COVID
articles authored by
Dr. T. Rama Prasad
and published in MEDICAL JOURNALS, making a WORLD RECORD
1. Rama Prasad. T., Origin of COVID. The Antiseptic, 2022 August; Vol. 119; No. 8 Indexed in IndMED – www.antiseptic.in
2. Rama Prasad. T., COVID Deaths. The Antiseptic, 2022 July; Vol. 119; No. 7; P: 14-22; Indexed in IndMED – www.antiseptic.in
3. Rama Prasad. T., The long and the short of COVID in India. The Antiseptic, 2022 June; Vol. 119; No. 6; P: 14-27; Indexed in IndMED – www.antiseptic.in
4. Rama Prasad. T., COVID Fear and Paranoia. The Antiseptic, 2022 May; Vol. 119; No. 5; P: 09-17; Indexed in IndMED – www.antiseptic.in
5. Rama Prasad, T., Post-OMICRON Peregrination. The Antiseptic, 2022 April; Vol. 119; No. 4; P: 06-14; Indexed in IndMED – www.antiseptic.in
6. Rama Prasad, T., COVID – still an enigma. The Antiseptic, 2022 March; Vol. 119; No. 3; P: 20-25; Indexed in IndMED -- www.antiseptic.in
7. Rama Prasad, T., OMICRON – A Paper Tiger. The Antiseptic, 2022 February; Vol. 119; No. 2; P:12-21; Indexed in IndMED – www.antiseptic.in
8. Rama Prasad, T., Ominous Omicron of COVID. The Antiseptic, 2022 January; Vol. 119; No. 1; P:25 – 29; Indexed in IndMED – www.antiseptic.in
9. Rama Prasad, T., COVID and Tuberculosis. The Antiseptic, 2021 December; Vol. 118; No.12; P: 11-17; Indexed in IndMED -- www.antiseptic.in
10. Rama Prasad, T. The Science and Nonsense around COVID. The Antiseptic, 2021 November; Vol. 118; No. 11; P: 8-14; Indexed in IndMED -- www.antiseptic.in
11. Rama Prasad, T. COVID, Children and Schools. The Antiseptic. 2021 October; Vol.118; No.10; P: 08-18; Indexed in IndMED -- www.antiseptic.in
12. Rama Prasad, T. India’s Third COVID Wave. The Antiseptic. 2021 September; Vol.118; No.9; P: 14-20; Indexed in IndMED – www.antiseptic.in
13. Rama Prasad, T. Vagaries of India’s COVID Vaccination Policy. The Antiseptic. 2021 August; Vol.118; No.8; P: 10-16; Indexed in IndMED – www.antiseptic.in
14. Rama Prasad, T. Mucormycosis and COVID-19 in India. The Antiseptic. 2021 July; Vol.118; No.7; P: 21-26; Indexed in IndMED -- www.antiseptic.in
15. Rama Prasad, T. Disastrous Second COVID Wave in India. The Antiseptic. 2021 June; Vol.118; No.6; P: 20-27; Indexed in IndMED – www.antiseptic.in
16. Rama Prasad, T. COVID Variants. The Antiseptic. 2021 May; Vol.118; No.5; P: 11-14; Indexed in IndMED -- www.theantiseptic.in
17. Rama Prasad, T. Covishield or Covaxin ? The Antiseptic. 2021 April; Vol. 118; No. 4; P: 12-16; Indexed in IndMED – www.theantiseptic.in
18. Rama Prasad, T., Versha Rajeev. The Conundrum of COVID-19 Vaccines. The Antiseptic. 2021 January; Vol.118; No.1; P: 10-17; Indexed in IndMED – www.theantiseptic.in
19. Rama Prasad, T. 40+15 Hypoxia Test in COVID-19. The Antiseptic. 2020 December; Vol. 117; No. 12; P: 13-17; Indexed in IndMED – www.antiseptic.in
20. Rama Prasad, T., Versha Rajeev. Antiseptics, Disinfectants and COVID-19. The Antiseptic. 2020 November; Vol.117; No.11; P: 26-28; Indexed in IndMED – www.antiseptic.in
21. Versha Rajeev., Rama Prasad, T. Fear and COVID. Health. 2020 November; Vol.98; No.11; P:31-32
22. Rama Prasad, T., Versha Rajeev. Tea and COVID. Health. 2020 October; Vol.98; No.10; P: 4-6.
23. Rama Prasad, T. Is the “Lockdown Medicine” too toxic ? The Antiseptic. 2020 October; Vol. 117; No. 10; P: 13-15; Indexed in IndMED – www.theantiseptic.in
The articles may be accessed at IndMED – www.antiseptic.in
A brief introduction
In the words of Prof C H Sivaraman, FRCP (London):
“ ... Dr. T. Rama Prasad belongs to a distinctly different and unconventional species of doctors. He speaks sparingly and does not even display his qualifications or merits, but his innumerable published writings (he calls them ‘scribblings’ though they are ‘pearls of wisdom and knowledge’, sprinkled with a bit of humour and sarcasm) which received wide acclaim talk eloquently for him. The ‘PAY WHAT YOU CAN’ Clinic where services are available for which one may pay whatever one can is a facility run by Dr. Prasad for a very long time which could be a world record. Dr. Prasad is called a “god” by his patients, and many of them named their children after his name “Prasad” -- that is the height of recognition of goodness of a human being... ”
This is not an ad, it’s about an odd service.
GREETINGS from
‘PAY WHAT YOU CAN’ Clinic
“Thena thyakthena bhoojithaha”– Ishopanishad
( Translated by Prof. B.M. Hegde as: “Rejoice in giving.”)
True to this quote, I have been rejoicing at what little I could give. Defying stereotypes, this clinic has been in existence for a very long time, sans glitz, blitz, ads, microphones, speeches and noise. As a matter of my policy, publicity is shunned. The reason is simple. Good work needs no noise and nonsense. My ‘SCRIBBLINGS’ on related topics may be accessed at: http://drtramaprasad.blogspot.com or www.rama-scribbles.in
My consultation fee is not decided by me. It is the patient’s pleasure. The patient may pay (donate) whatever he can and what he wishes. If one is short of money, he or she need not pay anything. And the money thus received is used for charity to help the needy, the poor and the less fortunate. If interested to know more about this facility, go to: http://drtramaprasad.blogspot.com/2017/06/pay-what-you-can-clinic.html
"We need not run after money. If we are meritorious and compassionate, money would run after us, and it eludes us if we run after it.” -- T. Rama Prasad
“Richness is not having lots of money. It is the feeling that one has enough of it. Contentment sans comparison is what makes one really rich.” -- T. Rama Prasad.
Dr. T. Rama Prasad, Director, ‘PAY WHAT YOU CAN’ Clinic, PERUNDURAI, Erode Dt., TN, India. Former Medical Superintendent (Special), RTS & IRT Perundurai Medical College and Research Centre, Perundurai, Website: www.rama-scribbles.in , Blog: https://drtramaprasad.blogspot.com, Email:drtramaprasad@gmail.com, Facebook: T Rama Prasad, Twitter: @DrRamaprasadt, WhatsApp: +91 98427 20393
AUTHOR Dr. T. Rama Prasad
A short list of some of the published articles in The Antiseptic (a premier Medical & surgical journal),
‘The Hindu’ (a national Newspaper), etc. authored by Dr. T. Rama Prasad.
1. Digital clubbing and Hypertrophic Pulmonary Osteoarthropathy -
Pathogenesis -- The Antiseptic, Vol. 76. pp. 213-215, 1979
2. Childhood Tuberculosis - Part I -- The Antiseptic, Vol. 76, pp. 449-504,1979
3. Childhood Tuberculosis - Part II -- The Antiseptic, Vol. 76. pp. 567-574, 1979
4. Stevens-Johnson Syndrome and Thioacetazone -- The Antiseptic, Vol. 77, pp. 99-102, 1980
5. Highly Purified Insulins - An Assessment -- The Antiseptic, Vol. 77, pp. 3455-347, 1980
6. Is the "Lockdown Medicine" too toxic ? -- The Antiseptic, Vol.117, No.10, pp. 13 - 15, 2020
7. Antiseptics, Disinfectants and COVID-19 -- The Antiseptic, Vol.117, No.11, pp. 26 - 28, 2020
8. Disastrous Second Covid Wave in India -- The Antiseptic, Vol.118, No. 6, pp. 20-27, 2021
9. Covid Variants -- The Antiseptic, Vol. 118, No.5, pp. 11-14, 2021
10. The Conundrum of COVID-19 Vaccines -- The Antiseptic, Vol.118, No. 1, pp. 10-17, 2021
11. Covishield or Covaxin ? -- The Antiseptic, Vol.118, No. 4, pp. 12-16, 2021
12. 40+15 Hypoxia Test in COVID-19 -- The Antiseptic, Vol. 117, No.12, pp. 13-17, 2020
13. Mucormycosis and COVID-19 in India -- The Antiseptic, Vol. 118, No. 7, pp. 21-26, 2021
14. Vagaries of India’s Covid Vaccination Policy – The Antiseptic, Vol. 118, No. 8, pp. 10-16, 2021
15. India’s Third Covid Wave -- The Antiseptic, Vol. 118, No. 9, pp. 14-20, 2021
16. Covid, Children and Schools -- The Antiseptic, Vol. 118, No. 10, pp. 08-18, 2021
17. The Science and Nonsense around COVID -- The Antiseptic, Vol.118, No.11, pp. 08-14, 2021
18. Covid and Tuberculosis – The Antiseptic, Vol.118, No.12, 2021
19. Tea and Covid -- Health, Vol. 98, No.10, pp. 4-6, 2021
20. Fear and Covid -- Health, Vol. 98, No. 11, pp. 31-32
21. HEALTH CHECK-UP: how healthy is it ? - The Hindu, Open Page, January 15, 2012 –
https://www.thehindu.com/opinion/open-page/Health-check-up-how-healthy-is-it/article13379235.ece
22. THE ‘GOOGLE EFFECT’: may be good, may be bad - The Hindu, Open Page, April 22, 2012
23. OF TEA, COFFEE and COMMERCE - The Hindu, Open Page, January 12, 2014 …
https://www.thehindu.com/opinion/open-page/of-tea-coffee-and-commerce/article5567951.ece
24. A BAD PATCH - The Hindu, Open Page, March 15, 2020 ...
https://www.thehindu.com/opinion/open-page/a-bad-patch/article31069356.ece
25. Yellow Nail Syndrome - Chest (U.S.A.), Vol. 77, p.580, 1980
https://journal.chestnet.org/article/S0012-3692(16)40458-7/fulltext
26. Yellow Nail Syndrome - The Indian Journal of Chest Diseases & Allied Sciences, Vol. 22, pp. 69-72, 1980.
27. Drug Resistance in Tuberculosis - Journal of the Indian Medical Association, Vol. 64, pp. 264-267, 1975.
References to more articles by Dr. T. Rama Prasad may be found in: http://drtramaprasad.blogspot.com
Dear Dr. Rama Prasad
I am sure the world will be a better place, if people understand your writings ... ‘EXCELLENT’ is the word. I cannot find any other word in this language to describe what you have written without any pretensions. You have brought out some home truths to those who care to read your website ... You are a great thinker, writer and crusader ... As usual, your messages are incisive, to the point and make lots of sense, much better than my articles …
... You are not only GREAT, but are a true missionary in medicine. May your tribe increase for the good of mankind. ….
Love,
-- Padma Bhushan Prof. B. M. Hegde, (awarded Padma Vibhushan in 2021)
MD, FRCP (Lond), FRCP (Edin), FRCP (Glas), FRCP (Dub), FACC (USA), FAMS, Former Professor of Cardiology, Middlesex Hospital Medical School, University of London, UK, Former Vice-Chancellor, Manipal University, India, Affiliate Professor of Human Health, Northern Colorado University, USA, Editor-in-Chief, The Journal of the Science of Healing Outcomes, Chairman, State Health Society’s Expert Committee, Govt of Bihar, India and Padma Bhushan awardee of 2010. www.bmhegde.com
CLICK ON THE HEADINGS BELOW TO ACCESS THE “SCRIBBLINGS”
· ABOUT ME and MY SCRIBBLINGS (2) 'PAY WHAT YOU CAN' Clinic
· MY LOVE STORY & good old days (4) BETTER HALF (4) SHIVA, KRISHNA, Ramanuja & Ramanujan (5) MOTHER-IN-LAW (6) YOU ARE NOT OLD (7) MODERN MEDICINE -- the Good, the Bad and th... (8) Dr. Peon, PhD (9) MEDICAL CONFERENCES & Clinical meetings (10) RUN ON MONEY (11) MEDICINE IN RURAL INDIA (12) RURAL ARE THE REAL (13) INTERNET EFFECT (14) MARKETING TRICKS & INNOVATIONS (15) INCREDIBLE INDIA ! (16) SCHOOL EDUCATION (17) DEVALUED DEGREES (18) TEA, COFFEE and COMMERCE (19) SEX. and MARRIAGE (20) THE CHANGING WORLD (21) RAPE (22) SEXUAL HARASSMENT (23) DRESS SENSE (24) OPEN AIR DEFECATION (25) ONAM 2017 (26) TEST-TUBE BABIES and TERMINATION BABIES (27) TEST-TUBE PUPPIES (28) ASTHMA, ALLERGY & COPD (29) GIRL CHILD : GOLDEN CHILD (30) MY REAL AWARDS (31) TREES and PLANTS (32) PERUNDURAI MEDICAL COLLEGE & SANATORIUM campus (33) SOPHISTICATED CHEATING (34) NIPAH & ZIKA viruses (35) SWINE FLU -- A (H1 N1) influenza (36) INDIAN SUPERBUG (37) HCQ, IVERMECTIN, CORONAVIRUS and FRAUDS (38) YOGA (39) CORONA and CHARLES DARWIN (40) GOD, RELIGION & UNIVERSE (41) LOCKDOWN MEDICINE (42) CODUP (43) GOD-MEN (44) DOGS (45) CANCER (46) SMILE and STRESS (47) CIVIC SENSE & MANNERS (48) MY ART (49) TUBERCULOSIS in India (50) DIABETES (51) FOOLED TO BELIEVE (52) DENGUE, ZIKA and MOSQUITO (53) COMPLEXION (54) BAHUBALI (55) VINAYAKA chathurdhi 2017 (56) SUNDAY LUNCH ... Dec 3, 2017 (57) ABDUL KALAM (58) BIRDS and DRUGS (59) YELLOW NAIL SYNDROME (60) RICHNESS and HAPPINESS (61) FISHES (62) KMCH (63) MY 'SCRIBBLES' IN NEWSPAPERS (64) To live in INDIA or ABROAD ? (65) SILENT, ISOLATED and INSULATED (66) PONGAL FESTIVAL (67) SPB (68) CESAREAN DELIVERY (69) POLLUTION, Disease and Deepaavali (70) HAPPY 2018 (71) BRINGING UP CHILDREN (72) SINGAPORE (73) STAFF & STUDENTS. -- photos (74) "AHIMSA" (75) GRADUATION DAY -- 2018, Perundurai Medical Col... (76) PERUNDURAI is the GEM (77) WORLD CANCER DAY ..February 4, 2017 (78) INDIAN ENGLISH (79) FOOD, EXERCISE and SLEEP (80) Nurses Day 2017 (81) DEEPAAVALI (82) PUTHAANDU -- Tamil New Year Day - 2018 & 2017 (83) COMPUTER. ILLITERATE (84) SMILE and LAUGHTER (85) REMOTE ANCESTORS (86) ODD things ... wow, whacky & weird ! (87) FACEBOOK 'scribbles' (88) HANDWRITING (89) MY QUOTES
The following is the comment written by the internationally renowned scholar, Pritam Bhattacharyya (Editor-at-Large of Pentasect and Founder and Chief of Wordsmith at Wordsmith Communication, Chairman of Freelance Foundation, ) on the blog article on Coronavirus and COVID-19
(1) https://wordsmithofbengal.wordpress.com/2012/01/16/health-un-heath-and-fear-of-un-health/
(2) https://wordsmithofbengal.wordpress.com/2012/04/23/google-effect-and-kali-yuga-prophecies/
wordsmithApril 12, 2020 at 10:42 PM
“One of the best articles I have read on this theme and having balance, measure and proportion. Miss Corona in hindsight is really kind and benign in a sense - Nature has rolled a dice with fatality of 2-3%. She is under no obligation not to roll a dice of fatality 40,50,60% with Ms. Corona being "size zero" and "air-borne". Consider what would have happened ?
Dr. Prasad is one of the few doctors whom I know who fall into the rare category of "healers". A healer knows the art, science and commerce of healing, i.e. allowing the innate immunity of the body to manifest itself.
One should be very careful and critical about three things in the world : Big Pharma, Big Government, Big Science. In the proverbial Kali-Yuga, all three converge with overlapped agendas and sometimes not with the best interest in mind of the end users : patients, citizens, learners.
Finally, this pandemic will also pass. The system will come to a new equilibrium. But I think a whole generation will carry this impression forward and may become saner with this.
I nurture another hope : just like pivotal events propel a whole generation (Apollo Mission and interest in space science), this may inspire many young Indians to shift their focus into public healthcare, virology, immunology, public immunity, psychological counselling and learning the art and science of healing.
Again, it was very nice to find an article of this time in the avalanche of printed words in this theme.
Continue your good work.”
COVID world: 23 of my articles on ‘COVID’ were published in 23 months in Medical Journals which is a WORLD RECORD in Medical Journalism.
This article titled “Origin of COVID” is the 24th one.
-- Dr. T. Rama Prasad, ‘PAY WHAT YOU CAN’ Clinic, Perundurai, India
---------------------------------------------------------------------------------------------
. Origin of COVID .
RAMA PRASAD T.
Dr. T. Rama Prasad,
Formerly: Medical Superintendent (Special) of RTS & IRT Perundurai Medical College and Research Centre, Perundurai, Tamil Nadu, India.
Presently: Director of ‘PAY WHAT YOU CAN’ Clinic, Perundurai, Erode District, TN – 638052. drtramaprasad@gmail.com WhatsApp +91 98427 20393 BLOG https://drtramaprasad.blogspot.com WEBSITE www.rama-scribbles.in Twitter @DrRamaprasadt Facebook T Rama Prasad Telegram Dr T Rama Prasad
`
A MONTHLY JOURNAL OF MEDICINE AND SURGERYSN
Vol. 119 No. 8 August 2022 ISSN 0003 5998
Indexed in IndMED Email: admin@theantiseptic.in www.theantiseptic.in
GREAT HOLY SOUL
16.10.2017
" ... I always wonder that we both seem to be identical in our thoughts, deeds and actions. ... I always cherish your friendship and appreciate your humanitarian attitude towards life, poor rural people and the needy. ... I went through your articles ... especially, the 'PAY WHAT YOU CAN Clinic' touched my heart, and after studying, I wondered: "What a great holy soul you are !" You are a living example of Swami Vivekananda. ... "
Dr. J.K.K. Munirajahh, M.Tech (Bolton)
Chairman, JKKM Group of Institutions & Industries
Komarapalayam, Tamil Nadu, India
"...A study of your work reveals how fertile is your brain and how facile is your pen. Your command of English is breathtaking. One cannot help being astounded by your encyclopaedic range of knowledge and its depth is unfathomable......Your sense of humour is very much to be appreciated. Your invaluable treasure "SCRIBBLINGS" is to be preserved for posterity....."
-- Prof. P. Lakshmi, MA,
Principal, Vellalar College for Women,
Thindal, Erode, Tamil Nadu, India
Dear Dr. Rama Prasad,
“..When I saw a copy (of your book titled "Some of my SCRIBBLINGS") in the medical college library, curiosity got the better of me and I borrowed it. As I went through it, curiosity turned into admiration. What struck me first and the most was your command over the language. I appreciated your interest in widely varied subjects, from pornography to piano, as the saying goes. I also realised that the interest was not just superficial, but substantial as evidenced by the statistics quoted to emphasise a point. When I finished with it, it left me wondering how you continued to sustain your interest despite having spent more than 3 decades in this place, well isolated and insulated from academic and intellectual environment...”
--- Group Captain (Retd) Prof. N. Ramachandran, MD,
Professor of Paediatrics, Perundurai Medical College Perundurai, Erode District, Tamil Nadu, India
“… I am amazed to find how the book (Some of my “Scribblings”) mirrors your multifaceted personality – the sterling qualities of head and heart. It reflects the encyclopedic range of your mind. I am struck by the fact that there was no subject that is untouched – from physical to metaphysical, sacred to secular, all under the sun have been dealt with quite thoroughly, authenticated and well-documented to reveal a genuine humanist at work. … Combined with the art of healing is your art of drawing and painting. … We are amazed to see your paintings and to learn that the illustrations in the “Scribblings” are your own. …”
-- Prof. V. Prafulla,
M.A., Ph.D. (Eng.), M.A. (Hindi), P.G.T.E., Former Principal, Erode Arts College for Women, Erode, Tamil Nadu, India; Former Professor of English, Visalakshi College, Udamalpet, Tamil Nadu, India.
WRITINGS AND TALKS of Dr. T. Rama Prasad
List No. 1
1. Drug Resistance in Tuberculosis - Journal of the Indian Medical Association, Vol. 64, pp. 264-267, 1975.
2. Digital clubbing and Hypertrophic Pulmonary Osteoarthropathy - Pathogenesis - The Antiseptic, Vol. 76. pp.
213- 215, 1979.
3. Childhood Tuberculosis - Part I - The Antiseptic, Vol. 76, pp. 449-504,1979
4. Childhood Tuberculosis - Part II - The Antiseptic, Vol. 76. pp. 567-574, 1979
5. Yellow Nail Syndrome - Chest (U.S.A.), Vol. 77, p.580, 1980 –
http://journal.chestnet.org/article/S0012-3692(16)40458- 7/fulltext
6. Short-course Chemotherapy - The recent Advances in the Treatment of Respiratory Tuberculosis - Current Medical Practice,
Vol.24, pp. 41- 46, 1980.
7. Stevens-Johnson Syndrome and Thioacetazone - The Antiseptic, Vol. 77, pp. 99-102, 1980.
8. Yellow Nail Syndrome - The Indian Journal of Chest Diseases & Allied Sciences, Vol. 22, pp. 69-72, 1980.
9. Highly Purified Insulins - An Assessment - The Antiseptic, Vol. 77, pp. 3455-347, 1980.
10. Diabetes and Tuberculosis - The Medicine and Surgery, Vol. 21, pp. 10-12, 1981.
11. Tuberculosis Control in India - In Press
12. Tuberculin Test - Relevance to diagnosis in India today - In Press
13. Toxic Epidermal Necrolysis - The Antiseptic, Vol. 75, p. 194, 1978.
14. Drugs in the treatment of Tuberculosis - The Antiseptic, Vol. 75, p.678, 1978
15. Chemotherapy of Tuberculosis - The Antiseptic, Vol. 76, p.248, 1979.
16. Streptomycin in Tuberculosis - The Antiseptic, Vol. 76, p.516, 1979.
17. Health of the citizen (Special article) - The Hindu, Vol.99 A, No.198, p.8, 1976
18. How effective is the TB control programme ? (Special Article) - The Hindu, Vol.100, No. 274, p.8, 1977.
19. Five years Plans and TB Control Programme (Special Article) - The Hindu, Vol.101, No. 275,
20. BCG vaccination - The Antiseptic, Vol. 76, p. 726, 1979.
21. Genetic Selection - The Antiseptic, Vol. 77, p.258, 1980.
22. National Tuberculosis Control Programme - views presented, on invitation by the Tuberculosis Association of India,
at the 32nd National Conference on Tuberculosis and Chest Diseases, 1977.
23. Correlation between Geomagnetic Activity and Haemoptysis - paper presented at the II Tamil Nadu State Conference
on Tuberculosis & Chest Diseases, 1980.
24. Snakes.
25. AIDS - the disease of the decade - Radio Talk - All India Radio, Coimbatore, Feb. 1, 1986.
26. AIDS - What next ? - Radio Talk - All India Radio, Coimbatore, May 24, 1986
27. BRAIN FEVER (Encephalitis): taming the scourge - Radio Talk - All India Radio, Coimbatore, February 14, 1987.
28. HEALTH OF THE HIGH RISK GROUPS: Mothers, Children and elderly - Innovative Health Care Programmes,
Paper submitted for Scientific Session of the National Annual Conference of the Indian Society of Health administrators.
29. SAVING THE YOUNG - healthcare of the children in developing countries - Radio Talk -
All India Radio, Coimbatore, January, 1988.
30. MEDICINE and MONEY - Co-Chamber Journal, Vol. 5, Issue 8, p.8, 2010,
31. THE INDIAN SUPERBUG - Co-Chamber Journal, Vol. 5, Issue 9, p.15, 2010
32. SWINE FLU - Co-Chamber Journal, Vol. 5, Issue 10, p. 13
33. HEALTH CHECK-UP: how healthy is it ? - The Hindu, Open Page, Jan. 15, 2012 -
……http://www.thehindu.com/opinion/open page/article2801701.ece
34. THE ‘GOOGLE EFFECT’: may be good, may be bad - The Hindu, Open Page, April 22, 2012
...http://www.thehindu.com/opinion/open-page/article3340116.ece
35. OF TEA, COFFEE and COMMERCE - The Hindu, Open Page, January 12, 2014 …
… http://www.thehindu.com/opinion/openpage/of-tea-coffee-and-commerce/article5567951.ece.
36. A BAD PATCH - The Hindu, OPEN PAGE, March 15, 2020 ...
https://www.thehindu.com/opinion/open-page/a-bad-patch/article31069356.ece
37. MODERN MEDICINE: how good is it in India ? - Co-Chamber Journal, Vol. 11, Issue 5, p. 23, June 2016 & Vol. 11,
Issue 6, p. 18, July 2016
38. WORLD TB DAY: March 24, 2016 - Health, Vol. 94, No. 5, p. 20, May 2016
39. IS THE "LOCKDOWN MEDICINE" TOO TOXIC ? -- The Antiseptic, Vol.117, No.10, pp. 13 -15, 2020
40. ANTISEPTICS, DISINFECTANTS and COVID-19 -- The Antiseptic, Vol.117, No.11, pp. 26 - 28, 2020
41. 40+15 HYPOXIA TEST in COVID-19 -- The Antiseptic, Vol.117, No.12, pp.13 –17, 2020
42. THE CONUNDRUM of COVID-19 VACCINES – The Antiseptic, Vol. 118, No. 1, 2021
43. Fear and COVID-19 – HEALTH, Vol. 98, No. 11, pp. 13 -14, 2020
44. Tea and COVID-19 – HEALTH, Vol. 98, No. 10, pp. 4 – 6, 2020
List No. 2 contains references to about 1000 writings which may be found on my Website -- T. Rama Prasad
“Education is the most powerful weapon we can use to change the world.” --- Nelson Mandela
Dr. T. Rama Prasad www.rama-scribbles.in
LOVABLE RURAL FOLK ... February 10, 2018
Yes, rural are really lovable folk. Most of them have a refreshingly rural and innocent background. They have blind faith in gods, and doctors as well.
After a few decades, we may see no more of such good plain-hearted rural folk. And, even now, we rarely see the good old grand grandmother of ‘topless’ (‘blouseless’) era ! The women of that generation cover their upper bodies with a piece of a cloth only (end piece of saree) wrapped around without any underclothing like bra or blouse.
Today (February 10, 2018), one frail-looking grandmother in that 'topless' attire (see the attached photo) walked into my consultation chamber, accompanied by her grandson, but not needed to be assisted by him to walk in. She (Gowandayamml) fluently talked in the grand old style ... said she got the appointment with great difficulty (limited consultations today, as I had to spare some time to attend my granddaughter's 'food court bonanza' at her school). At the end of the consultation, she wanted a 'cough syrup' (most of the 'cough syrups' are used unnecessarily and for psychological satisfaction, and to the great delightfulness of drug industry !). I gave her a sample bottle of a cough syrup, free of cost, of course ... and lo and behold, her face was lit up with happiness. Little pleasures ... little things matter in life ... read the 'Scribbling' titled 'Richness & Happiness' on my blog. She narrated at length of her previous visits over decades and profusely thanked me for keeping her fit (in fact, it is her good old lifestyle and her constitution that kept her fit, not me !). I asked her whether I may have a photo with her. She was amused and laughed. I called the receptionist to take a photo. The lady of the old school put up a serious pose for the photo. Receptionist, Nandhini, asked her to smile ... in vain ... perhaps, the grandma thought that one should not move or smile when the camera clicks (In our school days, photographers used to instruct us not to move or smile when they take group photos in the school, with those bulky 'plate' cameras with a long exposure time !). I shall give her a print of the photo when she visits me again ... curiously, we both are of the same age group by the calendar, though seem not to be by the images ! Finally, the plain, simple, candid and 'topless' granny left my chamber. After a while, she came back with money (hundred rupees notes) in her hand to put into my tiny 'Pay what you can' hundi, as consultation fee. I had to persuade her a lot not to give any consultation fee, saying that it's a great pleasure for me to treat her free of cost ... again there was a flash of a cheerful smile across her face. This is the most pleasant reward we get in medical practice -- the cheerful smile of satisfaction.
If you wish to read more about the good rural folk, click on http://drtramaprasad.blogspot.in/2017/08/rural-are-real.html
Reprinted from FACEBOOK … go to Facebook to read comments on this.
Dr. T. Rama Prasad, www.rama-scribbles.in http://drtramaprasad.blogspot.in
'PAY WHAT YOU CAN’ Clinic, Perundurai, Erode Dt., TN, India., Former Medical Superintendent (Special), RTS & IRT Perundurai Medical College and Research Centre, Perundurai.
WORLD HEART DAY … September 29
Various writings and ads (with commercial colour of discounts) appeared today across the globe scaring the public about their heart health. Some of them, purported to be of educative value to the public, may have a hidden agenda of vested interests. And, some normal persons may be converted into patients ! People are confused on knowing about needless tests, medicines and even surgeries.
Much of the modern treatment may be like cutting some of the branches of an evil tree without tackling the roots. ‘Modernity’ in lifestyle brought in its wake all the adverse factors, STRESS & ECOLOGICAL IMBALANCE (destruction of Nature) being the important ones, associated with money, materialism, competition, comparison, ego, hubris, hegemony, selfishness, greed, arrogance, anger, miserliness, manipulability, vanity, vengeance, etc. MODERNITY may be the root cause for the arrival of COVID. Moderns may have to mend their ways to prevent emergence of more novel viruses. Should we celebrate March 11 (March 11, 2020 was the day on which the WHO declared ‘Covid’ as a pandemic) as the ‘WORLD COVID DAY’ ?
Cell phones arrived, we forgot writing letters;
Automobiles arrived, we forgot walking;
Computers arrived, we forgot spellings;
Calculators arrived, we forgot mathematics;
Modern jobs arrived, we forgot families;
TVs arrived, we forgot cinema theatres;
Digital games arrived, we forgot playgrounds;
Modern pharma arrived, we forgot grannies’ remedies;
Speciality hospitals arrived, we forgot ‘MBBS clinics’;
Super-specialists arrived, we forgot family doctors;
Nuclear families arrived, we forgot relationships;
Junk food arrived, we forgot healthy meals;
Food courts arrived, we forgot cooking;
HEART specialists arrived, we forgot HEARTY meals !
COVID has arrived, we forgot everything else !
(In 22 months, 22 of my articles on COVID were published – a WORLD RECORD !)
Dr. T. Rama Prasad,
https://drtramaprasad.blogspot.com www.rama-scribbles.in
drtramaprasad@gmail.com, Director, 'PAY WHAT YOU CAN' Clinic, Perundurai, Erode Dt., TN, India., Former Medical Superintendent (Special), RTS & IRT Perundurai Medical College and Research Centre.
“We are sometimes praised and sometimes pilloried. We should neither bask in the glory of success nor sulk in the shadows of defeat.”
23 of my articles on ‘COVID’ were published in 23 months in Medical Journals which is a WORLD RECORD in Medical Journalism.
The article titled “Origin of COVID” is the 24th one.
-- Dr. T. Rama Prasad, ‘PAY WHAT YOU CAN’ Clinic, Perundurai, India
Dr. T. Rama Prasad's Scribblings...
In the words of Prof C H Sivaraman: “ ... Dr. T. Rama Prasad belongs to a distinctly different and unconventional species of doctors. He speaks sparingly and does not even display his qualifications or merits, but his innumerable published writings (he calls them ‘scribblings’ though they are ‘pearls of wisdom and knowledge’, sprinkled with a bit of humour and sarcasm) which received wide acclaim talk eloquently for him. The ‘Pay what you can’ Clinic where services are available for which one may pay whatever one can is a facility run by Dr. Prasad for a very long time which could be a world record. Dr. Prasad is called a ”god” by his patients, and many of them named their children after his name “Prasad” -- that is the height of recognition of goodness of a human being... “
https://drtramaprasad.blogspot.com/2017/04/about-me-and-my-scribblings_38.html
https://drtramaprasad.blogspot.com/2020/06/coronavirus-covid-19-sars-cov-2_43.html
Dear Dr. Rama Prasad,
I am sure the world will be a better place, if people understand your writings ... ‘EXCELLENT’ is the word. I cannot find any other word in this language to describe what you have written without any pretensions. You have brought out some home truths to those who care to read your website ... You are a great thinker, writer and crusader ... As usual, your messages are incisive, to the point and make lots of sense, much better than my articles …
... You are not only GREAT, but are a true missionary in medicine. May your tribe increase for the good of mankind. ….
Love,
-- Padma Bhushan Prof. B. M. Hegde, (awarded Padma Vibhushan in 2021)
MD, FRCP (Lond), FRCP (Edin), FRCP (Glas), FRCP (Dub), FACC (USA), FAMS, Former Professor of Cardiology, Middlesex Hospital Medical School, University of London, UK, Former Vice-Chancellor, Manipal University, India, Affiliate Professor of Human Health, Northern Colorado University, USA, Editor-in-Chief, The Journal of the Science of Healing Outcomes, Chairman, State Health Society’s Expert Committee, Govt of Bihar, India and Padma Bhushan awardee of 2010. www.bmhegde.com
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The following is the comment written by the internationally renowned scholar, Pritam Bhattacharyya (Editor-at-Large of Pentasect and Founder and Chief of Wordsmith at Wordsmith Communication, Chairman of Freelance Foundation, ) on the blog article on Coronavirus and COVID-19
(1) https://wordsmithofbengal.wordpress.com/2012/01/16/health-un-heath-and-fear-of-un-health/
(2) https://wordsmithofbengal.wordpress.com/2012/04/23/google-effect-and-kali-yuga-prophecies/
“One of the best articles I have read on this theme and having balance, measure and proportion. Miss Corona in hindsight is really kind and benign in a sense - Nature has rolled a dice with fatality of 2-3%. She is under no obligation not to roll a dice of fatality 40,50,60% with Ms. Corona being "size zero" and "air-borne". Consider what would have happened ?
Dr. Prasad is one of the few doctors whom I know who fall into the rare category of "healers". A healer knows the art, science and commerce of healing, i.e. allowing the innate immunity of the body to manifest itself.
One should be very careful and critical about three things in the world : Big Pharma, Big Government, Big Science. In the proverbial Kali-Yuga, all three converge with overlapped agendas and sometimes not with the best interest in mind of the end users : patients, citizens, learners.
Finally, this pandemic will also pass. The system will come to a new equilibrium. But I think a whole generation will carry this impression forward and may become saner with this.
I nurture another hope : just like pivotal events propel a whole generation (Apollo Mission and interest in space science), this may inspire many young Indians to shift their focus into public healthcare, virology, immunology, public immunity, psychological counselling and learning the art and science of healing.
Again, it was very nice to find an article of this time in the avalanche of printed words in this theme.
Continue your good work.”
Pritam Bhattacharyya
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This is not an ad, it’s about an odd service.
GREETINGS from
‘PAY WHAT YOU CAN’ Clinic
“Thena thyakthena bhoojithaha”– Ishopanishad
( Translated by Prof. B.M. Hegde as: “Rejoice in giving.”)
True to this quote, I have been rejoicing at what little I could give. Defying stereotypes, this clinic has been in existence for a very long time, sans glitz, blitz, ads, microphones, speeches and noise. As a matter of my policy, publicity is shunned. The reason is simple. Good work needs no noise and nonsense. My ‘SCRIBBLINGS’ on related topics may be accessed at: http://drtramaprasad.blogspot.com or www.rama-scribbles.in
My consultation fee is not decided by me. It is the patient’s pleasure. The patient may pay (donate) whatever he can and what he wishes. If one is short of money, he or she need not pay anything. And the money thus received is used for charity to help the needy, the poor and the less fortunate. If interested to know more about this facility, go to: http://drtramaprasad.blogspot.com/2017/06/pay-what-you-can-clinic.html
"We need not run after money. If we are meritorious and compassionate, money would run after us, and it eludes us if we run after it.” -- T. Rama Prasad
“Richness is not having lots of money. It is the feeling that one has enough of it. Contentment sans comparison is what makes one really rich.” -- T. Rama Prasad.
Dr. T. Rama Prasad, Director, ‘PAY WHAT YOU CAN’ Clinic, PERUNDURAI, Erode Dt., TN, India. Former Medical Superintendent (Special), RTS & IRT Perundurai Medical College and Research Centre, Perundurai, Website: www.rama-scribbles.in , Blog: https://drtramaprasad.blogspot.com, Email:drtramaprasad@gmail.com, Facebook: T Rama Prasad, Twitter: @DrRamaprasadt, WhatsApp: +91 98427 20393
WRITINGS AND TALKS of Dr. T. Rama Prasad
List No. 1
1. Drug Resistance in Tuberculosis - Journal of the Indian Medical Association, Vol. 64, pp. 264-267, 1975.
2. Digital clubbing and Hypertrophic Pulmonary Osteoarthropathy - Pathogenesis - The Antiseptic, Vol. 76. pp.
213- 215, 1979.
3. Childhood Tuberculosis - Part I - The Antiseptic, Vol. 76, pp. 449-504,1979
4. Childhood Tuberculosis - Part II - The Antiseptic, Vol. 76. pp. 567-574, 1979
5. Yellow Nail Syndrome - Chest (U.S.A.), Vol. 77, p.580, 1980 –
http://journal.chestnet.org/article/S0012-3692(16)40458- 7/fulltext
6. Short-course Chemotherapy - The recent Advances in the Treatment of Respiratory Tuberculosis - Current Medical Practice,
Vol.24, pp. 41- 46, 1980.
7. Stevens-Johnson Syndrome and Thioacetazone - The Antiseptic, Vol. 77, pp. 99-102, 1980.
8. Yellow Nail Syndrome - The Indian Journal of Chest Diseases & Allied Sciences, Vol. 22, pp. 69-72, 1980.
9. Highly Purified Insulins - An Assessment - The Antiseptic, Vol. 77, pp. 3455-347, 1980.
10. Diabetes and Tuberculosis - The Medicine and Surgery, Vol. 21, pp. 10-12, 1981.
11. Tuberculosis Control in India - In Press
12. Tuberculin Test - Relevance to diagnosis in India today - In Press
13. Toxic Epidermal Necrolysis - The Antiseptic, Vol. 75, p. 194, 1978.
14. Drugs in the treatment of Tuberculosis - The Antiseptic, Vol. 75, p.678, 1978
15. Chemotherapy of Tuberculosis - The Antiseptic, Vol. 76, p.248, 1979.
16. Streptomycin in Tuberculosis - The Antiseptic, Vol. 76, p.516, 1979.
17. Health of the citizen (Special article) - The Hindu, Vol.99 A, No.198, p.8, 1976
18. How effective is the TB control programme ? (Special Article) - The Hindu, Vol.100, No. 274, p.8, 1977.
19. Five years Plans and TB Control Programme (Special Article) - The Hindu, Vol.101, No. 275,
20. BCG vaccination - The Antiseptic, Vol. 76, p. 726, 1979.
21. Genetic Selection - The Antiseptic, Vol. 77, p.258, 1980.
22. National Tuberculosis Control Programme - views presented, on invitation by the Tuberculosis Association of India,
at the 32nd National Conference on Tuberculosis and Chest Diseases, 1977.
23. Correlation between Geomagnetic Activity and Haemoptysis - paper presented at the II Tamil Nadu State Conference
on Tuberculosis & Chest Diseases, 1980.
24. Snakes.
25. AIDS - the disease of the decade - Radio Talk - All India Radio, Coimbatore, Feb. 1, 1986.
26. AIDS - What next ? - Radio Talk - All India Radio, Coimbatore, May 24, 1986
27. BRAIN FEVER (Encephalitis): taming the scourge - Radio Talk - All India Radio, Coimbatore, February 14, 1987.
28. HEALTH OF THE HIGH RISK GROUPS: Mothers, Children and elderly - Innovative Health Care Programmes,
Paper submitted for Scientific Session of the National Annual Conference of the Indian Society of Health administrators.
29. SAVING THE YOUNG - healthcare of the children in developing countries - Radio Talk -
All India Radio, Coimbatore, January, 1988.
30. MEDICINE and MONEY - Co-Chamber Journal, Vol. 5, Issue 8, p.8, 2010,
31. THE INDIAN SUPERBUG - Co-Chamber Journal, Vol. 5, Issue 9, p.15, 2010
32. SWINE FLU - Co-Chamber Journal, Vol. 5, Issue 10, p. 13
33. HEALTH CHECK-UP: how healthy is it ? - The Hindu, Open Page, Jan. 15, 2012 -
……http://www.thehindu.com/opinion/open page/article2801701.ece
34. THE ‘GOOGLE EFFECT’: may be good, may be bad - The Hindu, Open Page, April 22, 2012
...http://www.thehindu.com/opinion/open-page/article3340116.ece
35. OF TEA, COFFEE and COMMERCE - The Hindu, Open Page, January 12, 2014 …
… http://www.thehindu.com/opinion/openpage/of-tea-coffee-and-commerce/article5567951.ece.
36. A BAD PATCH - The Hindu, OPEN PAGE, March 15, 2020 ...
https://www.thehindu.com/opinion/open-page/a-bad-patch/article31069356.ece
37. MODERN MEDICINE: how good is it in India ? - Co-Chamber Journal, Vol. 11, Issue 5, p. 23, June 2016 & Vol. 11,
Issue 6, p. 18, July 2016
38. WORLD TB DAY: March 24, 2016 - Health, Vol. 94, No. 5, p. 20, May 2016
39. IS THE "LOCKDOWN MEDICINE" TOO TOXIC ? -- The Antiseptic, Vol.117, No.10, pp. 13 -15, 2020
40. ANTISEPTICS, DISINFECTANTS and COVID-19 -- The Antiseptic, Vol.117, No.11, pp. 26 - 28, 2020
41. 40+15 HYPOXIA TEST in COVID-19 -- The Antiseptic, Vol.117, No.12, pp.13 –17, 2020
42. THE CONUNDRUM of COVID-19 VACCINES – The Antiseptic, Vol. 118, No. 1, 2021
43. Fear and COVID-19 – HEALTH, Vol. 98, No. 11, pp. 13 -14, 2020
44. Tea and COVID-19 – HEALTH, Vol. 98, No. 10, pp. 4 – 6, 2020
List No. 2 contains references to about 1000 writings which may be found on my Website -- T. Rama Prasad
“Education is the most powerful weapon we can use to change the world.” --- Nelson Mandela
CLICK ON THE HEADINGS BELOW TO ACCESS THE “SCRIBBLINGS” on other subjects
· ABOUT ME and MY SCRIBBLINGS (2) 'PAY WHAT YOU CAN' Clinic
· MY LOVE STORY & good old days (4) BETTER HALF (4) SHIVA, KRISHNA, Ramanuja & Ramanujan (5) MOTHER-IN-LAW (6) YOU ARE NOT OLD (7) MODERN MEDICINE -- the Good, the Bad and th... (8) Dr. Peon, PhD (9) MEDICAL CONFERENCES & Clinical meetings (10) RUN ON MONEY (11) MEDICINE IN RURAL INDIA (12) RURAL ARE THE REAL (13) INTERNET EFFECT (14) MARKETING TRICKS & INNOVATIONS (15) INCREDIBLE INDIA ! (16) SCHOOL EDUCATION (17) DEVALUED DEGREES (18) TEA, COFFEE and COMMERCE (19) SEX. and MARRIAGE (20) THE CHANGING WORLD (21) RAPE (22) SEXUAL HARASSMENT (23) DRESS SENSE (24) OPEN AIR DEFECATION (25) ONAM 2017 (26) TEST-TUBE BABIES and TERMINATION BABIES (27) TEST-TUBE PUPPIES (28) ASTHMA, ALLERGY & COPD (29) GIRL CHILD : GOLDEN CHILD (30) MY REAL AWARDS (31) TREES and PLANTS (32) PERUNDURAI MEDICAL COLLEGE & SANATORIUM campus (33) SOPHISTICATED CHEATING (34) NIPAH & ZIKA viruses (35) SWINE FLU -- A (H1 N1) influenza (36) INDIAN SUPERBUG (37) HCQ, IVERMECTIN, CORONAVIRUS and FRAUDS (38) YOGA (39) CORONA and CHARLES DARWIN (40) GOD, RELIGION & UNIVERSE (41) LOCKDOWN MEDICINE (42) CODUP (43) GOD-MEN (44) DOGS (45) CANCER (46) SMILE and STRESS (47) CIVIC SENSE & MANNERS (48) MY ART (49) TUBERCULOSIS in India (50) DIABETES (51) FOOLED TO BELIEVE (52) DENGUE, ZIKA and MOSQUITO (53) COMPLEXION (54) BAHUBALI (55) VINAYAKA chathurdhi 2017 (56) SUNDAY LUNCH ... Dec 3, 2017 (57) ABDUL KALAM (58) BIRDS and DRUGS (59) YELLOW NAIL SYNDROME (60) RICHNESS and HAPPINESS (61) FISHES (62) KMCH (63) MY 'SCRIBBLES' IN NEWSPAPERS (64) To live in INDIA or ABROAD ? (65) SILENT, ISOLATED and INSULATED (66) PONGAL FESTIVAL (67) SPB (68) CESAREAN DELIVERY (69) POLLUTION, Disease and Deepaavali (70) HAPPY 2018 (71) BRINGING UP CHILDREN (72) SINGAPORE (73) STAFF & STUDENTS. -- photos (74) "AHIMSA" (75) GRADUATION DAY -- 2018, Perundurai Medical Col... (76) PERUNDURAI is the GEM (77) WORLD CANCER DAY ..February 4, 2017 (78) INDIAN ENGLISH (79) FOOD, EXERCISE and SLEEP (80) Nurses Day 2017 (81) DEEPAAVALI (82) PUTHAANDU -- Tamil New Year Day - 2018 & 2017 (83) COMPUTER. ILLITERATE (84) SMILE and LAUGHTER (85) REMOTE ANCESTORS (86) ODD things ... wow, whacky & weird ! (87) FACEBOOK 'scribbles' (88) HANDWRITING (89) MY QUOTES
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COVID world: 23 of my articles on ‘COVID’ were published in 23 months in Medical Journals which is a WORLD RECORD in Medical Journalism.
This article titled “Origin of COVID” is the 24th one.
-- Dr. T. Rama Prasad, ‘PAY WHAT YOU CAN’ Clinic, Perundurai, India
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. Origin of COVID .
RAMA PRASAD T.
Dr. T. Rama Prasad,
Formerly: Medical Superintendent (Special) of RTS & IRT Perundurai Medical College and Research Centre,
Perundurai, Tamil Nadu, India.
Presently: Director of ‘PAY WHAT YOU CAN’ Clinic, Perundurai, Erode District, TN – 638052. drtramaprasad@gmail.com WhatsApp +91 98427 20393 BLOG https://drtramaprasad.blogspot.com
WEBSITE www.rama-scribbles.in Twitter @DrRamaprasadt Facebook T Rama Prasad
Telegram Dr T Rama Prasad
The Antiseptic
`
A MONTHLY JOURNAL OF MEDICINE AND SURGERYSN
Vol. 119 No. 8 August 2022 ISSN 0003 5998
Indexed in IndMED Email: admin@theantiseptic.in www.theantiseptic.in
CORONAVIRUS -- COVID-19 ... September 1, 2020
"Panicky over-reaction to corona deaths has destroyed global economy;
Strict implementation of 'hygiene advisory' would have been sufficient."
Life is like a prepaid card paid by the Creator. We don't know how much was paid and how much is in balance. Insurers are now stunned to know that COVID-19 can bring the balance down to zero within hours or days of its attack.
The British Prime Minister's card balance dropped suddenly to almost zero before he came out of the Covid ICU, days before a son was born to his fiancee !
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Is the “LOCKDOWN MEDICINE” too toxic ?
http://drtramaprasad.blogspot.com/2017/04/lockdown-medicine.html
The subject of 'Lockdown' is an epidemiological hot potato. Is 'lockdown' right or wrong ? Both ! An Orwellian world (dis) order. Hubris is toxic which conjures up pitfalls for all of us. Puffed up with exuberant hubris, we humans have committed two blunders simultaneously :
(1) We acted like the 'virus deniers' and ostriches (the Brazilian President Jair Bolsonaro, the British Prime Minister Boris Johnson and the US President Donald Trump), didn't care for the advisory and left our own fate to the destiny. To know more about these ostriches, click on:
https://www.thehindu.com/opinion/op-ed/the-club-of-virus-deniers/article32071033.ece
(2) We imposed 'Total Lockdowns' which could not be implemented as they should be and left the fate of the citizens to the destiny. In many countries, the delusive idea of lockdowns rested on a parade of fallacies and follies, and the people didn’t care for the hygiene advisory on prevention. Unplanned lockdown is a death sentence to economy.
Considering the complex nature of the virus, we shouldn't let our guards down and simply surrender to the destiny. There is no uniform default strategy for all the countries and we have to make course corrections nimbly to maintain a balance between economic and public health costs and benefits. It is like being on a Schrodinger's seesaw. For instance, Sweden didn't lose much (lives, freedom & economy) despite not imposing tough lockdowns, perhaps because of voluntarily adhering to health advisory and the sense of social responsibility. And lowest mortality rates are logged in by Japan and South Korea without resorting to lockdowns, perhaps due to their culture of mask-wearing.
India is different. It is a large country with different zones having different timelines of onset of the epidemic. Added to this is the notoriously poor compliance with guidelines by the 'bemused-cum-resigned' Indians. This means that a total lockdown of the whole country would not yield the desired result. Moreover, lockdowns have no 'historical scientific basis'. Eight months into the pandemic, it still remains an enigma. Cases surging further. Economy dipping lower. The number of cases has increased from 500 to over three million and the number of deaths has increased from 10 to over 64,000 in five months after the 'lockdown' in India. Economy ? GOK.
The Corona Conundrum
“Doctor, is the lockdown good or bad for us ?,” asked my patient Vinodini. I said, “both good and bad, like the Schrodinger’s cat which is both alive and dead.” The Nobel Laureate Erwin Schrodinger devised the famous ‘thought experiment’ of putting a cat and some lethal things inside a box to see whether the cat would be alive or dead in order to prove a point in quantum physics. Until one opens the box, the cat is supposed to be both alive and dead ! The same is the case with the lockdowns.
NOT A PLAGUE
The life in the first half of 2020 was like looking at scoreboards and listening to continuous commentary over media as of cricket or election results. The "case" score went on spiralling up. Erroneously, people have come to think that the "cases" are "patients suffering from COVID-19 requiring admission or quarantine." And that they are "dangerous and untouchables" though there is nothing to be alarmed or ashamed about it.
The people are more scared of the quarantine and the social stigma rather than the virus. The fact is only that the virus is detected in their bodies, and that about 80% of them may not have any symptoms or only mild symptoms which may not require any specific treatment. We all have thousands of microbes in our bodies which may not produce disease because of our immunity. And, in course of time, we may gain immunity, called ‘herd immunity’, to this coronavirus also, through natural sub-clinical infections or vaccine when it is made.
The Delhi sero-survey findings published in July 2020 indicate that a whopping 50 lakh people have already developed 'herd immunity' through 'silent infection', while only 100,000 cases (1 in 50 of the infected) were detected through RT-PCR testing, in Delhi of a population of 20 million. Later in August 2020, a new jaw-dropping sero-survey result followed – 57% positivity in Mumbai slums and 51% in some areas in Pune. Perhaps, because of better ‘India-specific’ racial immunity passed on through generations of cellular immunity and 'pre-existing' 'cross-reactive' ‘memory T cells’ against spike or membrane proteins of SARS-CoV-2, the ‘Case Fatality Ratio’ has been less than 2% in India, despite the creaky, rickety and shambolic health care systems. This is a sliver of a silver lining to our dark cloud.
THREAT PERCEPTION
The alarmist predictions on ‘Covid’ proved wrong. On a larger canvas, the damage done by the virus does not seem to be huge, especially in India. Less than 65,000 people died so far in India, as on 01.09.2020, due to COVID-19. It is a small number compared to 4,35,000 deaths due to TB annually or 1,50,000 deaths due to road accidents per year, in the country. How about deaths due to other diseases ? Too many. Ten million Indians die every year of various causes – an international disgrace. Just look at the figures for the lockdown period of 6 weeks (March 25 to May 5) -- India's pro-rated death toll from all causes would be 10 lakhs, including due to -- influenza and pneumonia of 75,000, TB of 54,000, diarrhoea of 50,000, road accidents of 32,000 and suicides of 24,000. The media have set the eyes of the whole country on only one coronavirus death out of 638 total deaths ! We had been kept in the dark about the other 637 'non-Covid' deaths ! Even that one death is mostly due to co-morbidities, the purely COVID-19 death rate being around 0.3 per cent.
Lockdown, a blunt instrument, has become the default strategy and an epidemiological fashion, based on mathematical models of a limited theoretical frame. An indefinite pan-national blanket ban of all activities just to tame one disease in a country like India is an example of profound insanity. Further lockdowns may further vitiate a nebulous situation. Can we lockdown for another two years ? During a press briefing in Geneva on August 21, 2020, Dr. Tedros, the head of the WHO said: "We hope to finish this pandemic in less than TWO YEARS, especially if we can pool our efforts."
Instead of using the 'sledgehammer of lockdown' to crack the 'nut of virus', strict enforcement of the troika of masks, distancing and hygiene, along with prompt 'testing', 'tracing' and 'treating' would have been sufficient for India. Improving the creaky health structure of 1.3% of GDP is imperative. Of course, we can’t fix decades of neglect while in the throes of a pandemic.
LEARN TO LIVE WITH IT
The only thing we are worried is about the speed with which this virus killed around the world and the mysterious pathology involved. But even then, the number of the COVID-19 deaths is nothing when compared to the deaths that occur routinely due to other diseases. At least 1,000 people have been dying every day in India due to TB alone over decades. Did we 'lockdown' the country ? We learned to live with it and we have to do the same with Corona. Perhaps, additionally, we have to learn to die in 'cytokine storms' ! "Learn to live and die with Corona" is far better than "Learn to live and die with Lockdown."
Mathematical models are different from ground realities. The cavalier calculations remained a mirage – where is that time-table of ‘peak’, 'flattening', ‘decline’ and ’community spread’ ? The scientific hubris backfired -- cases increased from around 500 to around three million and the deaths from around 10 to around 65,000, after the lockdown in just about five months, in India. Virtues of a martinet governance have been an illusion. Governmental obfuscation which took on mythic proportions and infected policymaking, is a matter of concern. It is highly complex -- it's not like switching-on and switching-off a light. With just an order everything can be locked down, but can't be opened the same way.
TUBE VISION
During the corona period we have cultivated a 'tube vision' which lets us see only about corona, blind to other diseases, hunger, deprivation, livelihood, GDP, etc. And, the 64 million city-slum-dwellers and the scores of migrant labour were outside the field of vision when the surgical strike of the lockdown was a 'breaking news'. Or was it a 'braking news' ? Millions of people were adversely affected due to break in vaccination schedules and unavailability of services for 'non-Covid' ailments, because of the restrictions imposed by lockdowns -- just one example: there was a 64% rise in deaths of dialysis patients between March and May of 2020.
Of course, one may argue that the scenario could have been worse, without the lockdowns -- a conjecture and an assumption. It’s like saying that if BCG was not given, Covid deaths would have been enormous. May be there is some truth, but not the whole truth. The pandemic-lashed reality intrigued both scientists and soothsayers alike.
RECALIBRATE THE STRATEGY
Nevertheless, lockdown is a very effective preventive medicine but is too toxic for India where it cannot be implemented as it should be on a national scale. Nonetheless, localised lockdowns (cluster restrictions) are necessary. Lockdown is just one of the tools, not a silver bullet. Not even the vaccine that may be coming. Going forward, a recalibration of the strategy is imperative. And only people-friendly strategies would work.
In India, stringent implementation of ‘Covid-preventive protocols (masks, distancing, hygiene, etc.)’, strict restriction of risk-prone activities in selected locations and PERFECT cost-free treatment of all the patients at any cost to save lives, and rendering all possible service at the PEOPLE'S DOORSTEP would yield better results than by imposing 'total lockdowns' and repressive police-powered restriction of movement of people. It should be a PEOPLE-FRIENDLY activity devoid of social stigma. No need to beat the poor and hungry migrant workers for the 'fault' of walking back to their homes across the States. No severe injuries due to thrashing for the fault of not wearing face masks. No fatal tortures for closing the shop late by one hour. No assaults on frontline-workers and doctors. All this happened – did it not ? It should be a 'containment' activity, not a 'lockdown' activity. There is a lot of difference between the two.
An enormous number of 'Mobile Medical Units' should go around all the living places continuously. These "Units" should go to the doorsteps, educate people about preventive steps, test them, trace the contacts, treat them at home on a daily visit basis, take them to hospitals when institutional treatment is needed (only about 10% need it), help them empathetically, drop them back at home after discharging and follow them up daily later. The holy grail should be 'at-home care'.
HOLISTIC APPROACH
They should also take care of the people's non-Covid ailments during this interim period. Scores of people suffered and died due to the lockdown-related difficulty to access hospitals for 'non-Covid' illnesses. For various reasons, many private doctors and hospitals shut their doors at this point of time when they could have played a pivotal role. One of the reasons is the set of ‘rules & protocols’ of the government. And some of the allegedly greedy hospitals that treated Covid patients were the cause for the General Insurance Council (GIC) to move the Supreme Court of India for overcharging. When objected by the GIC, in one case, the bill of Rs.14 lakh was brought down to less than 4.5 lakhs ! An alleged unholy nexus between clinical laboratories and hospitals to fabricate ‘fake Covid positive’ results that may enhance admissions out of fear is reported.
A total 'touch-me-not' attitude prevailed, while the dire need was a total and friendly service. The public service was distant and scary at the mercy of the officials. If the help was at their doorsteps, people would have gained confidence, cooperated and even helped the authorities. Scared of quarantines, they wouldn't have evaded to report symptoms and went underground breeding the virus and disseminating, as it had been happening -- this is a very important cause for the surge of the cases during the lockdown period.
‘Beds’ don't save patients. 'Quarantine prisons' won't halt the march. ‘Tests’ can’t cure. We relied too much on these. It is the “friendly human touch" that's important to persuade people to participate. They need not scramble and run around like a headless chicken to finally get only a piecemeal type of impersonal response. All this had robbed TRUST and frustrated the people. The people lost FAITH in the system and the science itself. We should not waste precious time waiting for the people to come for treatment. They won't come in the present panic-filled scenario unless trust is built up urgently. A delay in disease detection would lead to a cascade of events which negatively impact everything, from a deluge of patients to tragic fatalities. It’s all about using the right tools at the right time in a given situation. I repeat: The holy grail should be 'at-home care'.
A MARATHON, NOT A SPRINT
In this plan of action, there won't be many defaults. There won't be confrontations with officials and disregard to their protocols. Of course, an enormous number of vehicles and dedicated manpower is to be inducted. The cost involved and the loss of life (including that indirectly due to the lockdown) by doing it this way would be phenomenally much less than what it could have been with a 'total lockdown'. This is a homely holistic solution. It is the media overplay, coronaphobia' and the 'lockdown-overreaction' that killed everything.
GOVERNMENTS MISGUIDED
Governments cannot be blamed for all this because they are mostly guided by their scientific advisors, rightly or wrongly." But the bewildering fact is that the hard-hitting ‘Joint Task Force’ official statement issued by Indian Public Health Association (IPHA), Indian Association of Preventive and Social Medicine (IAPSM) and Indian Association of Epidemiologists (IAE) bluntly blamed the government for relying more on the bureaucrats than on experts in the field1. The statement pointed out several lapses by the government and made many recommendations to replace what they called "draconian lockdown." See the full statement in the link provided at the end.
Now that It's clear that the fight is a marathon and not a sprint, the need is for endurance, perseverance and patience, at least until we get a vaccine. Vaccine-making is another mindless hasty activity (getting ready by August 15, 2020 !) like the 'lock down'. See the speedy 'Russian roulette' of 'Sputnik V' which set aside scientific norms and pursued 'vaccine nationalism'. If this vaccine fails, it may generate mutants more hazardous than D614G.
Vinodini looked a tad beyond and said that the surge to seek therapy from shrinks would also shrink by this holy grail of 'at-home care'. In India, 7.5% of the population suffers from mental disorders, according to the WHO. And It is estimated that the ‘lockdown-stress’ would increase this mental illness by 20%.
(Based on the transcript of a WEBINAR by Dr. T. Rama Prasad.)
Dr. T. Rama Prasad
drtramaprasad@gmail.com
Formerly: Medical Superintendent (Special) of RTS & IRT Perundurai Medical College and Research Centre, Perundurai, Tamil Nadu, India.
Presently: Director, PAY WHAT YOU CAN Clinic, Perundurai, Erode District, Tamil Nadu – 638052.
Reference:
More information on the lockdowns and the coronavirus may be accessed at: http://drtramaprasad.blogspot.sg
UNPLANNED LOCKDOWN IS A DEATH SENTENCE TO ECONOMY
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September 1, 2020: UNLOCKED. No, we are not scared Miss CORONA. We have decided to live with you because "LEARN TO LIVE AND DIE WITH CORONA" is better than "LEARN TO LIVE AND DIE WITH LOCKDOWN". Let us have a HAPPY LIFE TOGETHER. -- Dr. T. Rama Prasad, PAY WHAT YOU CAN Clinic, Perundurai.
First confirmed case of COVID-19 infection in India: A case report
This article has been cited by other articles in PMC.Sir,
Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East respiratory syndrome (MERS)-CoV and severe acute respiratory syndrome (SARS)-CoV1. On December 31, 2019, China informed the World Health Organization (WHO) about cases of pneumonia of unknown aetiology detected in Wuhan city, Hubei province of China. From December 31, 2019 to January 3, 2020, a total of 44 patients with pneumonia of unknown aetiology were reported to the WHO by the national authorities in China2. During this period, the causal agent was not identified. The cases initially identified had a history of exposure to the Huanan Seafood Wholesale Market3. The most common clinical features of the early clinical cases from Wuhan, China, were fever (98.6%), fatigue (69.6%) and dry cough (59.4%)4. The second meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (2005) regarding the outbreak of novel coronavirus 2019 in the People's Republic of China on January 30, 2020, declared COVID-19 outbreak as Public Health Emergency of International Concern (PHEIC)5. As on February 17, 2020, except China, 25 other countries have been affected by COVID-19 outbreak with 70,635 confirmed cases and 1,772 deaths in China. Outside China, 794 cases were reported with three deaths6.
We present here the first case of COVID-19 infection reported in Kerala, India. On January 27, 2020, a 20 yr old female presented to the Emergency Department in General Hospital, Thrissur, Kerala, with a one-day history of dry cough and sore throat. There was no history of fever, rhinitis or shortness of breath. She disclosed that she had returned to Kerala from Wuhan city, China, on January 23, 2020 owing to COVID-19 outbreak situation there. She was asymptomatic between January 23 and 26. On the 27th morning, she felt a mild sore throat and dry cough. She did not give a history of contact with a person suspected or confirmed with COVID-19 infection. She did not visit the Huanan Seafood Wholesale Market, however, she gave a history of travel from Wuhan to Kunming by train where she noticed people with respiratory symptoms in railway station and train. She received the instructions from the Kerala State authorities to visit a healthcare facility if she develops any symptoms because of the travel history to China.
In the Emergency department in General Hospital, she was afebrile with a pulse rate of 82/min, blood pressure 130/80 mmHg, temperature 98.5°F and oxygen saturation 96 per cent while the patient was breathing ambient air. Lung auscultation revealed normal breath sounds with no adventitious sounds. In view of her travel history from Wuhan, the district rapid response team decided to admit her in an isolation room which was designated for the corona epidemic. An oropharyngeal swab was obtained and was sent to the ICMR-National Institute of Virology (NIV), Pune, for the detection of viral respiratory pathogens on January 27, 2020. Three millilitres each of EDTA blood and plain blood samples were also collected and sent to NIV, Pune, where COVID-19 was diagnosed using real time reverse transcription PCR. Specimen collection was done on day 0 (admission) and every alternate day. Urine and stool samples were also sent for detailed evaluation. She was started on azithromycin (500 mg), cetirizine (10 mg) and saline gargle. Over the next three days, her symptoms improved.
Her oropharyngeal swab result was reported by the NIV, Pune, to District Control Cell on January 30, 2020 as positive for COVID-19 infection. The details of basic laboratory investigations done on days 3, 7 and 20 of illness are shown in the Table. On day 1 of illness, the total white blood cell count was towards the low normal side, but on days 5 and 20, the count showed a rise which was consistent with a viral infection. Erythrocyte sedimentation rate was highest on day 7. The rest of the investigations were normal. She was referred to the Government Medical College, Thrissur, Kerala on January 31, 2020, and was admitted in isolation block designated for corona infection. By this time, the outbreak monitoring unit of the institution had brought out a detailed policy regarding the standard operating procedures including infection control measures to be followed in the isolation block. On presentation, she had only mild sore throat and rhinitis. She was conscious, oriented, afebrile, with pulse rate 76/min, blood pressure 100/70 mmHg, respiratory rate 12/min and oxygen saturation 97 per cent in the ambient air. General examination revealed no significant findings. She was started on oseltamivir and symptomatic measures. She gradually improved over the three days and became asymptomatic on February 3, 2020 and became negative for COVID-19 infection on day 19 of her illness. The oropharyngeal swabs for diagnosis of COVID-19 infection were collected on days 1, 4, 5, 7 and every alternate day, i.e. days 9, 11, 13 and so on after the onset of illness. The initial swabs remained positive till day 17 after which the swabs on days 19, 21 and 23 were negative and the patient was discharged. She was discharged from the hospital on February 20, 2020.
VARIANT MUTANTS
But, in December 2020, when we thought you were packing away, scared of the vaccines, you have sprung a surprise through changing your coat -- the UK variant !!!
The first incidence of this new virus was detected in U.K.in September 2020 and within three months it has widely spread in UK and in many Europian countries.The name given to the virus appears as jargon to most of us . Kindly go through this post for easy understanding. It is named as V.U.I.2020/12. The expansion for this abbreviation is Virus Under Investigation in December 2020. The technical name is B.1.1.7 that means that a British virus discovered for the first time with seventeen mutations since its first appearance in Wuhan. The corona virus is an RNA virus and it enters human cells by cheating the angio-tensin converting enzyme 2 (ACE-2) receptor because the amino acids present in the spike protein has homological resemblance to ACE from sequence 270 to 510. So any mutation occurring in this region may become advantageous or disadvantageous for the virus. The corona virus has two major proteins namely the spike protein and the nucleo capsid protein. The spike protein gets locked up with the ACE 2 receptor and the nearby heparan sulfate receptor in the human cells and then injects the viral RNA into the cells. Hence all the vaccines are aimed against the spike proteins to prevent the viral entry into the cells. The genetic sequencing of the spike protein show the presence of 9909 amino acids.Each amino acid is coded by three nucleic acid bases such as A(adenine), U(uracil),G (Guanine)and Cytosine (C) .Eg. UUU codes phenyl alanine,UAU codes Tyrosine and so on.Hence the 9909 amino acids in the spike proteins have 9909 multiplied by 3 that is 29727 bases.
Now, the new British virus is found to be
N501Y. This means that the amino acid at position no. 501 is Asparagin written in short form as N. the code for which is AAU. Now the first letter A (adenine) is mutated to U(uracil) and the code is changed to UAU which codes for Tyrosine written in short form as Y. So ,N501Y means that at position 501 asparagin is changed to tyrosine. It is an advantageous mutation for the virus because it gives a tight binding of the spike protein to the ACE 2 receptor.Hence the virus sreads with 70% increased speed.(double speed). But whether it is more lethal is yet to be known.
Anyway the vaccines already manufactured against the older spike protein is expected to be useful against the new mutant virus also.
NATURE is more powerful than man and the Darwin's doctrine that 'Survival of the Fittest' holds good at all times and for all organisms including man.
A letter from CHARLES DARWIN
As a proxy for Charles Darwin, I wrote this
letter which is a mix of facts and fantasies.
. -- T. Rama Prasad
CHARLES ROBERT DARWIN
Westminster Abbey, LONDON
September 9, 2020
Dear Humankind,
“It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is the most adaptable to change.”
Once again, read my quote of the 18th century about adaptability. SARS-CoV-2 is 'most adaptable to change'. That's why it is surviving and thriving. That's the secret of success of some species. Some of you might have read my writings on "Origin of Species", "Theory of Evolution", "Natural Elimination of the Weakest", "Survival of the Fittest", etc. You, Humans, are still on earth because of your adaptability. But now you are not able to cope up with Corona. When you can't conquer Corona, you have to adapt rather than to surrender.
It's a pathetic sight to see you all scramble over like a headless chicken and finally locking yourselves inside your homes with absolute uncertainty of coming out. How long are you going to lockdown your means for livelihood and still be alive ?
This novel Corona is a story about 'Much ado about nothing'. OK, it's about 'Much ado about something', because it spread faster, killed quickly and affected many, a tad unlike the previous coronaviruses and pandemics. But it need not cause panic. It is a fitting solution for the overpopulation and indiscipline, and an action of nature in tune with happenings for healthy sustenance of species.
You had 'super-evolved' to manipulate 'Nature' to suit your self-centred materialistic interests. You had altered the course of evolution and invited calamities like droughts, floods, forest fires, earthquakes, tsunamis, formidable diseases, both metabolic and infective, etc. And now you invited Coronavirus. It will be your permanent guest. Nature has its own ways of controlling ecosystems and maintaining environmental balance. Don't interfere with it too much. Adapt, adapt and adapt.
When you go beyond a limit, nature steps in for a speedy correction of the course of evolution which in normal course takes a very long and sinuous course. The speedy correction is needed in your own interest, to upgrade species and provide them better evolutionary opportunities and perfections. And more importantly to correct your erratic mindset. That's why Corona stepped in. Let it do its job, while you protect yourselves and treat yourselves to the possible extent. But don't go overboard.
The idea of nature is to relieve the hopelessly sick, weak and unproductive, and to endow the rest of the over-populated lot with better living conditions, and to promote more robust genetic pool of human species. You are nearly eight billion and nine per cent of you are aged 65 or over. You were half of this number half-a-century ago. It is the evolutionary necessity to get rid of the dead wood (some of the aged and the chronically ill who are hopelessly vulnerable to serious illnesses and who may soon succumb even without COVID-19) which is more of a liability, health wise and economy wise, at present and in future. Corona may take away some of these people 'naturally'.
In the large context of species preservation, there is not much place for sentiments. This doesn't mean that all the vulnerable would be or should be wiped out -- those with good immunity and who take extra care would escape. And who knows ? The number of these 'natural covid' deaths may be much lesser than the deaths due to your interventions -- and think about the enormous number of deaths that may occur indirectly for various reasons due to consequences of lockdowns. Irrespective of the deaths and the demographic balance, the most important benefit accrued due to the pandemic would be the realisation of human values, correction of lifestyles, shedding materialistic outlook, and preservation of 'nature'.
This is my recognised theme of ecosystems -- 'Natural elimination of the weakest and survival of the fittest'. What doesn't kill one , makes one stronger, and more immune. Moreover, the virus would have taught all the human beings, by now, how to live a 'good lifestyle' and prevent future calamities, catastrophes and cataclysms.
What did you do when this corrective step by nature struck you ? You mortals interfered with nature again, too much. Didn't allow the virus to do its job. It couldn't 'peak' early, decline early and leave early, leaving you with some sort of 'herd immunity'. You delayed everything and upset your own whole set up. You 'locked down' everything and deployed all your ammunition to kill the enemy. Unmindful of your defences and offences the highly 'adaptable' enemy forayed into every nook and corner of the globe and tanked you all. The lockdowns didn't kill the raging virus, but they sure did kill millions of jobs.
Arrogance against nature. Albert Einstein said: "The only thing more dangerous than ignorance is arrogance." When arrogance failed, you went into a fit of fear out of which you went into a mode of "Lockdown." You have sent the whole economy into a tailspin, with jangled nerves and rattled lives, presaging difficult times ahead, and with uncertainty looming large. Your meticulously programmed career schedules, birthday bashes and holiday itineraries are kaput. Oh, how scared you humans are -- non-touch friendship, non-touch romance, non-touch weddings ... ! And all your big investments, backed by prudent actuarial consultants, went bankrupt. The highly ambitious launches of big business barons are going down the sunset. All these could have been avoided if you had sensibly handled the situation without hubris, and with adaptiveness and level-headedness. Industrial ecosystems can't be created by magic nor can they be revived by a silver bullet. You destroyed them, just as you destroyed forests out of your greed. Over the top reaction. Can you reforest by a click on your laptop ? Your greed has no limits and ethics at all -- even in the midst of the corona crisis, you indulged in murky profiteering activities through shameful and fraudulent research publications about anti-corona drugs in reputed journals like The Lancet and The New England Journal of Medicine. And you call it 'Modern Medicine' ! And your 'modern medicine' billed $1.1 million in the US and Rs.16 lakh in India to treat just one Covid patient. Overcharging is so rampant that the General Insurance Council (GIC) moved the Supreme Court against alleged 'profiteering' by private hospitals in India. When objected by the GIC, in one case, the bill of Rs.14 lakh was brought down to less than 4.5 lakhs ! And your 'modern laboratories and private hospitals' have an unholy nexus to promote admissions based on fake Corona positive lab reports and then to exploit the terrified patients.
Through your stupid 'lockdown reactions', you thought that you saved a lot of lives, but it is insignificant when compared to the overall deaths, death of economy, sliding down of living standards, attrition, recession and severe slowdown over an indefinite period of future.
While taking some basic precautions and necessary treatment, if you had allowed the virus to do its job of "evolution" and allowed yourselves to do your jobs normally, some of the 'dead wood' would have perished, but the remaining lot would have been robust both health-wise and economy-wise. The fear now is that the whole lot may become "dead wood" in course of time for 'non-COVID-19' reasons. And I hate to write a book titled "The Extinction of Humankind."
Long live Homo sapiens !
Yours humanly,
CHARLES DARWIN
 |
| Westminster abbey |
"[My] judgment often fluctuates…. Whether a man deserves to be called a theist depends on the definition of the term … In my most extreme fluctuations I have never been an atheist in the sense of denying the existence of a God. — I think that generally (and more and more so as I grow older), but not always, — that an agnostic would be the most correct description of my state of mind." -- Charles Darwin
Dr. T. Rama Prasad
Formerly: Medical Superintendent (Special) of RTS & IRT Perundurai Medical College and Research Centre, Perundurai, Tamil Nadu, India.
Presently: Director, PAY WHAT YOU CAN Clinic, Perundurai, Erode District, Tamil Nadu – 638052.
Mentally blank and imbalanced. UNCERTAINTY is the synonym of this ominous and looming pandemic. Remedial measures seem to be worse than the malady. The world is trapped in an intriguing maze of interventions. How to come out ?
(1) About 5% of the patients with mild symptoms suddenly ran into life-threatening emergencies. (2) Blood oxygen dropped too low without causing the usual warning of breathlessness, but killing the brain / heart fast -- 'happy hypoxia' -- even while 'happily' taking dinner or walking -- see the newspaper report below. (3) Lining of the blood vessels in the lungs and many other organs in the body were affected rapidly. (4) Extensive pneumonia was present without severe external symptoms. (5) Unexplainable clotting of blood occurred which quickly lead to death, even in young people. (6) Heavy casualties occurred in the most developed countries (about 4 million cases and more than 1,46,000 deaths -- a quarter of the global burden, as on 27.7.20, in the US which has the world's best healthcare infrastructure). (7) Exceptionally fast and wide spreading.
Except for these speedy catastrophic events, most of us would not have even known the name of this disease.
Until a vaccine or cure is found, it seems we are doomed to "Touch -me-Not".
Uncertainties and vicissitudes in life often make one hobble through life with the help of the crutches of faith. During the past half-a-century, "true devotion" seemed to have become slightly faded, partly due to scientific advancements and arrogance of affluence. Now that the science couldn't certainly stop Corona and lockdowns, and that lockdowns are melting away affluence and arrogance, people are leaning more on faith for support. Alas ! Then the temples are closed. A new temple has come up as you can see below:
This is what 'CORONA DEVI' said:
People are suspicious of everybody being a potential carrier of the virus. They can't do away with maids and they don't want to risk their coming in. They behave with them as though they are devils bringing in the virus. Be humane -- treat them with kindness, dignity and respect. After all, they have been cleaning our houses, cooking our food, washing our clothes, bringing up our children, etc. Read about the paranoia in the clipping below.
An estimated 67 million people are employed in domestic work around the world. Most of them are women. This is a vast but hidden force asserting their rights on the 'International Domestic Workers Day' on June 16.
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STATISTICS
World 17,351,647 cases 2,226 ca/1m 673,339 deaths 86 dts/1m
US 4,612,837 cases 13,930 ca/1m 154,766 deaths. 467 dts/1m
India 1,639,350 cases 1,187 ca/1m 35,789 deaths. 26 dts/1m
China. 84,165 cases. 58 ca/1m 4,634 deaths. 3 dts/1m
Singapore 51,809 cases. 8,850 ca/1m 27 deaths. 5 dts/1m
INDIA
Before 'Lockdown' on 24.03.2020 564 cases 10 deaths
After 'Lockdown' on 01.07.2020 585,729 cases 17,410 deaths
01.08.2020 1,639,350 cases 35,789 deaths
01.09.2020 3,624,613 cases 64,646 deaths
Before the ‘lockdown’ on March 24, 2020, there were 564 ‘cases’ and 10 deaths in India. When it was ‘unlocked’ on June 1, 2020, there were 97,008 cases and 5,606 deaths. And, just after 30 days, on July 1, 2020 the number of cases had increased to 585,729 and the deaths had increased to 17,410. And look at the figures of August 1, 2020 !!! It looks that all the efforts of lockdown probably only delayed rather than averted the effect of the epidemic. At best, they were only partially-successful, especially by not allowing the fatality rate to go up enormously. When a ‘green zone’ is opened it is turning into a ‘red zone’ in no time.
India: 50,000 cases up to May 6th; In the next 27 days - increased to 200,000.
'Total Lockdown' from March 24 to May 31. In the next 27 days, it has
- Worldwide, 80 million infected, 1.75 died.
- In India, 10 million infected, 1,50,000 died.
- In Tamil Nadu, 8 lakh infected, 12,000 died.
- Melody king SPB and former president Pranab no more.
- Wildfires in Australia and California.
- Taal volcano in the Philippines.
- Oil spill of 20,000 tonnes into a river in Russia.
- Plane crashes in Tehran & Pakistan killing 213.
- Cyclone Amphan killed 130, & made homeless 500,000.
- Steepest fall of global stock market.
- Millions lost their jobs.
- Stadiums, theatres & malls gathered dust.
- Many, many, many more maladies.
- But, more hygiene, more philosophy, more caring.
- We are brought down to the basics -- how to survive.
LIFE INSURANCE and COVID-19
And many are rushing for LIFE INSURANCE policies for HUGE AMOUNTS.
The 'Insurance Regulator' has made announcements regarding "COVID KAVACH" and "COVID RAKSHAK" health insurance schemes.
"We may be coming to the close of a 'lockdown' period. Let us not debate whether the lockdown did good or bad, as much can be said on either side. Leave alone the micromanaging controversies and try to see the larger picture and learn and unlearn quickly and prudently."
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"COVID-19 is our permanent guest. When it mutates into a less lethal strain, it would be just another guest like H1N1, AIDS, Dengue, Flu viruses, etcetera about which we don't bother so much. Finding -- T. Rama Prasad
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"If the mode of transmission is understood and the imperative preventive measures are strictly practised by the entire populations around the world, the disastrous economic destruction due to lockdowns could have been avoided. And the COVID-19 patients could have been treated according to the need without the terrifying mass quarantines of stupendous negative impacts."
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"The greatest damage that this pandemic did and will do is of infusing FEAR into our blood through media. The 'INFODEMIC' is the real pandemic destroying health and economy through FEAR which leads to frightening thoughts and disastrous interventions." -- T. Rama Prasad
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"Let's not debate. This virus has come here as a permanent guest. Let's not be obsessive to eradicate it. Even if we lockdown for 3 years, it would be there, mutating continuously. We have to act in a smart and nimble way where responsibility is shared between government and society." -- T. Rama Prasad
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which goes laughing all the way to the blood bank."
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Lockdowns are kaput - Epidemiologists fainted - Economic analysts confounded
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Strict implementation of 'hygiene advisory' would have been sufficient."
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"Going forward, the COVID-19 could become a 'viral/bacterial syndemic' posing to kill many more synergistically by joining hands with other microbes, what with the antibiotic resistance across the world and the weakened immunity."
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"Not getting into the 'whirlpool' of an ICU with a 'cytokine storm' is a profit of tens of lakhs of rupees." --
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When two or more epidemics interact synergistically to produce an increased burden of disease, we call it a 'syndemic'. The Asian Influenza Pandemic of 1957 killed not only by primary viral infection, but also by secondary bacterial infections. It was a viral/bacterial syndemic. Now, the COVID-19 can join hands with other microbes and cause further havoc.
https://www.thehindu.com/opinion/op-ed/preparing-for-a-syndemic/article31617304.ece
MOSQUITO
Another cause of concern is the possible alarming emergence of other diseases like dengue and malaria with the upcoming monsoon season associated with mosquitos in tropical South Asia. Chennai city reported over 400 cases of dengue in 2019. Thousands of "Domestic Breeding Checkers" (DBCs), as they are called to control mosquito breeding places around residential areas, are now diverted to 'Corona Duty'. This may lead to increase in mosquito related diseases.
which goes laughing all the way to the blood bank."
Schrodinger’s cat … alive or dead ? -- BOTH
Coronavirus … living or non-living ? -- BOTH
Lockdowns … success or failure ? -- BOTH
Un-lockdowns ... relief or danger ? -- BOTH
Coronavirus … did good or bad ? -- BOTH
ICU patient … alive or dead ? -- BOTH
They are all there to confuse --
The 'social distance' was 3 feet ... then it was made 6 feet. Now, with this information published in the journal 'Physics of Fluids', it seems it is to be increased to 18 feet ! With movement of air around at the speed of 4 kmph, droplets can go up to 18 feet in 5 seconds, it said. Right now (20.05.2020) the wind speed of the Amphan cyclone, hitting West Bengal and Bangladesh, is such that the droplets can travel up to 720 feet in 5 seconds !!! Safe distance may now mean 10 passengers in a big bus and 30 passengers in a big plane !!! Oh, invisible Corona, what a power you have ! You have distanced even the gods in the temples from us ! Uncertainty about you is the only certainty !
MODE OF TRANSMISSION
CORONA PANDEMIC - CORONA INFODEMIC - CORONA ANXIODEMIC / PSYCHODEMIC
A lot of confusion is infused by the other pandemics - 'Infodemic', etc.. Unsolicited information 24/7 through countless channels had driven us into another pandemic - 'Anxiodemic'. Anxiety, tension and fear. We feel engulfed. The fear is such that, even when the lockdown is lifted, we shall still remain in a foetal crouch !!!
Though COVID-19 is exceptionally infectious, it is not very lethal. In fact, 90% of the cases in India had no or only minor symptoms, and deaths are less than 4%. So get rid of the FEAR first.
The alarmist predictions on Covid proved wrong. On a larger canvas, the damage done by the virus does not seem to be huge, especially in India, up to July 1, 2020. Less than 18,000 people died in India as on 01.07.2020 due to COVID-19. It is a small number compared to 4,35,000 deaths due to TB annually or 1,50,000 deaths due to road accidents per year, in India. How about deaths due to other diseases ? Too many. Ten million Indians die every year of various causes. Just look at the figures for the lockdown period of 6 weeks (March 25 to May 5) -- India's pro-rated death toll from all causes would be 10 lakhs, including due to -- influenza and pneumonia of 75,000, TB of 54,000, diarrhoea of 50,000, road accidents of 32,000 and suicides of 24,000.
All this means that the 'Infodemic'-focussed media have set the eyes of the whole country on only one coronavirus death out of 638 total deaths ! We had been kept in the dark about the other 637 deaths ! Compared to the Western countries, Covid-19 death rate in India is low due to multiple factors (see the list of 13 below), including local conditions which have an impact on epidemic trajectories. Fortunately, the virus by itself didn't affect India much so far due various factors (mentioned below under the subheading "Unanswered Questions"). But the collateral damage is huge. Hence the small number of corona deaths need not cause fear. Get rid of the FEAR first. Think more about the 'SIDE EFFECTS".
Points of discussions may be hypothetical and revolve around conjectures, especially when India is a data-poor country when it comes to human health.
A UK study, published on July 22, 2020, from the found that viewing TV for more than two hours a day resulted in an increase of 6 per cent of all-deaths and 8 per cent of cardiovascular deaths. There has been an enormous increase in TV viewing during the 'corona lockdowns'.
CORONA era cars: Ford introduces a new model in 2032 -- Ford Corona V-19. Two seater - one front & one back, just like all other cars. Fitted with Ultraviolet Disinfection lamps, and virus alarm system. Automatic oxygen pumping when O2 saturation falls. Sleek antique design like the 1932 model. No guarantee or warranty just as for human life, with COVID-29 around. -- Dr. T. Rama Prasad, Perundurai. THE LOCKDOWN CONUNDRUM
Lockdowns are kaput - Epidemiologists fainted - Economic analysts confounded
In this context, there is one crucial question to be answered. Will the SARS-CoV-2 linger continuously or mutate itself into oblivion soon ? If we had known the answer, we could have avoided the disasters we made for ourselves.
'Lockdown' is a double-edged sword. It is a fiercely debatable subject. See how they are fighting in the US -- Donald Trump and the fear-mongering welfarism -- the Republican Red States and the Democratic Blue States, for and against lockdowns ... Tesla Inc chief dared arrest saying he would open his factories against the law, and threatened to move his gigantic factories from California to Texas. Paradoxically, the US, the most empowered country on the planet is the most adversely affected one by the Covid. And, its president, the most powerful man in the world, seems to believe that the pandemic controlling honchos and the highly talented academic brains are not necessarily the best or smart people around. It may sound a trifle ironic that the US president is against lockdowns and is at loggerheads with Anthony Fauci, the top medical advisor to the US. The virus issue has become an international political issue too, with tensions ratcheted up between Washington and Beijing as they trade barbs over the origin of the virus.
SCENARIO in INDIA
It is LIFE versus MONEY. Without life there's no money, and without money there's no life. It's the affordability of a country that should decide the type of the 'LOCKDOWN'. Different 'pundits' expressed different views. America is an example of the conflict, Trump backing the protestors against lockdown in some States. For India, perhaps, a 'soft and selective lockdown' without a big blow to economy might have been desirable, along with very rigid restrictions in hotspots like Dharavi in Mumbai.
There are various ways of assessment. One is to apply the 'human capital' concept of economics. People die in pandemics ... in massive numbers ... magnitude varies from country to country due to varied circumstances. As a byproduct of 'infected cases', immunity develops in the surviving population. 'Survival of the fittest' of Darwin's theory -- immunity is the only long term asset. Perhaps, the low death rate in India is due to the 'herd immunity' we have. Preventive precautions are to be taken, including lockdowns which are to be implemented judiciously depending upon the specific local factors and the possible economic impact. Sometimes, mathematical and epidemiological models may go for a toss and decisions made on their basis may ignore the seriousness of other compelling adversities on health and economy. Other diseases don't get proper attention. Disproportionally large damage may occur to the health of the citizen due to the surge of non-Covid diseases for various reasons like inaccessibility to treatment and a break in general vaccination schedules. In such circumstances, a midcourse correction from highly flawed lockdowns to less flawed followups is to be made.
According to a study conducted in South Africa a lockdown would kill 29 times more people than it saves. The extent of economic damage would be anybody's guess. According to a mathematical model by two former senior scientists of CSIR / NIIST (Ajit Haridas and Roschen Sasikumar), lockdowns would be ineffective when started too early when only less than 1% of the population is infected, and it takes more than 70 days to cross the 1%; day 70 to 100 -- 22.5%; day 100 to 140 -- 1% again without intervention. First, the 'herd immunity' must be let to develop, before taking the drastic step of lockdown. But, herd immunity may take a very long time to develop. And nobody knows how long the immunity developed after recovery would last.
https://www.medrxiv.org/content/10.1101/2020.05.06.20093104v1However, one economic assessment says: If there is no lockdown the economic loss due to 5 million deaths would be about Rs. 20 lakh crore. If there is a lockdown the economic loss due to disruption of production would be only Rs. 7 lakh crore -- https://www.newindianexpress.com/opinions/2020/may/07/lockdown-an-economically-sound-decision-2140161.html . Now, look at the figures below:
India's industrial output, as measured by IIP, contracted by 16.7% in March, 2020. A mega 10% of GDP, Rs. 20 lakh crore stimulus package was announced by the Prime Minister of India on May 12, 2020, after about 50 days of lockdown, to help nurse the economy back to health.
During the corona period we have cultivated a 'tube vision' which lets us see only about corona, blind to other diseases, hunger, deprivation, present and future livelihood, future GDP, etc. And, the 64 million city-slum-dwellers and the scores of migrant labour were outside the field of vision when the surgical move of the lockdown was a 'breaking news'. Or was it a 'braking news' ?It is highly complex -- it's not like switching-on and switching-off a light. With just an order everything can be locked down, but can't be opened the same way. Lots of risks -- risk of more number of cases, risk of not getting back production, economy, health and life to the 'old normal' in the near future. Even inside the health care system, the COVID-19 has crowded out 'non-covid' care, both public and private, to almost nil, as the days rolled on and the lockdown moved on from phase to phase -- 1 to 4. This may lead to stupendous 'non-covid' health problems in future. Is the country's multi-layered health system being sacrificed at the altar of one virus ?
India -- 9 weeks after lockdown ... 01.06.2020
Benefit or Loss ? None can give a satisfactory answer as the issue is riddled with a multiplicity of factors in India, including statistical inaccuracies. It is an experiment.
Prime Minister Narendra Modi wrote / said on 29.05.2020 that despite tremendous suffering due to the lockdown, India has averted a huge corona disaster. On the same day, Dr. Balram Bhargava, Director-General of ICMR, said that though there has been a rise in positivity rate, the fatality rate could be kept low, in spite of the healthcare-spending being only around 1% of GDP. He seemed to have indicated helplessness when he expressed the hope that COVID-19 would also quit like H1N1 (swine flu) which suddenly came as a big wave, stayed for a long time and suddenly disappeared, some years ago.
India started the first phase of lockdown on March 24 and entered the first phase of 'Unlock' on June 1, 2020.
In the first phase of 3 weeks, between March 24 and April 15, the number of cases had gone up by 20 times, and it is still growing even at the end of 2 months. Just in 10 days between May 18, 2020 and May 28, 2020 the number of positive cases had grown from 1,00,328 to 1,65,799 -- a whopping 65,000 increase. And in just 7 days between May 26 and June 2 the number went up from 1.5 to 2 lakh -- an alarming increase of 50,000 in one week. But the death rate is low which is the most important factor (0.3 deaths per one lakh of population -- lowest in the world). And sadly, the economy plunged down exponentially beyond any hope of full recovery in near future. Added to this is the pathetic collapse of the migrant workers livelihood and their miserable run to their native States which couldn't be foreseen. The impact of migrant work force on health and more so on industrial economy also could not be fathomed. Apart from the agony they suffered to travel back to their native places, they were stigmatised by their own people as virus carriers -- and in fact they might have spread the infection in remote rural areas where healthcare vigilance is substandard. .If the lockdown was only for three weeks, the workers would not have gone back and the employers would have fully supported them for those three weeks.
Proponents of the lockdown say that the situation would have been lots worse if the lockdown was not clamped and that a humongous catastrophe could be averted. The critics say that it failed to contain the spread. If it had failed, why it didn't work according to the expectations ?
(a) The dense population and the deeply entrenched social customs and cultural conventions. 'Social distancing' is not practicable and can't be enforced in the vast heterogenous and congested India.
(b) For various reasons, people didn't and couldn't follow the 'health advisory'.
(c) Outbreaks occured at different places at different times, asynchronously', jeopardising calculations based on mathematical models.
(d) Owing to loss of income over extended periods, people went into negative thinking and failed to be compliant.
(e) This virus is different in its mode of spread and sustainability.
(f) Last, but not the least, it could be due to a flawed strategy based on just academic advice and mathematical models. Governmental hubris sans war-room thinking, keeping the private medical sector away from the battle field, the incoherent and rapidly shifting strategies and policies, etc may also be the reasons. Read: https://www.thehindubusinessline.com/opinion/indias-corona-strategy-is-very-amoebic/article31165263.ece
Total lockdown for a long time may not be right for a country like India -- both for health and economic reasons, and both for short-term or long-term benefits. The following could have been done after the first phase of the lockdown:
(a) Strict and universal use of masks and hygiene measures at least until the end of 2020 at all places.
(b) Strict tailor-made location-specific restrictions depending on the situation in selected zones.
(c) Strict medical supervision of all the vulnerable -- elderly persons and all those having chronic problems of lung, heart, kidney, metabolic disorders, etc., irrespective of the age, at least until the end of 2020. If this segment is protected, the rest of the population is not at much risk.
(d) Prompt and proper treatment of all suffering from cough and fever.
(e) The rest of the majority of the working population could have been permitted at the end of the first phase of the lockdown to attend to their duties as usual, but taking all the precautions -- mainly using masks and hand-sanitisers. 'Social distancing' is neither practicable nor very necessary.
(f) All this should have been done at the end of the first phase (March 24 to April 15 during which period the number of cases had increased by 20 fold), as further extension of lockdowns would only worsen the overall situation, especially the livelihood and national economy, and as it may take another six months or even more to ideally 'flatten the curve' or to reach the 'bottom line'. Just imagine the extension of lockdowns until the end of the year or even after, as it would take a long time to achieve ideal epidemiological goals for lifting the lockdown.
Finally, this is not to cast aspersions on anybody. But let us be honest. False statistical figures make us lose all the credibility. People around the world are wondering why the death rate due to COVID-19 in India is so low - lowest in the world at just 0.3 per lakh of population. Just have a look into the matter in the photocopies below and know what even our own experts feel about it. People of late have been obsessively tracking COVID-19 statistics, hour to hour, day to day. What would they think when they realise that these are just some numbers !
The following observations highlighted by the hard-hitting joint statement issued by experts in the Indian Public Health Association (IPHA), the Indian Association of Preventive and Social Medicine (IAPSM) and the Indian Association of Epidemiologists may serve as a 'post-mortem report':
" ... The lockdown is draconian and based on flawed models presumably drafted by an influential institution which presented a worst-case simulation, which is shown to be way off the mark by subsequent events ... Had the government of India consulted field-level epidemiologists who have better grasp of disease transmission dynamics compared to modellers or theoreticians, the purpose would have perhaps been better served ... Enforcing the lockdown indefinitely would be too disruptive and the deaths due to the lockdown for various reasons may overtake lives saved due to the lockdown-mediated slowing of the COVID-19 progression ... From the limited information available in the public domain, it seems that the government was primarily advised by clinicians and academic epidemiologists with limited field training and skills ... India is paying a heavy price both in terms of humanitarian crisis and disease spread, because policy makers relied overwhelmingly on general administrative bureaucrats instead of engaging with expert technocrats in the areas of epidemiology, public health, preventive medicine and social science ... The incoherent and often rapidly shifting strategies and policies, especially at the national level, are more a reflection of afterthought and catching-up phenomenon by the policy makers rather than a well-thought and cogent strategy with an epidemiological basis ... Open and transparent data sharing with scientists, public health professionals and the public is conspicuous by its absence till date ... Had the migrant persons been allowed to go home at the beginning of the epidemic when the disease spread was very low, the current situation could have been avoided.
In a matter like this, opinions of experts do differ, but the hard-hitting collective observations made by the three highly recognised academic associations of authentic experts can't be brushed away as just another opinion. It is compelling on us to ruminate fundamentally on the wisdom of taking a decision to lockdown and on the way of conducting the lockdown.
https://timesofindia.indiatimes.com/blogs/the-interviews-blog/we-cannot-look-at-this-epidemic-as-a-single-axis-of-how-many-people-are-going-to-become-infected/
It is pathetic that the society had to respond to the lockdown, extended lockdowns and reimposition of lockdowns as though they were "Law and Order" problems. Rigid implementation of the rules without sensitivity and pushing people into nightmarish quarantines, hellish and fatal run of the migrant labour along railway tracts, alleged custodial torture for minor violations of the lockdown, etc had distanced people from voluntary participation. People had become terrorised more because of the HEAVY-HANDED POLICING-LED actions and quarantines rather than the VIRUS. Virus fear went into the background in the minds of the people. It's reported that about 50 per cent of the people tested for the virus give false addresses and phone numbers to evade follow up and quarantine. They are said to be tracked , traced and treated like criminals -- and imagine the stigma factor. People are afraid of going out for a morning walk, even with masks on deserted roads, for fear of being fined 100 rupees (see the receipt attached).
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Profiteering or Struggle for existence ? |
All this is written without prejudice and bias. This is based on the views of various experts in the field -- of course, experts disagree on issues, and the myriad of reports.
https://www.thehindubusinessline.com/opinion/indias-corona-strategy-is-very-amoebic/article31165263.ece
https://www.thehindu.com/opinion/op-ed/can-indias-workforce-have-a-safe-return-to-business/article31698049.ece
SOCIAL VACCINE
We have to use the vaccine that is available now. It is the 'SOCIAL VACCINE', made by lockdowns, that is to be taken seriously by everybody around the world. 'Social Responsibility, 'Personal Hygiene', 'Lifestyle Modification' and 'Preserving Nature' are the main ingredients of this vaccine. Don't foolishly think that lockdown is the remedy and the end of corona crisis -- this is just the beginning. Lockdown is just a short-period demonstrative and training course of lessons in the 'classroom at home' to learn how this 'Social Vaccine' is to be taken in course of time. Last but not the least is 'Preserving Nature' which only has the long lasting benefit.
After the 'lockdown' is lifted, leave this 'classroom at home' and take this 'Social Vaccine' daily as a routine until a really effective biomedical vaccine is made. And, it is most unlikely that a 'Really Effective' vaccine can be made in the near future. This means that you have to take these preventive measures indefinitely for a long time even if you are free to go out for work or studies. Miss Corona would be our permanent guest.
If carrots didn't work in the class room, teachers used canes ... in the corona case, the caning would not be from teachers or police, it will be from COVID-20 !!! The Westerners need to learn this lesson seriously, lest they would sink the whole world to unfathomable depths.
We have been advocating ‘Covid-appropriate behaviour’ (masks, distancing & hygiene) for over one year to prevent a second wave. Recklessness to this advice might also be the cause for the shocking swell in the cases. This incessant advisory didn’t work though it is of paramount importance. People have developed a strong sense of déjà vu about it as the recipe is the same over a long period. They are fatigued and dejected. Sermonic repetitions yielded only contrarian effects. Most of the people, including many doctors, didn’t follow the advisory, as it is not practicable in India. But, it is the cheapest and best preventive measure. How many, including doctors, are wearing proper masks properly and disposing them off properly ? While the advisory didn’t work, it is to be made very clear that no Covid virus can expand its footprint without the lack of ‘Covid-appropriate behaviour’ of humans. Under the existing circumstances, vaccination is the only thing available and reliable to stem the scourge. And until the vaccination is completed the only preventive measure is to strictly follow the ‘Covid-appropriate behaviour’.
Further reading:
https://www.thehindu.com/opinion/lead/a-shot-of-hope-with-a-game-changing-vaccine/article31383184.ece (article by Dr. T. Jacob John, Virologist & Dr. Prathap Tharyan, Epidemiologist -- both from Christian Medical College, Vellore -- published in The Hindu of April 20, 2020)
-- T. Rama Prasad
Everybody wants to go back to the "BUSINESS AS USUAL & MAKE MONEY" mode. But, Miss Corona says: "Well, at the risk of your LIFE."
-- T. Rama Prasad
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"If you destroy NATURE, it would wipe you out with NUCLEIC ACIDS, not NUCLEAR WEAPONS." -- T. Rama Prasad.
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My close relative, Dr. Bhagyashri Navalkele is the Medical Director of Infection Prevention and Control at the University of Mississippi Medical Center (USA). She was born and brought up in India and had her basic medical education in Mumbai. She has been a 'game-changer' at the university's COVID-19 facility and the
https://www.clarionledger.com/story/news/2020/04/24/community-heroes-april-2020-ummc-doctors-play-key-role-coronavirus-fight/3004388001/
-- T. Rama Prasad
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Bread is masculine and beer is feminine. Every noun in French has a gender. And now the Academic Franchise has decided to approve feminine form for COVID-19.
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Dear Miss Corona,Good morning. You seem to be a smart and voluminous lady like our actress Sunny Leone or Vidya Balan. Researchers told us that you are the largest among known RNA viruses (0.125 microns) and that we may use even ordinary surgical masks instead of the expensive N95 masks to filter you out. We are lucky that you are not of the 'size zero' of the actress Kareena Kapoor !
You have become the most feared foe for us today. You have been so cruel to infect around 28,00,000 and kill about 200,000 humans and to crash down global economy shockingly, all within four months. You have sent the stock market into a tailspin of shock waves, made the airlines industry to nosedive causing a loss of hundreds of billions of dollars, and made our Indian dream of '$5 trillion economy' move into the realms of fantasy by impacting our trade by about hundreds of millions of dollars, all within a span of four months. All our developmental plans had gone for a toss. You had closed even our big temples, including Tirupati Tirumala, let alone huge malls, markets, theatres and tourist spots even before the 'LOCKDOWN' in our country. Loss on tourism sector would be of gargantuan proportions. All this you did within a short span of about four months ... we are terrified of what is yet in store for us, and we are scurrying around like headless chicken, not knowing how to contain you. What with all the WHO declaring you as a 'pandemic' scourge of stupendous stature.
You have a well planned agenda to kill. You killed the whistleblower Dr. Li Wenliang who posted early warnings of your presence on this planet on his social media group. Also you killed Dr. Liu Zhiming, Director of Wuhan Wuchang Hospital who was trying to save people from your attack. And you infected most of the medical staff in Wuhan and many in the West too, and killed more than 100 doctors in Italy. You have terrorised the affluent Western societies by infecting lakhs of people and killing about half-a-lakh, and driving the British Prime Minister, Boris Johnson into ICU. And, you killed 2,000 in one day on 07.04.2020 in America alone, and a total of around 17,000 in Italy alone (much more than the fatality of about 4,000 in China). Your performance is acclaimed to be the best when you infected about 8,00,000 and killed about 45,000 in the indomitable America, the US. As on April 22, 2020, you made a whirlwind tour across the globe and infected about 28,00,000 people and killed nearly 200,000 in 210 countries / territories !!! Your most speedy and stunning blow is on the US which is highly empowered with grand health infrastructure ... you seem to be more angry with America ... perhaps, you don't like the one-upmanship of 'Uncle Sam' and his arrogance.
But, Miss Corona, why are you doing all this ? ... A revenge ? What harm we humans did to you ? ... Oh, that's it ? We had tinkered with nature and caused an ecological imbalance in the forests where you were residing in animals ... yes, it's true ... we disturbed you all. Out of sheer greed, we encroached the territory of wildlife and deprived them of food and water ... so the animals, bats, birds, etc. are forced to come out of the wild into human habitations. And you viruses also came along with them and jumped from them into us to taste our blood with impish glee. Alas ! What to do now, Miss Corona, to send you back into the forests ? We can't go back to the good old culture and habits. We can't change the environment. We are incorrigibly addicted to 'modernity'. And you can't be bribed to strike a deal to send you back to the forests we deforested.
We humans, normal imperfect mortals, first think of buying you with money because we strongly believe that money would take care of everything -- jobs to judgments, taxes to temples, deprivation to depression, etc. ... the pernicious influence of our deep trenched systems make it seem that it is easier to get marks, degrees, jobs, licenses, approvals, certifications, and votes through money. Nothing vague or amorphous ... vulnerable to venality. Miss Corona, let me be honest ...if you are interested to know more about our nefarious "Kali-Yuga" activities, please click on the following two links, written by the internationally renowned scholar, Pritam Bhattacharyya (Editor-at-Large of Pentasect and Founder and Chief of Wordsmith at Wordsmith Communication, Chairman of Freelance Foundation, ) -- (1) https://wordsmithofbengal.wordpress.com/2012/01/16/health-un-heath-and-fear-of-un-health/
(2) https://wordsmithofbengal.wordpress.com/2012/04/23/google-effect-and-kali-yuga-prophecies/
(Pritam Bhattacharyya posted a comment on this 'scribbling' which may be seen at the end of this writing - wordsmith.)
If you are interested we can pay you a huge ransom through a global fund. We have nuclear arsenals to annihilate humankind en masse but not you only. Further, as a gesture of goodwill, we humans will make December 31 as the WORLD CORONA DAY (the first death due to COVID-19 occurred on December 31, 2019 in Wuhan, China). So, Miss Corona, be benevolent and let the human race exist. Kindly retreat.And finally, we have one more request, Miss Corona. Please don't get married. When you marry someone in your community of vicious viruses, you may beget children with treacherous genomes which may wipe out the remaining 40% of the world population, faster than by you -- one Chinese billionaire in the US estimated that 60% of the global population would vanish because of you.
Postscript:
It may not be palatable to you, Miss Corona, but let me tell you this. You had indeed killed around 100 thousand in the rich Western countries, but you couldn't do much havoc in the Indian subcontinent and the African continent, despite our lower standards of living, personal hygiene, sanitation, education, environment and medical facilities. And add to that, our not praiseworthy habits and beliefs -- some of us are not touching newspapers and drinking cow's urine to ward you off ! Hot climate may not be the only factor, as some countries in the tropical zone are also badly affected by you. In India, of the size of 1.3 billion people, you could infect only around 19,000 people and kill only around 600, as on 22.04.2020. You know why ? Lower standards are a blessing in disguise for us.
Our environment is full of filth, bacteria and viruses. So, we had a lot of subclinical (not very symptomatic and not compelling to see a doctor) infections which generated immunity (resistance) -- like racial or herd immunity, over a period of decades and centuries. Lower resistance in western societies may curiously be due to over-sanitisation (too much of cleanliness and hygiene). If a little is good, a lot need necessarily not be better. This concept may seem strange and unacceptable, but this view may be vindicated by 'post-corona' epidemiological studies.
If you go a little back into the history of science, you may think of Darwin's theory of evolution - natural elimination of the weakest and survival of the fittest. One telling example is this: Dharavi in Mumbai is the Asia's largest slum. 15 lakh people live on the little space of 613 hectares with no proper ventilation, sanitation, light and other basic facilities like water. In the normal thinking, any infection like coronavirus in this slum would infect the entire Mumbai in no time. Earlier, a decade ago, when swine flu struck India, hardly any case was detected in this slum while around 3,000 people died in the country. Some researchers and Satish Pawar, Director of Maharashtra Health Mission said that the immunity of the population in this slum is robust which may explain this paradox. Hence, Miss Corona, don't touch us, we are resistant and may retaliate brutally. And we have the unique miRNA, 'has-miR-27b' armour !
Yours truly,
T. Rama Prasad.
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Miss Corona
Why are we coming out of our cosy caves and pristine jungles ? Because you incomprehensible humans caused an ecological imbalance through thoughtless tinkering with nature -- invaded our forests, destroyed them, forced animals along with us (viruses) to come out of the forests, polluted the planet, caused global warming, etc. Stupids to the core you are. You are killing the hen that is laying golden eggs. And you have all changed your lifestyle to the worst with scant regard for good old habits ... lost the sense of values ... and you Indian sheep embraced the bad of the western culture -- shaking hands, hugging and kissing everybody, devouring junk food ... good, not yet using toilet paper instead of water. Anything 'modern', you are hooked by, moral or immoral.
You mortals are all intelligent idiots ... used your intelligence to become affluent, arrogant, adamant, angry, egoistic, and inhuman ... used your idiocy to materialistically overexploit nature and fiercely fight among yourselves, even using us (microbes) in your warfare. You are all abysmally cruel and brutal not only to your neighbours but also to all other creatures ... look at your abattoirs where you slaughter millions mercilessly under the eerie veil of kind words like 'humane killing'. Appalling. What a treacherous lot you are ! Nature is not your inherited property to sap it to please your perverted tastes and crazy senses.
Don't arrogate with your sense of supreme intelligence and blindly believe that you can prevent and cure diseases with vaccines and drugs. I had exposed your hollowness. Flames of my fury devoured your firewalls ! What could those highly empowered fatty western countries with impeccable health infrastructure could do when I unleashed my might ? Scurrying around like headless chicken ? I upended their comfort zone. I challenged their certitudes. I did kill brazenly, unlike you timid tots who do it clandestinely. Prasad, I am killing only to save you all and the remaining life on this planet, by forcing your selfish selves to live sensibly, sensitively and humanely. Shed hypocrisy, megalomania and one-upmanship. Be human. But you are not humans, you are the vicious viruses of all time, full of soulless greed, distilled selfishness and insatiable corruption.
You are notorious not to learn lessons. Earlier, my cousins (SARS, MERS, EBOLA, NIPAH, H1N1, et al) came to discipline you, but in vein. That's why I had to step in. I don't trust you, incorrigible humans. Once the 'LOCKDOWN'' is over, you clever and stupid fellows would get back into the 'BUSINESS AS USUAL' mode. That's why I may extend my stay for some more time until you are mellowed, tamed, tuned and detoxified. And imagine your misery when I extend the 'personal distance' to 10 metres ! You need to wash your brains, not just hands.
Postscript:
Miss Corona.
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Buy one bra & get one mask worth Rs.195 free
Limited edition offer, hurry up !
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The world has entered unchartered territory in its battle against the deadly coronavirus.
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The article cited above (America's junk food), with statements by Dr. Nicole Saphier, MD, a radiologist at New York's Memorial Sloan Kettering Cancer Center makes the following home truths come to the surface:
The tragic spillover of the Western life style is that some of our wealthy, fussy and food-centric 'pseudo-western-Indians' have been embracing the Western way of eating and living as a status symbol and getting ruined -- aping the Western tastes ... processed foods, packaged foods, pizzas, pastas, burgers, cookies, rolls, colas, avocado, zuccotto, corona beer, E-cigarettes, McDonalds, KFCs, etc. ... all status symbols ... hypocrisy. They cultivated an exalted and dizzy feeling of superiority over the 'rubbish folk of Indian lifestyle and culture' !!! If you live the life right, you may as well forget the three Ds -- Diseases, Doctors and Drugs !
Most of the corona deaths are associated with co-morbid conditions like diabetes, heart disease, metabolic diseases, obesity, etcetera. These are all related to a great extent to the food habits which Dr. Nicole Saphier mentioned in the above article.
Obesity a driving factor in many COVID-19 deaths, international study indicates ... March, 2021
Reuters (3/4, Kelland) reports researchers found in an international study that the majority of deaths from COVID-19 “have been in countries where many people” have obesity, “with coronavirus fatality rates 10 times higher in nations where at least 50% of adults” have overweight. According to the report, “90% or 2.2 million of the 2.5 million deaths from the pandemic disease so far were in countries with high levels of obesity.” The researchers analyzed “COVID-19 death figures from Johns Hopkins University in the United States and the World Health Organization’s Global Health Observatory data on obesity.”
The Hill (3/4, Choi) reports the findings were released in the World Obesity Federation’s annual report.
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| AT TULSA RALLY |
"The appearance, at the Dream City megachurch, was one of his first rallies since taking a three-month hiatus because of the coronavirus pandemic. Images from the event showed a large crowd tightly packed together, with almost no one wearing protective masks. There were no temperature checks for the estimated 3,000 cheering attendees who, like many of Trump’s staunchest fans, ignored a new local ordinance requiring them to wear a mask, despite a public-health plea from the Democratic mayor on Monday." There were 3,591 new cases and 42 deaths on that day, and Trump made fun of coronavirus at the meeting.
https://www.politico.com/news/2020/06/23/trump-rally-arizona-336565 .
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| AMERICA -- "The Land of the Free" On July 1, 2020, Anthony Fauci, infectious disease expert and the leading member of President Donald Trump's coronavirus task force said: "The number of cases could go up to 100,000 per day if authorities and the public fail to take steps to suppress the pandemic ... Americans should wear masks and avoid crowds and mend lax behaviour ... I'm very concerned and I'm not satisfied with what's going on, because we're going in the wrong direction."  The LAND of the FREE While the medical head of that land said so, the administrative head ventilated about the freedom. They are at loggerheads. 'Uncle Sam' assured that the citizens will have the freedom to choose between 'mask' or 'no mask', in 'the land of the free'. Wisdom and science of the POTUS !!!  |
On July 13, 2020, a BCG study trial is initiated to evaluate the effect of BCG in preventing or modifying COVID-19 in the age group of 60 to 95 years at the National Institute for Reseach in Tuberculosis (NIRT) at Chetpet, Chennai under the auspices of the Indian Council of Medical Research (ICMR). Five more centres are chosen for this study in Gujarat, Rajasthan, Madhya Pradesh, Maharashtra and Delhi. 
The greatest damage that this pandemic did and will do is of infusing FEAR into our blood through media. The 'INFODEMIC' is the real pandemic destroying health and economy through FEAR which leads to frightening thoughts and disastrous interventions. We are drowned and suffocated with information, misinformation and fake information. Fear, fear and fear. Fear makes one mad.
When it is said that a normal person without any symptoms can potentially transmit this deadly virus through normal breathing, how can one be without fear ?
Doctor is afraid of seeing a patient. Patient is afraid of being tested. Everybody is afraid of quarantine and social stigma. Homemaker is afraid of a housemaid. Maid is afraid of a coughing child in the house. Employee is scared of going for work. Employer is worried about closure of his factory if an employee tests positive. One is scared of touching a newspaper. Another is afraid of using sugar without washing it ! We are afraid of each other. What life is this ?
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| Remedy seems to be worse than the malady |
Already many of the diseases in the 'modern' world are due to stress. Now, Covid is adding fuel to the fire, immensely enhancing the fear of the virus and the fear of loss of livelihood. Tension and stress lead to mental illnesses which in turn lead to physical illnesses. Fear destroys immunity and stress kills. Sooner and later, directly and indirectly, there could be enormous morbidity and mortality due to fear and stress, much more than that due to the virus illness. The impact would be more due to the fear of losing life and the stress of economic crush / crash / crunch, consequent to the ongoing disruptions in supply and production across the world. Uncertainty of everything is the greatest stress.
FEAR is both good and bad. Excessive fear destroyed the economy and mental health through 'lockdowns'. Lack of fear spread the virus by not observing preventive measures. If it is 'unlocked' a bit, people are going about as though the virus is absent. If you behave like the UNWISE MONKEY, you will be totally 'caged' again !!!
https://timesofindia.indiatimes.com/blogs/toi-editorials/fear-and-trembling-sushant-singh-rajputs-tragedy-speaks-to-the-wider-mental-health-challenge-of-covid-times/
In 1855, 'Bubonic Plague' pandemic swept the world and rapidly killed 10 million people in British India. The epicentre of the outbreak was also in China -- a place called Yunnan. Later in 1918, the Spanish flu swept the world from Kansas to China ... perhaps, it didn't start in Spain though it's named so -- it might have started in the US Army / Navy, perhaps, the news was played down in those days of war, jingoism, censorship and denial. The Spanish Flu killed as many as two crore Indians. The Spanish Flu pandemic dealt a hammer blow to the already battered world economy by the ravages of World War I. The prediction was that the world would plunge into catastrophic decline. Contrary to the prediction 1920s saw a roaring development comparable to the development after the 'Black Death' medieval plagues in Europe followed by the Renaissance. We hope a rebound development in the post-covid 2020s.
COVID-19 is a new virus which started its journey in China (Wuhan) in December 2019 and spread fast and wide to 210 countries / territories across the world within a short period of less than five months, https://www.verywellhealth.com/difference-between-epidemic-and-pandemic-2615168 ). It's a humongous task to deal with. Nearly100,000 were killed eclipsing the death toll of 774 of the global outbreak of SARS that also started in China. The future course of the disease is very unpredictable, with the unexpectedly devastating spread to many countries.
The following are the links to my 'scribblings' on some other viruses:
SYMPTOMS, DIAGNOSIS, PREVENTION and TREATMENT SYMPTOMS: The symptoms are like those of most viral fevers - 'cold and flu-like' symptoms - mainly fever, cough, shortness of breath and tiredness. During the third week of April, 2020, the CDC (USA) added another 6 symptoms -- chills, repeated shaking with chills, muscle pain, headache, sore throat, new loss of taste or smell. It is reported that loss of smell and taste may also be present. A study from the University of Oxford, the Imperial college, London and the NIH, USA revealed that grey matter loss in brain was seen after Covid with symptoms of loss of smell and taste. 'Chest X-rays' may show abnormalities in lungs. Lung infection, mainly, and kidney / heart failure in some may lead to death. Elderly people and those with co-morbidities (diabetes, heart disease, lung disease, kidney disease, etc.) are more vulnerable. And, men seem to be more vulnerable, possibly due to the higher levels of ACE2, one of the strongest biomarkers (European Heart Journal). Symptoms after recovery: As it is in September 2020, the symptoms after recovery have started to loom large. As the cohort of COVID survivors is getting larger, a large number of the patients have been complaining of various symptoms even long after being declared free of the disease. A study from Italy reported that only 12.6% of the 'recovered' were free of any symptoms two months after 'recovering'. In course of time, the symptomatic population of the 'recovered' is expected to be a huge challenge to the medical services. The symptoms pertain to various systems in the body. (1) shortness of breath - lung damage (2) palpitations & chest pain - heart damage (3) fatigue and loss of muscle strength - nerve damage (4) loss of smell & taste, head ache, memory loss, suicidal tendency, sleeplessness, stress, anxiety, depression, mental illness - brain damage / psychological, etc. It is a matter of grave concern that some of the 'mild' cases also exhibited these symptoms after recovery. It may be naive to assume that one would become 'normal' after 'recovery'. Psychological support, empathy and a graded physical rehabilitation are key factors to achieve normalcy. According to a study published in the Journal of American Medical Association, 87.4% of the patients complained of symptoms, particularly of weakness and breathlessness, even two months after being discharged from hospitals. DIAGNOSIS:  'Next Generation Sequencing' which scans the entire virus genome, unlike the RT-PCR (70 - 80%), gives more accurate results (97%).  Real time RT-PCR stands for real time reverse transcription–polymerase chain reaction. We are mostly relying on the result of this test to know whether a person is infected with the SARS-CoV-2 virus or not. Those who are tested positive in any country are called "cases" though they may not be patients suffering from symptoms. And, more importantly, this test may give 'false positives' (meaning a positive report of a non-infected person due to some errors) and 'false negatives' (meaning a negative report of an infected person due to some errors or due to the inherent incapacity of the test to detect which itself may be as high as 30% !) These pitfalls are to be taken into account while diagnosing. This is why a clinical diagnosis is as important as the lab tests which may mislead us. There is an excellent article by Dr. T. Jacob John and Dr. M. S. Seshadri (The Hindu, July 1, 2020) on this subject -- go to the link: Rapid Antigen Tests Standard Q COVID-19 Ag kit Test -- antigen antibody -- (brand name: PathoCatch -- Mylab -- about Rs.500) -- moderate sensitivity but high specificity -- 'Rapid Point of Care' test which doesn't require equipment -- like a card test -- result within 30 minutes -- if positive, may be confirmatory -- if negative, to be further tested by RT-PCR, if symptomatic. Many countries are working with the IAEA to use real time RT-PCR to diagnose a variety of human, animal, and zoonotic diseases, including COVID-19. CBC, LFT, CRP, Serum Ferritin, D Dimer, LDH are some of the investigations which would be of help. 'Chest X-rays' may show abnormalities in lungs. Lung infection, mainly, and kidney / heart failure in some may lead to death. Elderly people and those with co-morbidities (diabetes, heart disease, lung disease, kidney disease, etc.) are more vulnerable. And, men seem to be more vulnerable, possibly due to the higher levels of ACE2, one of the strongest biomarkers (European Heart Journal).
Chest X-ray & CT Scan As coronavirus affects lungs in most of the cases, Chest X-ray / CT scan would be an important diagnostic tool. Very widely varied abnormalities were noted within a week or two - mostly of pneumonia. CT Chest yielded more information -- Peripheral lesions, Ground glass appearance, Patches of consolidation, Reverse halo sign, Air bronchogram, Vasculation sign, Prominent pulmonary vessels, Crazy pavement pattern.
Clinical features, serum markers and CT chest are more dependable than RT-PCR test alone. "RECOVERED" patients tested "POSITIVE" and / or "SYMPTOMATIC" !!! Weeks after making full recovery, 260 people tested positive (RT-PCR) in South Korea. It was confirmed that 'dead virus fragments' were still present in the recovered patients. These were labelled as 'false positives'. In Wuhan Pulmonary Hospital, 651 'recovered' patients were found to be 'positive' in about two weeks after discharge. And 35% of them had one or two symptoms. These patients may be infective, while the others may only be having 'Residual non-pathogenic viral components'. Symptoms after recovery: According to a study published in the Journal of American Medical Association (JAMA), 87.4% of the patients complained of symptoms, particularly of weakness and breathlessness, even two months after being discharged from hospitals. A study published in the JAMA (July 2020) revealed that 80% of the 100 patients who recovered from COVID-19 had 'heart inflammation' and cardiac manifestations (Germany's University Hospital). RE-INFECTIONS: A few people are infected twice over by SARS-CoV-2. Earliest case was from Hong Kong. They are mostly asymptomatic. One of those reinfected in India appeared to carry a variant that conferred resistance to neutralising antibodies. (CSIR-IGIB). The infections were mild and it seems that this is not of a serious concern at present. SERUM MARKERS are important in the diagnosis. PREVENTION: The most important preventive steps would be: 'testing / tracing / isolating as well as ideas to deploy a population health surveillance technologies like smart thermometers (Kinsa) and oximeters." And, there are only general preventive tips: Live a good hygienic lifestyle, Upgrade personal hygiene -- wash hands frequently with soap and water after touching common objects; cover nose and mouth while sneezing or coughing; wear a mask, avoid to stay in close proximity of people suffering from cold, cough, fever or flu-like symptoms; "Social / physical distancing" --keep one metre distance from others; avoid touching face, nose and eyes without washing hands; avoid crowded places; avoid travel with people from countries of high virus burden; thoroughly cook non-vegetarian food; keep surroundings clean and disinfected; reduce direct unprotected contact with wild or farm animals. Avoiding touching nose with infected hands is important as 'Goblet and Celiated' cells in noses have high levels of 'Entry Proteins' that may get attached to the 'Spikes' on the coronavirus. There’s currently no vaccine to prevent coronavirus disease (COVID-19). You can protect yourself and help prevent spreading the virus to others if you: Do Wash your hands regularly for 20 seconds, with soap and water or alcohol-based hand rub Cover your nose and mouth with a disposable tissue or flexed elbow when you cough or sneeze Avoid close contact (1 meter or 3 feet) with people who are unwell Stay home and self-isolate from others in the household if you feel unwell Don't Touch your eyes, nose, or mouth if your hands are not clean The preventive measures mentioned above are of paramount importance: Using soap and water is the cheapest and best, more effective and much less costly than alcohol-based hand rubs or the antiseptic lotions to clear the hands of dirt and grease. Face masks may be beneficial in a general way and when one is near people coughing and sneezing, but not absolutely essential when in clean surroundings. Of course, the scare and the undue importance given to the hand sanitisers, antiseptic lotions and face masks have pushed up their sales and made them disappear into 'black market' !  https://www.newindianexpress.com/todays-paper?sectionname=Opinions&date=05-24-2020 If you read the article cited in the above link, you may doubt the scientific validity of the ICMR's decision on HCQ. A publication in the LANCET indicates that there is no benefit of HCQ in treating COVID-19 patients. It also mentions of more cardiac problems and deaths ( https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext#seccestitle70 ). To know more about Chloroquine and Corona, click on: http://drtramaprasad.blogspot.com/2017/04/coronavirus-covid-19-2019-ncov.html  A large study sponsored by University of Oxford on the efficacy of Chloroquine in preventing COVID-19 is going to take place - May 2020 to May 2022 ( https://clinicaltrials.gov/ct2/show/NCT04303507 ). According to the protocol of this study, a loading dose of 10 mg per kg of body weight of Chloroquine base is to be followed by 150 mg per day for 3 months. Some people in India have already started taking Chloroquine, and if the trend catches up, the stock on the shelves would vanish as happened in the US ! Right now we don't know for certain the protective value of Chloroquine. And, there seems to be some evidence to suggest that some anti-diabetic drugs (Metformin, DPPA inhibitors - Gliptins - Sitagliptin, etc.) may prevent attack by COVID-19.  Many natural food items which we take traditionally improve collectively our immunity generally against all the disease producing elements, including coronavirus. It is said that Indian food items are more immunogenic due to some ingredients -- spices, condiments, garlic, turmeric, pepper, ginger, curd, buttermilk, traditional cereals, pulses, etc. Various studies, 'telescopically' study various food items and draw conclusions that 'this is good for this' and 'that is good for that'. Manufacturers take out some substances from these food items, project these study results, often out of context and commercially exploit the market ! For example, there is a study done at University of Queensland, Australia ( https://thevaultzmag.com/index.php/vaultz-daily-brief/bananas-help-prevent-coronavirus ) which indicates that bananas confer immunity against the coronavirus by virtue of good amounts of vitamins B6, vitamin C, etc. One may extract something out of one banana, put into a capsule and sell it for 100 rupees ... you may as well buy 10 bananas for that amount and enjoy eating them ! And there is the fake news that tea inhibited coronavirus and that tea is being given 3 times a day to patients in China ! About tea, go to http://www.thehindu.com/    Keep "SOCIAL DISTANCE" dear pumpkin lovers ! LOCKDOWN for prevention India is under LOCKDOWN (march-April, 2020) which is considered as the most effective preventive step to stem the rot. The Central Government is in a mission mode and the State Governments have to be as proactive. Ultimately, it is in the peoples hand. It all depends on how meticulously they follow the advisory and the rules. The bitter pill may not be liked, but the result would be sweet. The 'LOCK DOWN' has, in fact, given a chance (at least to those in the higher income groups) to improve their health and lifestyle (over a short period of time) --- timely home food (sans junk food), exercise in sunlight (jogging on terraces), enough sleep, no work tension, less spending and more saving (for the salaried segment). Here again, it is up to the people to use this opportunity this way or to be as in the photo below:  However, there are experts in the field who think sceptically about the benefits of lockdown. It may all depend on the specific situation in a locality or the country at a particular point of time. An editorial in a world famous medical journal, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30938-7/fulltext ). Our own advisors seem to have followed double standards as can be inferred from the following report:   It is LIFE versus MONEY. Without life there's no money, and without money there's no life. It's the affordability of a country that should decide the type of the 'LOCKDOWN'. Different 'pundits' expressed different views. America is an example of the conflict, Trump backing the protestors against lockdown in some States. For India, perhaps, a 'soft and selective lockdown' without a big blow to economy might have been desirable. The police, officials and army, if necessary, could have been posted inside (now, they are posted outside) the working places and educational institutions to enforce preventive measures in addition to 'educate' them on precautions to be taken in daily life. it's all hypothetical and conjectural due to insufficient information about this disease. Anyway, we are half way through now (20.04.2020). Let's see the results. Is LOCKDOWN an economically sound decision ?  It is a fiercely debatable subject. There are various ways of assessment. One is to apply the 'human capital' concept of economics. If there is no lockdown the economic loss due to 5 million deaths would be about Rs. 20 lakh crore. If there is a lockdown the economic loss due to disruption of production would be Rs. 7 lakh crore. Which is higher ? Critics may not agree with this model of calculation and the data factored in. For more details, click on: https://www.newindianexpress.com/opinions/2020/may/07/lockdown-an-economically-sound-decision-2140161.html But, how long can we keep the watermelon without opening ? DON'T GET SCARED ... use the troika of 'masks, physical distancing and hygiene', in a logical and measured way. Cooperation of the public and the participation of the 'private medical sector' are crucially needed. Mid-course corrections are necessary as there are many knowledge gaps in the 'corona compendium'. According to a study conducted in South Africa a lockdown would kill 29 times more people than it saves. The extent of economic damage would be anybody's guess. A little more about this may be found under the subheading "LOCKDOWN SYNDROME" in the above pages.Clear understanding of the facts about this disease and voluntarily applying the knowledge goes a long way to prevent morbidity and mortality, rather than coercive and punitive measures. FACE MASKS CDC researchers say mask mandates and dining restrictions tied to decreases in SARS-CoV-2 infections and deaths from COVID-19The New York Times (3/5, Rabin) reported CDC researchers found that in counties across the US, wearing masks “was linked to fewer infections with” SARS-CoV-2 and fewer deaths from COVID-19. In the same study, “researchers also found that counties opening restaurants for on-premises dining – indoors or outdoors – saw a rise in daily infections about six weeks later, and an increase in [COVID-19] death rates about two months later.” The AP (3/5, Stobbe) reported CDC Director Dr. Rochelle Walensky said, “All of this is very consistent. You have decreases in cases and deaths when you wear masks, and you have increases in cases and deaths when you have in-person restaurant dining.” The Hill (3/5, Sullivan) also covered the study. ... March 2021  Smile is the most enchanting expression of a human being which has the most positive value. Alas, it made an obscure retreat behind a face mask ! A smile used to add tremendous value to a face. Now it is reduced to zero. The mask turned smiling faces into inanimate objects. We don't know whether a receptionist is inviting us with a smile or sullenness.  Yet, fashion is unique. FASHION is a very powerful facet of a human being, even when the world is in the throes of a pandemic. For example, see the $185 Luxury Face Mask from Belgium in the photo. Interestingly, I stumbled upon an article written by a school student on FASHION which you may read in the link below. -- T. Rama Prasad. https://bluemaskjolting.blogspot.com/2020/08/do-we-need-fashion.html    Primarily there are 3 kinds of masks: 1. Cloth masks 2. Surgical masks 3. Respirator masks. For details, Click on: "The best evidence of utility of masks comes from East Asian countries with a culture of mask wearing and a collective adherence to civic duties making coercive masking laws virtually redundant. A common strand among these countries, ranging from democracies like Japan and Taiwan to authoritarian ones like China and Vietnam, is the relatively low Covid infections and mortalities despite high population density compared to Western nations. Not surprisingly the East Asian economies fared better than those nations which went easy on masks and opted for stringent lockdowns instead."  "MASKS CONUNDRUM: The much maligned WHO which hemmed and hawed over the efficacy of masks even when this juggernaut virus begun to leap across continents, has now came out favouring use of masks." -- Dr. T. Rama Prasad, 'Pay What You Can' Clinic, Perundurai. Wearing of a mask by one who is coughing or sneezing offers good protection to the others around. (1) A cough may release 3,000 droplets of secretions. Each droplet may contain up to 2 million virus particles. (2) A sneeze may release 40,000 droplets at a speed of 320 mph ! (3) A single minute of loud speaking could generate 1,000 micro droplets. According to aerodynamic studies, droplets of the size of 18 to 50 microns can travel up to 13 feet in the still ambience. (4) Also read under the subheading "MODE OF TRANSMISSION" on this page further up. A study published in strategy does make sense. "Interestingly, the much maligned WHO, which hemmed and hawed over the efficacy of masks even when this juggernaut virus begun to leap across continents, came out with a protocol" now (June 2020) that favours using masks -- Senior Citizens : Medical Mask; Others : 3-layer fabric Mask. A recent study (September 2020, University of California, TNEJM) suggests that 'Universal Mask Wearing' would not only prevent disease, but also acts as something like a vaccine -- a small number of virus particles inevitably pass through the masks, enter the body, produce T cell immunity without causing disease (subclinical infection) and thus protect.  According to this, if all the 'carriers' wear masks and no one else wears a mask, the risk is only 5%. And if this 5% is to be brought down to 1.5% (not much difference), the whole ocean of 'healthy contacts' has to wear masks to be protected from this drop of 'carrier' ! Here the caveat is 'how big is this drop' ! No one knows -- that's the problem of the WHO which had been reluctant to declare mask as essential until June 6, 2020. And, it should be remembered that the 'transmission probability' figures were mostly obtained from 'simulation' and 'mathematical models', not from field conditions.
History: Jan 29, 2020 -- WHO said "In community settings, face mask is not required by individuals without respiratory symptoms Feb 5, 2020 -- CDC does not currently recommend face masks as a preventive as there is no community spread in the US. Feb 29, 2020 -- The US Surgeon-General said "stop buying masks ... not effective for general public." April 6, 2020 -- WHO continued to discourage people from wearing a face mask. June 5, 2020 -- WHO reversed its position saying masks protect individuals from coronavirus infection. June 11, 2020 -- A paper was published in the Proceedings of the National Academy of Sciences documenting the benefits of wearing face masks. But 85 scientists raised a hue and cry about serious errors in the methodology and wrong data projections of the study and demanded retraction of the paper ! An egregious blunder. And now (July 2020) another debate is going on -- whether it is an 'airborne' infection or not. In an 'open letter' to the WHO, 239 scientists from 32 countries have asserted that this virus can infect through small aerosol particles of less than 5 microns in size which can be 'airborne'. They want the WHO to revise its recommendations on prevention based on this evidence. These small droplets can spread much beyond 3 feet and infect. "DON'T USE VALVED N95 MASKS"  And now on July 20, 2020, the Union Health Ministry advised public not to use 'Valved respirator N95' face masks. The one-way valve is incorporated in N95 masks to (1) prevent moisture / sweat build up and heat build up (10degrees F lower) inside the mask area, and to prevent fogging of glasses (2) make breathing (exhalation) easier. The downside of the valved mask is that it allows aerosols (which may contain microbes) in the breathed out air to go out without filtering. Anyway, how many millions of the 1.3 billion are using the costly 'Valved N95 masks' ? This is a very fussy subject. If one wants to be more fussy, one must buy a "Fit Test Kit" to determine which size, style and shape of a mask fits the face. Just go out on to Indian roads and see our 'mask culture' ! We talk about the importance of micronutrients in our diet while we have the 'silent killer' of chronic malnutrition, which is a euphemism for slow starvation ! And, Chinese stopped wearing masks in general public areas with normal people around, perhaps because they may not be much benefit. And finally, the efficacy of a mask depends on the quality of the mask and the properness of wearing the mask. As we see in India, most of the people don't wear the mask properly -- it is just piece of cloth loosely hanging over the nose, mouth or neck. Some visible piece on the face to escape punishment just as they put something like a hemet on handlebar or on head when helmet-wearing is made compulsory for two-wheeler riders ! If everyone wears a right mask in a proper way, there wouldn't be a need for 'lockdown'. Chinese are no more required to use masks in general public areas with normal people around. They celebrated victory over Covid in September 2020, while the US and many other countries are still struggling hard to contain the disease !   That's THE LONG AND THE SHORT OF the masks !!! And then, FUNNY MASKS !        
 NEXT ADVISORY: Never get married, but may have 'Test-tube' babies !!! -- Dr. T. Rama Prasad, PAY WHAT YOU CAN Clinic, Perundurai. http://drtramaprasad.blogspot.com/2017/04/lockdown-medicine.html  CORONA TSUNAMI devastated lifestyle and economy on this planet. The world would start limping back to normalcy only when people would no more need to wear face masks. WHEN ? ... may be 6 months, 6 years or never !!! - Dr. T. Rama Prasad, PAY WHAT YOU CAN Clinic, Perundurai. THAT's ABOUT MASKS -- in 'lighter & serious vein' !!!  AMERICA -- "The Land Of The Free". Should we wear the face mask or not ? The LAND of the FREE: While the medical head of that land said no, the administrative head ventilated about the freedom. They are at loggerheads. 'Uncle Sam' assured that the citizens will have the freedom to choose between 'mask' or 'no mask', in 'the land of the free'. Wisdom and science of the POTUS !!! VACCINES and TREATMENT  Lure of speed of entry and making a fast buck often put quality concerns on the margin. A lot of fraud is being committed in research and treatment. If inquisitive to read about it, click on the two links below: http://drtramaprasad.blogspot.com/2017/04/coronavirus-covid-19-2019-ncov.html http://drtramaprasad.blogspot.com/2017/06/modern-medicine-good-bad-ugly.html HYDROXYCHLOROQUINE: A shame on researchers and a blot on medical journals. An apology was tendered and the article in The Lancet was retracted.
Researchers all around the world are working at a furious pace to make a vaccine 'immediately' ! Over 70 groups are working with100 vaccine candidates and 460 clinical trials. They want to make it in 2020 itself. But it could be 2030 or never ! There has been mounting criticism from the world medical community that regulatory authorities are bowing to political pressures. It is a global competition -- academic and commercial as well, and even political ! And, a vaccine nationalism ! For instance, the mindlessly hurried Russian vaccine Sputnik V is like a Russian roulette. If it succeeds, it's a bounty, otherwise it's a disaster to the humanity. Who can regulate ? There is also the urge as the global economy is on the verge of collapse. The race is against time. The race for a vaccine is more of a marathon than a sprint. That's the reality. (1) On July 22, 2020, the Trump administration inked a 2 billion dollars deal for 600 million doses of COVID vaccine with Pfizer and BioNTech, even before the development of the vaccine. The US biotech firm Moderna's vaccine candidate has shown some promise and will enter final stage trials in July 2020. (1a) mRNA COVID-19 vaccine. (2) British (Oxford) ChAdOx1 nCoV-19 (AZD1222) vaccine uses 'live chimpanzee adenovirus type 5' - initially failed in monkeys, but being tried in volunteers. Being on a 'tried-and-tested' platform 80% success is predicted -- may be available by the end of 2020 for Rs.1,000, made from the Serum Institute of India, Pune. (3) 'Challenge' trials of COVID-19 vaccine -- involving infecting willing people with the virus to know the protective effect. (4) "COVAXIN" is an indigenously developed 'inactivated vaccine' at the Hyderabad-based (India) vaccine manufacturer, Bharat Biotech. It's permitted to do Phase I & II human clinical trials in June 2020 --results expected in October 2020. Meanwhile the ICMR chief kicked up a 'scientific storm' by 'ordering' completion of the trials 'quickly' so that the vaccine could be ready for use by August 15, 2020 ! (5) "ZyCov-D" is the vaccine candidate of Zydus Cadila, slated to complete late-stage trials by March 2020. (6) Russia and China may suddenly market their vaccines any time. Chinese firm CanSino Biologics Inc is developing a vaccine (Ad5-nCoV) based on the adenovirus mechanism. It is approved for use by Chinese military and is lined up for being tested in Russia, Mexico and Saudi Arabia, having obtained a patent approval from Beijing. On 11.08.2020, President Vladimir Putin said that Russia had become the first country to grant regulatory approval to a COVID-19 vaccine to be called 'Sputnik V. This has raised concerns as this has not passed through the customary tests for efficacy and safety. This vaccine consists of two serotypes of a human adenovirus, each carrying an S-antigen of the new coronavirus, which enter human cells and produce an immune response -- a recombinant adenovirus type 26 (rAD26) vector and a recombinant adenovirus type 5 (rAD5) vector, both carrying the gene for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike glycoprotein (rAD26-S and rAD5-S). So far, adenovirus vector vaccines have never been used as commercial human vaccines except for a rabies vaccine and in some experimental studies.(7) Monoclonal antibodies. (6) Numerous drugs and treatment protocols. These are all in the pipeline -- may come out or not ! https://indianexpress.com/article/india/covid-19-vaccine-may-be-ready-in-12-18-months-says-who-chief-scientist-6478396/  Celebrate INDEPENDENCE DAY with our corona vaccine. Even the baby is laughing at the idea ! Fast-tracking medical research studies is a matter of concern. Can we produce a baby in one month bygetting nine women pregnant !!!" Russia named its yet to be born baby "Sputnik V". Let's rename ours as "Chandrayaan C" ! -- T. Rama Prasad.  This is going to be a long haul ... don't expect magic bullets or silver bullets. However, amidst the doom and gloom, there is the news today (19.05.2020) (1) that volunteers who received the US vaccine (mRNA-1273 of Moderna biotechnology company) showed good immune response, and (2) that at China's prestigious Peking University, a new way of treating with 'Neutralising Antibodies' made from the blood of recovered patients using 'Single-cell Genomics' technology is being developed.  There are two vaccines available at present in India. One is Covishield and the other one is Covaxin. We will see some of the facts of this two vaccines now (January 2021) Covishield : It is not exactly a live attenuated Vaccine. It's an engineered Simian Adenovirus vector vaccine. It is replication deficient as some genes required for replication is deleted. The genome of Covid Spike Protein is then inserted. After injection into the body it produces Spike Protein of SARS COV2 which triggers immunological reactions. Simian adenovirus has been used because many people already have antibodies against human adenovirus developed from the recurrent common cold.This may prevent the development of adequate antibody response to the vaccine This is the first ever Adenovirus vector vaccine licensed to be used in large scale ( Of course one Adeno virus vector vaccine was granted emergency use authorisation for Ebola previously and used in small number only and subsequently found to be not useful much. Normally Adenovirus vector vaccines are superior in producing T Cell response and inferior in producing B Cell antibody response. B Cell producing antibodies are normally good in preventing the intrusion of virus into the cell and there by neutralising the virus in the extracellular space Where as T Cell response is good for mainly destroying the infected host cell. I feel this may be the reason for the slightly decreased efficacy of Covishield in preventing the infection. At the same time please remember that even if the efficacy is slightly less it's very good in preventing the development of severe Covid, hospitalisation and death as inferred from the studies. Moreover there are no major adverse events reported sofar. Covaxin : Coming to covaxin It a killed vaccine. Conventional killed vaccines produce weak immunological reactions and that's why adjuvants are added to enhance the immunological reactions. Multiple booster doses may be required as the immunity is not long lasting. They are more stable and generally safe. The disadvantage of the Covaxin is that the phase 3 trial results are not yet out. At the same time we have to accept that there are no major adverse events reported so far to Covaxin also. The theoretical superiority in efficacy of Covaxin over Covishield will be known only after the phase 3 trials are out. Whichever may be the vaccine it may be beneficial to get vaccinated than getting an infection. Those who have contracted the disease previously : should also get vaccinated because no one knows really how long the immunity from the infections last. Moreover mucosal infections generally don't produce adequate antibody response. Only infections causing Viremia produces good neutralising antibodies. Please remember that it was only a mucosal infection in many of the Covid patients. So it may be better to get vaccinated even if one had contracted the disease previously. Coming to the Antibody dependent enhancement of infection ( ADE ) : The theoretical chances of getting a severe Covid subsequently on exposure to SARS COV2 in a previously vaccinated person has not been reported sofar in Covid. Please note that ADE is more common with Flavi virus infections like Dengue only. The jury is still out on treatment protocols. Corona would have been unknown to the common man if it didn't kill so fast, so many and in so many countries. If many didn't die, it would have been just another 'flu' and just another permanent guest ! Now, common people know of some 'desivir' or some 'zumab' ! A great majority of the cases recovered without intensive treatment. A few patients (around 3 per cent) succumbed in spite of intensive care -- and a few of these few might have died due to the "intensive care" with needless ventilators and heroic treatment without tackling inflammation and thrombosis ! We have to restructure our strategies based on recent postmortem findings which point to an unthought of pathophysiology. The sudden and conventionally unexplainable deaths might have been due to a massive 'tsunami-like' 'allergic reaction' -- a 'cytokine storm' of widespread severe inflammation resulting in disastrous occlusion of small blood vessels due to micro thromboembolism / disseminated intravascular coagulation / vasculitis in lungs and other vital organs as well. Some observations of endothelitis and vascular complications suggest that the disease is systemic and mainly involves the vascular endothelium. Still, these insights into the pathology of severe COVID-19 are only hypothetical. Ventilators and oxygen couldn't save, as the problem was elsewhere. Hypoxia didn't respond to PEEP. Anti-inflammatory drugs, thrombolytic agents and blood transfusions were not given priority in the first three months of the crisis. Viral myocarditis with elevated troponin was not actively studied. COVID-19 is more than a lung infection. It affects the blood vessels of lung and many other organs. It produces blood clots (thrombosis) associated with acute life-threatening events. Some recommend a low dose of HEPARIN and Aspirin to all COVID-19 patients admitted into hospitals to prevent clot formation. Riveroxaban (in a dose of 15 to 20 mg once a day in the evening for one to four weeks depending on CT chest and D-dimer value findings) is also recommended. And some suggested TISSUE PLASMINOGEN ACTIVATOR which helps dissolve clots. A specialised test, Thromboelastography (TEG) is being studied. This test is a whole blood assay that gives a lot of information about blood clots. It is not yet clear as to what extent these clots are responsible for the deaths. https://www.medicalnewstoday.com/articles/are-blood-clots-to-blame-for-covid-19-deaths STEROIDS How to suppress this overreaction of our immune system ? There are some drugs, but they may compromise our defence system by over suppressing ... IL-6 inhibitor, Actemra (Tocilizumab) and IL-1 modifier, Anakinra reduce the flow of macrophages into lungs without hampering CD4 & CD8 cells -- so they are less compromising, but very costly and not easily available. Next alternative -- steroids like prednisolone .. very cheap and available everywhere, but they suppress the immune system very broadly, very compromisingly. When nothing else is there to save a life, steroids are being tried in some countries during 'cytokine storms'. Who knows ? Though the WHO is against steroids, they may be life-saving ! In fact, some promising evidence has come-forth to proclaim that DEXAMETHASONE is a life-saving drug. It is a very cheap (few rupees)and very widely available drug. The anti-inflammatory drug TOCILIZUMAB seems to be a promising life-saving medicine -- about 50,000 rupees per dose. REMDESIVIR FAVIPIRAVIR Fabiflu PRONING COVID-19 RESOURCES
CANCER DRUG: Ex-vivo studies indicate elevated Bruton Tyrosine Kinase (BTK) activity, as evidenced by autophosphorilation and increased IL-6 production in blood monocytes, in severe COVID-19 patients. This has lead to the study of ACALABRUTINIB which targets activated BTK in macrophages and reduces inflammation. Acalabrutinib (Calquence of AstraZeneca) is already in use in cancers like Chronic Lymphocytic Lymphoma / Mantle Cell Lymphoma. Administration of Acalabrutinib (off-label drug for COVID-19), a BTK inhibitor, showed clinical improvement as published in the journal 'Science Immunology' on June 5, 2020 --https://immunology.sciencemag.org/content/5/48/eabd0110 Like methemoglobin, the 'virus structural protein' may stick to heme, displace oxygen, displace iron, and the free iron toxicity (high Fio2) may cause inflammation of alveolar macrophages. Radiological images may be vaguely interpreted as 'pneumonia', 'infiltration', 'consolidation', 'ground glass lesions' or some fancy term. Frequent transfusions of RBC / blood may be beneficial. MONOCLONAL ANTIBODIES & Plasma Therapy Our biological protective reaction to corona is a double-edged weapon - it may kill the virus or it may kill us also through overreaction ... Cytokines & Interleukin-6 (IL-6) ramp up immune response ... Macrophages, CD4 T, CD8 T initiate immune response and protect us. All these are our 'biological policemen'. But too much of a response may harm us -- too much of macrophage inflammation may damage normal lung cells and kill us also. When policemen harm people, we have to correct them, not abandon them -- same is the case with our 'biological policemen'. How to suppress this overreaction of our immune system ? There are some drugs, but they may compromise our defence system by over suppressing ... IL-6 inhibitor, Actemra (Tocilizumab) and IL-1 modifier, Anakinra reduce the flow of macrophages into lungs without hampering CD4 & CD8 cells -- so they are less compromising, but very costly and not easily available. Next alternative -- steroids like prednisolone .. very cheap and available everywhere, but they suppress the immune system very broadly, very compromisingly. When nothing else is there to save a life, steroids are being tried in some countries during 'cytokine storms'. Who knows ? Though the WHO is against steroids, they may be life-saving ! In fact, some promising evidence has come-forth to proclaim that DEXAMETHASONE is a life-saving drug. It is a very cheap (few rupees)and very widely available drug. The anti-inflammatory drug TOCILIZUMAB seems to be a promising life-saving medicine -- about 50,000 rupees per dose. Interleukin-6 InhibitorsLast Updated: April 21, 2021 Interleukin (IL)-6 is a pleiotropic, proinflammatory cytokine produced by a variety of cell types, including lymphocytes, monocytes, and fibroblasts. Infection by the severe acute respiratory syndrome-associated coronavirus (SARS-CoV) induces a dose-dependent production of IL-6 from bronchial epithelial cells.1 COVID-19-associated systemic inflammation and hypoxic respiratory failure can be associated with heightened cytokine release, as indicated by elevated blood levels of IL-6, C-reactive protein (CRP), D-dimer, and ferritin.2-4It is hypothesized that modulating the levels of IL-6 or its effects may reduce the duration and/or severity of COVID-19 illness. There are two classes of Food and Drug Administration (FDA)-approved IL-6 inhibitors: anti-IL-6 receptor monoclonal antibodies (e.g., sarilumab, tocilizumab) and anti-IL-6 monoclonal antibodies (i.e., siltuximab). These drugs have been evaluated for the management of patients with COVID-19 who have systemic inflammation. Itolizumab, an injectable monoclonal antibody drug in use for the skin disease 'Psoriasis', reduces inflammation by inhibiting key inflammatory markers like IL-6 and TNF and hence may be useful in tackling 'cytokine storm' of COVID-19, according to some evidence. The Central Drug Standards Control Organisation (CDSCO) said that after detailed deliberation the Drug Controller General of India (DCGI) decided to grant permission (July 2020) to market the drug for the treatment of Cytokine Release Syndrome in moderate to severe Acute Respiratory Distress Syndrome (ARDS) of COVID-19 patients. But some experts are not impressed by the data, presented by the company to the DCGI of the study of just 30 patients across 4 hospitals of whom only 20 were given Itolizumab along with 'Standard Care Treatment', to justify such a permission. They also pointed out that conducting Phase 3 trial was waived which is a bad move scientifically. It costs about Rs. 7,500 per pack (Alzumab of Biocon). Bamlanivimab, Etesevimab, Casirivimab and Imdevimab Products farthest along in clinical trials have been created by Eli Lilly and Regeneron. Eli Lilly’s monoclonal antibody regimen, bamlanivimab (also known as LY-CoV555), consists of two antibodies directed against the SARS-CoV-2 spike protein and its receptor binding domain; Regeneron’s products, casirivimab (REGN10933) and imdevimab (REGN10987), consists of two antibodies that bind to different regions of the SARS-CoV-2 spike protein receptor binding domain. This antibody cocktail (Roche / Regeneron) is given emergency authorisation in May 2021 amidst the severe second wave. The therapy is a cocktail of two antibodies Casirivimab and Imdevimab, which are synthetically manufactured copies of antibodies that the body produces after an infection. It has been shown to reduce hospitalisations in COVID-19 patients who are at a high risk of developing severe illness. https://www.reuters.com/world/india/india-approves-rocheregeneron-drug-covid-19-2021-05-05/ Eli Lilly's combination of two synthetic antibodies against COVID-19 reduced hospitalisations and deaths by 70% in high-risk patients, according to a study. There has been a lot of confusion and controversy about the MONOCLONAL ANTIBODIES. To know some details, click on: Like many other things in 'Covid treatment', opposing views are expressed about the efficacy of 'convalescent plasma' (CP) treatment.  'Convalescent plasma' consists of 'polyclonal antibodies' in serum derived from convalescing patients, whereas 'monoclonal antibodies' are produced by some genetic engineering technology. So far, they are found to be useful in RSV and Ebola diseases only. INTERFERON On April 23, 2021, the Drug Controller General of India (DCGI) approved Indian pharma company Zydus Cadila’s anti-viral drug, Virafin, for emergency use to treat ‘moderate Covid-19 cases’ Virafin is the trade name used by Zydus Cadila for Pegylated Interferon alpha-2b. For the uninitiated, interferons are signalling proteins found in our bodies that act as immunological agents. Zydus Cadila has outlined that this medicine can be given when there is a moderate degree of infection. When the viral load is between moderate and high, the need for oxygen is rapid. So, by administering this medicine, the viral load will decrease, and the need for oxygen will also reduce, within one week after a single dose. This is a repurposed drug which is already in use for treating Hepatitis C. CHOLCICINE Scientist in Israel discovered a chemical known as Alpha Defensin produced by WBC can cause the micro-clots in blood vessels of lungs, and that this can possibly be prevented by a drug called CHOLCICINE, a drug used for many decades for treating Gout. METFORMIN Metformin, widely used for diabetes, may prevent the entry of this virus by interacting with ACE2 receptors to which the virus binds and gains entry into the body. This drug may reduce elevated blood glucose levels, and this virus itself may produce Type1 diabetes by destroying beta cells in the pancreas that produce insulin. It is advisable not to use this drug in combination with HCQ. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190487/ HYDROXYCHLOROQUINE (HCQ) IVERMECTIN Ivermectin, an approved drug for treating various parasite infestations, is under study for its anti-viral action as it was found to inhibit the replication of COVID-19 with an IC50 of2.2 - 2.8 uM. It is a potential anti-virus agent in Chikungunya and Yellow Fever. Ivermectin has grabbed headlines for wrong reasons. Based on the study data of Surgisphere, the company behind some discredited research studies (including those of HCQ), officials of Latin American countries recommended ivermectin as a possible coronavirus drug. Clinicians there say the effects have been extremely devastating. People emptied the drug stores and self-medicated with no scientific indications, and entered into a false sense of safety. Back in India the UP government officials approved (August 2020) ivermectin for treatment and prevention of COVID-19, based on the evidence of a handful of in vitro and observational studies. One Prof. Thomas Borody from Centre for Digestive Diseases in Australia 'believes' that ivermectin with zinc and doxycycline is a cure for COVID-19. Prof. Ian Musgrave, a molecular pharmacologist from the University of Adelaide said: "Prof. Borody's 'belief' is to be taken with a pinch of salt as ivermectin acts only in test tubes." Prof. Borody wondered why Australia didn't consider his recommendation to include ivermectin in COVID-19 treatment while the 'HUGE INDIA' approved it ! Uttar Pradesh government approved it in August 2020. Concerns have been raised that human use of ivermectin may do more harm than good. The hype has shifted from HCQ to Ivermectin. It's no wonder Miss Corona made people lose faith in "scientific" medicine ! The Pan American Health Organization, a regional office of the World Health Organization, has issued a statement warning against the use of ivermectin to treat COVID-19. The statement notes that the antiparasitic drug is being investigated in clinical trials, but currently, “ivermectin is incorrectly being used for the treatment of COVID-19, without any scientific evidence of its efficacy and safety for the treatment of this disease.” For details go to the links below: Massachusetts General Hospital (MGH) COVID-19 Treatment Guidance(13) If empirical antibiotics are indicated, the recommendation is for: Doxycycline 100 mg PO BID x 5 days or Azithromycin 500 mg PO x 1 then 250 mg PO daily for 4 days along with Ceftriaxone 1 gm IV daily. For nonpregnant patients, doxycycline is preferred over azithromycin. Coronavirus disease 2019 (COVID-19) continues to remain a significant public health challenge, and the current antiviral arsenal for its treatment is limited, with questionable efficacy. While efforts are underway for the discovery of new effective agents, validation of their actual potential may take quite some time Therefore, the repurposing of existing drugs for new indications is the need of the hour, as we see it happening globally. Along with this endeavor, Doxycycline emerges as an antimicrobial agent possessing antiviral and anti-inflammatory activities; which by dampening the critical cytokine storm has the potential to prevent lung damage.(14) Along with its cost-effectiveness, acceptable tolerance (15) and ease of availability, Doxycycline, as a prominent consideration in patients with COVID-19 seem a rational as well as a realistic one. https://medicaldialogues.in/pulmonology/news/doxycycline-rationale-for-use-in-covid-19-68527 https://medicaldialogues.in/pulmonology/news/doxycycline-rationale-for-use-in-covid-19-68527 Combinations of drugs with Albendazole / Doxycycline are also being tried. All the above mentioned remedies are to mitigate the impact of the virus but not directly to neutralise the virus. AYUSH -- systems of alternative medicine - indigenous Various preparations belonging to the alternative systems of medicine in India, some approved and some not approved by governments are in the market as claimed to prevent / cure COVID-19. 'Arsenicum album 30' is one which is said to be recommended by the State governments in Rajasthan, Karnataka, Tamil Nadu, Andhra Pradesh and Kerala. 'Coronil' of Patanjali is another brand in the market after settling a dispute about the claims. Zingivir-H is an Ayurveda (system of 'Alternative Medicine') drug which is approved for trials in Indian patients. "Another patient of about 40 years with high fever and who tested positive for COVID-19 in USA tested negative for Covid-19 with Ayurvedic medication. A detailed case study has been cited ( If the treatments promoted to treat COVID-19 by the alternative systems of medicine are not to be "derided or scoffed at", the ICMR should guide them to conduct RCT studies of robust and hard caliber to prove their worth. At present (June 2020), there is no conclusively proven specific drug or vaccination against the virus. But lives may be saved by giving supportive and symptomatic treatment.  PLATELET THEORY: It is opined that platelets are the ones that lead to lung inflammation. CD13 (Human receptor) and HCoV-229E strains are 82% similar to SARS-CoV-2 which share similar function to intake the virus (University of Perugia, Italy). As it stands today (June 2020), most of these drugs are being used as "Compassionate / Emergency / Salvage" drugs, meaning that the drugs are permitted to be used for study or as a last resort, with some evidence in their favour but not yet conclusively proven to be effective and safe in COVID-19 disease. Remdesivir Favipiravir - brand name: Fabi flu - a course of 15 days costs around Rs. 13,000 per patient - Tablets 200mg - 1800mg twice a day for one day followed by 800mg twice a day for the next 14 days. These two antiviral drugs may be available in India from July 2020 for 'regulated' use in COVID-19 cases. Transfusions of RBC / blood, anti-inflammatory steroids, thrombolytic drugs, 'plasma therapy', antibiotics, immunotherapy, etc. are also being employed. And, some centres are trying the anti-malarial drug Chloroquine to prevent / cure this disease without conclusive evidence of its efficacy. A publication in the LANCET (22.05.2020) of a large multinational real-world registry analysis indicates that there is no benefit of HCQ in treating COVID-19 patients. It also mentions of more cardiac problems and deaths ( https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext#seccestitle70 ).October 17, 2020  Uncertainty of outcomes of 'modern medical treatment' in COVID-19 is certainly evident. Plasma therapy is claimed to be beneficial and proved to be useless (PLACID trial of ICMR for convalescent plasma). And more disappointingly, the hope of preventing deaths by using many costly repurposed drugs is shattered by the world's largest clinical trial, the SOLIDARITY trial of the WHO. Numerous people in India lost their loved ones and their livelihood after borrowing and spending an average of ten lakhs of rupees on each patient on these expensive drugs of no value. The vaccine game of billions of dollars is currently going on. With what certainty of positive results ? -- Dr. T. Rama Prasad, PAY WHAT YOU CAN Clinic, Perundurai. http://drtramaprasad.blogspot.com/2017/04/hydroxychloroquine-hcq-and-coronavirus_29.html Consequent to the fraudulent publication in The Lancet, WHO suspended its HCQ drug trial, over safety concerns. France, Italy and Belgium have stopped using HCQ from 27.05.2020. Touting of this drug by Trump and his outbursts at WHO about -China issue is a different story.  American Association of Physicians and Surgeons (AAPS) is supporting Trump on his HCQ statement. (https://www.theguardian.com/us-news/2020/may/24/hydroxychloroquine-trump-us-doctors-coronavirus) Some are using 'Blood Plasma' donated by patients who have recovered from COVID-19 as a treatment option. Interferon alfa 2a and 2b is also under trial. Some are using cells grown from human placenta -- Placental Expanded Cells.Corona lung infection seems to exhibit very uncommon features. Patches of pneumonitis were seen in 'chest X-rays' even when the patients had minimal symptoms - as in the first case in the USA ( Link to the first case report: https://www.nejm.org/doi/full/10.1056/NEJMoa2001191
In some cases, the lesions rapidly progressed within hours / days and killed. Oxygen availability in tissues was unexpectedly low though the blood oxygen didn't fall as much. Hypoxia (low amount of oxygen reaching the body tissues) - even 75% - was out of proportion to the breathlessness or 'X-ray' changes. As such, conventional oxygen therapy or ventilator support didn't yield the expected results. Around the 10th day, patients died of 'cytokine storm', acute ARDS, multi organ failure, etc. The speed and the volume of loss of life over a short period of time is the main concern. The spread and the pathogenesis of this virus would be an everlasting enigma. https://www.drugs.com/medical-answers/ivermectin-treat-covid-19-coronavirus-3535912/prevent development of COVID-19 in certain high-risk groups, just as is the case with Hydroxychloroquine ? We don't know yet. Combinations of drugs with Albendazole / Doxycycline are also being tried.  The US president Trump had declared that Chloroquine was approved in the US to treat COVID-19. But Fauci, the top US expert in infectious diseases, contradicted it saying that the drug needs to be studied for its efficacy against the coronavirus and that the claims are only 'anecdotal' ! The following is a report in the press: ... "A run on anti-malaria drugs chloroquine and ...19 hours ago: Hospitals and doctors are wiping out supplies of Chloroquine, an unproven coronavirus treatment. Lack of definitive evidence has not stopped exploding ... " One Chinese publication indicated that Chloroquine may be beneficial in treating Coronavirus Pneumonia ( https://www.ncbi.nlm.nih.gov/pubmed/32164085 ). To know more about Chloroquine and Corona, click on: http://drtramaprasad.blogspot.com/2017/04/coronavirus-covid-19-2019-ncov.html https://drtramaprasad.blogspot.com/2017/04/coronavirus-covid-19-2019-ncov.html And, there are reports that Hydroxychloroquinde killed some in the US !!! Clin Med COVID article May 2020.2020-0188.full.pdf  MOLNUPIRAVIR "The drug, translated as "Molnupiravir" was jointly developed by two major pharmaceutical companies, "Rigibel" in Germany and "Merck" in the United States, and has successfully completed the first and second phases of clinical trials in humans. The effect is 100%; the current phase 3 clinical trial is nearing the end and the effect is very good. If it goes well, it will be available in the market within 4 to 5 months (end of 2021 ?). The patient can take the drug by himself at home, and heal in 5 days, which is very convenient to use. Treating the new coronavirus in the future is like treating the common cold now. The new coronavirus is not terrible." At the end, what's the correct protocol of treatment ? GOK ! But, Miss Corona, we shall continue to fight. We have lots of weapons. Chloroquine to Favipiravir ... Actemra to Anakinra ... Interferon to Immunoglobulins ... miRNA to has-mir-27b ... Gangajalam to gomoothra and so on. ----------------------------------------------------------------------- WHO and POTUS "Both utter and do amusing and improper things. In the context of the Covid Pandemic, both are accused of functional inefficiency, organisational lethargy, paucity of decisive leadership, bureaucratic indolence and shifting strategies. WHO made another U-turn on 17.06.20 and dropped Hydroxychloroquine (HCQ) from SOLIDARITY (CORONA) drug trial. Trump seems to have made WHO lost its mental balance. Click on the link below to read about the sensational story about HCQ, Trump, WHO, The Lancet, NEJM, medical frauds and tricks, and the politico-pharmaceutical ramifications based on influence and money." -- T. Rama Prasad https://drtramaprasad.blogspot.com/2017/04/coronavirus-covid-19-2019-ncov.html WHO -- (1) Initially, denied person-to-person transmission of coronavirus. (2) Denied and delayed declaring COVID-19 as a pandemic by 2 weeks. (3) Initially, it announced that mask-wearing was not necessary for the uninfected. But after a few months recommended face masks. (4) Said that recovered patients are unprotected by antibodies from re-infection. (5) Alleged influence and haste in declaring H1N1 as a pandemic. (6) Hastily suspended its HCQ drug trial and made a U-turn next week. Again made a U-turn to stop HCQ arm of the trial.    TRUMP thought that the LION was in CHINA -- mislead by the guide called WHO ! After realising the fact, he stopped funding the WHO. https://www.newindianexpress.com/magazine/2020/may/03/coronavirus-chronicles-descent-into-horror-2137496.html(https://www.newindianexpress.com/opinions/editorials/2020/apr/27/trumps-attempt-to-disinfect-patchy-corona-record-2135734.html ) CORONA and KAWASAKI  ( https://www.livescience.com/covid-19-and-kawasaki-disease-children.html ) ( https://www.bbc.com/news/health-52648557 ) Similar cases were found in New York, London and France. The chief of WHO, Tedros Adhanom Ghebreyesus said in May 2020: "It is critical to urgently and carefully characterise this clinical syndrome, to understand causality and to describe treatment interventions." SMOKERS and CORONA   There is an unexpectedly good news for smokers ! A top French neurobiologist said nicotine in tobacco gets attached to ACE2 receptors to block entry of CORONA virus ! It may also lessen the 'cytokine storm' of COVID-19 ! In Paris hospitals, only 8.5% of the 11,000 Covid-19 patients were smokers while 25% of the population in France are smokers ! Please don't cite this as an excuse for smoking !!! January 17, 2021: A first pan-India survey tracking nearly 10,000 employees of the Scientific and Industrial Research (CSIR) on the prevalence of COVID-19 found a significant association between smoking and protection against SARS-CoV-2. The study (ICMR-IGIB) also found Covid seroprevalence was highest for blood group type AB, follower by group B, group O and group A. Blood group O was observed to be protective. -- Dr. T. Rama Prasad, EYE and CORONA  The digital wizardry of modern technology has burdened the EYE very much. During the LOCK DOWN period, the organ most overused is the EYE ... electronic screens, newspapers, books. And now, another new risk is added to the eyes of students -- online E-classes. Authorities should realise that continuous viewing on electronic screens may be detrimental to the eyes of the pupils. A break of 5 minutes may be given after every 20 minutes of teaching. And for everybody the rule of 20-20-20 is recommended -- after every 20 minutes of exposure to digital screens see objects beyond 20 feet for 20 seconds before resuming the activity. After the 'corona period', have your eyes checked up if you hadn't recently. I am not an eye specialist ! During the 'corona period', (1) Don't touch your eyes. If necessary, wash your hands thoroughly before you touch. Coronavirus may gain entry into the body through eyes and may spread through eye secretions. (2) Wearing glasses may add a layer of protection. If wearing contact lenses, switch over to ordinary glasses during this period. 1 to 3% of corona patients may get "pink eye" (conjunctivitis) which may be a rear early symptom of coronavirus. It may be interesting to know that the Chinese whistleblower ophthalmologist, Dr.Li Wenliang developed symptoms of coronavirus after having treated a woman (for glaucoma eye disease) who was a contact of her daughter who had coronavirus infection. It's unfortunate that this 32-year-old doctor died of coronavirus on February 7, 2020 at Wuhan Central Hospital. Beware of the importance of EYE in relation to CORONA ! According to an international study by UK's 'FeelGood Contacts' (that collated data from various sources such as Lancet Global Health, WHO, and screen time tracker DataReportal), nearly 23% of the Indian population had deterioration of eyesight mostly because of excessive time spent on electronic screens due to coronavirus induced shutdowns which forced people to take to screens for education, work, entertainment, etc. (6 hours and 36 minutes per day in 2020 in India). The study noted that though it is a global phenomenon, Indians were found to have suffered the most damage to eyesight and vision. Added to this is the Mucormycosis fungal infection of the eye which is associated with COVID-19. The infection may lead to removal of the eye with a death rate of around 50% -- the disease races at a high speed from the nose to the eyes and on to the brain. Head ache, drooping of eyelid, eyelid swelling, double vision, red eye, and blurred vision may be the symptoms pertaining to the eye. SKIN and CORONA  Some skin lesions may give a clue to the underlying COVID-19. People should be wary of it. Changes to the tongue, the hands or the soles of the feet could give an early indication of COVID-19, according to Spanish researchers (British Journal of Dermatology). Swelling of the tongue and the appearance of patches, along with loss of taste is dubbed as 'Covid Tongue'. | |||||||||||||||||||||||
| ' | PREGNANCY and CORONA  As on July 16, 2020, in Tamil Nadu, 1,606 pregnant women tested 'positive' for coronavirus. At the Institute of Obstetrics and Gynaecology(IOG) and Hospital for Women and Children, Egmore, Chennai, 39 newborns tested 'positive', accounting for nearly about 12%. National Health Mission has issued 'Special Protocol' for the care of antenatal women to the Comprehensive Emergency Obstetric and Newborn Care (CEmONC) centres and private obstetricians. A study of over 700 cases at this hospital revealed that in-utero transmission of Covid is rare. But, at the Dr.Mehta's Hospitals, Chennai, about a dozen cases of in-utero transmission were identified during 2020-21, the latest being in May 2021 which had around 90% lung infection due to Covid. A four-day-old baby girl tested positive died of Meconium Aspiration Syndrome at Government Rajaji Hospital on August 2, 2020. Her mother also tested positive. Another nine new borns were treated at the same hospital. All this may just be the tip of the iceberg. As of 12th August, 2020, 100 Covid positive women gave birth to their babies at MGMGH, Trichy -- 22 of them were normal deliveries, while 78 were of C-sections. Two of these babies tested positive. It was reported that more cases are being attended to at government hospitals as private hospitals are turning away patients fearing the virus infection. VERTICAL TRANS-PLACENTAL transmission. At least six published studies suggest this route of transmission. A publication in Nature Communications (Daniele De Luca of Paris Saclay University, France, July 2020) has confirmatory evidence that the virus can infect a foetus through mother's blood via placenta. Amniotic fluid positive. Placental tissue positive. Congenital SARS-CoV-2 infection. Cerebral vasculitis - white matter injury - The newborn had neurological manifestations. https://www.nature.com/articles/s41467-020-17436-6Sasson Hospital in Pune, India and some hospitals in the US and France also reported similar cases of vertical transmission. Vertical transmission is well-documented in HIV and ZIKA virus infections. A survey done abroad revealed that many couples now are either deciding to have pregnancy some time later or never to have children, due to the consequences of the pandemic. https://qz.com/india/326402/cesarean-births-in-india-are-skyrocketing-and-there-is-reason-to-be-very-worried/ http://drtramaprasad.blogspot.com/2017/04/modern-medicine-good-bad-and-ugly_30.html Second Wave' killed more pregnant women At the SVP Hospital in Ahmedabad, 13% (19 out of 148) of the Covid positive pregnant women admitted died during the 'Second Wave'. Most of them had lung complications, sepsis, myocarditis and renal problems. The percentage was 0.3% (1 out of 359) during the 'First Wave'. The same trend was observed in many other hospitals. COST and CORONA  "COSTLY CORONA: Rs. 600 lakh ($1 million) hospital bill. Yes, it's a costly disease. They didn't overcharge. In India it's much cheaper in private hospitals, and "free" in public hospitals. The choice is there. Spending by the hospitals varies from case to case. Fixing "MRP" may only dilute the standards. Of course, there are black sheep in all the fields." -- T. Rama Prasad    https://timesofindia.indiatimes.com/blogs/jugglebandhi/hospital-hostages-thanks-to-coronavirus-one-sector-of-the-economy-is-making-mega-bucks-like-never-before/ From one point of view, this looks like exploitation and profiteering. Seen from another angle, it looks like a struggle of the private hospitals for existence.https://www.thehindu.com/opinion/op-ed/needed-a-transfusion-for-public-health-care/article31798593.eceand read under the sub-heading "POST-MORTEM of the LOCKDOWN" above. Business crashed. No passengers. No patients. One may hopefully think that these are isolated and aberrant cases occasionally occurring. But if one goes through the following news it seems that it is so rampant that the issue is taken up by a court. TEA and CORONA STORM in a CORONA TEACUP ... 2020  While tea industry is grinding to a halt because of lockdowns around the world, tea is making grand rounds on the Internet. Social media flashed fake news about the benefits of tea in COVID-19. One hurriedly published article (which was later removed) in the WeChat account of Zhejiang CDC on Feb 26, 2020 claimed that drinking tea may help prevent COVID-19, based on the flimsy evidence that tea inhibited proliferation of the virus in vitro (test tubes). Added to this, is the circulating news that the whistleblower Chinese ophthalmologist, Dr. Li Wenliang (who died of coronavirus) had documented evidence to support that tea has anti-coronavirus properties, and that tea was being given 3 times a day to patients in hospitals in China. This is a big fat fake news. Tea has a lot of exciting background. To know more about TEA, read my article published in THE HINDU. The link to the article is given below: http://www.thehindu.com/ GUT and CORONA Prevent transmission through stools.  | ||||||||||||||||||||||
kissed INDIA on 30.1.2020
Dr. Li Wenliang who posted early warnings of the presence of this virus on his social media group (considered to be an offence and punishable by the local authorities) died due to infection by the same virus ! Dr. Liu Zhiming, the Director of Wuhan Wuchang Hospital and an expert in Neurosurgery, died on February 11, 2020 due to this virus. More than 1,700 medical workers were infected, and six of them died as on 20.02.2020. Most medical staff in Wuhan are said to be infected by this virus. In Italy, more than 100 doctors died of this disease. More than this number of doctors (more than 200) died in India too.
Infected doctors seem to have a 10-12% risk of mortality (10 times that of the general population -- CFR for doctors is 17%; for the population, it is 1.7%, in India). This is due to exposure to a HIGHER VIRUS LOAD, which may lead to a 'cytokine storm'. People, in general, are usually infected through air and contacts or fomites (infected surfaces). Fomites have a lower virus load, and hence a lower mortality rate of about 2-3%. Doctors attending on the COVID-19 patients, pulmonologists, intensive care specialists anaesthetists and also the staff attending on these patients are at higher risk. The nurses (20%) and sanitation staff (30%) seem to have a higher risk of mortality.
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| This picture is made of numerous photos of numerous doctors and nurses who died of COVID-19. Magnify the picture and see the small photos. July 1, 2020 -- DOCTORS DAY. We doctors thank you all for the greetings. We want to keep the "PATIENT FIRST" in our minds. This is AC era (After Corona). Patients are afraid of going to doctors. Doctors are afraid of attending to patients. 'Fear Pandemic' is worse than the 'Virus Pandemic'. |
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| Diamond Princess Cruise Ship with 3,600 passengers was quarantined in Japan. 356 of them were found to be p[ositive for this virus Some cases across Europe were traced to a business meeting in Singapore attended by more than 90 foreigners in January 2020. International fear has been growing with increased virus cases and deaths in countries outside China -- Middle East, South Korea, Italy, Iran, etc. |
We don't know how the virus came to France, but a study published in the International Journal of Microbial Agents indicates that an old sample of one patient (Mr. Amirouche Hammar) treated in December 2019 was positive for the coronavirus. He lived in France with no recent travel history.
" ... CORONA FLOWERS: Physically, coronavirus, looks like a ball of sun with a circle of corona of spikes -- thus derives its name. We identified 3 kinds of flowers which are 'lookalikes' of coronavirus -- (1) Haemanthus / Scadoxus multiflorus (2) Sphaeranthus indicus (3) Memecylon edule !!! -- Mrs. V.S. Rajyalakshmi, M Sc (Botany) & Dr. T. Rama Prasad. ..."
PETS and CORONA
EMERGE ?
The virus issue has become an international political issue too with tensions ratcheted up between Washington and Beijing as they trade barbs over the origin of the virus.
It is reported that China is also having the problem to deal with another virus disease outbreak -- a "highly pathogenic" strain of Birdflu or H5N1.
March 2020: 1. Flight - Mumbai to Singapore - the 256-seater plane had just 25 passengers ! 2. Flight - Mumbai to London return ticket -Rs. 80,000 ticket was just for 46,000 !
There was only one passenger on the American Airlines flight 4511 from Washington Reagan National Airport to New Orleans on April 3, 2020 !
May 19, 2020: Japan, world's 3rd-largest economy, falls into a recession for the first time since 2015.
(These humorous lines were written at the beginning of the pandemic in India. Now, 8 months later, we have to accept that this virus is of HIGH QUALITY !!!)
CORONA FESTIVAL is a year-long celebration. Next one in 2025--once in 5 years. After an intensive study, psychiatrists found that most of the diseases and deaths during the past 100 years were due to STRESS, and they suggested a long holiday to unwind. No other disease had generated so much of fake news, rumours and misinformation than Coronavirus COVID-19. Honestly speaking, we don't have much of proven facts about this disease. This is the exact reason for the great bulk of misinformation about it on the Internet. While the scientific world is struggling to find facts about this new virus, innumerable preventive and curative suggestions are made with no scientific proof. Millions of dollars are being spent on products of unproved efficacy. During the past one month, you would have seen innumerable suggestions of "eat this" and "don't eat this" on the Net. Tall claims were made by alternative systems of medicine, though with no verifiable scientific proof. Many of the suggested food items or medicinal supplements may, of course, boost immunity in a general way -- but nothing very specific to this virus. And some of the misinformation lead to a needless scare about certain things like newspapers, chicken, etc. And it also promoted some drugs, vitamins, minerals, cow's urine, tea, bananas, etc. as preventive agents against COVID-19.
When are we going to eradicate this new virus ? Perhaps, we may not be able to do. Like H1N1 virus and TB this also may become an uninvited permanent guest. The mortality due to H1N1 (swine flu) virus over the past several years has been still high in India. 1,218 people died in 2019 in India due to swine flu. About 20,000 people die every day in India due to various diseases -- 5,000 due to heart disease, 2,000 due to brain disease. And, 1,000 people are dying everyday in India due to Tuberculosis (TB) which is still the world's single most lethal infectious disease, killing 1.5 million worldwide (2018), 220,000 of whom were in India (and 27%of them are drug resistant). Click on:
https://www.thehindu.com/
Don't get panicked about Miss Corona who killed only around 100,000 in the whole world so far (10.04.2020), but the fear of an invisible enemy in the very air that we breathe is primal. It is the nature's way of balancing life on the planet. Move on, my dear ones !
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-- T. Rama Prasad
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OPEN PAGE -- THE HINDU, August 28, 2022 -- A ‘Web Special Premium Article’
COVID questions
T. Rama Prasad https://www.thehindu.com/opinion/open-page/covid-questions/article65803119.ece
AUGUST 28, 2022 01:08 IST
UPDATED: AUGUST 27, 2022 14:16 IST
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Often, patients find themselves f material when they go looking for medical i
The pandemic has given rise to a breed of inquisitive patients who want to know all about the infection
A patient asked me whether she may have ‘Corbevax’ as a ‘booster’. I said: “Why not, it’s available in India since August 12, 2022.” Seemingly unconvinced by my answer, she said that the WHO had not approved it. She then wanted to know whether COVID vaccines would protect her. I said: “Why not, because of the vaccines we are now able to move about freely.” Came the answer: “But, doctor, the highly cautious American President Joe Biden, British Queen Elizabeth II, and the young U.S. Surgeon-General Dr. Vivek Murthy got the infection after multiple vaccinations.”
To convince the patient of the goodness of the vaccines, I explained: “Occasionally, ‘breakthrough’ infections may occur, but the disease won’t be severe.” She then queried if ‘Paxlovid’ may be taken in the case of such infections. Surprised by her knowledge on COVID treatment, I again said: “Why not, it must be beneficial.” Betraying a tinge of derision, she said that Biden had ‘Paxlovid rebound’ infection. I didn’t say it out loud, but this is the problem in handling ‘Internet-educated’ patients.
After all these questions, the patient wanted to know whether it is safe to take ‘Covishield’ and ‘Covaxin’. I said: “Why not, we gave them to most of our eligible population with a good safety profile.” With an expression of amusement, she pointed out that many countries stopped using ‘Covishield’ (Oxford AstraZeneca) for some time due to dangerous blood clots, and that the WHO had suspended supply of ‘Covaxin’ through United Nations agencies. Even before I started to explain, she said three Canadian doctors “had died after taking COVID vaccine, all within a week in July 2022”. With clinical coolness, I countered that the deaths were stated to be not related to vaccination. With a wry smile, she made a sarcastic comment: “Yes, yes, it was stated that the death of our comedian movie actor Vivek, one day after being vaccinated, was also not related to the vaccine.” I decided not to get into the quagmire of controversies.
She then wondered if the vaccine was so dangerous that Novak Djokovic preferred to forego the French Open and Wimbledon titles rather than getting vaccinated. I curtly said: “There are stupid people who opposed measles vaccine and let their children die. Brazilian President Jair Bolsonaro said that COVID vaccines would convert people into crocodiles. Former U.S. President Donald Trump touted hydroxychloroquine and wondered why disinfectants are not injected into people.” The patient reinforced her stance saying that some recent reports said that polio was spreading in rich countries through the ‘Oral Polio Vaccine’. I said I didn’t know anything about it.
She was curious to know whether ‘Remdesivir’ had any role in treatment. I said, “Why not, in a few cases it may be beneficial.” She commented that the drug was grossly overused to the tune of ₹593 crore from June to December 2020 in India where the need might have been only a fraction of that amount. She asked me whether taking medicines was safe at all. Defensively, I said: “Why not, millions of lives are saved every day.” She remarked that the risk of being harmed during medical treatment is one in 300, while it is one in 1,000,000 in air travel, and that 750 older adults are hospitalised every day due to side effects of medicines in America alone.
Then she went on to question about the validity of studies on COVID published in medical journals. Meekly, I said: “Because of the evidence-based publications, millions of lives could be saved, and life on Earth could become almost normal within three years after the onset of the pandemic. We should say hallelujah.” With a winning smile, she cited the infamous articles that were published and retracted in famous journals like The Lancet and The New England Journal of Medicine using allegedly fraudulent and fabricated data generated by the Surgisphere. I said: “Of course, that’s an aberration, black sheep are there in every field from paleontology to nanotechnology.” She took a dig at my profession, saying that modern medicine is getting a taste of its own medicine.
Then she wanted to know about the utility of “lockdowns”. I said, “Lockdowns contained the disastrous spread of COVID and prevented a lot of deaths.” Unconvinced, she asked: “Did not the lockdowns indirectly kill a lot more non-COVID patients and would not they continue to kill more in the future as a fallout of the economic downslide?”
Finally, she asked me why I had spent so much of my time talking to her. I said: “At the age of 80, I am not ‘young and ambitious’ to build up practice; now, I usually give appointments for only five patients a day.” All the while, she was doing the questioning and I’d been answering her patiently. Now, it was my turn to ask her: “What’s your medical problem, madam?”
She replied that she had come only to get to know something about COVID and inquired about the consultation fee to be paid. I said: “You are not a patient and I didn’t treat you. You need not pay anything. Even if you are my patient, this is the ‘Pay What You Can Clinic’.” She looked at me as if I were a fool kicking away a pot of gold, and then wanted to know more about the clinic, me and... COVID.
Dear Reader,
If you also want to know more about “the clinic, me and … COVID”, just as the “above patient”, please click on: https://drtramaprasad.blogspot.com/2017/04/dr-t-rama-prasad.html
T. Rama Prasad
COVID world: To date, 28 of my articles on COVID-related matters were published in the MEDICAL JOURNAL, The Antiseptic over 30 months (a sort of World Record in medical journalism – one subject; one author; one monthly medical journal; 28 articles in 30 months).
-- Dr. T. Rama Prasad, ‘PAY WHAT YOU CAN’ Clinic, Perundurai, India
An anecdote about “GORU”
During my childhood, one of my schoolmates had huge nails. Her name was Gowri. We nicknamed her as ‘Goru’ (‘goru’ in Telugu means nail of a finger or toe ). They used to say that her huge nails caused a problem in her heart. It might be a case of ‘Digital Clubbing’ (abnormal nails present in some ‘Congenital Heart Diseases’). After one summer vacation, ‘Goru’ didn’t come back to the school. It was learnt that she died due to the nail / heart problem, and that treatment could not be availed as they didn’t have money to pay for it.
Perhaps, this incident prompted me to look at everyone’s nails from that time which might have led me to report the first case from India of ‘Yellow Nail Syndrome (YNS)’ from India in 1980 (published in an American journal, CHEST) and the first case in the world of ‘Yellow nails & Covid’ in 2023, published in an Indian journal, THE ANTISEPTIC - https://drtramaprasad.blogspot.com/2017/04/yellow-nail syndrome_28.html
And perhaps, the preventable death of ‘Goru’ due to the inability to pay for the treatment motivated me to start my ‘PAY WHAT YOU CAN’ Clinic (PWYCC) half-a-century ago where patients may pay whatever they can. No fixed fee ( http://drtramaprasad.blogspot.com/2017/06/pay-what-you-can-clinic.html ). The credit for these case reports on YNS and the starting of my PWYCC should go to ‘Goru’. Thanks to “Goru”.
-- T. Rama Prasad
More at : https://drtramaprasad.blogspot.com/2017/04/dr-t-rama-prasad.html
This is not an ad, it’s about an odd service.
Dr. T. Rama Prasad’s
‘PAY WHAT YOU CAN’ Clinic
“Thena thyakthena bhoojithaha”– Ishopanishad
( Translated by Prof. B.M. Hegde as: “Rejoice in giving.”)
True to this quote, I have been rejoicing at what little I could give. Defying stereotypes, this clinic has been in existence for a very long time, sans glitz, blitz, ads, microphones, speeches and noise. As a matter of my policy, publicity is shunned. The reason is simple. Good work needs no noise and nonsense. My ‘SCRIBBLINGS’ on related topics may be accessed at: http://drtramaprasad.blogspot.com
My consultation fee is not decided by me. It is the patient’s pleasure. The patient may pay (donate) whatever he can and what he wishes. If one is short of money, he or she need not pay anything. The money may just be put into the ‘hundi’ box kept outside the consultation room. And the money thus received is used for charity to help the needy, the poor and the less fortunate. If interested to know more about this facility, go to: http://drtramaprasad.blogspot.com/2017/06/pay-what-you-can-clinic.html . And, if you wish, you may also 'contribute what you can' through bank (Dr. RAMA PRASAD T, A/C No. 451075868, INDIAN BANK, IFS CODE IDIB000P155, PERUNDURAI, Erode District, Tamil Nadu - 638052 ).
"We need not run after money. If we are meritorious and compassionate, money would run after us, and it eludes us if we run after it.” -- T. Rama Prasad
“Richness is not having lots of money. It is the feeling that one has enough of it. Contentment sans comparison is what makes one really rich.” -- T. Rama Prasad.
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Consult your local doctor before rushing to me
Most ailments can be cured at local level
Sir, Corona virus Covid 19 is not To be blamed at all. Mankind is just being too foolish to intrude into safe zones of viruses, fungi and deadly microbes, that are in animals, protected by Nature. Man cannot play with Mother Nature. Nature always punishes and wins every time humanity acts stupidly. Thanks for your humorous write.
ReplyLearnt a lot....I wish to request you my dear Doctor the virus vs salt....what is the base for virus ...any element ....I develop halophilic bacteria in salinity of 24% sea water 3.5% to develop metabolic heat to evaporate sea water..by developing pigments ....I have to sit again read your article yet seeking some information on virus vs salt...Regards
ReplyRahman
One of the best articles I have read on this theme and having balance, measure and proportion. Miss Corona in hindsight is really kind and benign in a sense - Nature has rolled a dice with fatality of 2-3%. She is under no obligation not to roll a dice of fatality 40,50,60% with Mr. Corona being "size zero" and "air-borne". Consider what would have happened ?
Dr. Prasad is one of the few doctors whom I know who fall into the rare category of "healers". A healer knows the art, science and commerce of healing, i.e. allowing the innate immunity of the body to manifest itself.
One should be very careful and critical about three things in the world : Big Pharma, Big Government, Big Science. In the proverbial Kali-Yuga, all three converge with overlapped agendas and sometimes not with the best interest in mind of the end users : patients, citizens, learners.
Finally, this pandemic will also pass. The system will come to a new equilibrium. But I think a whole generation will carry this impression forward and may become saner with this.
I nurture another hope : just like pivotal events propel a whole generation (Apollo Mission and interest in space science), this may inspire many young Indians to shift their focus into public healthcare, virology, immunology, public immunity, psychological counseling and learning the art and science of healing.
Again, it was very nice to find an article of this time in the avalanche of printed words in this theme.
Continue your good work.