amar_p wrote:
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)
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 18:45
by 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.
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 19:11
by Nalla Baalu
According to this news report, some of the recent cases across the country have been traced back to this event.
SRoy wrote:In the meanwhile, Delhi Police has cordon off Nizamuddin. Peacefuls in Tableeghi Jamaat gathering were over thousands. Some 300 were found COVID19 positive today.
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 19:17
by Sachin
Nalla Baalu wrote: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.
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 19:32
by 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.
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 19:43
by niran
Rsatchi wrote:
nandakumar wrote:
[/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
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 19:50
by niran
Rahul M wrote: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.
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 20:10
by sanjaykumar
Waksman at Rutgers found streptomycin in the early 1950s.
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 20:11
by Zynda
If this is true, then it is really worrying & scary...
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.
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 20:12
by nandakumar
Dileep wrote:
amar_p wrote:
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.
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 20:12
by nandakumar
Dileep wrote:
amar_p wrote:
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.
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 20:37
by 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.
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 20:38
by 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.
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 21:28
by nvishal
Containment zone for worli koliwada area
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 21:36
by 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.
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.
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 21:56
by Deans
madhu wrote: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.
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 22:18
by Mort Walker
From the India COVID-19 tracker, today was a bad day with +176 cases.
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 22:21
by suryag
thanks to Tableeghi Jamaat religious conference and I have mixed feelings
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 22:27
by sudarshan
Deans wrote:
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.
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 22:53
by madhu
Deans wrote:
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.
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 22:53
by 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.
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 23:02
by shaun
Mort Walker wrote:From the India COVID-19 tracker, today was a bad day with +176 cases.
from where u got that figure ??
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 23:08
by Krita
shaun wrote:
Mort Walker wrote:From the India COVID-19 tracker, today was a bad day with +176 cases.
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.
Scumbags provoked these guys and encouraged them to act like idiots. Now covering their a$$
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 23:42
by 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.
Re: Wuhan Coronavirus Resource Thread
Posted: 30 Mar 2020 23:49
by ranneel
shaun wrote: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.
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?
Re: Wuhan Coronavirus Resource Thread
Posted: 31 Mar 2020 00:16
by milindc
Zynda wrote: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.
Re: Wuhan Coronavirus Resource Thread
Posted: 31 Mar 2020 00:27
by DrRatnadip
Zynda wrote: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?
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·
Re: Wuhan Coronavirus Resource Thread
Posted: 31 Mar 2020 01:13
by KJo
milindc wrote:
Zynda wrote: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.
)
