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CMAAO Coronavirus Facts and Myth Buster: COVID Asian Update Part 2

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Dr KK Aggarwal    20 August 2020

1053:  Update on COVID-19

Minutes of Virtual Meeting of CMAAO NMAs on “Asian countries update – part 2”

15th August, 2020, Saturday, 9.30am-10.30am

Participants: Member NMAs

Dr KK Aggarwal, President CMAAO; Dr Yeh Woei Chong, Singapore Chair CMAAO; Dr Alvin Yee-Shing Chan, Hong Kong; Dr Marie Uzawa Urabe, Japan; Dr Sajjad Qaisar, Pakistan; Dr Prakash Budhathoky, Nepal

Invitees: Dr Russell D’Souza, UNESCO Chair in Bioethics, Australia; Dr S Sharma, Editor IJCP Group

Key points from the discussion

  • The COVID-19 virus has six antigens: E, S, N, ORF 1a, ORF 1b and RDRP antigen. E antigen is common to coronaviruses; if negative, no corona. The rest five are specific to COVID-19.
  • RT PCR - antigen has been reported for up to 40 days. But, there is no data available as to how long any of these antigens last in the body.
  • The RT PCR tests the antigen; it does not detect the virus. If only one antigen is tested, the sensitivity is low. Testing for two or more antigens incurs higher cost.
  • In cold, frozen foods, the virus can survive for much longer.
  • The virus becomes non-replicable inside the body after 9 days.
  • We need to have studies to find out how long these antigens remain inside the body.
  • The virus is present in skin. The Lancethas published a case report where RT PCR was negative, but the skin biopsy samples from rash, were positive for the virus.
  • COVID-19 causes immune hyperreaction in the body. It is a multisystem disorder, especially in children and now, also in adults. Skin could also be involved.
  • It is the duty of the treating doctor to decide after Day 14, whether his patient is infectious or not.
  • The certificate stating simply positive/negative status has no value. The doctor should mention if the patient is infectious or not.
  • For instance, a doctor should be able to give a certificate that the patient is non-infectious under following conditions: the patient demonstrates the presence of IgG antibodies with or without presence of antigens, the patient is asymptomatic after 10 days without doing antigen test, the patient is positive for 2 weeks, his ESR and CRP are normal.
  • We should know which antigens are being tested. A person detected negative in one country may test positive in another country. This depends on the antigen/s being tested.
  • It was suggested that a survey could be conducted in the member countries to find out which country is testing which antigen.
  • In Singapore, chip machines check for N, ORF and S antigens at the airports.
  • In Japan, the quarantine period has been reduced from 14 days to 10 days. It is a recommendation and not a law.
  • Regarding the strike in South Korea, it is risky to issue a statement without knowing all facts, as had been discussed in the last meeting.
  • Melbourne has reached the peak; the cases are now coming down over the last 3-4 days.
  • Masking and social distancing will only prevent the infection. So, prevent as long as you can and as much as you can.

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

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