise break up ? Or can some one find one!
~There should be a central data collation.
-MH & Kerala on expected lines have highest no. of nCV + cases cos they have Gulf returned Muslim crowd!
-1200 missing from quarantine in MH alone & many making VIP tours in Kerala ready to tank India's fate.
-This needs to be ironed out.
-God is still with India .....

no. of tests directly correlates with no. of lives saved

Mort Walker · Post by **Mort Walker** » 30 Mar 2020 03:43

IndraD,

This site has a breakdown by state and district. It also has a cluster map showing actual patients since the total is around 1139 cases and 1022 active cases:
https://www.covid19india.org/

Also check the Ministry of Health at: https://www.mohfw.gov.in/
GoI has screened over 1.5 million international air travelers since early February.

We will know by Wednesday as to how well the 21 day lockdown is going as it will mark 7 days in.

sgrover · Post by **sgrover** » 30 Mar 2020 03:48

Mollick.R wrote:Does it makes sense ??????

I don't think it makes sense, because there is time lag if approx 14 days from infection of person to that person showing up as infected person in govt. records.........

In the paper that I posted, they've modelled asymptomatic infected people, who will never show up in records because they'll never have symptoms. But once the lockdown ends, they'll start spreading the inflection. The infection + recovery rate for this group of people matters. They, too, have predicted a drop in the number of inflected individuals once the lockdown starts, only to rise again after it ends.

Edit: My previous explanation based on a cursory reading was not correct. They assume that inflected people will resume social contact after the lockdown ends and the large growth after 21 days is simply because the number of inflected people hasn't reduced sufficiently. If, at the end of 21 days, the inflected people are all in hospital or isolated, there will not be a sudden growth after the end of the lockdown as they predict.

Its a mathematical model and is bound to have its limitations, but is the only one I found which models the lockdown.

Karan M · Post by **Karan M** » 30 Mar 2020 04:01

https://in.news.yahoo.com/not-enough-ve ... 07389.html

According to industry sources, average demand for ventilators in India is about 8,000 pieces a year. (Representational image)

To ramp up ventilator capacity, not only have state-owned PSUs such as Bharat Electronics been working closely with private medical equipment suppliers, but large Indian corporates such as the Tata Group, Mahindra, and Maruti Suzuki Ltd, too have made quick plans to start production of ventilators.

According to industry sources, average demand for ventilators in India is about 8,000 pieces a year. However, with the number of COVID-19 cases rising, the country might need anywhere between 1,10,000 and 2,20,000 ventilators by May 15 in the worst-case scenario, according to an analysis by think tank Brookings India.

The government is pulling all stops in the procurement of ventilators — Bharat Electronics Ltd, a PSU under the Ministry of Defence, is in the process of manufacturing 30,000, while another 10,000 will come from HLL Lifecare Ltd, a PSU under the Health Ministry. The Integral Coach Factory in Chennai, makers of Train 18, is also attempting to manufacture ventilators.

“We are in the process of procuring adequate ventilators. One PSU is manufacturing 10,000 while Bharat Electricals is manufacturing 30,000,” Joint Secretary Lav Agarwal said.

Government sources said there were 14,220 ICU ventilators now (cumulative capacity of state hospitals). In addition to this, in hospitals (mostly state government) dedicated for management of COVID-19 patients, there are about 6,000 ventilators.

Karnataka-based medical equipment supplier Skanray Technologies is working with BEL to simplify the design of ventilators, and also with Tata Motors and Mahindra and Mahindra to fast-track production. The simplified model would help the firm overcome hurdles like sourcing imported components, so that it is able to service a surge in demand.

Maruti Suzuki India Ltd has also announced an arrangement with Noida-based AgVa Healthcare to “rapidly” scale up production of ventilators. “The intention is to reach a volume of 10,000 units per month,” the company said in a statement.

Vishwaprasad Alva, Founder and MD, Skanray, said the company can boost its production to 5,000 units in one batch. “Skanray alone cannot scale up production, so we have Bharat Electronics now, which has 10,000 employees and a very large factory in Bangalore. They were one of the first to contact us and offer their facility. Their designers are already in Skanray and production has already been launched there,” Alva said.

“We also have the Mahindra and Mahindra engineering team here... We are working out three different approaches to respond to the emergency. Yesterday, the Tata chairman called and we expect to have their team here in a couple of days as well,” Alva said.

While the three firms would provide three parallel manufacturing facilities to boost ventilator production, the devices would have to be “customised” to M&M and Tata’s components as they are automotive firms. They are also trying to see if several electronic components, sensors and displays used to make ventilators can be “managed” with alternates. So far, ventilator makers have relied on imports for these components, but global supply chains have been hit due to the ongoing pandemic and the shortage of ventilators in other countries.

“Now, we can do away with the display. We can go to a total, simple user interface without just having buttons and it is automatically programmed without display,” said Alva.

Queries to M&M about the development remained unanswered Saturday. The Tata Group too had said the group was looking at setting up a plan to manufacture ventilators “on priority”.

full report on

www.indianexpress.com

IndraD · Post by **IndraD** » 30 Mar 2020 04:01

Mort Walker wrote:IndraD,

This site has a breakdown by state and district. It also has a cluster map showing actual patients since the total is around 1139 cases and 1022 active cases:
https://www.covid19india.org/

Also check the Ministry of Health at: https://www.mohfw.gov.in/
GoI has screened over 1.5 million international air travelers since early February.

We will know by Wednesday as to how well the 21 day lockdown is going as it will mark 7 days in.

so many thanks Mort Walker ji, hopefully we will do more tests !

Mort Walker · Post by **Mort Walker** » 30 Mar 2020 05:42

The Abbott Labs tester can do 50,000 tests per day. I don't know when these will be available in India, but I think it is sometime soon.

https://www.abbott.com/corpnewsroom/pro ... nutes.html

vijayk · Post by **vijayk** » 30 Mar 2020 06:00

https://finance.yahoo.com/news/novartis ... 52054.html

Novartis CEO says Malaria drug is biggest hope against coronavirus - SonntagsZeitung

Novartis has pledged to donate 130 million doses and is supporting clinical trials needed before the medicine, which U.S. President Donald Trump also has been promoting, can be approved for use against the coronavirus.

Other companies including Bayer and Teva have also agreed to donate hydroxychloroquine or similar drugs, while Gilead Sciences is testing its experimental drug remdesivir against coronavirus.

"Pre-clinical studies in animals as well as the first data from clinical studies show that hydroxychloroquine kills the coronavirus," Narasimhan told the newspaper. "We're working with Swiss hospitals on possible treatment protocols for the clinical use of the drug, but it's too early to say anything definitively."

He said the company is currently looking for additional active drug ingredients to make more hydroxychloroquine, should clinical trials be successful.

Narasimhan said three other Novartis drugs - Jakavi for cancer, multiple sclerosis drug Gilenya and fever drug Ilaris - are being studied for their effect on complications related to COVID-19, the newspaper reported. This follows separate efforts to re-purpose drugs made by companies including Roche and Sanofi to treat complications related to the disease.

vijayk · Post by **vijayk** » 30 Mar 2020 06:08

https://www.newindianexpress.com/good-n ... 22113.html

Hyderabad-based TCS scientists find 31 potential compounds to treat COVID-19
They will be collaborating with Council for Scientific and Industrial Research laboratories for synthesising and testing these compounds to find the perfect drug.

Speaking to Express, Ananth Krishnan, Chief Technology Officer of TCS, said, “The TCS Life Sciences Research Area is engaged in cutting edge application oriented research in Synthetic Biology. De-novo drug candidate design is the first step in a long sequence of steps to find a cure to COVID-19. The collaboration between TCS and CSIR is a standing example of public private partnership in tackling a problem of national importance.”

A common way to treat COVID-19 that scientists across the world are looking at is to inhibit protease called chymotrypsin-like (3CL), an enzyme that is present in ‘Severe acute respiratory syndrome Coronavirus 2’ (SARS-CoV-2) which causes COVID-19 disease.

The 3CL protease plays an essential role in cleaving long polyproteins generated by the virus into various functional proteins which is necessary for it to replicate in the human body. The TCS scientists used AI to design new chemical compounds that can help in inhibiting the protease.

A comparative analysis of the 31 new compounds revealed that they possessed protease inhibiting quality similar to compounds against COVID-19 that are presently under clinical trials. Scientists have also published the complete list of 31 new chemical compounds, so that anyone in the world can test them against SARS-CoV-2.

Dileep · Post by **Dileep** » 30 Mar 2020 09:08

Everyone and his chaprasi are now "making ventilators". My KB is too. I know at least ten startups here in Dera Mahab Ali trying it. Even my son's college announced a programme, but I think the mommas of the kids thrown tantrums. I know mine did.

Almost ALL of them (including Mahindra) are trying to "mechanize" an "ambu bag", which is the bladder like thingie you can squeeze to force air into the lungs. No one is thinking of the rest of the stuff, ie making the bag itself, and the mask / trachial tube that actually does the delivery. I am not sure if Mahindra included that also in the INR7500 figure?

We will need one 'breathing circuit' (or several) per patient. I had been looking for a source. Does anyone know?

My KB is at least doing it professionally. We had been building sub assemblies and kits for the machines for big brands for at least a decade, and designing stuff (but not yet a ventilator). So, we know our business. I think we can push out to mfg a 'reasonably safe and good to use in a crisis' (ie it can pass the review of our in house SRE team) by mid May if the logistics can be arranged to get supplies.

sanjaykumar · Post by **sanjaykumar** » 30 Mar 2020 09:48

Yeah I noticed the ambubag reference. Its like that oncologist proclaiming he is going to start work on cytokines hoping for results by the weekend.

I don't know if Indians the bullshiters or the Indian press is merely clueless.

sanjaykumar · Post by **sanjaykumar** » 30 Mar 2020 09:49

https://www.businessinsider.com/coronav ... ina-2020-3

Boris Johnson's government is reportedly furious with China and believes it could have 40 times more coronavirus cases than it claims

UK government officials say there'll be "reckoning" for China over its handling of the coronavirus.

g.sarkar · Post by **g.sarkar** » 30 Mar 2020 09:55

https://www.nytimes.com/2020/03/29/worl ... dates.html
Coronavirus Live Updates:
Trump Extends Social Distancing Guidelines to April 30 as U.S. Cases Top 140,000
The global count has passed 700,000, an official warns Britain that some kind of lockdown may last for months and Joe Biden urges mail-in elections.
RIGHT NOW More than 894,000 tests have been performed in the United States, according to the Trump administration’s point man for testing.
200,000 Americans could die even if the U.S. takes aggressive action, Fauci says.
Two of the top doctors advising President Trump on the coronavirus pandemic warned on Sunday that as many as 200,000 Americans could die during the outbreak, even with much of the country already under stay-at-home orders and practicing social distancing.
Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases and the nation’s leading infectious disease expert, said during a White House briefing that the grim projection was based on scientific modeling, and the forecasts had convinced Mr. Trump to extend social distancing guidelines through the end of April.
“I think it’s entirely conceivable that if we do not mitigate to the extent that we’re trying to do that you could reach that number,” Dr. Fauci said.
Dr. Deborah L. Birx, the lead coordinator of the White House’s coronavirus task force, said that without any precautionary measures, the same models projected that 1.6 million to 2.2 million Americans could die from complications of the virus.
.....
Gautam

Rahul M · Post by **Rahul M** » 30 Mar 2020 10:16

milindc wrote: So true..
Below is a message from personal friend managing a large govt funded hospital in Hyderabad
Hi guys,
Had another long day battling the Corona panic in the hospital. Received a deluge of complaints from medical technicians & few junior doctors about social ostracisation from landlords & neighbours.. shocking!
More junior doctors put up their resignations..
We are faced with jittery & sobbing nurses on a daily basis.
I think the lockdown is helping, but if it’s not combined with a massive exercise to test & identify the positive cases & isolate them all these efforts would be in vain!
One question that remains to be answered... Will all nations have to pay the heavy price that China & Italy have paid, and Spain & probably the US is paying now? Or do we really have a short cut out of this? Hopefully yes.. But only time will tell...
Cheers guys & Wishing
good health to all of us & our families..

Hi Milind, please check your Pvt msg inbox. (Top right of page)

manju · Post by **manju** » 30 Mar 2020 11:03

saip wrote:Looks like it is common in India to administer BCG vaccine and others like polio in the hospital itself at the time of birth. Let us hope BCG DOES give protection and India dodges the bullet.

almost 100% coverage in India with BCG

sanjaykumar · Post by **sanjaykumar** » 30 Mar 2020 11:26

I believe only since the 1980s.

Gyan · Post by **Gyan** » 30 Mar 2020 11:29

https://www.businessinsider.in/science/ ... 872111.cms

So are we saying that China has 3000×40= 120,000 deaths and 80,000×40=320,000 patients??

milindc · Post by **milindc** » 30 Mar 2020 11:33

Rahul M wrote:
milindc wrote: So true..
Below is a message from personal friend managing a large govt funded hospital in Hyderabad

Please check your e-mail.

Aditya_V · Post by **Aditya_V** » 30 Mar 2020 11:43

Gyan wrote:https://www.businessinsider.in/science/ ... 872111.cms

So are we saying that China has 3000×40= 120,000 deaths and 80,000×40=320,000 patients??

It may still worse, China is closed society with a large population. 22-25 Lacs people will be dying every month across the country. Most people in small towns and villages will know have a great awareness of Corono virus. 20K extra deaths a month will not register. As it is the persons most vulnerable will be people with existing Health conditions so cancer, Diabetes, pneumonia etc. will be reported as the reasons for these deaths, nobody is going to dig deep to see what pushed them over the edge. XI will try and hope once the Chinese summer sets in the virus spread will be contained and normal business can continue. Unless something like 1 -2 crore people drop dead suddenly in a month China will not admit it has a problem.

SRajesh · Post by **SRajesh** » 30 Mar 2020 11:51

nam wrote:Is BCG the reason for lower effect of the Chinese virus on kids?

I always wondered how immune system of kids seems to be able to contain the virus better than a grown up? where as technically their immunity is not as "experienced" compared to a grown up.

One reason put forth is the immaturity of the ACE receptors in lungs of kids compared to adults(Virus may use the receptor to gain entry to the lungs cells!

Rahul M · Post by **Rahul M** » 30 Mar 2020 12:25

milindc wrote:
Rahul M wrote:
Please check your e-mail.

Thanks and replied.

SRajesh · Post by **SRajesh** » 30 Mar 2020 12:49

^^
Yes, but true benefits of BCG difficult to measure.
India is one of the few countries with extensive childhood immunization programmes.
Many in the west have given up compulsory MMR (Parents choice) seeing a recurrence of Mumps/measles etc.
will probably need large numbers to prove the BCG benefits in respiratory viral infections!!
Post CHINAVIRUS lets see if some retrospective study/data comes up from India

Rahul M · Post by **Rahul M** » 30 Mar 2020 12:50

Hakims on BR, especially those working in India, would it be a good idea for hospitals to arrange for medical staff to stay on in the campus or a separate location ?
I understand that this would create problems for their families but would make it easier to enforce decontamination SOPs and also prevent an inadvertent spread to families and friends. I think china followed something similar.
Please share your views on pros/cons and any other inputs/suggestions on COVID preparedness you may have. My email is rahulmDAWTbrfYAT"gmailDAWTkom"
Me and a few others are gathering suggestions to make recommendations to the authorities. Now I can't promise that everything you suggest will be implemented but it will surely reach the powers that be. This is an opportunity to make your voice heard to the decision makers about the issues you feel strongly about.

P.s. just as I was writing this I came to know that this has been implemented at 2 hospitals in Delhi.

SaraLax · Post by **SaraLax** » 30 Mar 2020 13:11

Dileep wrote:Everyone and his chaprasi are now "making ventilators". My KB is too. I know at least ten startups here in Dera Mahab Ali trying it. Even my son's college announced a programme, but I think the mommas of the kids thrown tantrums. I know mine did.
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Echoing the above post from Dileep - It seems manufacturing Ventilators all of a sudden is very complex (even if idle Car manufacturers wish to do it).

Please read the below interview where the company head of a leading German Ventilator manufacturer throws lots of insights into making Ventilators, possible alternatives available to them and the need for qualified people to make use of ventilators.

"Absolutely Mission Impossible"- Drägerwerk is a world leader in the production of ventilators. In an interview (to SPIEGEL magazine), company head Stefan Dräger, 57, discusses the challenges of keeping up with current demand as the corona crisis accelerates

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DER SPIEGEL: Car manufacturers and other firms have announced that they can manufacture ventilator components. Is that purely a PR move or is it actually helpful?

Dräger: There is little point in adapting unused production capacity to manufacture respiratory aids. I spoke with Daimler over the weekend. They would also like to help. But it’s unfortunately not so simple. We can’t build cars either. Before we invest too much thought into this, we should focus on getting devices that are sitting around in a basement somewhere back into working order. Or can we repurpose other devices? There is a lot of potential there.

DER SPIEGEL: Where do you think these kinds of reserves would come from?

Dräger: I believe it’s possible to use devices from ambulance service or anesthesiology departments. Such devices aren't meant for long-term respiration, but they can serve that purpose. We estimate that in Germany alone, 5,000 devices could be mobilized from this reserve. To make that possible, hospital staff, of course, need to be instructed in how to use these devices. And it also requires action on behalf of the regulatory authorities.
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DER SPIEGEL: What is so demanding about these devices?

Dräger: It’s not about the device, but about the person who is attached to it. You have to be able to evaluate the person’s state and know how to precisely adjust the device to first save the person's life and then ensure that they quickly grow healthy again. This requires years of experience.
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nandakumar · Post by **nandakumar** » 30 Mar 2020 13:29

Rsatchi wrote:
Bart S wrote:^^How long ago did India start vaccinating people for TB? Can't be that long ago because we still have a massive number of TB patients.
BCG was started as routine 1962 :
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4078488/
gives some time scales

Even as far back as 1974 when I was a student trainee for chartered accountancy I was deputed to an office for audit assignment. Someone fell I'll in the office and later the office staff were saying he was diagnosed as suffering from TB. I recall thinking that 'fancy, someone catching TB in this era and age'. Not sure if Streptomycin antibiotic was developed by then.

Cyrano · Post by **Cyrano** » 30 Mar 2020 14:03

It seems like great news that many companies with NO prior experience in manufacturing medical equipment are racing to produce ventilators in response to the current pandemic crisis.

The science & medical procedures behind ventilation seem to be fairly complex and any improvisation or inadvertent misuse can cost the patient's life. Check out this series of instructional videos.
https://youtu.be/gk_Qf-JAL84
Perhaps doctors/medical field experts on this forum can shed some light on:

1. Is it reasonable to think that ventilators with all the required features and failsafe mechanisms can be produced by novice companies even if they have other mfg experience?
2. Can they be mfgd with required reliability & MTBF with adequate QC?
3. Can they be manufactured, packaged, shipped and installed with the required sterile conditions?
4. How long does it take for training medical staff to operate each model with required safety and optimum settings to not endanger the patient?
5. Since we are talking about intubating COVID patients in serious condition, the ventilator will extract CO2 rich air which will also be rich in virus containing air or droplets. Where does this "exhaust" from the ventilator go? How can we ensure this expelled air does not contaminate others ?
6. Does the world run a considerable risk trying to save already critical patients with these jugaad ventilators produced in urgence ?

Thank you.

pgbhat · Post by **pgbhat** » 30 Mar 2020 14:11

Bengaluru-based Skanray aims to make 1 lakh ventilators, opens up design IP

The DRDO, in particular, is helping Skanray find equivalent components from other industries. DRDO will help source local components from aeronautical, entertainment and auto industry that can be used in ventilators with a few design changes.

“This is the only way to overcome the shortage. There are components like flow and volume censors that are used in aeronautical industry, which can be used in ventilators too. We just need to alter the design and check for safety,” Alva said.

Skanray has already manufactured one model with lower import content and the redesign was drawn in just 15 days, he added.

The critical components needed for medical devices sector has seen a sharp rise in demand.

However, components for other industries are in good supply and that situation can be utilised in favour of critical equipment manufacture in India.

SRajesh · Post by **SRajesh** » 30 Mar 2020 15:43

nandakumar wrote:
Rsatchi wrote: I recall thinking that 'fancy, someone catching TB in this era and age'. Not sure if Streptomycin antibiotic was developed by then.

INH+ Streptomycin original treatment plan with Folic Acid supplements(was avialble in 70's)
Like malaria, TB national programme morphed from control to eradication and then back to control.
These used to be drilled into the med students In the P&SM classes(for the uninitiated P&SM = Preventive and Social Medicine

)
Now after the newer drugs and people taking or rather skipping full therapy one saw drug resistant strains( and add to this the HIV and HIV associated TB)
BCG wont completely stop or cure TB!

shaun · Post by **shaun** » 30 Mar 2020 18:06

https://www.newindianexpress.com/lifest ... 23093.html

https://www.indiaspend.com/1-in-50-covi ... in-the-uk/

Primus · Post by **Primus** » 30 Mar 2020 18:09

Rsatchi wrote:
Bart S wrote:^^How long ago did India start vaccinating people for TB? Can't be that long ago because we still have a massive number of TB patients.
BCG was started as routine 1962 :
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4078488/
gives some time scales

sanjaykumar wrote:I believe only since the 1980s.

BCG was available long before that (1962) - from the same paper cited above. From 1948 onwards in fact, but mass campaign started in 1951.

Both SHQ and myself carry the scars

And yes, Streptomycin was available not long after WWII.

SRajesh · Post by **SRajesh** » 30 Mar 2020 18:28

^^^
Sure available long before that but only post 1962 after an enactment, did the GOI offer it to the public!!