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CMAAO IMA HCFI Corona Myths Buster (12-15) (For attention of Doctors) |
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CMAAO IMA HCFI Corona Myths Buster (12-15) (For attention of Doctors)

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 One should stock up on bottled water:  The water supply is not at risk, and there is no need to stock up on bottled water. If you normally drink tap water, you can keep drinking it.

Maids working at home are OK:  The Harvard Medical School suggests the following:

  • Choose a worker who has minimal exposure to other people besides your family
  • Limit the number of workers. Keeping the number to one is ideal. However, if multiple workers are required, keep the number as low as possible
  • Ensure that the worker understands the need to practice social distancing and limits physical interaction with the elderly as much as possible
  • Inform the worker not to come to your house if he/she is feeling unwell, even the slightest bit, or has had known exposure to coronavirus
  • Ensure that everyone washes their hands frequently throughout the day, particularly before eating.

It’s safe to get takeout from restaurants: You may wipe down the packaging and containers. There’s no evidence stating that coronavirus is transmitted through food, says the CDC. It’s generally spread through respiratory droplets.

But it would be good to disinfect the takeout containers and wash your hands afterward.

 

Outbreak never comes in waves

The outbreak could come in waves. Research by the Imperial College in Great Britain seems to suggest that these kinds of measures need to be put into operation for five months, that too vigorously.

 

It is safe to go to the dentist

Unless there is an emergency, the American Dental Association suggests rescheduling imminent appointments. The ADA has urged dentists to postpone elective procedures.

Coronavirus is as contagious as flu

No. Research suggests that a person with the flu infects about 1.28 other people, on average. However, with the novel coronavirus, the number is likely two to three other people.

I cannot get flu and coronavirus at the same time

It’s possible to get both at the same time. They share common symptoms, particularly fever and cough. Many coronavirus patients; however, suffer from shortness of breath, a hallmark of COVID-19. Other coronavirus patients show no symptoms.

Can we socialize within the family

If you must socialize, stay at least 6 feet away from others. Do not hug or kiss, wash your hands often for at least 20 seconds, and do not touch your face.

 

Older means age 65

 

According to CDC, older adults and people with serious chronic medical conditions have an increased risk of getting very sick from this illness.

Those above age 60 and those with underlying health problems should avoid places with large crowds, such as movie theaters, busy malls and even religious services.

The average age of death for people from coronavirus is 80 while the average age of people requiring medical attention is 60.

I should not disinfect my groceries

Wipe down external surfaces of canned or wrapped foods.

You must be washing the vegetables and produce anyway. Sanitize your hands or wash your hands after you unpack all your groceries.

 

I need not stock up on extra food and supplies

Harvard Medical School recommends that you keep a two-week to 30-day supply of nonperishable food at home. You may also keep at least a 30-day supply of prescription medications.

Public transportation is safe

When you ride a bus or any other public transport, sneeze or cough into your elbow. Use a tissue to hold the pole. Try not to touch your face while you’re riding, and use hand sanitizer while you’re commuting.

It is important to wash your hands before, during and after your trip.

New York Gov. Andrew Cuomo recommends that you must let crowded trains or buses pass and wait for a less crowded one. It’s practically impossible to maintain a 6 feet distance on a packed public transport.

If you suffer from a chronic illness, use alternative means of transportation. Using a crowded public transport can heighten your risk of infection to a significant extent.

Uber is safe

Uber has said that it is trying to give drivers disinfectants in order to help keep their cars clean, and the company may also temporarily suspend the accounts of riders or drivers who are confirmed to have contracted or been exposed to COVID-19.

Air journeys are not safe

 

Most viruses don’t spread easily on airplanes because of the way the air circulates and is filtered, the CDC says.

In modern commercial jets, 10-50% of the air in the cabin is recirculated, mixed with outside air. The recirculated air passes through a series of filters 20-30 times per hour.

Additionally, the air circulates in specified areas within an aircraft. This restricts the radius of distribution of pathogens spread by small-particle aerosols. The cabin air environment is therefore not favorable for the spread of most infectious diseases.

But, you should still try to avoid contact with anyone sneezing or coughing. If you’re feeling sick, cover your mouth and nose with the inside of your elbow when you cough or sneeze.

I should spray myself or my kids with disinfectant

No. These products work on surfaces and can be dangerous to your body.

Certain chemical disinfectants, including bleach, 75% ethanol, peracetic acid and chloroform, may kill the virus on surfaces.

But if the virus is already in your body, putting such substances on your skin or under your nose won’t kill it. Instead, these chemicals can even harm you.

CMAAO IMA HCFI Corona Myths Buster 14

 Younger persons are not at risk: More than 40 percent of those who have tested positive for the virus in New York City are aged 18 to 44. Across the nation, about 12% of the intensive care patients were between ages 20 and 44. 

Herd immunity is the answer: No. Initially , U.K.’s chief science advisor’s statement, that the way out of this epidemic was to get to 60% or more of the population recovered from infection and thus approach “herd immunity” did not provide reassurance.

The public immediately understood that the settlement seemed to be to accept a large number of deaths soon, to get the population to a COVID-19-resistant state.

The minister of health; however, denied that this strategy was the government policy. (NEJM)

 Atithi devo bhava has no scientific evidence: Traditional Vedic teaching has been that all guests first are made to wash feet, then hands, mouth, gargles and then made to sit in place while bowing and not shaking hands with them. Visitor means someone who is not living with you. The same has now come back.

There is nothing like nonessential social contact

No. All elderly should avoid non-essential contact.

 Chanakya said

Yatha Chaturbhi Kanakam Parikshayate Sheelen Chednataaptadane

Tatha Chaturthi Purusham Parikshayate Tyagen Sheelen Guren Karmana

यथा चतुर्भि: कनकं परीक्ष्यते शीलेन छेदनतापताडनै:।

तथा चतुर्थि: पुरुषं परीक्ष्यते त्यागेन शीलेन गुणेन कर्मणा।।

Like the way gold needs to be cut, rubbed, hit and heated to see its actual brightness, similarly, in order to know about a person, what has he sacrificed in life, how he speaks, his qualities and his work needs to be seen.

Before meeting a non-essential contact, we need to see his or her hygiene habits.

Risk of transmission is same between ages 30 and 60

No. The risk of symptomatic infection increases with age (for instance, at ~4% per year among adults aged 30-60 years). [Nature Medicine 2020]

COVID-19 patients can share beds in the hospital

The US CDC recommends that patients with suspected or confirmed COVID-19 be placed in a single-occupancy room with a closed door and dedicated bathroom. The patient should wear a facemask if being transported out of the room, such as for studies that cannot be performed in the room. An airborne infection isolation room (ie, a single-patient negative pressure room) must be reserved for patients undergoing aerosol-generating procedures [Centers for Disease Control and Prevention. Interim Infection Prevention and Control Recommendations for Patients with Confirmed 2019 Novel Coronavirus (2019-nCoV) or Patients Under Investigation for 2019-nCoV in Healthcare Settings. February 3, 2020. https://www.cdc.gov/coronavirus/2019-nCoV/hcp/infection-control.html (Accessed on March 11, 2020).]

Pneumonia means severe case

Mild (no or mild pneumonia) has been reported in 81% of the patients.

Severe disease (eg, with dyspnea, hypoxia, or >50% lung involvement on imaging within 24 to 48 hours) has been noted in 14% cases.

Critical disease (eg, with respiratory failure, shock, or multiorgan dysfunction) has been reported in 5%.

 Case fatality will be the same in all countries

The proportion of severe or fatal infections may differ on the basis of location. For instance, in Italy, 12% of all detected cases and 16% of all hospitalized patients were admitted to the intensive care unit and the estimated case fatality rate was 5.8% in mid-March.

 However, the estimated case fatality rate around the same time in South Korea was 0.9%.

This may be attributed to distinct demographics of infection. In Italy, the median age of patients with infection was 64 years, while in Korea, the median age was in the 40s.

 

All will recover or die in 2 weeks

No. According to the WHO, recovery time appears to be around two weeks for mild infections and three to six weeks for severe disease.

 

In all, dyspnea will develop in 3 days

Some patients with mild symptoms in the beginning, may progress over the course of a week. A study of 138 patients hospitalized in Wuhan for pneumonia due to SARS-CoV-2 revealed that dyspnea developed after a median of five days since the onset of symptoms, and hospital admission occurred after a median of seven days of symptoms. [Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020] In another study, the median time to dyspnea was eight days [Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395:497.]

 

CMAAO IMA HCFI corona myth buster 13

Pandemic is going with the normal pace

No. The acceleration is like a T 20 cricket match.

WHO has warned that the pandemic is accelerating, with over 300,000 confirmed cases.

It took 67 days from the first reported case of COVID-19 to reach 100,000 cases, 11 days for the next 100,000, and only four days for the third 100,000.

Lock down alone will take care

No. You also need rigorous testing and contact-tracing strategies.

It isn’t possible win a football or a cricket game only by defending. You have to attack as well.

To win, we need to attack the virus with aggressive and targeted strategies, which encompasses testing every suspected case, isolating and caring for every confirmed case, and tracking and quarantining every close contact.

 COVID-19 does not affect the heart itself

No. Early information indicates that the heart may be affected by COVID-19.  Myocarditis, pericarditis, heart failure, heart attack, and heart rhythm problems have all been reported in the patients.

 However, it is not clearly known whether the heart-related signs or symptoms have a direct link with a primary issue with the heart, or are related to the heart’s reaction to other problems in the body such as low blood pressure or low oxygen levels. Until more information is gathered on the same, the answer is that the heart may be affected in some people with COVID-19, but there is much more that needs to be understood.

 I have high blood pressure, I am at the same risk

No. Those with high blood pressure may have a higher risk from COVID-19.

Like for those with heart disease, it is not yet known if having heart disease and high blood pressure leads to worse outcomes, or if these conditions are just associated with worse outcomes.

I have heart disease, I am at the same risk

No. The American College of Cardiology has stated that those with heart disease may have the highest mortality rate at over 10%. Focus on infection avoidance if you have heart disease.

Chloroquine and hydroxychloroquine are inter-changeable

No. A Chinese study involving the use of both chloroquine and hydroxychloroquine determined that hydroxychloroquine is more potent in inhibiting this novel coronavirus.

 COVID-19 and flu affect the same site in respiratory tract

No. COVID-19 starts in the respiratory tract - the airway between mouth, nose, throat, and lungs. This is where the common cold attacks. But COVID-19 can become more serious than the common cold as it can go deeper into your respiratory tract, including into the lungs. This is because the lower airways have more ACE2 receptors.

Good quarantine will take three months

No, effective quarantine period is 14 days. By this time, the curve can be flattened.

Masks means masks

No. Hospitals and clinics are running out of masks. Healthcare workers are going online to ask for more, with hashtags #GetMePPE and #WeNeedPPE trending on Twitter. Health providers are scared. Some people are even making their own.

Using a simple template, green surgical sheeting is cut into half-moons, which is pinned and sewed before attaching elastic straps.

 Deaconess Health System in Evansville, Indiana, has posted instructions for fabric masks on their website and asked the public to and sew their own masks.

At other places, healthcare workers have turned to diapers, maxi pads and other products to create masks.

Something is better than nothing, but they are not PPE.

Any mask would do for doctors

No. A recent review by Chinese researchers assessed six randomly controlled trials that included more than 9000 participants and found no added benefits of N95 masks over ordinary surgical masks for healthcare providers treating patients with the flu.

But COVID-19 is not influenza, and evidence suggests that it may require more intensive protection [JAMA]

 The virus can linger in the air for hours. N95 respirators are thus healthcare providers best option when treating infected patients.

CMAAO IMA HCFI Corona Myths Buster 12

COVID-19 patients cannot get heart attacks

An Italian patient in Jaipur died after 14 days of heart attack.

JAMA published a report of 21 patients from Washington state. Fifteen of these needed mechanical ventilation. All had acute respiratory distress syndrome, and eight developed severe ARDS by 72 hours. Vasopressors were used for 14 patients; however, most patients had no evidence of shock, and seven patients developed cardiomyopathy. Mortality among this group was 67%, 24% remained critically ill and 9.5% were discharged from the ICU, as of March 17.

The virus can spread in non clusters

Although there have been incidents of rampant spread, as the cruise ship Diamond Princess, the coronavirus more often affects clusters of family members, friends and work colleagues, according to Dr. David L. Heymann, chair of expert panel advising the World Health Organization on emergencies.

The lock down is not scientific

It is scientific. The virus would die out on every contaminated surface and, almost everyone develops symptoms within two weeks, therefore, it would be clear who was infected. If only there were enough tests for every person, even the completely asymptomatic cases could be detected and isolated. The crisis would be over.

Italy did everything they could do

No. Italy moved in an incremental way. Officials were slow and reluctant in closing restaurants, churches and museums, and banning weddings and funerals. 

COVID-19 will spare countries with best healthcare structures

Three weeks into the discovery of its first coronavirus infection, the New York City region reached a startling milestone on Sunday, accounting for about 5% of the world’s confirmed cases. This has made it an epicenter of the pandemic and has urged officials to take more drastic measures.

Isolating in absence of any case in the city is not scientific

People practice isolation and social distancing when there is an imminent threat. However, states without many confirmed infections should still react as if the virus is already widespread, since it probably is.

The results of lock down are visible the next day

No, the cases we see today are a result of transmission that has happened in the past. The result of lock down will be evident in reduction of new cases after 5-7 days and reduction in new deaths after 14 days.

 

Social distancing cannot be measured

To assess how social distancing has changed our behavior, analysts determine how far people travel on a daily basis using smartphone G.P.S. signals, and calculate an average distance for each county and state.

On any given day, people might commute for an hour to work or drive across town to drop their kids off at school. But after residents were encouraged to stay put, after workplaces and most schools were closed, the data revealed that travel quickly declined in many counties.

In Italy very few doctors got infected

No. In Italy, 20% of health care workers have been infected.

Everybody needs protection without priority

Protection should first be given to essential workers: first those in healthcare, and then pharmacists, police officers, firefighters and those who maintain public utilities and the supply of food. It should then be offered to everyone.

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

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