CME INDIA Presentation by Dr. Shashank Heda, Founder and Chief Executive, CovidRxExchange (CovidRxExchange is a Global Non-profit Organization registered with the US Govt. Exempt under IRS code 501 C (3), relentlessly working since March 2020, disseminating expertise and insight in the medical care of Covid), Dallas, Texas, US. Email: info@covidrxexchange.org; shashank.heda@covidrxexchange.org.
As of this writing, Omicron seems to have high transmissivity, but the disease is milder in non-vulnerable populations. There are predictions that Omicron will rapidly infect the communities across, but, given the milder nature of the disease, it is unlikely to create health concerns like the earlier variants.
What do we do?
- Continue with Vaccination.
- Stringently follow Covid Appropriate Behavior (including masks mandates).
- Do NOT PANIC. Continue with business as usual; there is no reason to huddle inside your space (but there is no need for extravagant socialization).
- Strictly follow local regulations.
- Keep alert on local incidences and prevalence. If the local disease increases, you need to scale up your precautions.
Alert: Clinical Features MAY Vary (Check for Rash)
- Understanding the differing spectrum of symptoms, it is crucial to map the phenotypic (clinical) pattern, and possibly with the Genotype (mutations) – CovidRxExchange. (Dec 8, 2021 7.00 AM IST).
- While Extreme fatigue for few days, Headache, Body-ache, Fever, Cough, and Shortness of Breath are among the symptoms. So are muscle aches. No loss of taste or smell are reported. So far, no reports on ‘Happy Hypoxemia’ are reported.
- “There had been calls for the list of symptoms to be expanded, as people with confirmed cases of Covid have reported a number of different symptoms.” The World Health Organisation (WHO) has previously said there is no information at present to suggest the symptoms of the Omicron variant are different from other Covid-19 variants.
- Parents should be aware of an “unusual rash” that has been linked to cases of the new Omicron Covid strain in children.
10 Latest updates
About 11 million, or 15%, of the remaining inventory of “Abenomasks,” the washable cloth masks accumulated by the administration of then-Prime Minister Shinzo Abe, have been found to be defective in a recent inspection.
1. Masks are still an important cause of failure. I would say (CovidRxExchange), Masks are still a single point of failure (SPOF). The quality of masks, the way those are worn, and the way those are cleaned (or not cleaned), are still the single most important determinant in the spread of Covid. Before any lockdowns, ensure quality masks, proper wearing and proper clean-up/use are emphasized. CAB is meaningful only if masks are use is optimized.
India has so far detected 200 omicron cases, with the states of Delhi and Maharashtra reporting the most infections, at 54 each, the health ministry says. The country reported its first two cases of the new variant on Dec. 2. India has already arranged a buffer stock of important medicines so that that don’t face any problem when the variant spreads.
2. Collapse of hospital infrastructure heralds the onset of lockdown (CovidRxExchange). Other than buffer stock, have we done a ”Value Chain Analysis” as recommended by CovidRxExchange? An end-to-end assessment is crucial, and this disaster management exercise has to be granular, i.e. at every district level. A transparent, auditable (non-finger pointing) approach is paramount.
Japan raises its overall economic assessment, but they signalled ongoing risks from supply constraints and raw material prices. They are testing for the omicron variant, doing genome analysis and ensuring more thorough measures to prevent the cluster’s spread.
3. Even if we have inadequate test kits, genome analysis should increase. CovidRxExchange’s sliding scale model can provide an alternative of scaling up or down, calibrating to the emanating risks. Can we build customized Sliding Scale models until the most significant granular level?
South Korea reports 5,202 new cases for Monday, with 49 omicron infections, While the total number of cases fell, the number of patients in serious condition rebounded to exceed 1,000, putting more pressure on a health system scrambling to secure hospital beds.
4. This is a classic example of how the best system comes under pressure. The most populous places finally dictate the success. Remember, Covid is a disease of aggregation, and dense population (CovidRxExchange). A different set of precautions are required for highly populous areas than those with medium or low-density areas.
The Centres for Disease Control and Prevention numbers show nearly a sixfold increase in omicron’s share of infections in only one week. Despite, the White House is considering easing travel restrictions to southern African countries as U.S. infection rates of the fast-spreading omicron variant rise.
5. Anomalous behavior: While countries and select states are gearing up for quashing the emerging wave, some countries like the US are buckling under pressure, and likely considering reopening travel ban (CovidRxExchange). Anomalous behavior is not country specific, it is a political will not to succumb to public sentiment. It is a knee jerk response without doing thorough due diligence. What is that due diligence?
Quebec, Canada’s second-most populous province, orders bars, gyms and casinos shut and directs people to work only from home to fight the rapid spread of the omicron variant of the coronavirus. Christian Dube, the province’s health minister, says Quebec had a record 4,500 new daily cases of the coronavirus.
6. Synchronous Behavior: Quebec is not alone; several countries and states are showing responsible behavior (CovidRxExchange). While the counter pressure from the polity is low, the political will to do in the best interests of the polity too is equally strong.
Moderna says a booster dose of its vaccine appears to protect against the fast-spreading omicron variant in laboratory tests. The company says its decision to focus on the current vaccine, mRNA-1273, was driven in part by how quickly the recently discovered variant is spreading. Moderna says it still plans to develop a vaccine to protect against omicron specifically and hopes to start clinical trials early next year.
7. A Rigid Yardstick for Pharma: In my 90-minute discussion on Dec 10, 2021 with the Indian Institute of Mass Communication, I emphasized a five-point rule to follow with the budding journalists. Sample size, confidence interval, randomization, cause effect rationale and design of experiment to confirm or rule out a hypothesis is fundamental. No pharmaceutical company should be taken at face value. Press Releases are managed, so rigid yardstick to evaluate is important.
India has administered over 1.37 billion vaccine doses, with 88% of its eligible adult population of 944 million having received at least one shot while 58% have gotten both doses, he says.
8. First, it is commendable job to give 1.37 billion doses. Remember, India is not China, it is an open democracy, it is highly diverse, and highly distinct in needs and challenges (CovidRxExchange). However, given the current reduction in vaccination efficiency, let me ask, “is this enough?”
The World Economic Forum postpones its 2022 meeting of global business and political leaders in the Swiss town of Davos due to the spread of the omicron coronavirus variant, saying it will put off the event scheduled for January 17-21 until “early summer. Despite the meeting’s stringent health protocols, the transmissibility of Omicron and its impact on travel and mobility have made deferral necessary.
9. WEF is a responsible body, its polity is homogenous, thus making a decision to reschedule an important meeting. However, not always the populist’s sentiments are supportive. Rabb and Khan from London, have shown the way, of how not to succumb.
And finally good news. South African cases dropped to lowest in the last 2 weeks.
10. It is a matter of time, let us modulate and mitigate, let us avoid any radical steps. A radical step is any polar extreme. Too stringent or too permissive, both are bad. Let us balance based on local risk.
If the local risk increases, double down on precautions
- Omicron may be milder or may cause more severity. However, while the scientists are learning the clinical features, let us follow the CAB stringently, let us continue with our vaccination, and let us get tested, and where required, let us request for genome analysis.
- Scoffing of as ‘knee jerk reflex’, or creating panic and pandemonium are not required. Neither of it helps. A systemic, scientific and risk-based approach will help us resolve the concerns with Omicron.
- Use CovidRxExchange’s Sliding Scale Model to calibrate your interactions. If the local risk increases, double down on precautions. If local risk decreases, keep a watch.
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