Wuhan Coronavirus Resource Thread

[Dileep]

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.

Not a doctor and not an expert, but my company design and manufacture a lot of stuff (for ventilators also) for big names. There are may others in India who does. So, answers to 1,2,3 is yes, since we were novices (with experience in other domains) once. We manufacture equipment that can actually positively fry a patient. Question 4 is moot if the design is already proven and FDA approved. Training is not the issue, especially for the "bag squeeze" type device.

Question 5: There are filters and disinfectation systems that process the exhaled air.

Question 6 is rhetoric, until you yourself get sick with COVID-19, and there is no ventilator available for you. THEN, you would beg to be put on the "ventilator" made out of a blacksmith's bellows.

So, yes, we should allow the 'jugaad' ventilators (if it meets basic functional, reliability and safety requirements) to be used if (god forbid!!) we get to levels where we run out of ventilators (and scrap them once the crisis is over)

[SRoy]

In the meanwhile, Delhi Police has cordon off Nizamuddin. Peacefuls in Tableeghi Jamaat gathering were over thousands. Some 300 were found COVID19 positive today.

[Nalla Baalu]

According to this news report, some of the recent cases across the country have been traced back to this event.

In the meanwhile, Delhi Police has cordon off Nizamuddin. Peacefuls in Tableeghi Jamaat gathering were over thousands. Some 300 were found COVID19 positive today.

[Sachin]

According to this news report, some of the recent cases across the country have been traced back to this event.

So tracking of the COVID-19 virus may also lead to unearthing of bigger viruses targetting India. The police and intel agencies unfortunately have now more work to do. COVID-19 virus has brought out illegal entrants hiding in mosques, clerics from other countries messing up things in India and organised migrant labour based riot mongering.

[Karan M]

These folks should have been dealt with an iron hand a long time back. We didn't and we are going to have our noses dragged in the mud, and a whole country's health infrastructure at risk due to CoVidiots who won't obey the rules.

[niran]

[/color][/b]
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!

Streptomycin is still added
1. Sputum AFB remain positive after 2 weeks
2. Therapy restart
3. reinfection

[niran]

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.

space for staff housing on campus can be used as isolation wards
there are steps to disinfect staff so that they do not spread infection.

[sanjaykumar]

Waksman at Rutgers found streptomycin in the early 1950s.

[Zynda]

If this is true, then it is really worrying & scary...

Whistleblower doctors say coronavirus reinfection even deadlier

Chinese doctors sounding the alarm on the coronavirus say the illness could be even deadlier for patients who catch it again, according to a report.

The whistleblowing physicians working to fight the virus in Wuhan, the epicenter of the outbreak, revealed that medically cleared patients have been getting reinfected, the Taiwan News reported.

“It’s highly possible to get infected a second time,” one of the doctors, who declined to be identified, told the outlet.

The physician said that medication used to treat the virus can have negative side effects on patients’ heart tissue, making them more susceptible to cardiac arrest.

“A few people recovered from the first time by their own immune system, but the meds they use are damaging their heart tissue, and when they get it the second time, the antibody doesn’t help but makes it worse, and they die a sudden death from heart failure,” the doctor said.

The doctor added that the virus has “outsmarted all of us,” since he says it’s able to hide symptoms for up to 24 days — which contradicts current guidance that the incubation period is two weeks.

What’s more, the infected patients often return false negatives before eventually being diagnosed with the illness.

“It can fool the test kit — there were cases that they found, the CT scan shows both lungs are fully infected but the test came back negative four times,” the whistleblower said. “The fifth test came back positive.”

The virus, officially known has COVID-19, has killed at least 2,004 people in mainland China and infected more than 74,000 others.

[nandakumar]

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.

Not a doctor and not an expert, but my company design and manufacture a lot of stuff (for ventilators also) for big names. There are may others in India who does. So, answers to 1,2,3 is yes, since we were novices (with experience in other domains) once. We manufacture equipment that can actually positively fry a patient. Question 4 is moot if the design is already proven and FDA approved. Training is not the issue, especially for the "bag squeeze" type device.

Question 5: There are filters and disinfectation systems that process the exhaled air.

Question 6 is rhetoric, until you yourself get sick with COVID-19, and there is no ventilator available for you. THEN, you would beg to be put on the "ventilator" made out of a blacksmith's bellows.

So, yes, we should allow the 'jugaad' ventilators (if it meets basic functional, reliability and safety requirements) to be used if (god forbid!!) we get to levels where we run out of ventilators (and scrap them once the crisis is over)

To supplement what You have said. I again go back to my student days in the early 70s. The CA firm where I trained as an articled clerk had a small engineering firm promoted and managed by a retired professor of Guindy Engineering College. My job was to go to the firm for two days every month write up the cash book, post the transactions into the ledger and prepare the Profit and Loss Account and Balance Sheet. In the 70s getting a license to import medical equipments was very difficult. At the most established Government hospitals would be given licence to import one or two equipment. So vast majority of small private hospitals had no means of accessing even rudimentary medical equipments. So this entrepreneur ventured into the field. Designed and developed a Treadmill for doing stress test on potential cardiac patients. I don't know how they stacked up against the likes of Philips, Siemens and GE made equipment. But hospitals were happy and placed orders. Then he ventured into heart lung machines for open heart surgeries. The response was encouraging. So much so even Philips proposed a JV as this company was providing stiff competition to the few orders that were coming by from private hospitals. These equipments probably canot be compared to the stuff with all its fancy electronics available today. But back in 1973, they were as good as what was available then.

[nandakumar]

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.

Not a doctor and not an expert, but my company design and manufacture a lot of stuff (for ventilators also) for big names. There are may others in India who does. So, answers to 1,2,3 is yes, since we were novices (with experience in other domains) once. We manufacture equipment that can actually positively fry a patient. Question 4 is moot if the design is already proven and FDA approved. Training is not the issue, especially for the "bag squeeze" type device.

Question 5: There are filters and disinfectation systems that process the exhaled air.

Question 6 is rhetoric, until you yourself get sick with COVID-19, and there is no ventilator available for you. THEN, you would beg to be put on the "ventilator" made out of a blacksmith's bellows.

So, yes, we should allow the 'jugaad' ventilators (if it meets basic functional, reliability and safety requirements) to be used if (god forbid!!) we get to levels where we run out of ventilators (and scrap them once the crisis is over)

To supplement what You have said. I again go back to my student days in the early 70s. The CA firm where I trained as an articled clerk had a small engineering firm promoted and managed by a retired professor of Guindy Engineering College. My job was to go to the firm for two days every month write up the cash book, post the transactions into the ledger and prepare the Profit and Loss Account and Balance Sheet. In the 70s getting a license to import medical equipments was very difficult. At the most established Government hospitals would be given licence to import one or two equipment. So vast majority of small private hospitals had no means of accessing even rudimentary medical equipments. So this entrepreneur ventured into the field. Designed and developed a Treadmill for doing stress test on potential cardiac patients. I don't know how they stacked up against the likes of Philips, Siemens and GE made equipment. But hospitals were happy and placed orders. Then he ventured into heart lung machines for open heart surgeries. The response was encouraging. So much so even Philips proposed a JV as this company was providing stiff competition to the few orders that were coming by from private hospitals. These equipments probably canot be compared to the stuff with all its fancy electronics available today. But back in 1973, they were as good as what was available then.

[madhu]

An intresting way of of looking at the data. I feel it makes more sence.
charts the new confirmed cases of COVID-19 in the past week vs. the total confirmed cases to date. When plotted in this way, exponential growth is represented as a straight line that slopes upwards. Notice that almost all countries follow a very similar path of exponential growth. A fall downward indicates things are improving and the situation has peaked. More you can find here



For today's situation, growth rate looks to be good. More over doubling rate is 19days now. Hope we hold on to it.

[nvishal]

Taxi drivers, medical shop owners etc have been found positive in Mumbai worli koliwada area(aka worli seaface). My family that lives there had been calling us since past three days claiming that kirana, ration, dairy shops in their area weren't opening(for unknown reasons) since the last three days and situation had become dire.

I guess they were awaiting test results and now whole area is barricaded in real 144 situation and disinfectant trucks and fire trucks have entered the area.

[nvishal]

Containment zone for worli koliwada area

[chola]

Economically, this thing will get much worse before it gets better. And that will make fighting the virus mich harder once you run out of the financial resources to keep up the fight.

It scares me what a German minister saw that made him give up and kill himself. Germans aren't prone to giving up.
https://www.euractiv.com/section/econom ... s-worries/

German minister commits suicide after ‘virus crisis worries’

Thomas Schaefer, the finance minister of Germany’s Hesse state, has committed suicide apparently after becoming “deeply worried” over how to cope with the economic fallout from the coronavirus, state premier Volker Bouffier said Sunday (29 March).

Schaefer, 54, was found dead near a railway track on Saturday. The Wiesbaden prosecution’s office said they believe he died by suicide.

“We are in shock, we are in disbelief and above all we are immensely sad,” Bouffier said in a recorded statement.

Hesse is home to Germany’s financial capital Frankfurt, where major lenders like Deutsche Bank and Commerzbank have their headquarters. The European Central Bank is also located in Frankfurt.

A visibly shaken Bouffier recalled that Schaefer, who was Hesse’s finance chief for 10 years, had been working “day and night” to help companies and workers deal with the economic impact of the pandemic.

“Today we have to assume that he was deeply worried,” said Bouffier, a close ally of Chancellor Angela Merkel.

[Deans]

An intresting way of of looking at the data. I feel it makes more sence.
charts the new confirmed cases of COVID-19 in the past week vs. the total confirmed cases to date. When plotted in this way, exponential growth is represented as a straight line that slopes upwards. Notice that almost all countries follow a very similar path of exponential growth. A fall downward indicates things are improving and the situation has peaked. More you can find here



For today's situation, growth rate looks to be good. More over doubling rate is 19days now. Hope we hold on to it.

Time is missing from this chart. Also, it is misleading, because both axis are basically the same thing - no of cases. Of course, every country has
to move along this path as their cases increase. What is interesting to me is that India is to the left of everyone else (fewer cases) despite being
hit relatively early AND having a much larger population.

There is a lag in reporting figures which makes the data fluctuate. Basically at the same stage (500-1000 cases) Europe and China were doubling every
2-3 days till they went from 500 to 5000 cases a day (in the case of US it continued till it hit 18000/ day. We are increasing in arithmetic progression (taking longer to double) with the effects of lock-down not visible, as its too early.

[Mort Walker]

From the India COVID-19 tracker, today was a bad day with +176 cases.

[suryag]

thanks to Tableeghi Jamaat religious conference and I have mixed feelings

[sudarshan]

There is a lag in reporting figures which makes the data fluctuate. Basically at the same stage (500-1000 cases) Europe and China were doubling every
2-3 days till they went from 500 to 5000 cases a day (in the case of US it continued till it hit 18000/ day. We are increasing in arithmetic progression (taking longer to double) with the effects of lock-down not visible, as its too early.

How much difference do you think the lock-downs in Italy and US made? From the data for the past couple of days, the US seems to be in the linear stage as well, I'm sure it wouldn't have happened so soon if the spring-breakers had carried on. But would the daily case load have shot up 10X? 100X? No way to tell for sure, but I was curious about whether you had any thoughts on it.

Cain Marko - are you still following the daily US death rate and comparing with that paper you posted? The trend seems to be deviating (in a good way). We'll know better in a couple of days. Most interesting part is, the deviation can't be attributed to any social distancing, because the author(s) of that paper said they had already accounted for that.

[madhu]

Time is missing from this chart. Also, it is misleading, because both axis are basically the same thing - no of cases. Of course, every country has
to move along this path as their cases increase. What is interesting to me is that India is to the left of everyone else (fewer cases) despite being hit relatively early AND having a much larger population.

That is the beauty of this chart. Logic is simple. If it is exponential growth then it forms a straight line on a log-log scale. When the data crosses inflection point then the plot deviates from being stright. Normally if we use time on x-axis we cannot see clearly the inflection point. So it is plotted with new case vs total case on log log scale insted of total case vs time.

[Mort Walker]

I think we need to have some data on actual hospitalizations or sick persons in India. Based on infected persons, India has 2.5% mortality rate. 34/1318 as of today.

[shaun]

From the India COVID-19 tracker, today was a bad day with +176 cases.

from where u got that figure ??

[Krita]

From the India COVID-19 tracker, today was a bad day with +176 cases.

from where u got that figure ??

https://www.covid19india.org/

The information in the website is crowdsourced and it is not very reliable.

Ministry of health is displaying different no.s

Total infected :1117

Discharged :101

Fatalities :32

https://www.mohfw.gov.in/

[Mort Walker]

From the India COVID-19 tracker, today was a bad day with +176 cases.

from where u got that figure ??

https://www.covid19india.org/

This is initial from from end of day 30 March.

[shaun]

Their update is still morning 10:30 AM

[Arun.prabhu]

More like the Chinese test kits aren't worth crap. We aren't hearing about a lot of re-infections in Italy and elsewhere where they aren't using Chinese test kits. In fact, several countries have returned and refused Chinese kits which have failed quality control by failing to correctly identify anywhere between 66% to 80% of positive cases. Makes one wonder whether the horrible quality is intentional.

[Nalla Baalu]

UP govt to house Covid front-line medical staff in hotels

[vijayk]

https://www.rediff.com/news/report/pix- ... 200330.htm
COVID-19: Kejriwal orders FIR against Nizamuddin maulana

Scumbags provoked these guys and encouraged them to act like idiots. Now covering their a$$

[Nalla Baalu]

Fervently hope Powers-that-are are using all technical means available to keep tabs on large-size congregations of last 2-3 weeks and in real time. Especially in hot spot clusters.

[ranneel]

Their update is still morning 10:30 AM

it shows updated 2hrs back. This statistics is ahead of the count by ministry of health which gets updated every morning.
You can have a look at the database and check for the source which is usually PTI Twitter and the daily briefings of state government.

[VinodTK]

https://www.rediff.com/news/report/pix- ... 200330.htm
COVID-19: Kejriwal orders FIR against Nizamuddin maulana

Scumbags provoked these guys and encouraged them to act like idiots. Now covering their a$$

Please watch, simply shocking!!!

[Rahul M]

https://timesofindia.indiatimes.com/cit ... 893257.cms
Police cordon off large area of nizamuddin.

That's the drdo mask being used by the Delhi police in the photo accompanying the article.

[SRajesh]

https://theprint.in/india/mishti-essent ... ly/391637/
https://theprint.in/india/unethical-to- ... nd/391569/
It can happen only in India!! and by the 'Firman' of the sikular CM's
Mishti doi and ETOH both have medicinal values U see: wonder whether they counteract against all the accumulated toxins (What is source of the toxins U might ask??? But if I answer I will get a warning!!! )

[Zynda]

A pretty basic question: Does hand wash solutions like Dettol, Lifebuoy & Salvon etc., are as, less or more effective when compared to soap (bars) during hand washing?

[milindc]

A pretty basic question: Does hand wash solutions like Dettol, Lifebuoy & Salvon etc., are as, less or more effective when compared to soap (bars) during hand washing?

No. Per the sources, soap both bar or bottled washes off the oil and dirt from your hands. Important thing is soap coverage and around 20-30 seconds of rinsing in flowing water to wash off the virus. Warm water above 30C helps in this process but even cold water is good.

[DrRatnadip]

A pretty basic question: Does hand wash solutions like Dettol, Lifebuoy & Salvon etc., are as, less or more effective when compared to soap (bars) during hand washing?

If used correctly both should be equally good..

[ranneel]

Now it's +208
Spike could be because of more tests results coming in like this from Mumbai:
https://economictimes.indiatimes.com/ne ... 880611.cms

[chetak]

Under the scheme: Buy one virus, get one ventilator free.

Shiv Aroor@ShivAroor
JUST IN: Indian Govt to order 10,000 ventilators from Chinese suppliers. #CoronaUpdate #Covid_19
6:24 PM · Mar 30, 2020·

[KJo]

A pretty basic question: Does hand wash solutions like Dettol, Lifebuoy & Salvon etc., are as, less or more effective when compared to soap (bars) during hand washing?

No. Per the sources, soap both bar or bottled washes off the oil and dirt from your hands. Important thing is soap coverage and around 20-30 seconds of rinsing in flowing water to wash off the virus. Warm water above 30C helps in this process but even cold water is good.

I watched a video where they say that any soap is good, but the washing should be minimum 20 seconds. The soap material kills the protein layer around the virus and destroys it (as I recall). 30 secs seems to be a safe time period.

[Bart S]

Now it's +208
Spike could be because of more tests results coming in like this from Mumbai:
https://economictimes.indiatimes.com/ne ... 880611.cms

It is because of the Tableeghi/Towheed nonsense. Expect 2-3K spike in cases owing to those groups alone, in the coming days.