The Resident Doctors Association of Mumbai's KEM Hospital has written an open letter to Maharashtra Chief Minister Uddhav Thackeray narrating the difficulties they are facing. the doctors have demanded shorter shifts and a separate ward for medical staff testing Covid-19 positive.
That was my biggest fear. Think I have mentioned repeatedly, a physician ( no matter how knowledgeable he/she is) needs training and real life exposure to tackle these situations. It is not only the physical stress ( mostly caused by the PPE) it is the mental one that kills a person.
Their demand for shorter shifts will increase the chance of spread. The protocol for wartime and epidemic is to work for 7 days at a stretch ( 4 hours of sleep, if you are lucky) and rest for 36 hours. As a member of doctor family I feel deeply for them. But this job is at times tougher than soldiers in war and they will eventually harden up and take up the challenge head on. A physically strong leader can help a lot in this situation. There must be some doctors with such strength ( not bulging muscles, those are the first to break down), it is usually some thin, tall guy who does not show any emotion.
We had a simplified protocol in Spain.
Sick patient with positive RT-PCR
1. Check serum ferritin level
if high or very low (with hemoglobin above 12, 11 for females)- tell the family family member that the patient may not survive with our best efforts. I will never give Tocilizumab to them (as cytokine storm will occur irrespective of TCZ) If required, will put on ventilator but no escalation. 90 PERCENT CHANCE THAT WE WILL LOOSE THE PATIENT.
2. If ferritin within normal range, I will go all out, TCZventilator, IABP ( if the heart gives up pumping function), ECMO ( if both heart and lung is failing simultaneously) and ventilator is not oxygenating enough. This approach saved about 70 percent of very sick patient.
No ****ing around with HCQS/ Azithral/ Remdesivir.
All my team member doctors/nurses can use their own judgement regarding investigations etc. but CAN NOT change this ferritin based protocol. If you break it, no one will complain against you. But I may break your jaw after the shift in my chamber, and you are free to sue me ( nobody did, in fact kissed by some emotional Spanish and British doctors who understood the logic and my ultimate intention, save maximum life with available resources)
My Indian friends should try some simple protocol to triage patients as this thing will shoot straight up and remain for 6-8 weeks.
This is the second time in under 6 months they have just trusted hearsay and propagated it instead of validating the claims and credentials of people making the claim.
The world has been forced to tolerate this clown and his sidekicks for a long time now.
But nothing will change in this time of need.
However everything in WHO will change in January next year.
The organisational structure will change completely.
Please trust me on one thing, WHO still has the most qualified and experienced public health experts and epidemiologists from all parts of world. Though they were never involved in the administration, from 2021 only these professionals will run WHO. We will get rid of all the MBA types and only 50 non medicos will be retained globally.
Things that the medics don't understand (IT, finance etc) will be strictly on contractual basis.
Other than the aforementioned 50, no one will be on payroll, everything will be professional fees and major part will be taxable (unlike now)
I am not going to leak salary of Tedros, but it's not a small amount and 100 percent tax free ( nowadays he doesn't do anything but press conference)
Though as consultants we at times earn more than him, but we pay taxes above a certain amount.
Please note at present only 5-6 key professionals are actively working for WHO ( Rest have gone home.
Tedros is hiding one fact everywhere. He used his entire manpower in Europe and very few have worked with US in their worst time ( Trump has done the right thing by cutting the enormous cashflow from US)
This is the second time in under 6 months they have just trusted hearsay and propagated it instead of validating the claims and credentials of people making the claim.
They have no choice now, everyone with technical knowledge has left WHO frustrated. The people appearing in televisions have no technical knowledge, they have never been in the battlefield.
Google their work in Google scholar, the results will shock you.
FYI combined all slums in India, Mumbai slums can easily house all of them & still leave space for slums of Sri lanka and not to ignore the density of people living inch to inch. And Mumbai is in top 5 populous city of the world with 60%+ only migrants who are anxious to go back to home. And you expect lockdown to be followed strictly when outsiders are staying here and willing to return back home at any cost!
The infected people form Mumbai are actually infecting MH. This pathetic govt. dont know why, allowed inter-city transport from Mumbai when it should be banned staright for 6 months. So other cities should have got less infected.
And for US/NY, the president and the public is @Hol as US feels too over smart and over confident and this very ego attitude will soon make them fall in front of other powerful countries incl. India. So US will be wagging tails in front of others.
Only mentioned that because i'm hearing too often this line that you can't do social distancing in slums and favelas. HK is densely populated too. NYC with still higher rates is proof of lax enforcement amounting to lockdown in name only. No contact tracing or containment. Bombay enforced masks early in April. Yet the numbers continued to rise. Intra city travel within Maha would play an important part.
So i mentioned 6 states where these inter ministerial teams went to investigate flagrant lockdown violations. I was wrong, they visited ten states and guess what Maha was not on the list. Looking at the stats today one would not think that.
To control only Mumbai a spl. govt. needs to be formed or name Mumbai a union territory.
And yeah I'm not interested in defending any city country or state or planet.
For Mumbai all I can say is do a strict lockdown for 2 more months and ban peoples movement to-fro till December by cutting down on road.rail/air/water/gas etc. traveling.
THing with migrants going back is you expect some sort of drop after isn't it. Because 60% of cases in my state are retunees from Maha. My state puts out detailed reports every day so all this info is available.
Assam's stats have jumped of late, same thing. Returning migrants. Though this problem isn't as bad as they are being caught as they enter and tested. It would be harder to catch people arriving in Pune from Mumbai. This would explain why Pune's numbers are so high.
With positivity rates as high in Maha, we have to think of it like some western country. Will need a different approach.
It wasn't followed by the migrants who had to suffer due to dear leader's poorly thought out/implemented lockdown, they were desperate to go home and congregated at railway stations in large numbers while gullible people kept donating to PMCARES fund.
I've heard this excuse by some of your MLA's, If only advance warning of lockdown was given situation could have been avoided.
Where was the advance warning for other states ?
The only other city that had this problem going by their stats is Delhi.
Tell me are there no migrants in the other metros ? Cal, Bangalore, Chennai.
Chennai's problem was the wholesale market not the migrants and they're recovering from it one month later. TN's stats show more recovered than infected. Massive super spreader problem addressed within a month. This can only happen if you have a working administration.
Maha has the most recovered in the country but keep on adding with no end in sight. Any policy change will have a month's lag time to see any effect.
There are almost a million people living in Dharavi in a 2 sq km area, anyone who talks about social distancing in Mumbai is a retard who hasn't ever travelled in a local train.
Your MLA's ?? BJP was in power for 5 years and they did nothing to improve the health infrastructure, now they are playing petty politics from the sidelines.
Please go watch this guy's videos and disappear for another month from this thread, it seems like you crawl out every week assuming everyone has an equally short attention span as yours to come and give a positive spin to your favorite party.
This is the second time in under 6 months they have just trusted hearsay and propagated it instead of validating the claims and credentials of people making the claim.
Problem as i see it is they went of a paper in Lancet that was based on questionable data. The indian council of medical research put out a paper showing HCW helped in prophylaxis.
There is a group in Oxford that is conducting their own trial because they found the data in the WHO trial had bias.
it's as if there is this conspiracy to defame HCQ because its cheap and available. Big pharma does not like that.
There's no conspiracy theory behind HCQS, it may have some prophylactic role. But it definitely worsened prognosis of ventilated patients.
Overuse in US and India is another big concern.
After all it's a quinine derivative, the first dose of 800mg made me extremely dizzy and nauseated and never took the weekly dose.
My wife took it and still got infected.
In Indian scenario, monitoring daily ECG and calculating QTc may be difficult.
The authors themselves pulled the Lancet study flagging risks of HCQS in covid 19.
WHO has become so impotent that they can not declare the simple fact
YES, HCQS HAS SOME BENEFICIAL EFFECTS ON COVID 19 WHICH OUTWEIGH THE RISKS INVOLVED. HOWEVER IT HAS NO ROLE IN SEVERE CASES OF ARDS LIKE STATE OR MYOCARDITIS ( CAN WORSEN THESE SITUATIONS)
BUT HCQS IS NOT THE CURE FOR THE DISEASE.
The ICMR paper on this is absolutely garbage with no real conclusion ( like thousands of other papers)
Your MLA's ?? BJP was in power for 5 years and they did nothing to improve the health infrastructure, now they are playing petty politics from the sidelines.
Please go watch this guy's videos and disappear for another month from this thread, it seems like you crawl out every week assuming everyone has an equally short attention span as yours to come and give a positive spin to your favorite party.
There's no conspiracy theory behind HCQS, it may have some prophylactic role. But it definitely worsened prognosis of ventilated patients.
Overuse in US and India is another big concern.
After all it's a quinine derivative, the first dose of 800mg made me extremely dizzy and nauseated and never took the weekly dose.
My wife took it and still got infected.
In Indian scenario, monitoring daily ECG and calculating QTc may be difficult.
^^ I have read it earlier. Typical ICMR bullshit. They wrote an entire paper about HCQS in covid 19, however couldn't copy the MOA properly from the source ( they copied the second paragraph with endosome and pH)
It's basically a 2 page paper made overcomplicated purposefully to make it look serious.
A simple chart (3 columns, 4 rows) would fit in their data perfectly.
What about the ones who made policy until the beginning of the year for the last 5 years ? Can't they be blamed for the poor state of health infrastructure or did all of it crumble in just 2 months after another party won ?
Also that vid has nothing about the BJP thinking about our state, it's a bhakt getting woke after voting for BJP twice, something useful for blind and asleep followers like yourself who can't see beyond political affiliations.
What about the ones who made policy until the beginning of the year for the last 5 years ? Can't they be blamed for the poor state of health infrastructure or did all of it crumble in just 2 months after another party won ?
Also that vid has nothing about the BJP thinking about our state, it's a bhakt getting woke after voting for BJP twice, something useful for blind and asleep followers like yourself who can't see beyond political affiliations.
I am asking you what positives you see right now in your state because there is not much info coming out. I don't follow media i look at data, the patterns come out much better there but i don't find much when it comes to your state.
Once again you fail to understand what's being said in this thread by everyone, it's not about the failure of one party over another, they are all equally incompetent and nothing ever changes no matter who's in charge, you cannot see that because of your blind allegiance.
I have just one question for you, what happened to PMCARES ? Go find an answer in one of those 300 open Chrome tabs.
I do not believe in a single word coming out of Modi`s mouth. But never thought he and his goons will steal from PMCARES fund and donated there. But they apparently did that too. How low can a PM of a country stoop?
What about the ones who made policy until the beginning of the year for the last 5 years ? Can't they be blamed for the poor state of health infrastructure or did all of it crumble in just 2 months after another party won ?
Also that vid has nothing about the BJP thinking about our state, it's a bhakt getting woke after voting for BJP twice, something useful for blind and asleep followers like yourself who can't see beyond political affiliations.
It has just begun for India. Once the daily toll reaches 500 deaths, it will be stable for 2 days and then skyrocket.
Everything will be blamed on the poor migrants. However less than 10000 casualties per day shouldn't affect common people's lives in general.
They will still think lockdown was a major success, even India ascends to second spot after US and cross them by first week of August.
Loosing a million people won't bother our PM a bit.
People will forget he scared the nation with less than 1000 cases before going into the stupidest lockdown ever.
By case count, India has already very close ( possibly even crossed) Italy within a week of unlocking...we all criticised European countries for not enforcing serious lockdowns, so what's now!!??
It has just begun for India. Once the daily toll reaches 500 deaths, it will be stable for 2 days and then skyrocket.
Everything will be blamed on the poor migrants. However less than 10000 casualties per day shouldn't affect common people's lives in general.
They will still think lockdown was a major success, even India ascends to second spot after US and cross them by first week of August.
Loosing a million people won't bother our PM a bit.
People will forget he scared the nation with less than 1000 cases before going into the stupidest lockdown ever.
By case count, India has already very close ( possibly even crossed) Italy within a week of unlocking...we all criticised European countries for not enforcing serious lockdowns, so what's now!!??
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