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Minutes of an International Weekly Meeting on COVID-19 held by the HCFI Dr KK Aggarwal Research Fund

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Dr Veena Aggarwal, Consultant Womens’ Health, CMD and Editor-in-Chief, IJCP Group & Medtalks Trustee, Dr KK’s Heart Care Foundation of India    20 November 2021

Topic: COVID-19 Update by National Medical Associations

13th November, 2021, Saturday; 9.30am-11am

  • Singapore Update: The delta variant is still prevalent. There are 1616 cases in hospital; 218 need oxygen, 31 are in ICU, though not intubated and 75 are intubated (ICU capacity in the public sector is 400; 132 are vacant). Overall ICU utilization rate is 67%. This is a cause for worry. Over the last one month, 90k patients have been infected. 98.7% are asymptomatic and are managed at home. Of the local cases, 0.8% need oxygen, 0.2% are unstable in ICU but not intubated. There have been 0.2% deaths. Elderly patients with comorbidities are treated with remdesivir, IV steroids, and high flow oxygen (60 L per minute). Vaccination rate is very high 86% (target is 92%), but there are still lot of elderly who are not vaccinated. The booster rate is 19% of the population. The government will not now pay for the treatment of patients, who have not taken the vaccine by choice and have developed Covid-19. Vaccine recognition is for up to one year from the day of vaccination. It does not include booster dose at present. Three doses of the Sinovac/Sinopharm vaccines are needed to be considered fully vaccinated. Pfizer (primary) + Moderna (booster), Pfizer (primary) + Pfizer (booster) or Moderna (primary) + Moderna. Vaccination for children, aged 5-11 years, not yet rolled out.
  • Brazil Update: 58% of the population has been fully vaccinated. A large number of people have received the third dose. New cases and deaths are declining. In the last 24 hours, there were 15,000 new cases and 6000 deaths. Vaccination of children 5-11 years not yet started. Because of inadequate doses, vaccination is done in priority groups. By the end of the year, all seniors will have received the third dose.
  • India Update: The number of new infections is coming down every day and range between 10k to 11k. About 40% of the population has received both doses and 60% have taken the first dose. The indigenous vaccine Covaxin has been recognized by the WHO and 103 countries have accepted the vaccine. Economy is opening up; flights (domestic and international) have opened up (two vaccine doses and negative RT PCR are required). There is now one week of self-quarantine for foreign travelers. Schools have reopened with teachers and other staff fully vaccinated. Delta is the predominant variant. The AY.4.2 variant has been detected in very few samples out of 80k samples tested. Almost 80% of population is antibody positive partly due to vaccine and partly due to infection. Treatment protocol has changed with steroid dependence coming down; high risk patients are given one dose of cocktail of monoclonal antibodies and are under home care. India is prepared for the third wave. Micro containment zones are still prevalent in areas of high infection. India has not yet started booster shots and vaccination for children.
  • Bangladesh Update: The number of new cases has been very low for the last one month - less than 200 per day. Only one death recorded on Thursday. Adherence to SOPs is not adequate. Economy is open, including international flights. No quarantine needed if the traveler is fully vaccinated. 19% is fully vaccinated. Children 12-17 years of age are being vaccinated now with Pfizer vaccine. Molnupiravir has been approved by the regulatory authority for marketing.
  • Malaysia Update: The country has opened up; wearing a face mask and social distancing have been made mandatory by law. The fine is 1500 ringgits for failure to comply with this law. Cases have now come down and have been around 6k in the last two days. 90% of the population has got both doses. About 14% of 12-17 years have been vaccinated. The Pfizer vaccine is being administered as the booster dose. The vaccine doses including the booster shot are given free by the government. There is some vaccine hesitancy about the booster shot. The government policy is that stage 1 and 2 Covid-19 cases are home quarantined and then RT PCR is done to see if still stage 1 and 2. If yes, then home quarantine continues for 10 days. But if in category 3 or 4, then the patient is transferred to the hospital.
  • South Africa Update: No province has shown a spike in infection after the elections. The fourth wave is anticipated in January and preparing for it - oxygen, bed capacity, ventilators, equipment etc. The vaccination rate among young adults is low driven by fake news. Second week of every month is the Vooma Vaccination Weekend, where citizens are encouraged to come forward to take the vaccine. The second dose of the J&J vaccine was rolled out this week and will continue till 15th Around 500,000 healthcare workers are eligible to take the second J&J dose under Sisonke2. In the last 24 hours, there were 393 new cases and 17 deaths. The recovery rate is 96.4%. So far, 19 million have been tested; out of these, 2.9 million were positive. Total deaths are 89, 469. The number of active cases has come down to 16k. Total vaccination 24 million, vaccination for children (12-18 years) has started. Vaccine hesitancy still prevails. There is no choice for booster dose; it is J&J.
  • Pakistan Update: The country has opened up now (schools, markets, transport). Aside from Covid, the rising dengue cases are a cause for concern. Many covid wards have been converted to dengue wards. 25% (47 million) of population is fully vaccinated and 77 million have got the first dose. Pfizer is being provided as booster vaccine. Vaccination for children 12–18-year age has started and the vaccine used is Pfizer. But there is reluctance for children vaccination. The number of deaths in the last 24 hours was 9 and the positivity rate is around 1.1.%.
  • Australia Update: Victoria continues to have around 1000 new daily cases, but most of these cases are in unvaccinated persons. Overall, around 70% of the country has received both doses. Victoria has vaccinated 86% of the population. Sydney has vaccinated 92% people. New South Wales has opened up. Vaccine coverage of 12–16-year age group is over 80%. Booster dose has started. Anybody who has taken the second six month ago is eligible for the booster shot. There are almost no cases in the other parts of the country.

Participants

Member National Medical Associations

Dr Yeh Woei Chong, Singapore, Chair CMAAO

Dr Ravi Naidu, Malaysia, Immediate Past President CMAAO

Dr Marthanda Pillai, India Member World Medical Council, Advisor CMAAO

Dr Wasiq Qazi, Pakistan, President-elect CMAAO

Dr Md Jamaluddin Chowdhury, Bangladesh

Dr Angelique Coetzee, South Africa

Dr Akhtar Hussain, South Africa

Dr Debora Cavalcanti, Brazil

Invitees

Dr Russell D’Souza, Australia UNESCO Chair in Bioethics

Dr S Sharma, Editor IJCP Group

Moderator

Mr Saurabh Aggarwal

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