Saturday, 18 July 2020

The 18th WACEM-ACAIM- Special Global Web Conference on Combating COVIFLU



18th in the series of  WACEM-ACAIM Joint Working Group Meeting

Mumbai Model

In today's meeting we were joined by Dr. Sunil Khaparde, Advisor Public Health Mumbai who presented the strategies adopted by the Brihanmumbai Municipal Corporation (BMC) to successfully curb the incidence of COVID-19 in Mumbai hot-spots. 

The Dharavi model saw the forging of public and private partnerships with involvement of local societal organizations, local medical services, and various foundations. Ambulances staffed with trained medical personnel carry out door-to-door screening in order to check for individuals with fever and other COVID-19 symptoms, comorbidities, and collect swabs. They have an aggressive approach towards chasing the virus by using the 4 Ts model (Tracing, tracking, testing and treating). Read more at:


Eicosanoid storm

We touched upon cytokine release syndrome and cytokine storm in previous discussions. With the evolving knowledge and science surrounding COVID-19, we now take a look at the eicosanoid storm. Eicosanoids such as prostaglandins, thromboxane, leukotrienes are pro-inflammatory chemokines that are mediators of processes such as fever, inflammation, pain etc. The cytokine and chemokine responses are closely associated. Note that not all eicosanoids are pro-inflammatory, and in fact, are also metabolized into anti-inflammatory mediators. Regulation of eicosanoids is an approach to be considered in COVID-19 therapeutics.

Simulation

As COVID-19 has brought with it the need for remote monitoring, telemedicine, and social distancing, it brought an obstacle into academic medicine unseen by the general public. Bedside teaching and learning has long been a classic method of medical education. In the last decade or so, the medical fraternity has seen an enthusiastic use of simulation based teaching. With evolving science, technology and educational techniques, simulation based learning is being adopted by many centers across the world. This pandemic has been a reason to further our enthusiasm. Simulation based learning using realistic scenarios, with interdepartmental team approach is both a helpful learning tool as well as a useful tool to find gaps and failures in the delivery of medical care (e.g. difficulty communicating whilst wearing PPE, difficulty identifying members of the team, inadequate knowledge of storage of equipment/medications, equipment failure, poor communication, etc.) We suggest standardization of simulation based learning and involvement of various in-hospital teams in the betterment of COVID-19 management, and beyond.

Sepsis Summit 2020

The World Wide Web Summit on Sepsis 2020, is planned for September 2020 hosted by WACEM and Jefferson University, led by Dr. David Gaieski, is open to WACEM members,









Wednesday, 15 July 2020

The 17th WACEM-ACAIM- Special Global Web Conference on Celebrating 100 Days of Web Conferencing on COVID Crisis




The 17th  in the series of WACEM-ACAIM Joint Group Meeting



The COVID Central Academic Information System:


Key Note Speaker:
Dr. Sean Downing
Sarasota Concierge Physician
Sarasota Florida

Dr. Downing various interventions done in his Special Patient Population incorporating TELEMEDICINE
1.     ASA
2.     Colchicine
3.     Montelucast
He discussed about the Role of Telehealth in one case where he used a combination preventive treatment to curb the surge of cytokines.

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

Plant Based Immunotherapy
The Multi-Center Study Protocol was presented for Plant Based Intervention for COVID Inflammatory Control. A New agent X was added to the protocol to have direct comparison with other candidates in a multi-arm study.

Oxygen Supply Chain
 Various Factors related to health Oxygen Biosecurity were presented we moved ahead in preparing the blue print for the Oxygen 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.



Wednesday, 8 July 2020

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 4th July 2020

The COVID Central Academic Information System:


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.




Wednesday, 1 July 2020

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










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

27th June 2020

The COVID Central Academic Information System:

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 4th July 2020




Tuesday, 23 June 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 14th  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:

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.







Saturday, 13 June 2020

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...






Tuesday, 9 June 2020

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

The 12th  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

Ventilator Sparing Protocols

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