CMAAO Coronavirus Facts and Myth Buster: Back to Basics in Management of COVID-19 |
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CMAAO Coronavirus Facts and Myth Buster: Back to Basics in Management of COVID-19
Dr KK Aggarwal,  21 October 2020
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With input from Dr Monica Vasudev

1115: Round Table Expert Zoom Meeting on “Back to basics in Management of COVID-19”

17th October, 2020, 11am-12pm

Participants: Dr KK Aggarwal, Dr AK Agarwal, Prof Mahesh Verma, Dr Suneela Garg, Dr Jayakrishnan Alapet, Dr KK Kalra, Dr Anita Chakravarti, Dr Anil Kumar, Ms Ira Gupta, Dr S Sharma

Key points from the discussion

  • The WHO Solidarity trial has shown that remdesivir, interferon, hydroxychloroquine and ritonavir + lopinavir are not effective.
  • Eli Lilly has halted its trial of its coronavirus antibody drug; J& J paused the trial of its vaccine; although Astra Zeneca has resumed the trial of its vaccine in the UK, India, South Africa, Brazil, the US FDA has not given the go-ahead for the trial to restart.
  • The WHO will now concentrate on monoclonal antibodies and immunomodulators, which means that treatment will be expensive. So, it’s back to basics, which is prevention. Masking (correct, consistent use of proper 3-layered mask) is the only answer.
  • The outer layer of the mask should have a splash resistance of more than 120mmHg.
  • The breathability should be less than 49 Pascals per sq cm.
  • The middle layer should be made of melt blown propylene (not spun) and should have filtration efficiency of 80%. There should be no visible holes in this layer.
  • The inner layer should be water absorbent.
  • The ear loops should be made of good quality elastic and not cause pain when wearing a mask.
  • Around 50% of masks do not have nasal clip.
  • Since masking is very important, it must be regulated. Medical masks are regulated, but fabric masks are not regulated. They should also be under some regulation for quality.
  • Government should ensure that quality masks are procured and made available to everybody at minimum cost.
  • Certification of masks is very important. The government has entrusted some agencies. In South India, it is done by SITRA (South India Textile Research Association), DRDO in North, Ahmedabad Textile Industry’s Research Association (ATIRA) in the West and West Bengal Textile Research Organizationin the East. The coordinating agency is Hindustan Lifecare. There are around 250 labs all over India to test and certify but implementation is poor. Only certified masks should be worn by healthcare workers.
  • Bureau of Indian Standards (BIS) has also issued standards for masks.
  • Final disposal of masks is also very important.
  • Bactericidal or virucidal claims of masks should be evidence-based.
  • The important days are Day 3 and Day 5. If rapid doubling of CRP can be detected within this time (pre-hospitalization), and appropriate anti-inflammatory (steroids) and oral anticoagulants are started, then mortality can be reduced.
  • CRP is the marker for cytokine wave.
  • While deaths of COVID patients are the focus of study, it was suggested that we also have to look into the survival of COVID patients.

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

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