The 16th WACEM-ACAIM- Special Global Web Conference on 100 Days of Web Conferencing on COVID Crisis

The 16th  in the series of WACEM-ACAIM Joint Group Meeting

 100 Days of WACEM-ACAIM Summit on 4^th July 2020

The COVID Central Academic Information System:

https://emaindia.net/home/covid_central

Key Note Speaker:

Professor Fatimah Lateef

Member of Parliament of Government of Singapore

Academic Emergency Physician- Singapore General Hospital “SingHealth”

Dr. Lateef highlighted various interventions done in Singapore at

1.     Public Health Level

2.     Hospital Level

3.     Department level

4.     Interpersonal Level

She also discussed about the Role of Simulation, Communication and Coordination between the above four sectors to make sure that Quality and Safety were not compromised at any level.

Global Data:

Dr. Sinha presented Mumbai Data:

·       ICU Definition and Capabilities were a major factor in mortality

·       Oxygen Supply Chain has failed and need immediate attention

·       Overstock of Ventilators without trained Nurses or Doctors

Telemedicine:

The WACEM TeleMedicine Global Gateway was presented. This will set up new benchmarks based on our 4 Pillars.

Plant Based Immunotherapy

The Multi-Center Study Protocol was presented for Plant Based Intervention for COVID Inflammatory Control.

BioSecurity in COVIFLU

Various Factors related to health Biosecurity were presented we moved ahead in preparing the blue print for the supply chain applications in the new era of COVIFLU.

Jefferson-WACEM Sepsis Summit 2020

In September 2020 WACEM along with Jefferson University will host the World Wide Web Summit on Sepsis 2020. It was announced that all WACEM Members can attend the summit and participate as speakers. Dr. David Gaieski is the Leader of this Summit.

The 15th WACEM-ACAIM- Special Global Web Conference on “COVIFLU Probabilities”

The 15^th  Weekly Summit in the series of WACEM-ACAIM Joint Group Meeting

27th June 2020

The COVID Central Academic Information System:

https://emaindia.net/home/covid_central

Global Data:

The Mumbai Numbers continue to surge as well the Florida and Texas Numbers in USA.

Clinical Studies:

Vaccine Studies at various levels still in progress

Stem Cell Studies look promising

Anti-Viral Options are limited.

Ventilator Sparing Protocols by the group are effective.

Telemedicine:

Detail, Discussion was held on formatting the TeleMedicine Science Section around the 4 Pillars. Discussion around how the framework would be unveiled was the epicenter of this meeting.

BlindSpots in COVID Care

Discussion was done on various BlindSpots in caring for COVID Patients and Combating the Pandemic at a Public Health Level. These will be applicable as COVIFLU becomes a reality.

Plant Based Immunotherapy (PBI)

Discussion was held on developing the PBI sector with a multi-center effort. Various Candidates were reviewed during the discussion.

BioSecurity in COVIFLU

Various Factors related to health Biosecurity were studied as we moved ahead in preparing the blue print for the supply chain applications in the new era of COVIFLU.

100 Days of WACEM-ACAIM Summit on 4^th July 2020

The 14th WACEM-ACAIM- INDUSEM-ACEE-EMA and Kerala Special Global Web Conference on “COVID Clinical Training on Silent Hypoxia, Ventilator Sparing Protocols & Home Oxygen Monitoring”.

The 14^th  in the series of WACEM-ACAIM Joint Group Meeting

Chief Patron:
Smt. K. K. Shailaja Teacher
Minister for Health, Social Justice and Woman and Child Development
Government of Kerala

Training Initiative Chairs
Dr. Sagar Galwankar (USA)
Dr. Sanjeev Bhoi (AIIMS,  New Delhi)

Lead Trainers:
Dr. Stan Stawicki (USA)
Dr. Indrani Sardesai (UK)
Dr. Sagar Sinha (India)

The COVID Central Academic Information System:

https://emaindia.net/home/covid_central

The WACEM- ACAIM Group continued the Training program for all Frontline Emergency Physicians and Critical Care Physicians in the State of Kerala India on the important clinical process called “Ventilator Sparing Protocols”

The Expert Academicians at The World Academic Council of Emergency Medicine (WACEM), The American College of Academic International Medicine (ACAIM), The Emergency Medicine Association (EMA-India) and The Academic College of Emergency Experts (ACEE-INDIA) have developed protocols, which augment effective utilization of ventilators for specifically indicated patients with specific parameters for escalating Oxygen and Ventilation Therapy in COVID19. 

Ventilators Demand has risen immensely in the COVID Pandemic. The protocols can result in Ventilator sparing and utilization of ventilators for the patients who really need them and in turn benefit from them. These protocols were presented by Experts.

Sub-clinical Hypoxia a.k.a 'Silent Hypoxia" and Home Oxygen Monitoring protocols were also discussed.

The Training was provided to selected Emergency Medicine Leaders and Critical Care Leaders from Institutions taking part in the Government of Kerala- COVID Patient Care Response.

The leaders are now empowered to implement these protocols across Kerala.

This training initiative was held in partnership with The World Health Organization Collaborating Center for Emergency and Trauma at AIIMS New Delhi and The Government of Kerala Ministry of Health and Family Welfare. 

The INDUSEM Mission, The Emergency Medicine Association and The Academic College of Emergency Experts were the key Partner Organizations for this program.

The 13th WACEM-ACAIM Special Global Web Conference on “COVIFLU: The Second Wave or The Tsunami"

The 12th WACEM-ACAIM meeting focussed on the expected second wave of COVID-19, perhaps even a Tsunami when COVIFLU hits in Influenza season.

Contingency planning

We recognize the need to practice proactive medicine rather than reactive medicine. With contingency planning, looking all the phases of disease management, table-top exercises, major incidence planning and disaster management; as well as lessons learnt from previous (and this current) pandemic in prevention of future crises.

Immunological pathway for COVIFLU

We are closer to publication of our immunological model for COVID-19, but also describing a model for the expected COVIFLU wave. The key point being that we expect a synergistic immunological response in COVIFLU, thus further driving the need for immunomodulatory therapies.

Pluristem

We were joined by Mr. Lirans, representing Pluristem (visit: https://www.pluristem.com/ ) an Israeli stem cell therapy company. They produce ethically accepted, placenta-derived cell therapy. A single vial is delivered via intramuscular injection, with the basis of treatment being adaptive slow cytokine release, resulting in immunomodulation rather than immunosuppression. The treatment, and this company show great promise and we are following their incredible journey.

Telemedicine update

a. Our telemedicine paper is under development.

b. Telemedicine platform - we hope to launch the website which will be an interactive audio-visual interface for telemedicine, with a plan to eventually support multilingual use. 

Supply chain

Restructuring the existing supply chain, for instance by localization, leads to improving biosafety and biosecurity. Until now, supply chain models have been used in vaccine provision, biowaste disposal, and more routine usage in the chemical industry. However this extends further to general living, medical resources; and it is particularly important to main and restructure this during pandemics or other crisis scenarios. 

Until next time...

The 12th WACEM-ACAIM- INDUSEM-ACEE-EMA and Kerala Special Global Web Conference on “COVIFLU Clinical Training on Ventilator Sparing Protocols”.

The 12^th  in the series of WACEM-ACAIM Joint Group Meeting

The WACEM- ACAIM - INDUSEM- EMA -ACEE  Team created a new benchmark as they led a Training program for all Front-line Emergency Physicians and Critical Care Physicians in the State of Kerala India on the important clinical process called “Ventilator Sparing Protocols”

Ventilators Demand has risen immensely in the COVID Pandemic.

The Expert Academicians at The World Academic Council of Emergency Medicine (WACEM), The American College of Academic International Medicine (ACAIM), The Emergency Medicine Association (EMA-India) and The Academic College of Emergency Experts (ACEE-INDIA) have developed protocols, which augment effective utilization of ventilators for specifically indicated patients with specific parameters for escalating Oxygen and Ventilation Therapy in COVID19.

The protocols can result in Ventilator sparing and utilization of ventilators for the patients who really need them and in turn benefit from them.

These protocols were presented by Experts.

Sub-clinical Hypoxia a.k.a 'Silent Hypoxia" and Home Oxygen Monitoring protocols were also discussed.

The Training was provided to selected Emergency Medicine Leaders and Critical Care Leaders from Institutions taking part in the Government of Kerala- COVID Patient Care Response.

The leaders are now empowered to implement these protocols across Kerala.

This training initiative was held in partnership with The World Health Organization Collaborating Center for Emergency and Trauma at AIIMS New Delhi and The Government of Kerala Ministry of Health and Family Welfare. 

The INDUSEM Mission, The Emergency Medicine Association and The Academic College of Emergency Experts were the key Partner Organizations for this program.

Chief Patron:
Smt. K. K. Shailaja Teacher
Minister for Health, Social Justice and Woman and Child Development
Government of Kerala

Training Initiative Chairs
Dr. Sagar Galwankar (USA)
Dr. Sanjeev Bhoi (AIIMS,  New Delhi)

Lead Trainers:
Dr. Stan Stawicki (USA)
Dr. Indrani Sardesai (UK)
Dr. Sagar Sinha (India)


COVID19 Experts:
Dr. Salvatore Di Somma (ITALY)

Dr. Prabath Nanayakkara (Netherlands)
Dr. Manish Garg (USA)

Protocols:

COVID Primer

http://www.jgid.org/article.asp?issn=0974-777X;year=2020;volume=12;issue=2;spage=47;epage=93;aulast=Stawicki

Ventilator Sparing Protocols

http://www.ijciis.org/article.asp?issn=2229-5151;year=2020;volume=10;issue=2;spage=56;epage=63;aulast=Sinha

Silent Hypoxia

http://www.jgid.org/article.asp?issn=0974-777X;year=2020;volume=12;issue=2;spage=39;epage=43;aulast=Chauhan

The 11th WACEM-ACAIM Joint Special Global Web Conference on "Living with COVIFLU"

In this 11th WACEM-ACAIM Joint Working Group, we venture into furthering work we have already commenced and introducing the topic of supply chain dynamics in the COVID-19 era. Today we were joined by President-Elect of the American Academy of Emergency Medicine (AAEM), Dr. Lisa Moreno, with whom we hope to establish a long and fruitful collaborative relationship.

Situation in Greater Mumbai

We learnt of the further worsening situation in Greater Mumbai, particularly focussing on the severely inadequate ventilator to patient ratios. Our leaders are working hard on applying the algorithms we have jointly developed on the ground level, and gathering data derived from the practical application. Our prayers and well wishes go out to the healthcare workers and people of they city and country. 

Urban and Rural Pandemic in India

Though it started out an urban disease, as things stand with migration, and the natural course of spread, we will see two very different scenarios playing out - the urban pandemic struggling even with all its amenities and man-power, and the rural pandemic, which will be heavily reliant upon primary care, with very little scope of using tertiary care as their safety net due to an overwhelming of resources already in play. 

AAEM Collaboration

We were joined by Dr. Lisa Moreno, President-Elect of the American Academy of Emergency Medicine, who gave us a short overview on their excellent democratic model seeking to create a culture of fairness and equality for emergency physicians so they can in turn deliver the highest quality of patient care. We hope to develop a fruitful working relationship between ACAIM/WACEM and AAEM going forward in the realm of global emergency medicine.

Education Design

We hope to develop our work, papers and presentations into a structured educational course to benefit all physicians everywhere. For these purposes, we had an excellent presentation of developing a sound educational model based on successfully applied existing courses. 

Developing a Culture of Telemedicine

As discussed in previous meetings, and reiterated with good reason, the joint group is working on developing a paper that will encompass the topic of moving from crisis telemedicine to a culture of telemedicine. The paper will hope to answer the why, what, how and when questions, and hopefully provide a robust system that is practically applicable and medically sound.

Pathophysiology Hypothesis

Extensive work done by the immunologists in our working group is coming to fruition. We hope to soon publish the detailed work on the pathophysiology of the coronavirus infection, rooted in the workings of the immunology system - direct and indirect pathways, hopefully paving the way to a better understanding of the disease, and consequently developing immune-modulating treatments. 

Supply Chain Model to Restore the Economy

Understandably, the medical fraternity has been keenly focussing on the medical impact of the disease - either to patients, hospitals or healthcare workers. However, we need to expand this focus to the greater picture and work on reviving the economy as a whole, and medical care dynamics by creating a workable supply chain model. From the well off - focussing on safety, amenities, and the finest private medical care, to the socioeconomically deprived - worried about living hand to mouth, and the food reaching their plate, let alone a high standard of medical care, an operational supply chain is the basis of biosecurity. Again, we are working on developing the model and sharing our accumulative knowledge. 

More to come...

It's been 11 weeks since the commencement of these weekly meetings, and from abstract visions and undeveloped ideas, we have now reached the stage of creation, implementation, publications and expanding collaboration. No doubt there is more to come.

The 10th WACEM-ACAIM Joint Special Global Web Conference on “Living with COVIFLU”.

The 10^th  in the series of WACEM-ACAIM Joint Group Meeting was packed with presentations of important work being done by the group. Our continued gratitude to all presenters and panelists.

The leaders Celebrated 10 weeks of Academic Leadership across the World with our Web Conference crossing record registrations from all around the world.

Immunotherapeutic Combinations   

COVIFLU immunology was discussed with Therapeutic targets encompassing anti-viral and immune antibodies. The upcoming Publication was discussed in Detail.

Telemedicine

A working Group was created to work on building the science of TeleMedicine.

The group discussed the Four Pillars of TeleMedicine Sciences:
1. Recording of Audio Visual Data as Health Record
2. Reimbursements and Accountability
3. Telemedicine Metrics / Analytics / Reforms
4. Patient Safety & Confidentiality

Kerala COVID Control Model

A detail discussion was held on the success of the Kerala Model.

Contact Tracing, Transformational Leadership and a Strict Chain of Command with open communication with the citizens were found to be major success behind the COVID Control.

Detail discussion was held on each of the above aspects.

Agenda for Next Meeting

·       Education Framework

·       Translational Research Framework

·       TeleMedicine Systems Framework

Our COVID Publications:

Chauhan V, Galwankar SC, Yellapu V, Perez-Figueroa IJ, Stawicki SP. State of the globe: The trials and tribulations of the COVID-19 pandemic: Separated but together, telemedicine revolution, frontline struggle against “Silent Hypoxia,” the relentless search for novel therapeutics and vaccines, and the daunting prospect of “COVIFLU”. J Global Infect Dis 2020;12:39-43

http://www.jgid.org/article.asp?issn=0974-777X;year=2020;volume=12;issue=2;spage=39;epage=43;aulast=Chauhan

Thakur S, Chauhan V, Galwankar S, Kelkar D, Vedhagiri K, Aggarwal P, Bhoi S. Covid-19 testing strategy of India – Current status and the way forward. J Global Infect Dis 2020;12:44-6

http://www.jgid.org/article.asp?issn=0974-777X;year=2020;volume=12;issue=2;spage=44;epage=46;aulast=Thakur

Stawicki SP, Jeanmonod R, Miller AC, Paladino L, Gaieski DF, Yaffee AQ, De Wulf A, Grover J, Papadimos TJ, Bloem C, Galwankar SC, Chauhan V, Firstenberg MS, Di Somma S, Jeanmonod D, Garg SM, Tucci V, Anderson HL, Fatimah L, Worlton TJ, Dubhashi SP, Glaze KS, Sinha S, Opara IN, Yellapu V, Kelkar D, El-Menyar A, Krishnan V, Venkataramanaiah S, Leyfman Y, Saoud Al Thani HA, B Nanayakkara PW, Nanda S, Cioè-Peña E, Sardesai I, Chandra S, Munasinghe A, Dutta V, Dal Ponte ST, Izurieta R, Asensio JA, Garg M. The 2019–2020 novel coronavirus (severe acute respiratory syndrome coronavirus 2) pandemic: A joint american college of academic international medicine-world academic council of emergency medicine multidisciplinary COVID-19 working group consensus paper. J Global Infect Dis 2020;12:47-93

http://www.jgid.org/article.asp?issn=0974-777X;year=2020;volume=12;issue=2;spage=47;epage=93;aulast=Stawicki