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With input from Dr Monica Vasudev
1077: Minutes of Virtual Meeting of CMAAO NMAs on “One year of CMAAO & COVID-19 Update”
5th August, 2020, Saturday, 9.30 am-10.30 am
Participants, Member NMAs
Dr KK Aggarwal, President, CMAAO; Dr Marthanda Pillai, Member, World Medical Council; Dr Yeh Woei Chong, Singapore Chair, CMAAO; Dr Ravi Naidu, Malaysia, Immediate Past President, CMAAO; Dr N Gnanabaskaran, President, Malaysian Medical Association; Dr Alvin Yee-Shing Chan, Hong Kong; Dr Marie Uzawa Urabe, Japan; Dr Prakash Budhathoky, Nepal
Dr Tashi Tenzin, Bhutan’Dr Md Jamaluddin Chowdhury, Bangladesh
Invitees: Dr Russell D’Souza, UNESCO Chair in Bioethics, Australia; Dr S Sharma, Editor IJCP Group
This meeting was dedicated to the memory of all those who lost their lives in the COVID-19 pandemic.
Key points from the discussion
- Singapore Update:The outbreak in the dormitories is reaching its tail end; 40-50 cases; while cases in the community range from 0 to 1-2 cases. The focus is now on the economic damage and how the economy will open up. Singapore has opened its borders to New Zealand and Brunei.
- Bangladesh Update:Around 2000 cases per day; a concern is that people are not going for testing out of fear. A study in Bangladesh conducted by the Institute of Epidemiology, Disease Control and Research and the International Centre for Diarrhoeal Disease Research, Bangladesh in Dhaka has shown that 9% of population in slum areas and 6% in the non-slum areas have the infection. These are asymptomatic infections. The number of deaths is declining but hovering around 35-40 per day.
- Nepal Update: The infection rate is increasing, as are severity of infection and deaths. Random samples have tested positive. Russia/China/UK are conducting 3rdphase clinical trials in Nepal. Doctors are conducting awareness programs.
- Hong Kong Update: Universal community testing scheme is underway since the past week, although not too many people go for testing; less than one million people have joined testing in the last 5 days. Nasal (not nasopharyngeal) and oropharyngeal swabs are collected. Some silent cases have been detected. From two weeks of high incidence (140 per day) in end of July, cases have slowly decreased to now single digit in August. In some cases, no source could be traced. Schools have restarted; for now it is online learning; but planning to reopen schooling from end of September.
- Bhutan Update:The first case was detected on 5th March in an American tourist aged 76 years. Total 128 cases; 150 have recovered; no deaths have been reported. Some positive cases have been reported in the border town of Phuntsholing (red zone), but no severe cases. The King of Bhutan has actively participated in creating awareness. The quarantine period is 21 days. Cases are discussed with doctors from Singapore and India and other commonwealth countries. All schools have been closed countrywide.
- Malaysia Update: There are 9385 active cases; 9092 are recovering; less than 20 new cases and total deaths are 128. More than 2.5 million foreign/migrant workers are a concern; there is no wide testing, like in Singapore. Malaysia has detected a mutated strain of SARS-CoV-2 virus in a cluster of cases, called the “Sivaganga cluster”. The index case belongs to Sivaganga in Tamil Nadu. Because of clusters, RMCO has been extended to 31st December. The number of children affected is very small. Young people recover quite well. The Ministry of Health and the Malaysia Medical Association are working close together. People from any country which has 1,50,000 cases are not allowed entry into Malaysia.
- Japan Update: About 70,000 have tested positive; 103 deaths; the mortality rate is less than 1%. Treatment of inpatient is being gradually consolidated.Flu will soon begin; preparing to how to deal with both.
- India Update: The numbers are rising; India now has the 3rdhighest number of cases (at the time of virtual meeting). But, the mortality rate is less than 1.2%. Recovery rate is more than 70%. About 60% of infections are from southern states. Government has been proactive in controlling the disease as and when issues come up. Testing rate is going up. The pandemic in India should plateau within 2 weeks to a month.
- Australia Update: Victoria had a second wave due to failure of quarantine measures, but now the number has come down to around 70. Rest of the country has had no cases. The lockdown is going to continue for another week. Tomorrow (6th), the PM is going to give a pathway on how to relax the restrictions. Travel (airports, ships) has been stopped until December. Melbourne, Victoria is completely closed down. Deaths are mostly in the aged care homes; deaths in Victoria are around 600.
- Dr KK Aggarwal introduced his initiatives – Health Patrol, International Journal of Pandemic Research and COVID Educator Course. The objective of Health Patrol is to filter out fake news; you can visit the website and ask to check its authenticity. He asked Singapore to join as Knowledge Partner and all NMAs as advisors. The International Journal of Pandemic Research will publish articles related to COVID-19 and any other pandemic, as they are, without any change. Anybody from anywhere can publish data. These would subsequently be peer reviewed. All participating member NMAs were invited to be peer reviewers. Similar COVID Educator Courses can be started in member countries to create COVID Educators in the community.
- There are still some unanswered questions: Why does it cause post-COVID illness after 9 days and causing recurrent inflammations; why children are not spreading infection; which vaccine will work.
- The number of deaths so far in healthcare professionals throughout the world is 8% and the number of infections in them is 10-15% (WMA).
- The vaccine may not be widespread till mid 2021.
Dr KK Aggarwal
President CMAAO, HCFI and Past National President IMA