Saturday, 8 August 2020

The 21st WACEM-ACAIM Special Global Web Conference on COVID Crisis

 


21st in the series of the WACEM-ACAIM Joint Group Meetings

Plant based therapeutics

We have made further progress in refining the study design for trials with plant based therapeutics. 

Mumbai report

Maharashtra remains a hotspot for COVID-19 in India, and unfortunately has 40% of the deaths. Of the Maharashtrian burden, Mumbai houses 50%. 

India is now seeing a rural wave, with extension of the disease from urban and semi urban areas. Due to the restricted and limited access to primary care, the patients do not have access or have delayed access to simple clinical management measures (e.g. oxygen administration) and presentation to healthcare centers late in the disease process. 

We also have seen the practice of desperation medicine. Patients are being prescribed new medications as soon as they are on the market, with little or no evidence base by clinicians relatively unfamiliar with the drug profiles. 

To add insult to injury, the August deluge has sent Mumbai underwater. Due to heavy rains and floods, there will be a domino effect on healthcare with delayed access to care, supply chain issues, infrastructure problems, and vector-borne disease endemics that happen annually, now on the back of the present pandemic. 

Indigenous ventilator

Developed by a multifaceted team including, importantly, intensivists who actually use the machines, these ventilators are a much needed technological and medical innovation. 
Dr. Prachee Sathe's excellent blog explaining the journey and clinical background: https://dr-prachee-sathe.blogspot.com/

With technical specifications as recommended by the Ministry of Health and Family Welfare and the ICMR, and practical improvisations by the clinical teams managing patients, these ventilators were developed in a short time for use in ICUs. They were tested for endurance, battery time, different modes, parameters and displays, noise levels, and precision in delivery of FiO2, with volunteer based trials. One of the unique value of this NOCCARC v310 ventilator is the capability of high flow nasal cannula delivery of oxygen in addition to invasive ventilation and NIV modes. 

Ecuadorial hypothesis

We were joined by Dr. Ricardo Izurieta who shared some statistics of COVID-19 in Ecuador. 

There has been some consideration of association between geography/climate/environment with the COVID-19 illness, with reports looking into lower mortality rates in highland areas with some explanations offered e.g. ACE-2 receptor concentration, vitamin D3 levels etc. 

Dr. Izurieta also presented some interesting research into historical medicine, looking at cross-reactivity of yellow fever and dengue fever, which provided some food for thought about amnestic responses potentially in COVID. 

Calladoctor telemedicine platform

Being launched as a novel concept for kicking off telemedicine use in India. 

Masks

We had a presentation reminding us of various masks used during (and beyond) this COVID-19 pandemic, and the latest WHO recommendations. 










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