With the onset of the COVID-19 pandemic last year and now its resurgence in the second wave we have been left unprepared in true sense to fight this biggest threat to human race in recent times. There are different aspects that need to be seen which in general can help us understand and plan better for future as this disease is here to stay and may not be gone so soon.
Issues with COVID Pandemic
COVID infection has posed a recent threat to mankind especially considering its intensity of spread and also severity and increased mortality in cases with comorbidities or older age. The best of the countries too have failed in providing adequate attention to ailing cases because of a simple reason of sudden rise in total number of cases in society surpassing limits that healthcare infrastructure can accommodate at any given time. Secondly, being totally new viral disease, assured and complete treatment and prevention will take time to develop by researchers. So to limit the spread and halt the rate of spread is the best way forward as of date.
COVID and Cancer
In the last one year, we have seen COVID infecting mostly older age group, but now even the young and children are getting infected in the second wave probably due to the new mutant variant. Although complications can arise in almost any case, mostly people with co-morbidities and immune-compromised state have been found to be infected earlier and also have more complicated clinical course with mortalities. Cancer being a known immuno-compromised state thus poses a risk factor. Moreover, issue with cancer is unawareness, late presentation and lack of timely treatment which has made cancer as one of the most dreaded diseases. With COVID scare in public - restrictions due to lockdown and prevention protocols, it has posed as a major roadblock in active management in needy cancer patients. This has left common public and also the care giver confused about the right approach in cancer care in this pandemic era.
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Effect of Covid on Cancer Management
Cancer is a disease that is known of stage progression if left untreated. Also, cure from cancer treatment largely depends on the stage that the patient presents. Thus cancer is a disease where we cannot hold treatment fearing a possible infection which may or may not affect the individual depending on exposure risk and on the contrary may also not be symptomatic or life threating even if infected, in all cases. At the same time in an already infected case, individual's capacity to fight infection in immune-compromised state created with cancer therapy and the risk of cancer progression outcome on survival if treatment delayed , is something that has to be weighed with caution.
Effect on Infrastructure and Care Givers
Apart from effect of COVID on individuals, the effect on infrastructure and care givers also decides the management in cancer cases. With sudden rise of Covid cases, as per government policies a big share of infrastructure (beds, ICUs, oxygen, medications, staff) is being diverted to COVID emergencies, which is logical too. However, this poses a serious threat to our capabilities of providing adequate care to non Covid oncological emergencies and timely intervention in needy patients. Although the priority between a COVID or an oncological malignancy is something that cannot be decided so easily, at least treatment related known morbidities and emergencies in cancer cases ï¿½is something that really needs to be looked into.
Lessons Learnt and Precautions for Future
To summarise, it should be known that COVID is here to stay. State, care givers and individuals in public have their own important role to play. First and the foremost role is of an individual to take all steps to avoid spread of Covid infection by social distancing, face masks and frequent hand-washing. Specific to cancer patients do understand that cancer growth will not stop so we cannot neglect this disease, be it a pandemic or no pandemic. Timely detection of symptoms, consultation by specialists be it physical with all Covid precautions or better by a virtual mode can atleast help detect urgency, stage and then prioritize treatment to see if it can be delayed or needs urgent start. Once diagnosed, care givers take all due precaution to decide appropriate treatments where routine management can be slightly modified with non invasive and less toxic therapies given priority.
Truncated iso-effective therapies needing lesser visits and monitoring if possible are preferred. More emphasis of preparing the patient for treatment with adequate nutrition, timely immunization prevention and preventive treatments to spare cases landing into severe treatment related complications and admission are advocated. Understanding limited resources especially as seen in this second wave, it will be prudent to choose alternatives where chances of medical emergencies and need of special care like oxygen and ICUs are reduced as far as possible.
Lastly there is a huge demand and need for the authorities from state health departments to understand the ardent need of expansion of our health care system, timely pre-planning of improving infrastructure and establish disaster management protocols where we are well prepared to fight such unpredicted emergencies and we have ample preparedness to support our ailing population in the time of need and none of them suffer due to lack of healthcare facilities at least. It's a ongoing battle, which we sure are going to win with patience, understanding, cooperation and collaboration.
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New Delhi, June 19 (IANS) A software can now identify whether a patient will require ventilator support in an ICU or referral, and will make necessary arrangements before emergency sets in.At a time when sudden ICU and other emergency requirements during the pandemic have been a challenge for hospitals to manage, timely information about such situations would help manage the health crisis better.The software called 'Covid Severity Score' (CSS) consists of an algorithm that measures a set of parameters. It scores each against a pre-set dynamic algorithm multiple times for each patient and allocates a Covid Severity Score (CSS) mapping it in a graphical trend.The technology is being used in three community Covid care centres at Kolkata and suburbs including a 100-bed government mandated Covid care centre at Barrackpore, Kolkata.The Foundation for Innovations in Health, Kolkata, with support from the Science for Equity, Empowerment and Development (SEED) division of the Department of Science and Technology in collaboration with IIT Guwahati, Dr Kevin Dhaliwal, University of Edinburgh and Dr Sayantan Bandopadhyay, formerly WHO (SE Asia Regional Office), have developed an algorithm that measures symptoms, signs, vital parameters, test reports and co-morbidities of the Covid positive patient and scores each against a pre-set dynamic algorithm, thus allocating a Covid Severity Score (CSS).This technology has been made available at primary care e-Health clinics in resource poor settings through SEED Project support.Frontline Health Workers trained in National Skills Qualifications Framework (NSQF) aligned model and certified by National Skill Development Corporation (NSDC) are trained to record all these parameters in a tablet computer which has the software loaded in it.The 'CSS' is regularly monitored multiple times by 'remote' specialist doctors thus reducing the doctor's consultation time per patient and reducing the doctors travel requirement.The software can help early identification of patients likely to require ventilator support in an ICU and referral, reduce hospital referral for those unlikely to require critical care support, thus releasing more hospital beds in circulation.It will also help in providing monitored medical support to those patients who cannot afford treatment or cannot isolate at home due to poor housing conditions. The facility can be a huge support for 'Covid Care Centres' with beds and oxygen support only but no facility for invasive ventilation.--IANSrak/skp/
Brasilia, June 19 (IANS) The Brazilian government broke its daily record for vaccination against Covid-19, after accelerating its immunisation pace in recent days, the Ministry of Health said on Friday.In a statement on Friday, the Ministry said a new vaccination record was set on Thursday when 2,561,553 vaccine doses were administered in 24 hours, reports Xinhua news agency.So far, Brazil has administered 84.1 million doses, with 60.06 million people receiving their first dose and 24.03 million their second.The federal government has distributed about 109.29 million vaccine doses to states and municipalities, Health Minister Marcelo Queiroga said.The South American country began its immunisation drive in January using the CoronaVac vaccine from the Chinese pharmaceutical company Sinovac.Brazil later added the Oxford-AstraZeneca vaccine and the Pfizer-BioNTech vaccine.So far, the country has registered a total of 17,702,630 Covid-19 cases and 496,004 deaths.The caseload is the third highest in the world after the US and India, while the death toll is the second largest after the US.--IANSksk/
Moscow, June 19 (IANS) The highly-transmissible Delta variant has been detected in 89.3 per cent of the Covid-19 patients in Moscow as the Russian capital is witnessing a surge in new infections, the city's mayor Sergei Sobyanin said.To resist the Delta variant, people need to develop as twice antibodies as required before, which has caused the herd immunity level in Moscow to drop from 60 per cent to just 25 per cent, Xinhua news agency quoted Sobyanin as saying on Friday.Moscow, the country's worst-hit region by the pandemic, reported a record of 9,056 new cases over the past 24 hours, taking the city's total to 1,269,145, the country's monitoring and response centre said on Friday.Starting from Friday, Moscow hospitals have started providing medical care only to those vaccinated against the virus, excluding emergency treatment.Russia confirmed 17,262 new Covid-19 cases, the highest level since February 1, taking the nationwide tally to 5,281,309.The death currently stood at 126,300.Kremlin spokesman Dmitry Peskov on Friday attributed the new wave of infections in Russia to a low vaccination rate, the public's reluctance to observe restrictions, and the severity of the Covid-19 variant.Peskov said President Vladimir Putin is monitoring the pandemic situation and remains in close contact with regional leaders of the country.--IANSksk/
New Delhi, June 18 (IANS) Delhi Chief Minister Arvind Kejriwal on Friday apprised Lieutenant Governor Anil Baijal of the administration's action plan to battle the possible third wave of Covid in the national capital.During a meeting with Baijal, who also chairs the Delhi Disaster Management Authority (DDMA), Kejriwal presented a blueprint of the preparations being made by the Delhi government to tackle the possible third wave."A state-level task force, more healthcare staff and a special task force for treatment of children are among the Delhi government's action plan to deal with the third wave," the Chief Minister Office (CMO) said in a statement.During the meeting, Kejriwal told Baijal if the third wave hits Delhi, then during normal situation about 37,000 coronavirus cases can emerge per day, whereas if the outbreak is very high, then the count might climb to 45,000."Delhi government is preparing for the management of beds, among others, keeping in mind the normal and worst-case scenario. If there is a possible third wave of Covid and the situation in the national capital becomes extremely distressing, the government is working continuously on how many oxygen beds and ICU beds will be required during that time," CMO said.In view of this, the Delhi government has constituted a committee to enhance and strengthen the health infrastructure of the national capital, including a state level expert committee for mitigation and management of the third wave of Covid-19 cases in Delhi. Besides, a Paediatric task force for management of Covid-19 and treatment of children has also been set up.As per the data provided by the CMO, Delhi has so far installed 32 PSA oxygen plants with capacity of 29.77 MT and 7 PSA oxygen plants with capacity of 5.7 MT will be installed at the end of June. Further, Delhi will also install another 15 PSA oxygen plants with capacity of 18.8 MT July 31 and 10 more PSA plants with capacity of 10.42 MT will be added by end of September this year.--IANSpd/sdr/
Chandigarh, June 18 (IANS) The health condition of Covid-hit former India sprinter Milkha Singh has deteriorated with fever and de-saturation, the doctors said on Friday.The legendary athlete is undergoing treatment at the PGI hospital in Chandigarh. "His condition has deteriorated with oxygen levels stipping," said a doctor of the hospital.His daughter, Mona Milkha Singh, who is also a doctor, is monitoring his health.The 91-year-old had contracted the virus last month. His wife, Nirmal Milkha Singh, had succumbed to the virus on June 13.--IANSvg/arm