There are reprints of three published (in 2022) articles connected with "ZERO COVID" below (written by Dr. T. Rama Prasad) :
COVID world: This is one of my 25 articles on COVID-related matters, published in The Antiseptic over 27 months (a World Record of sorts in medical journalism – one subject; one author; one monthly medical journal; 25 articles in 27 months).
The last 19 pages about other writings, ‘about me’ and my ‘PAY WHAT YOU CAN’ Clinic are not part of the article.
-- Dr. T. Rama Prasad, ‘PAY WHAT YOU CAN’ Clinic, Perundurai, India
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. Zero-COVID strategy .
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 9842720393 BLOG https://drtramaprasad.blogspot.com
Twitter @DrRamaprasadt Facebook T Rama Prasad
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A MONTHLY JOURNAL OF MEDICINE AND SURGERYSN
Vol. 119 No. 12 December 2022 ISSN 0003 5998
Indexed in IndMED Email: admin@theantiseptic.in www.theantiseptic.in
Zero-COVID strategy
RAMA PRASAD T.
ABSTRACT
Theoretically, a ‘Zero-COVID’ strategy should have resulted in a halt to the march of the COVID quite swiftly. There is a scientific basis for this assumption. Unexpectedly, as it happened to be implemented for a long period, it met with resistance by the public. The strategy gained a political colour in some countries. By a strange quirk of a political twist, the ‘Zero-COVID’ policy had become a topic of intense debate now in November 2022. Public healthcare heads are scratching their heads, not knowing how to go about with the Covid problem. Nearly three years into the global pandemic, we’re still wondering whether the ‘social vaccine’ of ‘Zero-COVID’ policy would still work, especially after the Guangzhou episode in China. A few of the strange and controversial aspects of this strategy are highlighted in this article in an informal way.
Key words: Zero-COVID strategy, China and COVID-19, SARS-CoV-2, COVID-19 pandemic
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Introduction
COVID (SARS-CoV-2 / COVID-19) is known to have spread all over the world through ‘human to human’ contact. And the virus has a short – few days to a couple of weeks – incubation period. Hence it is logical to assume that the spread can be stemmed by minimizing contact between persons. This is the basis for all the restrictions on human movement, Covid-testing, quarantines and lockdowns. When this activity is stringently and severely implemented with the objective of bringing down the infection to ‘zero level’, it’s called a ‘Zero-COVID’ strategy. In the early phase of the Covid pandemic, most of the countries pursued this strategy / policy, in varying degrees of strictness and for varying periods of time. Later on, it morphed into an activity of ‘start-stop-start’ way of implementation, depending upon the ‘Covid waves’ and local situations. However, a few countries, especially China, followed the ‘Zero-COVID’ strategy religiously throughout, not minding the economic and social consequences. China is still on the ‘Zero-COVID’ path, very strictly observing the rules, and on November 14, 2022, the country faced an awkward situation of public unrest in the streets of Guangzhou, stridently voicing against restrictions imposed by ‘Zero-COVID’ policy. Some of the related information on this subject is presented in this article, a tad informally.
Breaking news
While I am writing this article, news of key pro-China-cheer-leader commentators unexpectedly raising questions about the harsh excesses in implementation of President Xi Jinping’s signature policy on ‘Zero-COVID’ has trickled in (November 11, 2022) without much censoring, through The Straits Times (https://www.straitstimes.com/asia/east-asia/china-s-social-media-cheerleaders-also-questioning-covid-zero-policy ). This is at a time when the Beijing’s Covid cases scaled to more than 10,000 for the first time since April 2022. At the recent meeting of Politburo Standing Committee, the Chinese president Xi Jinping, called for ‘more decisive’ measures to control the virus and resume normal life and production as soon as possible, according to the Xinhua News Agency. This indicated further resolve to continue the rigid ‘Zero-COVID’ policy.
More breaking news
The following news of Guangzhou slapped everyone with icy force and stunned disbelief. Within a week of the appearance of the above pretty damning critique on ‘harsh excesses’, crowds of people, some of them in ‘hazmat suits’, in the Chinese city of Guangzhou crashed through ‘Zero-COVID’ barriers and marched down streets in chaotic and noisy scenes on November 14, 2022, openly demonstrating resentment and protest against ‘Zero-COVID’ related lockdowns and enforced quarantines. In normal circumstances, this does not happen or allowed to happen under the rigid governance of China. Such demonstrations occurred in other countries where it’s considered ‘normal’, but not in the regimental regime of China. Though the number of cases has come down to two digits, Shanghai and ‘Shanghai Disney Resort’ are still shut. Perhaps, the virus is causing some evolution / revolution in the public through frustration over lack of normalization in living even after nearly three years of lockdowns, while the rest of the world said goodbye to ‘Zero-COVID’.
This ‘Zero-COVID’ related harrowing and distress can be a catalyst or a harbinger for a change in the ‘Zero-COVID’ policy or even in the wider trajectory of governance. But China is China, though it is caught in a ‘Zero-COVID’ trap. Among the latest Covid outbreaks in China, Guangzhou’s is the largest with more than 5,000 new cases daily for the first time; and the number is 17,772 for the country, the most since April 2022. China seems now is scrambling to limit the damage caused to its ‘Zero-COVID’ policy, three years into the pandemic, with a spate of dismal economic reports, consequent to the ‘Zero-COVID’ policy. Some analysts are now saying that “China’s strategy of lockdown and mass testing that made sense in a world without vaccines is now past its sell-by date. The continued extreme measures and the expansion of state power made the living in China lifeless, unworthy and frustrating.”
Bitter reality
While I am still writing this, my article titled “ ‘Zero-COVID’ struggles” is published in The Hindu (November 13, 2022) which is relevant to what is being written here. The last paragraph of the cited article (purported conversation between me and my patient Ms. Coveena) is reprinted below: 47
“ … The word ‘lockdown’ evokes a feeling of melancholy and dread among the people. The word Zero-COVID is more frightening. It’s the buzzword in media now. So, finally, Ms. Coveena herself answered her first question (Will Xi abandon the Zero-COVID strategy after he is reelected ?). She was of the view that he would not, because he knows that once the Zero-COVID umbrella is closed, there would be an acute and severe shortage of crematoria and burial grounds!!! …” 47
( https://www.thehindu.com/opinion/open-page/zero-covid-struggles/article66105508.ece )
This indicates the vulnerability of the Chinese population under their immunological circumstances in relation to the evolving Covid variants and the efficacy of ‘Chinese vaccines’.
Covid and China
‘C’ for Covid; ‘C’ for China. The two names seem to be inseparable. Before being christened, the novel coronavirus disease was known as ‘China virus disease’, nearly three years ago. Today’s hot topic about Covid is ‘Zero-COVID’ which has also become inseparable from China, though the chief of the World Health Organization (WHO) attempted to ‘separate them’ by giving China an earful on the unsustainability of its ‘Zero-COVID’ policy. But, Xi Jinping seems to be in a strong wedlock with ‘Zero-COVID’, only separated by ‘Y’ (XYZ) ! ‘X’ for Xi; ‘Z’ for Zero-COVID !
Zero
‘Zero’ is something which is unique – it may mean nothing or anything depending on where it is positioned, just like the ‘Zero-COVID’ strategy – before or after vaccines and variants. Place the zero before and after a number – what a difference ! Yet, zero is the last number to be ‘invented’, a ‘neutral element’, as adding it to any number will not change the value of the sum; an ‘absorbing element’, as multiplying any number with it will result in the same number. It’s a round symbol mentioned in the Chinese mathematical text “Qin Tiushao’s 1247 Mathematical Treatise in Nine Sections”. In around 500 AD, the famous Indian mathematician, Aryabhata, used the word ‘Kha’ for positioning ‘zero’. And, ‘Zero’ is the name of a fantastic ‘indie rock band’who reunited recently after a split. Anyway, this is by the way.
Definition
‘Zero-COVID’ is dogged by problems of definition because of the use of words like ‘elimination’, ‘eradication’, ‘mitigation’, ‘maximum suppression’, etc. which are often used interchangeably and which mean differently to different people including experts. Zero-COVID or COVID-Zero or FTTIS is a public health policy that has been implemented by some countries during the COVID-19 pandemic. "The strategy of control and maximum suppression (zero-COVID) has been implemented successfully in a number of countries. The objective of this strategy is to keep transmission of the virus as close to zero as possible and ultimately to eliminate it entirely from particular geographical areas. The strategy aims to increase the capacity to identify and trace chains of transmission and to identify and manage outbreaks, while also integrating economic, psychological, social and healthcare support to guarantee the isolation of cases and contacts. This approach is also known as “Find, Test, Trace, Isolate and Support” (FTTIS)" 1
A zero-COVID strategy has two components -- an initial suppression phase by which the virus is eliminated using aggressive public health measures, and a sustained containment phase, by which normal economic and social activities are resumed, and public health measures are used to contain new outbreaks before they spread speedily and widely.” 2 Mass Covid testing, isolation and treatment of the infected, contact tracing, restriction of movement, border quarantine, border closures and lockdowns, surveillance and mitigation software are the tools for ‘Zero-COVID’ strategy which is supposed to bring down the number of Covid cases to zero level and resume economic and social activities quickly.
A differentiation is made between ‘Zero-COVID’, which is an ‘elimination strategy’ that brings down the cases to zero, and ‘mitigation strategy’ that attempts to lessen the effects of the virus, but which still tolerates some level of transmission within the community. 3 These basic strategies can be pursued sequentially or simultaneously through the period when immunity is acquired through natural infection or a vaccine. 4
Let’s not get bogged down in the mire of controversies of nomenclature and let’s not be esoteric. Eradication is something which we can’t dream of for Covid in the near future. Smallpox is the only infectious disease which could be eradicated.
Brouhaha
The ‘Zero-COVID’ strategy has ignited much debate across the world, especially when it gained a political hue around the time (October 2022) when the 20th Chinese Communist Party Congress was underway, with Xi Jinping within the touching distance of an unconventional third term of five years as the head of the ‘Chinese party-state’. His pet dynamic ‘Zero-COVID’ policy earned Xi Jinping a lot of brownie points for him to get reelected. Some epidemiologists have affirmed that the unending ‘Zero-COVID’ marks the death knell of freedom and economy, while others argued that ‘Zero-COVID’ policy underscores its perpetual relevance. In all the brouhaha, the media and the commentariat confounded all including the scientists, overlooking the balance between utility and hazards of ‘Zero-COVID’ which is variable and specific to a given situation in a geographical area. Eric Schmidt once called media an ‘amplifier for idiots’ ! The urgency and uncertainty in matters connected with Covid prompted public health authorities to speedily ‘lockdown’ everything without application of mind to the woes of the public and economy.
Political virus
The ‘Covid virus’ has its own political grammar of origin, spread and sustenance. On October 17, 2022, the author of multiple books on China and a professor in Chinese and Sinological Studies at Jawaharlal Nehru University, Priyadarsi Mukhergi said: “ … But at the same time his (Xi Jinping’s) weaknesses have been revealed through the excessive lockdown policy imposed on the public in the name of achieving a zero-Covid level. Actually, he wants to root out any challenge to his power and authority. A zero-Covid strategy restricts public movement outside homes and thus neutralises any possibility of popular uprising. …” (The Times of India, October 18, 2022; https://timesofindia.indiatimes.com/blogs/talkingturkey/communist-china-has-never-been-a-friend-of-india-at-any-point-in-history-new-delhi-should-explore-relations-with-beijings-enemies/ ). 48
The tricky virus even stirred up politics between the two major economies of the world quite early in the pandemic, and made the countries throw barbs at each other, in the context of its origin. The fight went on to the extent of stalling funds to the World Health Organization (WHO) by the US, alleging bias for China by the head of the world body. The accusation of being too close to China was promptly denied by the UN agency. Donald Trump made an indelible ‘politico-Covid’ history. That’s about the past.
Of late, in a rare public comment on a government policy, the WHO chief Tedros Adhanom Ghebreyesus said China’s ‘Zero-COVID’ strategy is not sustainable and that it was time for change in the policy. Tedros’ comments were not covered in China’s State media and were censored on social media. On the issue of ‘Zero-COVID’ policy, on May 11, 2022, China hit back against what it called “irresponsible” comments by the head of the WHO, who described China’s ‘uncompromising and increasingly painful Zero-COVID’ policy as “not sustainable”. It was reported that the policy had placed millions of people across dozens of cities under various degrees of movement restrictions, most dramatically in Shanghai, causing significant psychological trauma and economic damage.
Is ‘Zero-COVID’ strategy still necessary ?
In the narrower context, is it still necessary for Xi Jinping to latch on to the ‘Zero-COVID’ policy even after getting elected for a third term ? In the wider ‘post-Covid vaccination’ context, is it still necessary to debate over ‘Zero-COVID’ strategy ? This would have been irrelevant, if the vaccines did their job well. There have been ‘breakthrough’ infections after vaccination. The vaccines, after having started out brilliantly, didn’t live up to the expectations in the real-life state of play. The results were self-evidently suboptimal or even dismal. However, they did a splendid job of preventing serious illness and death to a great extent.
Omicron and the subvariant BA.2 have managed to mutate almost every amino acid residue targeted by protective antibodies, and thus ‘escaped’ from the vaccines. There are many Omicron sub-lineages and recombinants like BQ.1 / XB / XBB, to name a few. They may also ‘escape’ from the vaccines. By virtue of the vaccines, we are living in a precarious truce of unhappy equilibrium endured by most of the world. But the sustainability of this compromised living with the virus is questionable what with the possibility of emergence of newer virulent variants, paving the way for the next pandemic to sidle up. The case surges in China, Hong Kong, Denmark and Scotland emphasize the fragility of that balance.
May be necessary
There have been far lower death rates and higher economic growth indices in countries that have pursued elimination through ‘Zero-COVID’ strategy during the first 12 months of the pandemic, prior to widespread vaccination compared with countries that have pursued only mitigation. 3 This shows that swift and strict measures to eliminate the virus allow a faster return to normal life. 3
In some form, ‘Zero-COVID’ may be necessary as the experience gained so far suggests that encounters with different variants of Covid or different types of vaccines can alter the effectiveness of future vaccinations in surprising ways – an effect called ‘immune imprinting’. This raises the possibility of less efficacy and less predictability of the future vaccines. Of course, work has been going on in full swing to make / evaluate newer Covid vaccines such as ‘Modified Vaccinia Virus Ankara (MVA/S), Intranasal vaccines, China’s inhalable vaccine, plant-based vaccine, receptor-binding domain-dimer-based vaccine, adjuvanted subunit vaccine, etc. In what is believed to be a world first, China just introduced a new type of vaccine that is to be inhaled (CanSino Biologics – 6185.HK). This injection-less vaccine can be a game-changer. 7, 8
May not be necessary
It may be argued that it's not a realistic goal to eliminate a respiratory virus such as SARS-CoV-2, any more than it is to eliminate the flu or the common cold. 5 To achieve a ‘Zero-COVID’ status in an area with high infection rates, one review estimated that it would take three months of strict lockdown. 6
Though the Covid pandemic has not been declared to be over, scientifically, most of the people in most of the countries have been going about with their activities normally for the past several months as though the pandemic was over. People seem not to care a hoot to any advisory on Covid prevention now. They are just not bothered to have even a booster dose, as significant number of serious cases are not being reported. Under the circumstances, people angrily question the need for ‘Zero-COVID’ restrictions. Even the countries that have been strictly following ‘Zero-COVID’ strategy are now abandoning it mostly due to public pressure and economic depression, and the impracticability of pursuing it on a long-term basis.
Who followed the ‘Zero-COVID’ strategy ?
Australia, Bhutan, Atlantic and Northern Canada, mainland China, Hong Kong, Macau, New Zealand, North Korea, Singapore, Scotland, South Korea, Taiwan, Tonga, and Vietnam had been implementing the ‘Zero-COVID’ strategy, of varying strictness though. From the second half of 2021, due to the different behaviour of the Delta and Omicron variants, and also because of the availability of Covid vaccines, most countries stopped pursuing ‘Zero-COVID’. While Macau and North Korea are still caring for the strategy, China is the only major economy that is still following the ‘Zero-COVID’ strategy assiduously and in letter and spirit, as of November 2022.
China versus the rest
During 2020 and 2021, the ‘Zero-COVID’ strategy, by most accounts, was widely popular in China as it ensured a degree of normal life within China while the rest of the world was struggling with waves of deaths and lockdowns (a fact proudly highlighted ad nauseam by the Chinese government media). The ‘Zero-COVID’ policy paid dividends -- schools remained opened; domestic tourism and manufacturing boomed; exports reached a record high; hundreds of thousands of lives were saved. All this happened while the rest of the world was upended with all sorts of problems. The enviable results elevated the image of China and ‘Zero-COVID strategy internationally. That was in 2020 and 2021.
Then, alas, came 2022 with more transmissible variants which jolted the government machinery. This change in the scenario made China to land in outbreaks, harsher ‘Zero-COVID’ restrictions, mounting costs, dwindling economy and public frustration and protests. As of early September, 33 cities and an estimated 65 million people in China were under ‘Zero-COVID’ lockdown (‘static management’ as is termed in China), according to a report in the Chinese magazine Caixin. It was reported that Shanghai was placed under a brutal lockdown of two months – disallowing to leave homes; facing food shortages; taking away Covid-positive children from their homes without their parents. Local governments are reported to be running out of money to fund the ’Zero-COVID’ activities. According to Caixin, from January 2020 to April 2022, China had carried out 11.5 billion RT-PCR tests, costing $45 billion ! In May 2022, Beijing which was under semi-lockdown conducted the ninth nucleic acid test for its over 21 million people. The strategy may not be any more viable.
The following is just an example of a ‘Zero-COVID’ lockdown in China in November 2022 (at a time when the rest of the world has mostly forgotten about lockdowns because of the low severity of the disease now, in spite of reports of hundreds / thousands of cases). Around 350 cases were reported on November 1, 2022, and on November 2, 2022, the Zhengzhou Airport Economy Zone in central China had imposed a strict ‘Covid lockdown’ on 600,000 people in and around the world’s largest ‘Apple iPhone’ manufacturing factory (Foxconn), barring all residents including 200,000 employees of the factory from going out and allowing only approved vehicles to ply. Just a day before, a ‘quasi-lockdown’ was lifted on nearly 13 million residents of the zone. Several employees of the factory fled on foot, prompting Foxconn to offer generous bonuses to retain their staff. Towards the end of the same fortnight of November 2022, China had recorded more than 10,000 cases.
With the adverse events mounting, some analysts commented that relentless controls and spot lockdowns across China have fueled discontent among residents, hampered economic growth and taken a heavy psychological and financial toll on people and factories. The claim that ‘Zero-COVID exacerbates inequality seems not be a red herring.
The basis for the strategy
Rewinding to the beginning, the novel coronavirus had rapidly spread from December 2019 from Wuhan city of China to almost all the countries across the world with unprecedented fury, and the WHO declared the disease as a pandemic on March 11, 2020. It was a century ago that the Spanish flu struck like this in 1918-20. It was known that the Covid virus had been spreading through air from person to person. It was also known that the incubation period of the virus was short, up to around two weeks, and that even asymptomatic people can infect others. So, the scientific logic said that COVID-19 could be eliminated / eradicated if people were separated from each other for a few weeks. How simple ! Hallelujah ! A relief for those who are worried about the ‘Trojan horse’ of pharmaceuticals.
This is the basis for the ‘Zero-COVID’ strategy to wipe out Covid which spreads from person to person through air. Theoretically, this is fine and ideal for a quick control of the infection within a short period of time. That’s no-brainer. Thus, the lockdowns were implemented widely and followed up with the ‘Zero-COVID’ strategy in some countries. One of the best implementations occurred in India, shutting down everything overnight. Notwithstanding, the ‘pre-lockdown’ number of 500 cases in March 2020 had increased to a staggering three million and the deaths from just around 10 to a massive 65,000 in just around five months after India was ‘locked down’ in March 2020 !
When the virus evolves into various variants of higher transmissibility / virulence over a long period of time, the wisdom of pursuing a ‘Zero-virus’ strategy on a long-term basis is highly questionable, considering the economic and social impacts. It’s hard to convert a biological phenomenon into an accurate math formula when various variables around the world can affect the virus and the humans as well.
The bias
As this is a new virus whose trajectory had been unpredictable, different countries followed different protocols according to the judgement of their health authorities. Ground realities and scientific predictions were at great variance. Results didn’t commensurate with the aggressiveness of control measures. People turned antagonistic to ‘Zero-COVID’ strategy. They saw a lot of sense in the quote of Wayne W. Dyer: “Go for it now. The future is promised to no one.” Some governments yielded to the people’s pressure, and some governments had a bias to implement the strategy at any cost. Some pontificated that every single life is more important than the country’s economic wellbeing. Australia, New Zealand, China, Hong Kong and several other Asia Pacific countries had the bias for ‘Zero-COVID’ policy and implemented highly restrictive measures, for different lengths of time and of varying degrees of severity.
Dilemma
It is impossible to conduct controlled trials to evaluate the efficacy of ‘Zero-COVID’ strategy. If at all, they can be done on small segments of population the results of which may not be applicable to the world at large. It is generally argued that economy would be disastrously ruined if ‘Zero-COVID’ strategy is implemented. But, there is no substantial or well-studied evidence to say that this damage could be more than that caused by ‘No-Zero-COVID’ strategy. As such there is a dilemma as to whether to have ‘Zero-COVID’ strategy or not in a country. As most of the matters connected with ‘Zero-COVID are hypothetical and uncertain, one can argue for or against the ‘Zero-COVID’ strategy, on both sides of the aisle.
Arguments for ‘Zero COVID’ strategy
Even as most of the countries are now abandoning the ‘Zero-COVID’ strategy, available experience and evidence shows that this strategy is the best route to root out COVID-19. Countries like New Zealand and Vietnam have changed the tack and stopped pursuing the ‘Zero-COVID’ policy, giving the false impression that ‘Zero-COVID’ policy is not advantageous. It’s a myth that ‘Zero-COVID’ strategy collapses the economy. Countries that stringently followed the ‘Zero-COVID’ playbook have done better on every measure from death rates to economic growth. As of March 18, 2022, New Zealand had just 151 ‘Covid deaths’ (0.003 per cent of its population) compared to more than 164,000 ‘Covid deaths’ in the UK (0.24 per cent of the population). Only around 5,000 ‘Covid deaths’ were reported in China whereas the number is one million in the US of just 0.3 billion people. If the figures are anything to go by, this is an outstanding achievement of China through the dynamic “Zero-COVID’ policy, even if the modifiers like a different definition of ‘Covid death’ in China and the alleged fudging of the figures are factored in. Just 5,000 Covid deaths among a population of 1.4 billion ! It looked too good to be true. And it was.
If the dynamic and stringent ‘Zero-COVID’ strategy as observed in China was followed in all the countries as soon as the pandemic started before development of variants, the world would have been back to normalcy quickly without much fatality. The initial cost of the ‘Zero-COVID’ strategy may be very high, but it is more than compensated as the return to normalcy is quicker and long-lasting. If the strategy failed, it was because all the countries didn’t take an early step seriously and simultaneously which led to emergence of variants which prolonged the pandemic over years. Because of this lapse, even countries like China couldn’t eliminate Covid even in more than two years. The failure is not due to the strategy, it’s only due to lack of participation by all.
Michael Marshall, a science writer in Devo, UK and the author of The Genesis Quest, wrote in March 2022: “ … Let’s go further. Consider what would have happened if, in early 2020, every country able to had adopted a zero-covid policy. It is incontestable that the global death count would be far lower, fewer people would have long covid and the economic damage would have been reduced. The virus would still be spreading, but slowly, and rising rates of vaccination would control it further. Crucially, omicron probably wouldn’t have had the chance to evolve. At the start of the pandemic, governments like the UK’s asserted that eliminating the virus was utterly impractical and so it was necessary to let it pass through the population in a “controlled” manner. Two years on, we know that was wrong. When the next pandemic emerges – as it will – governments should remember ‘zero covid, and work together to eliminate the new threat if they feasibly can. Coordinated international action is hard, but we must learn to do it. …”. ( https://www.newscientist.com/article/mg25433800-100-zero-covid-strategies-are-being-ditched-but-they-were-the-best-option/ ). 49 Yes, ‘Zero-COVID’ is the best, but now it’s like the dog barking after the thief left. The dog didn’t know the timing !
Arguments against the strategy
“What’s the point in saving a few people when many are going to die of starvation and other diseases ?” This question posed by those who oppose ‘Zero-COVID’ strategy has become the subject of a heated argument after some adverse effects of lockdowns became apparent. ‘Zero-COVID’ strategy is not only about ‘lockdowns’ as done all over the world at different times and of different strictness. It involves stringent restrictions, surveillance, mass testing, constant scanning of health codes and movement, and clinging on to a response designed to quash every outbreak at any cost. It’s ok if it’s for a short period and not repeated whenever a case is reported. Naturally, this causes immense inconvenience and loss of livelihood which leads to protests by people. As such, the suffering would be more and the economic loss would be gargantuan, though the hospitals are not swamped and death rates are low. For example, in China, official figure of youth unemployment now stands at 18.7%. Earlier this year, it was a nudging 20%. China's stricter lockdowns have caused widespread reports of people unable to source food and medicine. Moreover, zero-Covid is affecting people's daily lives in myriad other ways too.
Variants, vaccines and ‘Zero-COVID’
There is a link between variants, vaccines and ‘Zero-COVID’ strategy, and there lies the rub. If there is no emergence of variants, there is no need for prolonged lockdowns and ‘Zero-Covid’ activity. The pandemic would have lasted only for a short period of time. As the ‘Zero-COVID’ strategy was not implemented simultaneously and strictly by all the countries, the original strain had time and opportunity to mutate into variants. Of course, it is hypothetical. Despite, severe border restrictions, the variants developed in other countries somehow gain entry into countries where a strict regimen of ‘Zero-COVID’ is followed. This is what happened to China which is still stringently implementing ‘Zero-COVID’ policy.
The peculiarity of the problem with this novel coronavirus is that its variants ‘escape’ the immunity conferred by the currently available Covid vaccines. Initially it was thought that the speedily developed Covid vaccines would stem the tide quickly and effectively. If that thought was realized, there wouldn’t have been a place for the series of Covid waves all over. If variants keep on emerging, there wouldn’t be an end to the ‘Zero-COVID’ activity. Vaccines could decrease hospitalizations and deaths, but, viral evolution has plenty more to throw at us. The unforeseen and humongous onslaught by the highly immune-evasive variants had considerably piqued at the vaccine protagonists, and baffled immunologists and virologists, as the coronavirus family had been known to be more stable than many other viruses – less ‘error-prone’ in terms of dangerous mutations.
While SARS-CoV-2 started as a single entity, we now have a mix of a bizarre of permutations and combinations – Wuhan to Alpha, Delta, Omicron, BA.2, etc.; asymptomatic to mild to severe; not vaccinated to one dose to 4th booster. No two people share the same. The combinations endow us with a unique immune memory repertoire.
Is the ‘Zero-COVID’ too toxic ?
I wrote an article titled “Is the ’Lockdown Medicine’ too toxic ?” which was published two years ago in The Antiseptic of October 2020 (The Antiseptic. 2020 October; Vol. 117; No. 10; P: 13-15 ). The following is an excerpt from that article: “ … Lockdown, a blunt instrument, has become the default strategy and an epidemiological fashion, based on mathematical models of a limited theoretical frame. An indefinite country-wide 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 ? …” 33
And, here is an excerpt from my article published recently in The Hindu of August 28, 2022 ( https://www.thehindu.com/opinion/open-page/covid-questions/article65803119.ece ) -- a purported conversation between me and my patient which reveals more than what can be seen medical journals:
“ … 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 ? …” 46 A report released on April 29, 2022 by the Reserve Bank of India said that the deep economic injuries inflicted by the Covid pandemic on India will take 13 more years (up to 2035) to heal and that the losses were more than 50 lakh crore rupees. One has to ruminate on the wisdom of imposing ‘Zero-COVID’ / lockdowns.
Zero-COVIDs / Lockdowns, if at all necessary, should be tailor-made for a specific zone, time and intensity, depending upon the epidemiological situation. Covid is such a disease that uncertainty prevails on many of its facets. This can be perceived in many of my cited articles which include 24 articles on COVID-related matters published in The Antiseptic in 26 months (a World Record in medical journalism – one subject; one author; one monthly medical journal; 24 articles in 26 months). 8 to 47
Confound it !
Yes, we are annoyed with Covid which accounted for 641,666,268 cases and 6,620,348 deaths as on November 17, 2022. The claim that ‘Zero-COVID’ strategy would eradicate or at least eliminate Covid is a red herring. The WHO made it clear that the strategy is unsustainable due to the ever-changing behaviour of the coronavirus, and called on China to shift its much-touted dynamic policy. The following is an excerpt from my article titled “The long and the short of COVID in India” and published in The Antiseptic of June 2022: “ … And, look at the China’s ‘Zero COVID’ strategy of the strictest ‘lockdowns’ in the world. While it did well in the short term in terms of human loss, now the country is facing fresh surges of infection due to variants and is unable to lift the ‘lockdowns’. For how many more years the country can afford to shut away from the rest of the world ? …” 13
We do have complex problems demanding careful research, long-term planning, studies, trials, and even some intelligent crystal ball-gazing. We may be tempted to go to an oracle too. We have to evaluate many approaches and also pivot to targeting those parts of the spike that would be the same across all the past and the possible future variants, and, may be, even across those coronaviruses still awaiting crossover from bats or pangolins.
The take-home-message is that we are not out of the woods yet and that the pandemic is evolving in a sidle way, with a long bumpy peregrination ahead. Rosy assumptions that the pandemic is over would endanger public health. Policy makers must act more vigorously now to shape the future in the context of the possible emergence of more dangerous and more transmissible microbes. The option to sleepwalk this current short period of relatively uneventful journey, using ‘auto-pilot choices’ based on what was ‘good-enough’ in the previous waves, is one we may adopt at our peril. We must look at options beyond boosters and ‘Zero-COVIDs’.
Is ‘Zero-COVID’ good or bad ?
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 ‘Zero-COVID’ !
REFERENCES
1. Anna Llupià, Rodríguez-Giralt, Anna Fité, Lola Álamo, Laura de la Torre, Ana Redondo, Mar Callau and Caterina Guinovart (2020) What Is a Zero-COVID StrategyArchived 2022-01-03 at the Wayback Machine, Barcelona Institute for Global Health - COVID-19 & response strategy.
2. Li, Zhongjie et al (4 June 2020). "Active case finding with case management: the key to tackling the COVID-19 pandemic". The Lancet. 396 (10243): 63–70. doi:10.1016/S0140-6736(20)31278-2. PMC 7272157. PMID 32505220.
3. Oliu-Barton, Miquel; Pradelski, Bary S R; Aghion, Philippe; Artus, Patrick; Kickbusch, Ilona; Lazarus, Jeffrey V; Sridhar, Devi; Vanderslott, Samantha (28 April 2021). "SARS-CoV-2 elimination, not mitigation, creates best outcomes for health, the economy, and civil liberties". The Lancet. 397(10291): 2234–2236. doi:10.1016/S0140-6736(21)00978-8. PMC 8081398. PMID 33932328.
4. Bhopal, Raj S (9 September 2020). "To achieve "zero covid" we need to include the controlled, careful acquisition of population (herd) immunity". BMJ. 370: m3487. doi:10.1136/bmj.m3487. eISSN 1756-1833. PMID 32907816. S2CID 221538577.
5. David Livermore (March 28, 2021). "'Zero Covid' - an impossible dream". HART – Health Advisory & Recovery Team. Archived from the original on January 2, 2022. Retrieved January 2, 2022.
6. Mégarbane, Bruno; Bourasset, Fanchon; Scherrmann, Jean-Michel (2021-09-20). "Epidemiokinetic Tools to Monitor Lockdown Efficacy and Estimate the Duration Adequate to Control SARS-CoV-2 Spread" (PDF). Journal of Epidemiology and Global Health. 11 (4): 321–325. doi:10.1007/s44197-021-00007-3. ISSN 2210-6006. PMC 8451385. PMID 34734383.
7. https://www.reuters.com/world/china/china-rolls-out-first-inhalable-covid-vaccine-2022-10-28/
8. Rama Prasad. T., BCG and COVID. The Antiseptic, 2022 November, Vol. 119; No. 11; P: 11-19, Indexed in IndMED – www.antiseptic.in
9. Rama Prasad. T., The Long COVID. The Antiseptic, 2022 October; Vol. 119; No. 10; P: 12-19; Indexed in IndMED – www.antiseptic.in
10. Rama Prasad. T., COVID medical literature – the Good, the Bad and the Ugly. The Antiseptic, 2022 September; Vol. 119; No. 9; P: 07-19; Indexed in IndMED – www.antiseptic.in
11. Rama Prasad. T., Origin of COVID. The Antiseptic, 2022 August; Vol. 119; No. 8; P: 09-17; Indexed in IndMED – www.antiseptic.in
12. Rama Prasad. T., COVID Deaths. The Antiseptic, 2022 July; Vol. 119; No. 7; P: 14-22; Indexed in IndMED – www.antiseptic.in
13. 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
14. Rama Prasad. T., COVID Fear and Paranoia. The Antiseptic, 2022 May; Vol. 119; No. 5; P: 09-17; Indexed in IndMED – www.antiseptic.in
15. Rama Prasad, T., Post-OMICRON Peregrination. The Antiseptic, 2022 April; Vol. 119; No. 4; P: 06-14; Indexed in IndMED – www.antiseptic.in
16. Rama Prasad, T., COVID – still an enigma. The Antiseptic, 2022 March; Vol. 119; No. 3; P: 20-25; Indexed in IndMED -- www.antiseptic.in
17. Rama Prasad, T., OMICRON – A Paper Tiger. The Antiseptic, 2022 February; Vol. 119; No. 2; P:12-21; Indexed in IndMED – www.antiseptic.in
18. Rama Prasad, T., Ominous Omicron of COVID. The Antiseptic, 2022 January; Vol. 119; No. 1; P:25 – 29; Indexed in IndMED – www.antiseptic.in
19. Rama Prasad, T., COVID and Tuberculosis. The Antiseptic, 2021 December; Vol. 118; No.12; P: 11-17; Indexed in IndMED -- www.antiseptic.in
20. 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
21. Rama Prasad, T. COVID, Children and Schools. The Antiseptic. 2021 October; Vol.118; No.10; P: 08-18; Indexed in IndMED -- www.antiseptic.in
22. 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
23. 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
24. 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
25. 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
26. Rama Prasad, T. COVID Variants. The Antiseptic. 2021 May; Vol.118; No.5; P: 11-14; Indexed in IndMED -- www.theantiseptic.in
27. Rama Prasad, T. Covishield or Covaxin ? The Antiseptic. 2021 April; Vol. 118; No. 4; P: 12-16; Indexed in IndMED – www.theantiseptic.in
28. 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
29. 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
30. 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
31. Versha Rajeev., Rama Prasad, T. Fear and COVID. Health. 2020 November; Vol.98; No.11; P:31-32
32. Rama Prasad, T., Versha Rajeev. Tea and COVID. Health. 2020 October; Vol.98; No.10; P: 4-6.
33. 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
34. Rama Prasad, T., Digital clubbing and Hypertrophic Pulmonary Osteoarthropathy. The Antiseptic, 1979 April, Vol. 76; P: 213-215
35. https://drtramaprasad.blogspot.com/2017/04/tuberculosis-in-india_29.html
36. https://drtramaprasad.blogspot.com/2020/06/coronavirus-covid-19-sars-cov-2_43.html
37. https://drtramaprasad.blogspot.com/2020/
38. Rama Prasad, T., Versha Rajeev. https://drtramaprasad.blogspot.com/2017/04/covid-crocodiles.html
39. https://drtramaprasad.blogspot.com/2017/04/hydroxychloroquine-hcq-and-coronavirus_29.html
40. https://drtramaprasad.blogspot.com/2017/04/corona-and-charles-darwin.html
41. https://drtramaprasad.blogspot.com/2017/04/modern-medicine-good-bad-and-ugly_30.html
42. https://drtramaprasad.blogspot.com/2017/04/yellow-nail-syndrome_28.html
43. https://journal.chestnet.org/article/S0012-3692(16)40458-7/fulltext
44. http://drtramaprasad.blogspot.com/2017/04/what-you-can-clinic_30.html
45. https://www.thehindu.com/opinion/open-page/a-bad-patch/article31069356.ece
46. https://www.thehindu.com/opinion/open-page/covid-questions/article65803119.ece
47. https://www.thehindu.com/opinion/open-page/zero-covid-struggles/article66105508.ece
Scenario after writing this article
OPEN PAGE -- THE HINDU, November 13, 2022 – A ‘Web Special Premium Article’
T. Rama Prasad https://www.thehindu.com/opinion/open-page/zero-covid-struggles/article66105508.ece
‘Zero-COVID’ struggles
November 13, 2022 01:01 am | Updated 01:01 am IST
COMMENTS SHARE
Stringent lockdown and protocols for COVID-19 continue in China to this day. | Photo Credit: AP
Is it not exacting high economic, social and political costs, though lives are being saved?
My patient Ms. Coveena (recently changed her name) asked me last month: “Doctor, the Chinese Communist Party’s weeklong Congress is going on to pave for the ascendency to a third five-year-term for the President, Xi Jinping. Will Xi abandon the ‘Zero-COVID’ strategy after he is reelected ?”
I said: “Why should he ? The strategy saved a million lives. There have been only around 5,000 ‘COVID deaths’ among the 1.4 billion Chinese, in stark contrast with other countries where the virus killed more than six million people, one million in America alone.”
She made a derogatory remark: “Yes, yes, they are Chinese figures with questionable reliability... They have their own method of counting and doctoring COVID deaths; hiding deaths from the world like a serial killer burying bodies.”
I said that even if we factored in those elements and even if the numbers were wrong by tenfold, it was reasonable to believe that the fatality rate is admirably very low in the population because of the dynamic ‘Zero-COVID’ policy.
She retorted: “Why then was there the humongous surge in Shanghai leading to miserable effects of lockdowns like food supply shortage, disruptions to the economy and access to medical care, and protests by the public ?”
I explained that there was a new subtype of the virus and that the seemingly excessive Zero-COVID restrictions reflect the resolve of President Xi who has repeatedly said over the past two years that “people’s lives are of utmost importance” to justify elaborate border closures and strict pandemic control policies.
With an expression of disbelief, she asked: “Doctor, do you think that Xi’s Zero-COVID policy is for the benefit of the people ?” Sensing my bewilderment at that question, she quoted what Priyadarsi Mukhergi, professor in Chinese and Sinological Studies, Jawaharlal Nehru University, said recently, “…Xi Jinping’s weaknesses have been revealed through the excessive lockdown policy imposed on the public in the name of achieving a ‘Zero-COVID’ level. Actually, he wants to root out any challenge to his power and authority. A Zero-COVID strategy restricts public movement outside homes and thus neutralises any possibility of popular uprising.”
Ms. Coveena also launched into a more important reason for Xi doggedly clinging on to the Zero-COVID policy. The global admiration for the very low rate of COVID deaths in China gave a tremendous fillip and political popularity to Xi Jinping to get elected for another term.
Further, she posed a lot of questions: For how long would Zero-COVID be sustainable? Is it not exacting high economic, social and political costs ? And how long can the authorities stamp out public protests? Would not giving up the Zero-COVID policy be considered tantamount to Xi’s failure ? Would not a million of the immunologically naive Chinese die if Zero-COVID is suddenly given a farewell? Is this a historic turning point in state–society relations?
I was a tad confounded and said that eminent world leaders analyse things deeply in consultation with top experts in the field of health and medicine and act rationally. She pointed out that former U.S. President Donald Trump had suggested that disinfectants could be injected into people to keep COVID at bay, and that Brazilian president Jair Bolsonaro had told people that COVID vaccines would turn them into crocodiles, men into women and women into men.
The word ‘lockdown’ evokes a feeling of melancholy and dread among the people. The word Zero-COVID is more frightening. It’s the buzzword in media now. So, finally, Ms. Coveena herself answered her first question (Will Xi abandon the Zero-COVID strategy after he is reelected ?). She was of the view that he would not, because he knows that once the Zero-COVID umbrella is closed, there would be an acute and severe shortage of crematoria and burial grounds!!!
drtramaprasad@gmail.com
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
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 two 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
There are only 10 faces in this drawing, but the COVID has many more !
The face of COVID would be remembered for a longer time than any of the faces in the ‘tree’ above. Of course, everybody would be forgotten in course of time. And the ‘time’ is a very relative thing. Just see the ‘timeline’ below:
'Age' of the Sun -- 4.54 billion years. Expected lifespan. -- 7 billion years more
'Age' of the Earth -- 4.54 billion years. Expected lifespan -- 1 billion years more
'Age' of Himalayas -- 50 million years
'Age' of Humans. -- 3 lakh years
'Age' of Religions -- 4 thousand years
'Age' of Temples. -- 3 thousand years
‘Age’ of viruses -- 3.5 billion years
‘Age’ of viral epidemics -- 12,000 years
‘Age’ of COVID – about 3 years as in 2022
We have around 380 trillion viruses (mostly harmless) on or inside our bodies !!!
“Computer Virus” is a “Mechanical Organism”, such as a computer code, which may damage computers, ‘copy’ itself and ‘infect’ other computers, just like a “Biological Virus.”
Dr. T. Rama Prasad
A BLOG ARTICLE in : http://drtramaprasad.blogspot.com or www.rama-scribbles.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.."
Service to Humanity is service to God; Kindness costs nothing
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
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
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....."
05.08.1999 -- Prof. P. Lakshmi, MA,
Principal, Vellalar College for Women,
Thindal, Erode, Tamil Nadu, India
Dear Dr. Rama Prasad, 20 Jan 1999
“..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 encyclopaedic 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.
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 Medical Literature – the Good, the Bad and the Ugly’ The Antiseptic, September 2022, Vol 119, No 9
From the Editor........
The Editor wishes to inform the Readers of ‘The Antiseptic’ who are interested in having correct, complete and comprehensive knowledge of the current literature on Covid, to read the above article by Dr. T. Rama Prasad, written as is usual, in beautiful, flawless and inimitable English, with numerous apt quotations.
He further wishes to thank Dr. T. Rama Prasad profusely for choosing to publish all his ‘very interesting to read’ articles on Covid in ‘The Antiseptic’ and hopes that he (Dr. T. Rama Prasad) continues his benevolence.
-----------------------------------------------
I am greatly honoured and recognised, indeed, by this special ‘editorial comment’ of inspiring appreciation by the distinguished, scholarly, erudite, and eclectic editor of the premier journal, The Antiseptic, which itself is a rare treasure of documentation from the eclecticism of India’s diverse medical systems, including the dominant ‘modern medicine’. My articles were published in this long-standing and reputed journal even more than forty years ago.
-- T. Rama Prasad
COVID world: 24 of my articles on ‘COVID’ were published in 24 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 599 Indexed in IndMED Email: admin@theantiseptic.in www.theantiseptic.in
Some 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; P: 09-17; 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
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
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
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’ ? Or, should it be December 31 when the first outbreak in the world was reported in China in 2019 ?
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 !
(I too forgot everything else, and authored 24 articles in 24 months, on only COVID, which were published in a single medical journal, The Antiseptic -- a WORLD RECORD in medical journalism !!!)
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.
The first outbreak of COVID in the world was reported in China on the very next day (31.12.2019) of taking the above photo on 30.12.2019 !!!
“We are sometimes praised and sometimes pilloried. We should neither bask in the glory of success nor sulk in the shadows of defeat.”
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