Wuhan Coronavirus Resource Thread

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Manish_P
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Re: Wuhan Coronavirus Resource Thread

Postby Manish_P » 30 Jul 2020 18:23

nvishal wrote:^ There is an led that illuminates through your finger. A photodiode on the other end captures the light flickering and sends to a chip that creates an estimate. The pencil is either not wide enough to cover the diode or the light is scattering over the pencils varnish surface.

These 6 month course waala Journalists keep making a fool of themselves and the paper company they write for.


I have a US brand oximeter. I tried with thick and thin pencils, pens and some other items. For all of them it displays 'Finger out' message. It gives a reading only when a finger or toe is inserted

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Re: Wuhan Coronavirus Resource Thread

Postby DrRatnadip » 30 Jul 2020 23:55

nam wrote:
DrRatnadip wrote:https://m.timesofindia.com/viral-news/this-virus-has-a-cure-its-called-hydroxychloroquine-us-doctors-video-goes-viral/articleshow/77236226.cms

Wouldn't it be a good idea to start giving HCQ to the population, as a malaria prevention, given it is monsoon, with the added benefit of covid?

The irony is if people get malaria, their chances of reduced covid infection increases!


Hcq is not usual choice for malaria prophylaxis nowadays.. I have a feeling that one month prophylactic use of Hcq by everyone without known risk to it ( similar to polio drops , given in all susceptible children) might be more effective than strict lockdown..

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Re: Wuhan Coronavirus Resource Thread

Postby Jarita » 31 Jul 2020 06:45

DrRatnadip wrote:
nam wrote:Wouldn't it be a good idea to start giving HCQ to the population, as a malaria prevention, given it is monsoon, with the added benefit of covid?

The irony is if people get malaria, their chances of reduced covid infection increases!


Hcq is not usual choice for malaria prophylaxis nowadays.. I have a feeling that one month prophylactic use of Hcq by everyone without known risk to it ( similar to polio drops , given in all susceptible children) might be more effective than strict lockdown..


Isn’t that what was given in Dharavi as a preventative?
I think that is a great suggestion Dr. Perhaps a combination of HCQ, Vit D, Zinc as a preventative

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Re: Wuhan Coronavirus Resource Thread

Postby vimal » 31 Jul 2020 07:10

Slumdwellers of Dharavi develop herd immunity from Covid-19


Vayutuvan
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Re: Wuhan Coronavirus Resource Thread

Postby Vayutuvan » 31 Jul 2020 08:35

Manish_P wrote:I have a US brand oximeter. I tried with thick and thin pencils, pens and some other items. For all of them it displays 'Finger out' message. It gives a reading only when a finger or toe is inserted

100% correct. I too have one. All of us tested it. We all tested 96-99% resting.

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Re: Wuhan Coronavirus Resource Thread

Postby DrRatnadip » 31 Jul 2020 11:36

India's banking sector shares blame for poor penetration of health services in India.. They just dont support young doctors.. Hospital is slow growing business.. initial two years is mostly loss making then after third year you can expect profit.. Banks dont give proper moratoreum period or cash credits to hospital as some other business..
Last month we approched HDFC for loan to start a multispeciality hospital.. They outright rejected even partial funding because we dont own other hospital or business to sustain new project..Talking with HDFC guy made us feel sad and disaapointed.. It is nearly impossible to start new hospital for young upcoming doctors, unless we arrange finance from private investers or have preowned properties.. Land prices, taxation and running cost are exceptionly high.. Various requirements like NABH accreditation have put unnecessary burdeon on hospitals and pts..Without proper banking support it is not possible to run profitable hospital, which follows all rules and does ethical practice.. This is main reason most good doctors have to work in corporate hospitals ..
I think covid pandemic has made GOI realize importance of robust private healthcare sector.. I wish govt interrvenes to make life easier for doctors so they can focus on giving proper care to patients.. If govt started supporting hospitals run by Doctors for first three years we can soon expect quality healthcare at much lower prices than big corporate hospitals..

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Re: Wuhan Coronavirus Resource Thread

Postby Sicanta » 31 Jul 2020 11:58

DrRatnadip wrote:


I would like to help here. Can you give me an overview of your project? And how you plan to finance it

DrRatnadip
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Re: Wuhan Coronavirus Resource Thread

Postby DrRatnadip » 31 Jul 2020 12:20

Sicanta wrote:
DrRatnadip wrote:


I would like to help here. Can you give me an overview of your project? And how you plan to finance it


Thanks for offer sir.. Pls PM me your mail, so I can share with u overview of our project..

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Re: Wuhan Coronavirus Resource Thread

Postby Sicanta » 31 Jul 2020 12:49

DrRatnadip wrote:


Don't know how to pm. My email address is removed. I will remove it quickly

Sicanta
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Re: Wuhan Coronavirus Resource Thread

Postby Sicanta » 31 Jul 2020 13:47

Btw, they did not offer you CGTMSE coverage instead of asking for collateral alone?

Email - removed

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Re: Wuhan Coronavirus Resource Thread

Postby DrRatnadip » 31 Jul 2020 14:47

Sicanta wrote:Btw, they did not offer you CGTMSE coverage instead of asking for collateral alone?

Email - removed


No sir.. We are still looking for ways to make our project work..

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Re: Wuhan Coronavirus Resource Thread

Postby vijayk » 31 Jul 2020 20:19

DrRatnadip wrote:
Sicanta wrote:Btw, they did not offer you CGTMSE coverage instead of asking for collateral alone?

Email - removed


No sir.. We are still looking for ways to make our project work..


How much does these projects cost? Rough idea ...

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Re: Wuhan Coronavirus Resource Thread

Postby yensoy » 31 Jul 2020 22:30

vijayk wrote:
DrRatnadip wrote:No sir.. We are still looking for ways to make our project work..

How much does these projects cost? Rough idea ...

Very much interested in this effort as well, I will am unable to pm you.

Admin: how to turn on PM ability?

Land and equipment would be the major cost I think. I talked to a friend who has knowledge of the industry, it's at least 1Cr per ICU bed. Then the big machines (MRI and other scans), OT, path lab, regular rooms/wards etc. I think Chennai is the king of private hospitals - a lot of small outfits abound, many (but not all) are decent - and there are hospitals of all sizes and at all price points. Also there is a strong medical college tradition, as well as excellent nurses and caregivers. At the end of the day, it's the people who matter the most.

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Re: Wuhan Coronavirus Resource Thread

Postby vijayk » 31 Jul 2020 22:49

yensoy wrote:
vijayk wrote:How much does these projects cost? Rough idea ...

Very much interested in this effort as well, I will am unable to pm you.

Admin: how to turn on PM ability?

Land and equipment would be the major cost I think. I talked to a friend who has knowledge of the industry, it's at least 1Cr per ICU bed. Then the big machines (MRI and other scans), OT, path lab, regular rooms/wards etc. I think Chennai is the king of private hospitals - a lot of small outfits abound, many (but not all) are decent - and there are hospitals of all sizes and at all price points. Also there is a strong medical college tradition, as well as excellent nurses and caregivers. At the end of the day, it's the people who matter the most.


I am wondering if we can go Cloud kind of model. Create a bunch of facilities (owned by outside by company) which doctors can use it for surgeries/diagnostics etc w/o worrying about admin/setup etc. Is that realistic or unrealistic model? Will that even work in real-world?

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Re: Wuhan Coronavirus Resource Thread

Postby Jarita » 31 Jul 2020 23:03

yensoy wrote:
vijayk wrote:How much does these projects cost? Rough idea ...

Very much interested in this effort as well, I will am unable to pm you.

Admin: how to turn on PM ability?

Land and equipment would be the major cost I think. I talked to a friend who has knowledge of the industry, it's at least 1Cr per ICU bed. Then the big machines (MRI and other scans), OT, path lab, regular rooms/wards etc. I think Chennai is the king of private hospitals - a lot of small outfits abound, many (but not all) are decent - and there are hospitals of all sizes and at all price points. Also there is a strong medical college tradition, as well as excellent nurses and caregivers. At the end of the day, it's the people who matter the most.


One of the good innovations that came out of this crisis was the scaling up and down of hospital space leveraging other types of public infrastructure. It has taken hospital deployability to another level. An example being -:

https://www.travelandleisure.com/travel-news/india-repurposing-empty-train-carriages-coronavirus
As countries across the globe continue to respond to the coronavirus pandemic, India announced it will repurpose its famous railway carriages as makeshift isolation wards


Of course in other countries we have seen extensive portability of medical facilities through field hospitals, mobile trailors, deployable operating theatres. In normal times hospital capacity is not a constraint in most western countries. As such, a lot of these field hospitals and portable infrastructure will be rolled back.

However, for India, perhaps portability needs to be a new paradigm. There are a couple of things at play here - access for people, land costs and thereby return on investments, hospital utilization rates. Portability solves a lot of these problems. A simple hub and spoke with portable spokes would serve India very well to scale up on the hospital front without behemoth investments and timelines.

The cons of this would be collaboration, supply economies (imagine each portable unit has to have minimum supply thresholds) and switching of disease areas. Portability would serve standard procedures well (with telemedicine even more so - in several field hospitals, telemedicine already fills the gap for specialists who need to provide advise - telemedicine is now easy).

An example
https://www.odulair.com/mobile-operatin ... 20services.
https://hospitainer.com/products-and-se ... for-syria/

The market is already doing this, but I have not seen this in India beyond mobile clinics.

Mobile Operating Theaters Put Life-Saving Medical Services on Wheels
https://www.industrytap.com/mobile-oper ... eels/20985

India has a scarcity of hospitals, particularly in remote areas. We cannot scale up rapidly and it would not be economically feasible to build a multi specialty hospital everywhere. A travelling hospital however, is something that is being used in war zones and perhaps should be applied in India as well.

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Re: Wuhan Coronavirus Resource Thread

Postby DrRatnadip » 31 Jul 2020 23:40

yensoy wrote:
vijayk wrote:How much does these projects cost? Rough idea ...

Very much interested in this effort as well, I will am unable to pm you.

Admin: how to turn on PM ability?

Land and equipment would be the major cost I think. I talked to a friend who has knowledge of the industry, it's at least 1Cr per ICU bed. Then the big machines (MRI and other scans), OT, path lab, regular rooms/wards etc. I think Chennai is the king of private hospitals - a lot of small outfits abound, many (but not all) are decent - and there are hospitals of all sizes and at all price points. Also there is a strong medical college tradition, as well as excellent nurses and caregivers. At the end of the day, it's the people who matter the most.


Project cost depends on location.. Land and Infrastructure is major cost.. In our case Total project cost is around 16 cr for 50 bed hospital out of which 3/4 th is required for infrastructure.. :|

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Re: Wuhan Coronavirus Resource Thread

Postby darshan » 31 Jul 2020 23:43

Makes one wonder if India can improve access to medical system by having a hospital on train to reach many areas on regular basis.

Sicanta
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Re: Wuhan Coronavirus Resource Thread

Postby Sicanta » 31 Jul 2020 23:49

DrRatnadip wrote:Project cost depends on location.. Land and Infrastructure is major cost.. In our case Total project cost is around 16 cr for 50 bed hospital out of which 3/4 th is required for infrastructure.. :|


I hope you got my email id. Btw, for now, all psb's can only finance upto Rs 5 crore only under tailor made schemes. We can give concessions on margin, etc. You can access more under general schemes but than t&c may not be as good as former.

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Re: Wuhan Coronavirus Resource Thread

Postby Vayutuvan » 01 Aug 2020 03:40

DrRatnadip wrote: Last month we approched HDFC for loan to start a multispeciality hospital.. They outright rejected even partial funding because we dont own other hospital or business to sustain new project..


Are you starting in rural underserved areas of the country or in a big city? Land prices even in a third tier-city are quite high. On the other hand, most doctors (primary care) are required rural areas with 20-40K populations where there are PHCs but no dotors.

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Re: Wuhan Coronavirus Resource Thread

Postby chetak » 01 Aug 2020 04:23

Not able to go out.
Not able to order outside food.
Cooking ourselves.
Doing all household work ourselves.
Our generation is complaining about things which was basically a standard life for our parents to save money.
So do show some gratitude to them.
They've done an awesome job.

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Re: Wuhan Coronavirus Resource Thread

Postby Jarita » 01 Aug 2020 08:36

Posting it in this thread to demonstrate how the Wuflu is pushing some of the most vulnerable in India into extreme poverty. This is also the reality of India which is pitiful. Unfortunately the so called trickle down effect will not help such people. Only serious government intervention will.

India: Driven by extreme poverty due to COVID-19, a migrant labourer sold his 15-day-old daughter for Rs 45,000

Driven by extreme poverty and lack of work during the COVID-19 crisis, a migrant labourer in Assam sold his 15-day-old daughter for an amount of Rs45,000 (Dh2,212). Twitter users in India shared the “shocking” story on Saturday, and are thankful that the police rescued the baby.

On Friday, police officials said that the father, identified as Dipak Brahma, was arrested along with two other women for human trafficking. Reportedly, Brahma had recently returned from Gujarat, where he worked as a labourer. He was jobless, and finding it hard to support his family.


https://gulfnews.com/world/asia/india/i ... 5778402321

This is where we need an active ministry for human welfare/ child affairs. I know we have a WCD but it's virtually inactive. There is a lot of work to be done in this area but the ministry is fast asleep and less said about the bureaucrats the better. There have been so many such instances during the lockdown but remediation has been minimal.

Can someone advise on how to input images?

ricky_v
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Re: Wuhan Coronavirus Resource Thread

Postby ricky_v » 01 Aug 2020 09:26

^If the image is on the site that you are posting from, open it in a new tab and paste the url within the img tags here. If you want to post an image from your hard drive, upload it to some image hosting site such as imgbb, once uploaded, copy the url and paste here.
Some portions need to be trimmed in this case, only keep the portion within the "" that contains the https part.

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Re: Wuhan Coronavirus Resource Thread

Postby sudarshan » 01 Aug 2020 09:57

US case numbers are down, and then I go check the testing numbers, and it seems testing has come down :-?. Not just aggregate US numbers but also numbers in hot-spots. And again, testing is down in those places. Somebody playing games here?

The positive rate seems to be declining though, which is good news.

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Re: Wuhan Coronavirus Resource Thread

Postby Rsatchi » 01 Aug 2020 12:21

Did a retired Chinese General write about exporting Virus to cause a Pandemic??
https://youtu.be/QkGojp1dE08
This video report from Gravitas seem to suggest that and Also that Xi is facing a potential revolt!

chola
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Re: Wuhan Coronavirus Resource Thread

Postby chola » 01 Aug 2020 20:00

sudarshan wrote:US case numbers are down, and then I go check the testing numbers, and it seems testing has come down :-?. Not just aggregate US numbers but also numbers in hot-spots. And again, testing is down in those places. Somebody playing games here?

The positive rate seems to be declining though, which is good news.


They are averaging around 65K to 70K a day. I guess it is down compared to the spike of 78K a week ago but trajectory is not on a downward slope yet.

The death rate has gone up to 1400 a day.

I don't know about the drop in tests but that would be a very serious thing when the cases are growing that much daily and testing had dropped.

Trump actually asked to slow down testing as it hurts him in the polls. Could the GOP actually taken action on this?
https://www.cnn.com/2020/06/22/politics/donald-trump-testing-slow-down-response/index.html
Trump now says he wasn't kidding when he told officials to slow down coronavirus testing, contradicting staff

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Re: Wuhan Coronavirus Resource Thread

Postby SriKumar » 01 Aug 2020 20:08

The conduct and spread of this virus is based on nature/science/reality. It really does not care about the politics of the person. Reducing testing is not going to help. If testing is indeed reduced, and it lulls people into complacency, there will be a spike in hospitalizations later on- cannot be hidden (and in my book, hospitalizations is probably a more important indicator of the degree of the problem). As someone (sudarshan ?) commented, the rate of positivity is the thing to note, and that should not change with lower or higher testing. If the no. of tests is reduced, and we see a higher positivity rate those tested, then we all know what's coming ahead- it is spreading. Reality will out.

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Re: Wuhan Coronavirus Resource Thread

Postby darshan » 01 Aug 2020 20:20

How Amit Shah saved Delhi from hitting AAP’s ‘target’ of 5.5 lakh Coronavirus cases by July 31
https://www.opindia.com/2020/08/amit-sh ... s-july-31/

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Re: Wuhan Coronavirus Resource Thread

Postby sudarshan » 02 Aug 2020 06:00

https://coronavirus.jhu.edu/testing/ind ... states/usa

Testing does seem to be coming down in the US, the above is from Johns Hopkins, probably as official as it gets. It shows testing by state also, and in some hotspot states (FL, TX), again testing is down :-o. CA seems erratic.

Hope the UltraMarouns (UMs) aren't trying to bring down case counts by reducing testing, that would be stupid (even marounic). In a way, Trump is right, the rising case count numbers could cause unnecessary panic. I've also been arguing against case-count induced panic, but that is a public education issue, not an excuse to reduce testing per-se.

SriKumar wrote:...Reducing testing is not going to help. If testing is indeed reduced, and it lulls people into complacency, there will be a spike in hospitalizations later on- cannot be hidden (and in my book, hospitalizations is probably a more important indicator of the degree of the problem).


Yeah that would be my book also.

As someone (sudarshan ?) commented, the rate of positivity is the thing to note, and that should not change with lower or higher testing. If the no. of tests is reduced, and we see a higher positivity rate those tested, then we all know what's coming ahead- it is spreading. Reality will out.


My comments were that case counts were meaningless unless presented with testing and positivity rates, so yes, my comments were along the lines of what you're saying above. Positivity rate unfortunately depends on the testing strategy also, whether it's random (don't think so) or just testing those with some level of symptom severity (that's what I think the US was doing so far). If the UMs are going to change the testing strategy also to make the numbers look good, then that's one more bet which is off.

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Re: Wuhan Coronavirus Resource Thread

Postby Ambar » 02 Aug 2020 21:06

DrRatnadip wrote:
Ambar wrote:Thank you for your insights DrRatnadip. How often do you see aged patients with co-morbidities do well after severe covid ? How long does Remdesivir take to act ?


Many elderly pts ( around 60 %) , even those with comorbidities improve relatively well.. Pts who present late i.e those require ventilation within 24 hrs of admission have poor outcome.. I think so called " happy hypoxia " is at play here.. Pt dont realise about gross lung damage untill they feel difficulty in breathing..Such pts present with SpO2 less than 85%.. That is why it is important to monitor oxygen saturation with SpO2 probes..

It is hard to tell if Remdesivir is effective in perticular pt.. It is used in moderate pts who are already receiving cocktail of many drugs.. Those who are responding show clinical improvement in 24 to 48 hrs.. Improvement with Tocilizumab is rapid..


When i made this post asking Dr Ratandip on his experience on the recovery rate of covid patients with comorbidities , i was hoping my next post on this dreaded and depressing thread would be to share an uplifting story on how my family survived the coronavirus scare. Unfortunately fate had a different plan all along and I lost my dad to covid 5 days ago. 
He was a 'Corona-Warrior' in the truest sense. Despite his advanced age of 73, despite having comorbidities like asthma and a coronary artery bypass, he continued to visit his clinic in one of the poorest neighborhoods in my town just as he did everyday for the last 44 years including Sundays and every holiday.  After graduating from Mysore Medical College in 1975, he chose a district in the malnad belt of Karnataka, opened a small practice in a working class neighborhood and served in the same place for 44 years without expanding, building nursing homes/hospitals etc like many of his peers did. When the covid hit, we begged and pleaded with him to stop working atleast temporarily but he always retorted saying if doctors stay at home, then where will the patients go ? 

In the week of July 6th he came down with a cough and fever. Being a doctor he self medicated himself thinking its just a seasonal flu. After 3 days of antibiotics his fever went away and cough improved . But from around July 13th his cough was back and much worse, and he continued to treat himself until the 17th when he finally got his xray done and found out he had pneumonia in his lungs. Later that evening his oxygen dropped below 90, and he finally got the covid antigen test done and found out he was positive. 

Our nightmare began later that evening as the town he lives in only the district government hospital is treating covid patients, and despite him being a doctor, and the severity of his condition, we had to run pillar to post to find a ICU bed for him. Once they took him inside we lost all contact on how he was being cared and by whom. The government health authorities have zero communication plan, and the terrified family members are left begging and pleading for information. We were told that he was now on oxygen and his O2 saturation is now normal. Day 2 they began administering Ramdesivir and anti-inflammatory steroids,  but we have no idea if they were also giving him his daily heart medications. The communication improved as the DHO and the government doctors started getting a deluge of calls from IMA, other prominent doctors in the town, regular citizens and the media. On day 4 we were told that his condition had suddenly deteriorated as he had pulled the oxygen tubes likely due to ICU hypoxemia, and we were asked to make arrangements in a corporate hospital elsewhere. After we explained that his condition is too critical to move him to a bigger city 4 or 5 hours away, and no air-ambulances are accepting covid patients, they relented and continued his care. 

At this point my sister and my brother in law both of whom are doctors, had contacted atleast a dozen of their colleagues seeking advice on next steps, and heard about this anti-inflammatory drug tocilizumab .  As some of you may have heard, the drug has a severe shortage in India, it is being sold in black market for 4 to 5 times its price, and even then it is near impossible to find. And then there are stories of fake tocilizumab being sold in the market. My sister was able to find 2 vials from Bangalore with great difficulty and was shipped overnight to the city where my father was being treated. After the 2nd dose of the drug, my father's condition began improving dramatically, and by day 7 of his hospitalization his lung had begun to clear significantly. He was conscious , and the effects of hypoxemia seems to have reversed as he was able react to the commands of the doctors. At this point, probably due to the relentless pressure by my family and other citizens of the town, the doctors in the hospital suggested plasma therapy. They claimed it was absolutely safe even for those with heart conditions. Later that day they found out a neighboring city hospital had 2 bags of plasma that matched my dad's blood group, and we made arrangements with the local blood bank to immediately source it and passed it to the hospital without delay. Day 8 and day 9 both bags of plasma were used and my dad's condition had begun to improve significantly to a point where he apparently told one of the doctors to pass a message to us that he was feeling better. On the night of Jul 27 (day 11) of his hospitalization we were told that he had a massive attack and he passed away.

The details after his death are just too painful for me to narrate but neither me nor my sister could see him as neither of us live in the same city, and we couldn't travel. The body is not handed over to the family, and instead wrapped and dropped off at the cremation site with only 2 family members allowed to perform the last rites. So a doctor who cared for the poorest of the poor, the most vulnerable section of our society, the forgotten rural downtrodden masses, and someone who continued to care for his patients in the middle of this pandemic until he quite literally dropped was taken away from us cruelly by fate, and made much worse by the government. I'd like to make it abundantly clear that I am not blaming the doctors in the district government hospital who undoubtedly tried everything they could to save a fellow doctor but the lack of communication, no arrangement for the family members to see the patient even from a safe distance to boost their morale, and an undignified way of treating the departed soul has pained us deeply.
After having been through this ordeal, the pain of bereavement is something that I wouldn't wish on my worst enemy. It will probably take years if not a lifetime to overcome the grief and remorse. Please, please take all precautions against this dreaded virus, go get yourself tested at the first sign of trouble, and if you or your loved ones have pre-existing conditions then please stay as safe as possible, a life once gone cannot be brought back.  As much as i love my country, if you and your loved ones are in an advanced, first world nation then thank your lucky stars. If the above can happen to a very popular doctor in a small city then i can only imagine the plight of those who have no support. God bless you all. 

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Re: Wuhan Coronavirus Resource Thread

Postby Mukesh.Kumar » 02 Aug 2020 22:00

Ambar wrote:
DrRatnadip wrote:
Many elderly pts ( around 60 %) , even those with comorbidities improve relatively well.. Pts who present late i.e those require ventilation within 24 hrs of admission have poor outcome.. I think so called " happy hypoxia " is at play here.. Pt dont realise about gross lung damage untill they feel difficulty in breathing..Such pts present with SpO2 less than 85%.. That is why it is important to monitor oxygen saturation with SpO2 probes..

It is hard to tell if Remdesivir is effective in perticular pt.. It is used in moderate pts who are already receiving cocktail of many drugs.. Those who are responding show clinical improvement in 24 to 48 hrs.. Improvement with Tocilizumab is rapid..


When i made this post asking Dr Ratandip on his experience on the recovery rate of covid patients with comorbidities , i was hoping my next post on this dreaded and depressing thread would be to share an uplifting story on how my family survived the coronavirus scare. Unfortunately fate had a different plan all along and I lost my dad to covid 5 days ago. 
He was a 'Corona-Warrior' in the truest sense. Despite his advanced age of 73, despite having comorbidities like asthma and a coronary artery bypass, he continued to visit his clinic in one of the poorest neighborhoods in my town just as he did everyday for the last 44 years including Sundays and every holiday.  After graduating from Mysore Medical College in 1975, he chose a district in the malnad belt of Karnataka, opened a small practice in a working class neighborhood and served in the same place for 44 years without expanding, building nursing homes/hospitals etc like many of his peers did. When the covid hit, we begged and pleaded with him to stop working atleast temporarily but he always retorted saying if doctors stay at home, then where will the patients go ? 

In the week of July 6th he came down with a cough and fever. Being a doctor he self medicated himself thinking its just a seasonal flu. After 3 days of antibiotics his fever went away and cough improved . But from around July 13th his cough was back and much worse, and he continued to treat himself until the 17th when he finally got his xray done and found out he had pneumonia in his lungs. Later that evening his oxygen dropped below 90, and he finally got the covid antigen test done and found out he was positive. 

Our nightmare began later that evening as the town he lives in only the district government hospital is treating covid patients, and despite him being a doctor, and the severity of his condition, we had to run pillar to post to find a ICU bed for him. Once they took him inside we lost all contact on how he was being cared and by whom. The government health authorities have zero communication plan, and the terrified family members are left begging and pleading for information. We were told that he was now on oxygen and his O2 saturation is now normal. Day 2 they began administering Ramdesivir and anti-inflammatory steroids,  but we have no idea if they were also giving him his daily heart medications. The communication improved as the DHO and the government doctors started getting a deluge of calls from IMA, other prominent doctors in the town, regular citizens and the media. On day 4 we were told that his condition had suddenly deteriorated as he had pulled the oxygen tubes likely due to ICU hypoxemia, and we were asked to make arrangements in a corporate hospital elsewhere. After we explained that his condition is too critical to move him to a bigger city 4 or 5 hours away, and no air-ambulances are accepting covid patients, they relented and continued his care. 

At this point my sister and my brother in law both of whom are doctors, had contacted atleast a dozen of their colleagues seeking advice on next steps, and heard about this anti-inflammatory drug tocilizumab .  As some of you may have heard, the drug has a severe shortage in India, it is being sold in black market for 4 to 5 times its price, and even then it is near impossible to find. And then there are stories of fake tocilizumab being sold in the market. My sister was able to find 2 vials from Bangalore with great difficulty and was shipped overnight to the city where my father was being treated. After the 2nd dose of the drug, my father's condition began improving dramatically, and by day 7 of his hospitalization his lung had begun to clear significantly. He was conscious , and the effects of hypoxemia seems to have reversed as he was able react to the commands of the doctors. At this point, probably due to the relentless pressure by my family and other citizens of the town, the doctors in the hospital suggested plasma therapy. They claimed it was absolutely safe even for those with heart conditions. Later that day they found out a neighboring city hospital had 2 bags of plasma that matched my dad's blood group, and we made arrangements with the local blood bank to immediately source it and passed it to the hospital without delay. Day 8 and day 9 both bags of plasma were used and my dad's condition had begun to improve significantly to a point where he apparently told one of the doctors to pass a message to us that he was feeling better. On the night of Jul 27 (day 11) of his hospitalization we were told that he had a massive attack and he passed away.

The details after his death are just too painful for me to narrate but neither me nor my sister could see him as neither of us live in the same city, and we couldn't travel. The body is not handed over to the family, and instead wrapped and dropped off at the cremation site with only 2 family members allowed to perform the last rites. So a doctor who cared for the poorest of the poor, the most vulnerable section of our society, the forgotten rural downtrodden masses, and someone who continued to care for his patients in the middle of this pandemic until he quite literally dropped was taken away from us cruelly by fate, and made much worse by the government. I'd like to make it abundantly clear that I am not blaming the doctors in the district government hospital who undoubtedly tried everything they could to save a fellow doctor but the lack of communication, no arrangement for the family members to see the patient even from a safe distance to boost their morale, and an undignified way of treating the departed soul has pained us deeply.
After having been through this ordeal, the pain of bereavement is something that I wouldn't wish on my worst enemy. It will probably take years if not a lifetime to overcome the grief and remorse. Please, please take all precautions against this dreaded virus, go get yourself tested at the first sign of trouble, and if you or your loved ones have pre-existing conditions then please stay as safe as possible, a life once gone cannot be brought back.  As much as i love my country, if you and your loved ones are in an advanced, first world nation then thank your lucky stars. If the above can happen to a very popular doctor in a small city then i can only imagine the plight of those who have no support. God bless you all. 


Ambarji, please accept my condolences. Coming from a family of medical professionals I understand your pain. It is early as you are still in the period of grief but I hope you find peace in the fact that your father was a karmayogi. Parmatma unki atma ko shanti de.

sudarshan
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Re: Wuhan Coronavirus Resource Thread

Postby sudarshan » 02 Aug 2020 22:15

Ambar ji, very very sorry to hear. Wish you and your family all the best, and heartfelt pranams to your father for his selfless service.

Mort Walker
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Re: Wuhan Coronavirus Resource Thread

Postby Mort Walker » 02 Aug 2020 22:35

Ambarji,

Sorry to hear of this terrible loss of your father. The loss is not just of your family, but of the community. May he find moksha.

Jarita
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Re: Wuhan Coronavirus Resource Thread

Postby Jarita » 02 Aug 2020 22:43

He was a 'Corona-Warrior' in the truest sense. Despite his advanced age of 73, despite having comorbidities like asthma and a coronary artery bypass, he continued to visit his clinic in one of the poorest neighborhoods in my town just as he did everyday for the last 44 years including Sundays and every holiday. After graduating from Mysore Medical College in 1975, he chose a district in the malnad belt of Karnataka, opened a small practice in a working class neighborhood and served in the same place for 44 years without expanding, building nursing homes/hospitals etc like many of his peers did. When the covid hit, we begged and pleaded with him to stop working atleast temporarily but he always retorted saying if doctors stay at home, then where will the patients go ?

In the week of July 6th he came down with a cough and fever. Being a doctor he self medicated himself thinking its just a seasonal flu. After 3 days of antibiotics his fever went away and cough improved . But from around July 13th his cough was back and much worse, and he continued to treat himself until the 17th when he finally got his xray done and found out he had pneumonia in his lungs. Later that evening his oxygen dropped below 90, and he finally got the covid antigen test done and found out he was positive.


Terribly sorry to hear. 73 is not an advanced age in other parts of the world. He had so much more to do. What a loss? Nothing more can be said.
Om Shanti

SriKumar
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Re: Wuhan Coronavirus Resource Thread

Postby SriKumar » 02 Aug 2020 22:50

Ambar wrote: As much as i love my country, if you and your loved ones are in an advanced, first world nation then thank your lucky stars. If the above can happen to a very popular doctor in a small city then i can only imagine the plight of those who have no support. God bless you all. 
Ambar.....thanks for mentioning the details of the entire saga. My deepest condolences for your loss. I can understand your sense of pain that you were not there in his final moments in the hospital or after that for the last rites. I can only assume that htis is happening to many more people and we dont know about it. Anyone in any city, town or village can get infected, and clearly the facilities or procedures are not quite there to handle this epidemic.

Based on what you said of his service to the poor, you can stay assured (if you are of a religious leaning) that he has accumulated a lot of good karma, in preparation for his next journey. Hindu theology places more emphasis on the atma (soul) than the deha (body) and good actions are always enjoined upon the person. He lived his life in accordance with this dharma. May his atma have shanti.

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Re: Wuhan Coronavirus Resource Thread

Postby Raja » 03 Aug 2020 01:20

Too many people are self medicating and choosing not to get tested. I personally know of few instances in my parents neighborhood. There is a lot of fear of being forced to go to government hospitals which have really bad rep or quarantine. So they decide to hide their symptoms and not get tested. Unfortunately, the self quarantines are not always followed strictly and people soon start moving around after they think they have recovered.

vijayk
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Re: Wuhan Coronavirus Resource Thread

Postby vijayk » 03 Aug 2020 05:45

Ambarji - So sorry to hear the sad news. What a wonderful man your dad is! Please accept my condolences

Mukhi
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Re: Wuhan Coronavirus Resource Thread

Postby Mukhi » 03 Aug 2020 08:50

Ambar wrote:
DrRatnadip wrote:
Many elderly pts ..... God bless you all. 


Ambar. My condolences to you and your family. It is strange that I too lost my father and went through exact same ordeal. We initially admitted him to one of the worst hospital in Gujarat, Zydus Anand. However, he improved enough and We were fortunate enough to be able to take hime at one of the finest hospital in Gujarat, Zydus Ahmedabad. Once admitted, we were simply cutoff from him. Till the last day at Zydus, we were told there was not much to be done. By then, we simply Were Fed up of no improvement, very minimal contact, close to 23 days on ventilator and later trake tube, we deCided to bring him home. He passed away soon after we removed Ventilator support. Our out of pocket were 16 Lakhs. So I feel your pain and frustration. I have written to the Zydus management about the way they operate and their SOPs that make no logical sense. But we need to do something about it.. Please stay strong.

arshyam
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Re: Wuhan Coronavirus Resource Thread

Postby arshyam » 03 Aug 2020 09:04

Ambar-ji and Mukhi-ji, please accept my condolences. I am really saddened to hear what you both went through. There seems to be no clear pattern on how this virus affects people - I have known a couple of people with co-morbidities get tested +ve and hospitalized, but walked out a couple weeks later with nothing more than mild oxygen therapy.

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Re: Wuhan Coronavirus Resource Thread

Postby nandakumar » 03 Aug 2020 09:31

Ambar
My heartfelt condolences to you and members of your family at the loss. Makes the loss even more tragic as the deceased as a member of the medical fraternity could have been even more useful to the society in these challenging times.

Manish_P
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Re: Wuhan Coronavirus Resource Thread

Postby Manish_P » 03 Aug 2020 09:44

Om Shanti

My condolences to you Ambar ji and Mukhi ji

May you find the strength & solace to bear their loss

Lost mine a year ago but now, looking at the current situation, feel that maybe it was better that it happened then.


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