Delhi: Nurses recovered from Covid-19 help patients by donating plasma

NEW DELHI: A group of nurses infected by the novel coronavirus while on duty in Covid wards is continuing the good work of helping patients get back on their feet. Having recovered, they are now donating their antibody-rich plasma to be used for convalescent plasma therapy to assist serious Covid patients, realising in the process that their initial misery at contracting the disease was actually a blessing in disguise. The nurses’ informal plasma donation network on WhatsApp proved immensely beneficial to the family of critically ill Mukesh Kumar. Hunting for plasma donors, they reached out to common friends and sought help on social media platforms until a relative came across the group where the nurses of various Delhi hospitals coordinated efforts to donate plasma to needy patients for free. 100 nurses and a million blessings Kumar’s family was asked by AIIMS nursing officer Kanishk Yadav, the key person in the network, to contact Kamlesh Kumawat, nursing officer at Lady Hardinge Medical College. The patient’s condition improved after Kumawat’s donation facilitated the therapy, which uses antibodies in the plasma of recovered Covid patients to aid the healing of serious patients. Kumawat, 30, said of his good Samaritan deed, “I got exposed to the coronavirus in the first week of May while working in the Covid OT. I learnt about the Kumar family’s need late at night and in the morning went to the plasma bank at the Institute of Liver and Biliary Sciences to donate before going to work.” The network comprises around 100 people, mostly male nurses from AIIMS and Safdarjung, Ram Manohar Lohia, Lady Hardinge, Lok Nayak, Ambedkar and Guru Teg Bahadur hospitals. Lately, some doctors, paramedic staff, even a few police officers have joined the donors’ group. So far, they have provided plasma for 15 patients, and the requests are increasing as the group becomes more known. Delhi: Nurses recovered from Covid-19 help patients by donating plasma It was Yadav, an avid blood donor, who motivated his nurse friends in April to begin canvassing the support of friends for plasma donation after their recovery. They started a WhatsApp group. On June 15, Bhallaram Purohit, a nursing officer at AIIMS, became the first to donate plasma to ease recovery for a relative of an AIIMS resident doctor. Some of the nurses have donated plasma three times in the last 50 days. “The nurses are overcoming opposition to do this good work. Many of them do not even inform their families so as not to cause worry,” said Yadav. “But it is simple. Every Covid-19 recovered person should donate plasma. It does not cause any weakness and does not reduce their immunity to the coronavirus.” For Mumbai professional Bhavna Chadha, relief came in the person of a nurse from AIIMS who agreed to donate plasma to treat her 74-year-old mother in a private hospital at Shalimar Bagh. Chadha was at her wit’s end after her mother — her father too had tested positive for Covid — was in the ICU for 20 days. “We were desperate and happily took the donor to hospital on June 25. The process took more than six hours, but the donor was very patient. I will remain indebted to the nurse who gave us plasma and the people behind the nurses’ plasma network,” said a grateful Chadha. Chadha’s father recovered and was discharged on June 17. The plasma therapy led to improvement in the mother’s conditions, but she passed away on June 29. Social worker Roshan Lal Jain, who came to know about the network while scouting for plasma donor for his 60-year-old cousin, said it was very brave on the part of these recovered hospital employees to come forward to donate plasma. “A nursing officer from Safdarjung came to the hospital to help my cousin,” said Jain, and he remains thankful even though his cousin improved enough not to ultimately require plasma therapy. ETPrime

8th July, 2020

Chandigarh: GMCH to use GeneXpert for Covid-19 test before C-sections

Chandigarh: The pressing need for Caesarian section and emergency surgeries has spurred Government Medical College and Hospital (GMCH), Sector 32, to procure GeneXpert diagnostics for Covid-19 test. Only PGI has this machine which gives the report within 45 minutes and an hour as compared to RT PCR (Reverse Transcription Polymerase chain reaction) test that takes six to eight hours. “We have GeneXpert for tuberculosis. We do some 14-15 samples under the tuberculosis control national programme. For Covid, the software is different. We do not want to hamper the TB programme, so we are working on procuring another machine only for Covid testing,” said Prof B S Chavan, director-principal, GMCH. He said, “For delivery cases, we cannot wait for Covid reports and have to conduct the surgery without that. However, we follow strict protocols until the reports are out.” The GeneXpert is 99% accurate molecular diagnostic kit. Unlike the RT PCR test, the GeneXpert is safer as there is no need to deactivate the sample. The GeneXpert does not involve lot of tests and thus within no time results are out. Even for the normal deliveries due to the body fluid secretions, precautions have to be taken. “With the rapid kit, even when we wear PPE kits, we can be at ease once the rapid test is there, as it is very tough to be in those suits,” said a gynaecologist. As per the ICMR guidelines, all C-sections must get tested for the virus, at least five days prior to the surgery. “We have two slots one in the morning and another in the evening for testing of the C-section deliveries. But in case the surgeries do not fall in that schedule, surgeries are done, and tests reports come later,” said another doctor at the GMCH 32. Main challenges C-section takes two more hours due to PPE kits. A coverall is worn to avoid body fluids. There is a dedicated operation theatre for Covid surgeries. But for deliveries, the OTs are regularly fumigated as a routine practice. Also, all the instruments have to be kept for two hours in sodium hypochlorite solution and then autoclaved. This is similar to all other infectious diseases, like HIV and hepatitis. News Courtesy: ET Healthworld

8th July, 2020

Testing criteria for Covid-19 likely to be further eased in Mumbai

MUMBAI: The civic administration is likely to relax the testing criteria further in the city after its last decision to allow those above 70 years to get tested without a doctor’s prescription. Daily testing numbers suggest less than 50% of the capacity is being used. Additional municipal commissioner Suresh Kakani said they were thinking of offering relaxations so that more people could get tested. “We are still working out the details. We are thinking of allowing symptomatic persons to get tested directly by producing a self-declaration. However, it’s still being discussed and nothing has been finalised yet,” he said, adding besides allowing senior citizens to get directly tested through a self-declaration, the civic authorities had also allowed testing using e-prescription last week. The use of antigen kits is also likely to pick up by next week. Kakani said the aim was to carry out up to 2,000 tests daily using the antigen kits. Currently, an average 4,500 tests are being done using RT-PCR. News Courtesy: ET Healthworld

8th July, 2020

AIIMS-Patna to start clinical trials of vaccine

PATNA: The clinical trials of Covid-19 vaccine — Covaxin — will begin at All India Institute of Medical Sciences (AIIMS)- Patna on July 10. A team of doctors has been formed for human trials of the vaccine jointly developed by the National Institute of Virology-Pune and Hyderabad-based Bharat Biotech International Limited (BBIL) in collaboration with the Indian Council of Medical Research (ICMR). The ICMR has selected AIIMS-Patna among 12 institutes in the country for the clinical trials of the indigenous BBV152 Covid vaccine. The ICMR has selected only those institutes, which have clinical pharmacology wings and experienced medicos for handling similar human trials. AIIMS-P superintendent Dr CM Singh told this newspaper on Tuesday that the clinical trials of Covid vaccine would begin in the next two days, following completion of certain formalities related to logistics and other procedures. “Its pre-clinical trials on animals have been successful. The results were also encouraging. It was seen in the trials that animals developed immunity effectively. We would follow the protocol for clinical trials as suggested by the ICMR,” Dr Singh said. He added: “Initially, the clinical vaccine trials will be done on 100 people registered for the same. In the second phase, we will increase the number, depending on its outcome. The clinical trials duration is 6-8 months.” The vaccine trials would be done on only healthy people in the age group of 22-50 years, irrespective of gender. The ICMR would approve the vaccine for general use depending on the trials outcome, he said. The ICMR, in a statement on July 4, stated that based on in-depth scrutiny of the available data from pre-clinical studies, the Drugs Controller General of India has accorded permission to conduct phase-1 and 2 clinical trials of the vaccine developed by the BBIL in collaboration with ICMR-NIV, Pune. “Now that the preclinical studies have been completed successfully, the phase-1 and 2 human trials are to be initiated. A letter by DG, ICMR, to the investigators of the clinical trial sites, was meant to cut unnecessary red tape, without bypassing any necessary process, and to speed up recruitment of participants,” the ICMR has stated. It added: “Faced with the unprecedented nature of Covid-19 pandemic and the consequent dislocation of normal life, all other vaccine candidates across the globe have been similarly fast-tracked. ICMR’s process is exactly in accordance with the globally accepted norms to fast-track the vaccine development for diseases of pandemic potential wherein human and animal trials can continue in parallel.” ETPrime

8th July, 2020

Pune University plans testing lab for Covid-19, molecular research

PUNE: The Savitribai Phule Pune University (SPPU) has sought permission from the state government to set up a Biological Safety Level (BSL) III laboratory to test samples for Covid-19 on its premises. Vice chancellor Nitin Karmalkar said the laboratory will be set up in a new building on the campus at a cost of Rs 1.5 crore. Construction will be completed in one and a half months. The facility will test 400 to 500 samples per day. It will be used for molecular diagnostic and research too, making it the first such lab in a state university, Karmalkar said. Currently, the National Institute of Virology (NIV) has a BSL3 and BSL4 laboratory. “The proposal for a Covid-19 testing lab came a long time ago. We are putting in money, energy, resources and time so we need a facility like the Centre for Molecular Diagnostic and Research. Here, we will concentrate on respiratory diseases related to viruses,” Karmalkar added. The university has identified the land for the centre after seeking the opinion of a medical team and other experts who visited the university last week. “A BSL 2 facility is enough for Covid-19 testing. But we are aiming for a sustainable, dedicated research centre and opted for a BSL 3 laboratory. It will be the only such facility other than the NIV in the city. It can be upgraded to BSL 4 facility too,” Karmalkar added. The university has sent the proposal to the state government which will forward it to the Indian Council of Medical Research. The university improved its NIFR ranking based on research output like publications and citations. ETPrime

7th July, 2020

35% of excess deaths from pandemic not caused by COVID-19

New research suggests that in the United States, around 35% of excess deaths during the early phase of the pandemic were not directly caused by COVID-19. A recent study asks if experts may have underestimated the COVID-19 death toll. A new study has found that in the U.S., up to 35% of excess deaths during the early phase of the pandemic may not have been directly due to COVID-19. The research, which now appears in the journal JAMA, suggests that experts may have underestimated the pandemic’s death toll in publicly reported deaths. Stay informed with live updates on the current COVID-19 outbreak and visit our coronavirus hub for more advice on prevention and treatment. COVID-19 and mortality In severe cases, COVID-19 can cause pneumonia: The body’s inflammatory response overcompensates for the presence of the virus in the lungs, reducing the lungs’ ability to get oxygen into the blood. This can, in turn, lead to organ failure or serious cardiovascular events and, ultimately, death. However, as well as the direct effects of COVID-19 on a person’s body, the virus can also cause death by exacerbating underlying health issues; the body’s immune system is weakened while fighting off the illness. Furthermore, the sudden emergence and rapid spread of the disease overwhelmed critical care units when the virus was at its peak, reducing the amount of care any individual patient could receive. This affected not only COVID-19 patients but all those who may have needed critical care. Consequently, the effect of the pandemic on excess deaths — that is, the number of additional deaths beyond what experts expect of a country during a given time — may be greater than what experts have typically reported, particularly if those reports relied on deaths directly attributed to COVID-19. Excess deaths This was the finding of a new study that explored the attribution of cause of death for the excess deaths in the U.S. during the early phase of the COVID-19 pandemic. The study found that death toll reports attributed only 65% of the excess deaths in the U.S. to COVID-19. Furthermore, in 14 states — including California and Texas, which have large populations — reports linked less than 50% of excess deaths directly to COVID-19. For lead study author Prof. Steven Woolf, director emeritus of Virginia Commonwealth University’s Center on Society and Health in Richmond, this may mean that experts have underestimated the death toll of the pandemic. According to Prof. Woolf: “There are several potential reasons for this under-count. Some of it may reflect under-reporting; it takes a while for some of these data to come in. Some cases might involve patients with COVID-19 who died from related complications, such as heart disease, and those complications may have been listed as the cause of death rather than COVID-19.” “But a third possibility, the one we’re quite concerned about, is indirect mortality — deaths caused by the response to the pandemic. People who never had the virus may have died from other causes because of the spillover effects of the pandemic, such as delayed medical care, economic hardship, or emotional distress.”– Prof. Steven Woolf The study also found that excess deaths not linked to COVID-19 rose significantly in states that had the largest outbreaks of the disease during the virus’s peak in early April. These included Massachusetts, Michigan, New Jersey, New York, and Pennsylvania. For example, in these states, there were 96% more diabetes-related deaths than experts predicted. For heart disease, the figure was 89%; for Alzheimer’s disease, it was 64%; and for stroke, it was 35%. As well as people not being able to get the necessary treatment due to hospitals being overloaded, the study authors also speculate that people may have stayed at home due to the virus despite experiencing worsening symptoms of another condition they may have had. They also believe that the pandemic’s effects on people’s mental health may have played a part. As Prof. Woolf notes: “We can’t forget about mental health. A number of people struggling with depression, addiction, and very difficult economic conditions caused by lockdowns may have become increasingly desperate, and some may have died by suicide. People addicted to opioids and other drugs may have overdosed.” “All told, what we’re seeing is a death count well beyond what we would normally expect for this time of year, and it’s only partially explained by COVID-19.” These findings are particularly important, as new cases of the virus are beginning to surge after the relaxation of physical distancing rules in various states across the U.S. News Courtesy: Medical News Today

7th July, 2020

Oropharyngeal secretions may reduce false negative Covid-19 results

Beijing: Researchers have demonstrated that testing of oropharyngeal secretions (OS) -- secretions from the part of the throat at the back of the mouth -- may reduce the number of false-negative results from nasal swab testing of patients who have seemingly recovered from the disease. In the study, published in the Journal of Dental Research, a small number of patients that had tested negative through nasopharyngeal swabs were found to be positive through the testing of oropharyngeal secretions. The study from Huazhong University in China included 75 ready-for-discharge COVID-19 patients who tested negative using two consecutive nucleic acid amplification testing (NAAT) of viral samples retrieved with nasopharyngeal swabs (NPS). "The NPS test has a risk of sending home more patients who still have the infection while the OS test will make such errors in fewer patients," said study lead author Jingzhi Ma from Tongji Medical College of Huazhong University. Because of detection of potential false-negatives in that cohort, NAAT results of paired OS and NPS samples collected from 50 additional Covid-19 recruits during their recovery stage were used in a second prospective study to compare the diagnostic values of the two viral RNA sampling methods.Oropharyngeal secretions obtained from two of the 75 subjects in the first study yielded positive results for SARS-CoV-2 nucleic acid. In the second study, OS samples were significantly more sensitive for detection of the virus that NPS samples and missed only 14 per cent of positive cases compared with 59 per cent for the nasopharyngeal swabs samples. A sampling of OS is a simple procedure that can be performed in any quarantine setting and minimizes contact between healthcare workers and patients, thereby reducing the risk of virus transmission, the researchers said. "Although OS sampling improves the accuracy of SARS-CoV-2 nucleic acid testing, it must be emphasized that this conclusion is based on very small sample size," Ma noted. News Courtesy: ET Healthworld

7th July, 2020

Covid vaccine: Nod for human trials marks beginning of end, says Centre

NEW DELHI: As India races to develop a vaccine for Covid-19, the government on Sunday said that the country is entering the human trial stage which "marks the beginning of the end" of the pandemic. Covid-19 vaccine candidate Covaxin, developed by the Hyderabad-based Bharat Biotech International Limited (BBIL) in collaboration with the ICMR and the National Institute of Virology (NIV), had recently got the nod for human clinical trials from the Drug Controller General of India (DCGI). Talking about how Covaxin works, the ministry explained, "The Bharat Biotech's COVAXIN uses the virus isolated from an Indian patient by the National Institute of Virology to develop the inactivated virus vaccine." Separately, Zydus, which is part of Cadila Healthcare Ltd, said that it has also received approval from authorities to start human trials for its Covid-19 vaccine contender. Globally, 11 out of the 140 vaccine candidates have entered the human trial phase. "With the announcement of Covaxin and ZyCov-D Vaccine, the proverbial silver line in the dark clouds of Covid-19 appears at the horizon," the ministry of Science and technology said today, adding that the nod given by the authorities for human trials marks the "beginning of the end". Underlining India's role in global efforts to develop the vaccine, the ministry said, "In the past years, India has emerged as one of the significant vaccine manufacturing hubs. Indian manufacturers account for 60 per cent of vaccine supplies made to UNICEF." It added that regardless of which nation comes up with the Covid vaccine, they will have to depend on India for its ability for mass production. The government also cited two key players that have inked contract with Indian manufacturers for production of Covid vaccines. "AZD1222 developed by Jenner Institute of University of Oxford and licensed to AstraZeneca; and the MRNA-1273 vaccine developed by Kaiser Permanente Washington Health Research Institute have inked an agreement with Indian manufacturers for production of the Covid vaccines," it said. Earlier on July 2, the Indian Council of Medical Research (ICMR) wrote to 12 trial sites for the Covid-19 vaccine candidate, Covaxin, stating that all clinical trials need to be completed by August 15. Courtesy:ETPrime

7th July, 2020

City to conduct antigen tests on all high-risk asymptomatic patients

NEW DELHI: Scaling up the testing facilities to identify and isolate suspected Covid-19 patients, the Delhi government has decided to conduct rapid antigen detection tests on all high-risk asymptomatic patients admitted or seeking admission or individuals with influenza-like symptoms visiting any health facility. This includes those having influenza-like illness (ILI) symptoms visiting a hospital either for consultation with a doctor or accompanying a patient, said an official. The government has also made it mandatory for all asymptomatic patients undergoing aerosol generating interventions such as dental procedures and endoscopy, those requiring admission for chemotherapy, transplantations, those with malignant disease or HIV at any health facility to get rapid antigen detection tests done. All asymptomatic patients above 65 years of age and having comorbidities seeking admission in a hospital will also have to get the test done. The health and family welfare department on Sunday issued an order increasing the scope of rapid antigen detection tests, which give clear results whether a person is infected with coronavirus or not within 30 minutes. The decision was taken with a view to test as many people in the national capital for Covid-19 as possible. City to conduct antigen tests on all high-risk asymptomatic patients “All healthcare facilities are required to carry out ‘Rapid Antigen Detection Testing’ of following high risk of individuals who visit their facility – all individual/patients with ILI symptoms and all patients admitted with SARI (severe acute respiratory infection),” the order issued by the Delhi government’s health and family welfare department principal secretary Vikram Dev Dutt read. The order further said the health facilities will also require to conduct rapid tests on all asymptomatic patients in high-risk groups such as those undergoing chemotherapy, immunosuppressed patients, including HIV positive, patients with malignant disease, transplant patients, elderly patients (above 65 years) with comorbidities and undergoing aerosol generating interventions. According to the health bulletin released on Sunday, the Delhi government had conducted more than 23,000 tests on Saturday, which included 13,263 rapid antigen detection tests. The government has asked DMs of all 11 revenue districts to carry out 2,000 rapid tests each in their jurisdiction. While initially the rapid antigen detection tests were being conducted only on high-risk contacts and those living in containment zones, the Indian Council of Medical Research recently issued fresh guidelines to take all people under its ambit. All symptomatic people with influenza-like illness (ILI) in containment zones or hotspots and asymptomatic direct and high-risk contacts with other ailments are being tested with rapid antigen detection kits. of confirmed cases. Apart from setting up the testing centres outside the containment zones, some districts have even deployed mobile teams and given buses to move around and collect samples. The districts have shortlisted their own target groups for conducting the tests. While in some areas, the frontline workers such as those working in containment zones, healthcare personnel and sanitation staff are being tested with the rapid detection kits, in others those working as essential services providers are being given the priority. In some other districts, the health teams have been taking samples of random people from a cross-section of society on a first-come-first-served basis, sources said. The Delhi government had recently procured about six lakh rapid antigen detection kits and placed the order for another five lakh. A rapid antigen detection kit costs Rs 450 while an RT-PCR test comes for about Rs 2,400. ETPrime

6th July, 2020

India’s Covid count world’s 3rd highest; nearly 25,000 cases on Sunday

NEW DELHI: India now has the third highest Covid-19 caseload in the world after overtaking Russia on Sunday, even as new infections in the country rose to another record high of nearly 25,000 during the day. India also recorded 421 new deaths from the virus, taking the toll to over 2,300 in the five days of this month alone. Total Covid-19 cases recorded in India were 6,97,887 late on Sunday, as per data collated from state governments. During the course of the day, the count went past Russia’s current caseload of 6,81,251, as per the Worldometers website. With this, only the US and Brazil have recorded higher Covid-19 cases than India. As many as 24,912 new cases were detected in India on Sunday, taking the count in the five days of July so far to over 1 lakh. June, which was so far the worst month of the pandemic in the country, had witnessed a little over 4 lakh cases. Fresh cases have touch record highs on each of the past four days, starting with 22,045 infections reported on July 2. India’s Covid count world’s 3rd highest; nearly 25,000 cases on Sunday With the daily tally of infections in Assam (1,202 new cases) and Uttar Pradesh (1,155) crossing 1,000 for the first time, a record seven states reported cases in four figures on Sunday. As usual, Maharashtra had the highest count of 6,555, its second-highest tally after new cases on Saturday had crossed 7,000. Apart from Assam and UP, Karnataka (1,925 fresh cases), Andhra Pradesh (998), Bengal (895), Gujarat (725) and Rajasthan (632) were among the states that recorded their highest single-day jump in cases. Scaling a new high, Uttar Pradesh reported 1,155 new infections in the past 24 hours. With this, the total number of Covid cases in the state reached 28,061. Of the 75 districts in the state, 26 recorded cases in double digits. Six districts in the Meerut division, including Ghaziabad (182), Gautam Budh Nagar (118), Bulandshahr (37), Meerut (32), Baghpat (25) and Hapur (25), accounted for over one-third (419) of the total cases. Assam registered an increase of 1,202 Covid-19 cases, including 782 in Kamrup (metro), late on Saturday night, in the biggest spike thus far, prompting the state government to restrict functioning of several government departments. “In the biggest spike ever, Assam on July four reported 1202 cases... Time for all of us to be vigilant,” Assam minister Himanta Biswa Sarma tweeted. In Tamil Nadu, the number of new infections dropped below 2,000 cases for the second day in a row in Chennai, but the number of people testing positive for Covid-19 in other districts is on the rise. On Sunday, Tamil Nadu reported 4,150 new cases. Of this, 56 % were from Chennai (1,713) and its three neighbouring districts — Kancheepuram (152), Tiruvallur (209) and Chengalpet (274). Two weeks ago, these four districts together contributed 72% of total cases in Tamil Nadu. Gujarat in 24 hours ending 5 pm on Sunday recorded yet another highest daily tally of 725 cases — the sixth high registered in the past seven days – taking the total tally to 36,123. An analysis of the daily cases reveals that in the past seven days, the cases rose by 16%. In fact, the past week recorded 4,726 positive cases at the average of 675 cases daily – which is 13% of the total positive cases of Gujarat so far. The state also recorded 18 deaths, taking the state’s death toll to 1945. The deaths included nine from Ahmedabad, six from Surat and one each from Jamnagar, Gandhinagar and Kheda. Telangana recorded seven deaths and 1,590 new cases of Covid-19, even as authorities said the virus was again spreading in districts near Hyderabad. With the latest numbers, the coronavirus caseload now stands at 23,902, the seventh-highest among all states, while the death toll rose to 295. State health authorities are concentrating on Medchal and Ranga Reddy districts, which have seen a huge jump in cases. ETPrime

6th July, 2020