To,Sh Narendra Modi, Hon’ble Prime Minister of IndiaThis is why, because now we know That lock down has given us enough prevention guidelinesThat lock down has made India prepared for the eventualityThat by continuing lockdown we will only postpone doubling rate by a few daysThat lock down must continue in red spots in the countryThat many patients have insignificant symptoms and both asymptomatic and pre-symptomatic transmission of coronavirus can occur.That while world mortalit...
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That lock down has given us enough prevention guidelines
That lock down has made India prepared for the eventuality
That by continuing lockdown we will only postpone doubling rate by a few days
That lock down must continue in red spots in the country
That many patients have insignificant symptoms and both asymptomatic and pre-symptomatic transmission of coronavirus can occur.
That while world mortality is 6.90%, that of Asia is 5.7% (11 countries average 0.44; 10 countries average 1.6; 11 countries average 3.9; 3 countries average 9.6 and 3 countries average 41.3); Europe is 131 deaths per million population; North America is 42.88 deaths per million population; USA is 167 deaths per million population.
That mortality in India is 0.7 deaths per million population and combined for India, Pakistan, Nepal, Sri Lanka, Bangladesh is 0.58 per million population.
That Asian countries are behaving differently in terms of mortality and citizens living in India, Pakistan, Nepal, Sri Lanka and Bangladesh have the lowest mortality.
That SARS 2 virus behaves differently than SARS 1 virus. While SARS 1 was more transmissive in later part of illness, SARS 2 spreads early.
That SARS 1 was infective when the infection was in lower respiratory tract, SARS 2 spreads when the infection is in upper respiratory tract
That most serious patients do not require ventilators as they have problem in the capillaries and not the lung alveoli
That the disease can involve practically every organ of the body
That mild cases can be treated with home to hospital strategy
That hospitals can spread more than 40% of new cases if PPE are in short supply
That RT-PCR test may be negative in 33% of cases and rapid tests are not for the acute diagnosis
That we need to follow the strategy that every stranger we meet is coronavirus positive and any unknown surface we touch is coronavirus positive
The importance of social distancing and masking
The importance of hand hygiene, respiratory hygiene and cough etiquettes
The importance of selective elderly lockdown and lockdown of patients with comorbidities
That we have to live with COVID-19 as the virus is going to stay
Now we know that for the next two years we have to avoid gatherings
Now we know that we must start living with simplicity
Now we know that medical consultation is possible with telemedicine
Now we know violation of Epidemic Diseases Act means jail
Now we know that by downloading Arogya Setu app, I can know my risk
Now we know that even a slight mistake can make my green zone into red or orange zone and get sealed
Now I know that disciplined self-lockdown can reduce pollution and deaths due to typhoid, diarrhea, jaundice, food poisoning and pneumonia
Now I know that I need to decontaminate my frequently touched surfaces using 0.1% bleach at least three times a day
Now I know that I need to take care of my elderly
Now I know that I can work from home
That mortality can be reduced but not to become zero
That sudden death occurs in 1% of the symptomatic cases
That for every symptomatic case, there may be 50 asymptomatic cases
Now we know that 3% of new cases detected will require ventilators after 9 days
That 15% of new cases will require oxygen after seven days
That 80% of the people can be managed at home
That we must restrict the meeting time with strangers to less than 5 minutes
That doctors to patient face to side (not face to face time) will be less than 5 minutes
That single surgeon patient surgical time will be less than 30 minutes
That doctors will work in hospital for seven days and then off for seven days
That I must start walking or cycling for shorter distances
That I must walk stairs and avoid lifts when possible
That I must have fully ventilated areas to stay, work or sleep
That I must build my immunity; practice Pranayama when alone and start sleeping in prone position
That I must now start wearing masks, shoe covers, and head covers
That I must now think of getting impermeable cloths
That I may have to prefer spaced fully-ventilated hospital wards over closed AC single rooms
That if I am TB positive, I may be isolated till turned negative
That lockdown will be implemented if we all spread the pollution in winter
That it’s time to quit smoking as it can spread the virus.
Dr KK Aggarwal
President CMAAO, HCFI and Past National President IMA
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