A lockdown cannot be imposed on a whim or gut feeling. Crucially, it should never be imposed to garner approval ratings. There has to be a science behind it; the decision must be evidence based, not a reflection of a house constructed from sand. The lockdown in India, now all set to enter its fourth stage, is laughable. It was imposed from March 25. As per the WHO, there had been a total of 434 cases till that day, with a cumulative 9 deaths. Italy had 63,927 cases with 6077 deaths, and the US had 42,164 cases and 571 deaths.
In his daily briefings, the health ministry spokesman – a joint secretary level officer – repeatedly underscores the fact that almost a third of all COVID-19 infected people in India have a connection to the Tablighi Jamaat congregation in Nizamuddin last month. The constant reiteration may perhaps be justified if the intent is merely to warn people of the dangers of clusters catching the contagion. However, the public health costs of the resulting stigmatisation of the Jamaat – when amplified by the media and social media – could outweigh the benefits, if any, of this messaging. In any case, surely there are other far more important matters regarding the epidemic that need to be discussed or debated than repeatedly cataloguing the minutiae of this one incident.
Each day brings more information of SARS-CoV-2, its infectivity, its lethality, pathogenies and treatment. One of the most striking revelations has been that patients put on ventilators do extremely badly. Just about every centre reports very high rates of death once a tube is put in a patient.
Researchers in China, South Korea and Singapore have put together a significant amount of information about antibodies that human bodies release in their bloodstreams against the new coronavirus. The presence of these antibodies in the bloodstream could indicate that the person is infected with the virus, and researchers have used this immune response to develop new tests to detect COVID-19 infections faster than the genetic tests currently in prevalent use.
The coronavirus juggernaut bears on and the pandemic refuses to be tamed or slowed. Its social, economic and clinical complexities keep evolving by the day. We find out incrementally more about the virus every 24 hours, if not sooner. Out of Wuhan, the virus has run amok through Iran, Italy, Spain and – now – the United States. According to data compiled by Johns Hopkins University, the US currently has the world’s largest number of people with COVID-19, upwards of 104,000, while about 1,200 have died, yielding a case fatality ratio of 1.15%.
As if the panic and stress caused by the COVID-19 pandemic and the consequent lockdown were not bad enough, Bollywood star Amitabh Bachchan has recorded and posted an entire video centred around the claim that flies can spread the coronavirus if they come into contact with infected human faeces.
A micron is a millionth of a meter. A strand of human hair is approximately 50 microns wide while the red blood cell carrying oxygen in our blood is just 5 microns wide. One sneeze or cough may carry about 3,000 droplets, with each droplet being more than 5 microns across. When the suspended particle is smaller than 5 microns, it is called an aerosol.
You can be certain Prime Minister Narendra Modi is quite aware that tackling the COVID-19 pandemic will take more than one day of self-imposed quarantine by the people. Nonetheless, he deserves to be lauded for his efforts because, in all probability, he has sensitised the people of India for future lockdowns of longer duration, as the Chinese authorities imposed in Hubei province and as is increasingly being the case across Europe, including in Spain, France and Italy.
We now have about 3,000 confirmed cases worldwide, which is surely a conservative estimate.
The last day of the last decade provided the information that a brand new viral disease had emerged in Wuhan, China. Within a week, the new virus was recognised, which the World Health Organisation has named “2019-nCoV”.
Air pollution has been linked to depression, reduced cognitive function, dementia, brain cancer, chronic obstructive pulmonary disease and many, many other diseases.
The evidence is chilling. The time for blame-games is long past. There is also no need to point fingers because we’re likely past the point of no return. According to the latest WHO data, the world’s highest PM2.5 levels are to be found in India. We currently have 16 of the world’s 30 most polluted cities. These are remarkable figures that should surely be discussed fiercely on all TV channels every night.
Now that the can of worms had opened there will be the usual round of denials. The reaction of pure innocence at being caught with your pants down is incredulous. They would like you to believe that cricketers never dreamt of using ped( performance enhancing drugs) regardless of Shoaib’s eye opener.
The closely knit long distance running community has been shocked by the sudden death of 28 years old Ryan shay while competing in the US Olympics men’s marathon selection race a week ago. What’s really shocking is that this wasn’t your next door middle aged ad hoc runner out for a photo op or simple fun but an elite world class long distance runner strongly tipped to be on the us marathon team for the Beijing Olympics.
The shadow of doping has fallen on the Beijing Olympics. First it was Spanish female cyclist, who was caught for using erythropoietin – EPO a performance enhancer, and now there are few more who have come under suspicion for using banned drugs.
Recently, the journal JAMA Internal Medicine published a massive retrospective study that included almost a million subjects. Almost half a million people taking statins were compared to an equivalent population not popping in any. They also added more than 26,000 patients on non-statin lipid lowering drugs. The authors observed, in their own words, a strong association between first exposure to statins and acute memory loss diagnosed within 30 days immediately following exposure. The increase in memory loss was 4.40 times compared with non-statin users; in other words statins hiked up loss of memory by 440%.
The derision and hostility of the audience was palpable when, at a recent cardiology conference in Delhi, I stated that substantial data published in the leading medical journals of the world not only exaggerated drug effects but could also be considered misleading. There was stunned silence when I mentioned the New England Journal of Medicine (NEJM) as one of the leading culprits publishing manipulated data because the NEJM is considered by most to be the holy grail of medical journals.
One of the most dramatic and important achievements of the last century was the discovery of insulin in 1921, at the University of Toronto. Remarkably, the patent for it was sold for $1. Today, a single vial of long-acting insulin analogue costs almost $200 in the US. North America has 7% of the world’s diabetic population but accounts for more than 50% of insulin sales – whereas China accounts for 25% of the world’s diabetic population but accounts for only 4% of the sales. The total value of insulin sold worldwide last year is estimated to have been $20 billion.
The year’s Tour de France (TDF) has begun, and Geraint Thomas has won the first stage, becoming the first Welshman to wear the famed yellow jersey. The TDF is a gruelling long-distance cycling race that covers 3,500 km in over three weeks, around France and its bordering states. The competition is more than a century old and has been held every year since 1903 except during the two world wars. It is among the most physically demanding sporting events in the world.
At least three cricketers have developed a sore throat in the last two or three years and needed cough syrup. Sore throats are pretty common, last about a week, and a virus is usually the cause. It really needs no treatment as the course is self-limiting. Drinking warm beverages or warm saline gargling brings considerable relief. A pain killer can be taken in case of excessive discomfort (but never give aspirin to a child as this may trigger Reye’s syndrome
Have you watched a game of hockey being played in your neighbourhood park in the recent or distant past? I doubt it. For a city of more than 20 million people, Delhi has a troubling dearth of decent parks. In fact, there may not be more than a handful. The neighbourhood parks enjoy some bustle in the mornings when people can be seen going about their morning walks, quite a few still attached to their smartphones. The pace is leisurely, few break a sweat, and the parks are deserted for the rest of the day.
India, apart from being an ancient civilisation, never misses a chance to embrace good humour. You have jokes flying around all the time. For instance, did you know that TV anchors were given an extra lobe of the lung by the Almighty? But then He had to remove the spine in order to fit the lobe in. A doctor in Delhi says, rather than supporting corporate hospitals, doctors must support smaller hospitals run by a trust or a doctor. The good doctor seems oblivious to the fact that, in reality, more than 90% referrals for coronary angiography by Delhi doctors are to corporate hospitals. The reasons for these referrals are manifold, but the primary cause or incentive for this pattern is well-known and need not be dilated upon. So much for supporting small- and medium-sized hospitals.