COVID19 dairies
by Dr.Shafi M.D
Consultant TULIPS Clinic,Hyderabad.
Published on : 21st April 2020
I picked my friend’s call today ,he asked me Dr.Shafi ,I observed that ,out of 100 patients of COVID, 72 recovered have the habit of drinking Elachi tea,hence iam conducting a study on “Drinking Elaichi Tea will cause mild symptoms in corona””.he asked me how to go forth for testing in these patients,which made me put up a few points on Corona Testing.
As we are no where near to safely say that we have achieved Herd immunity and need to move on from accepting fact that “”when corona Is testing the world and practically think how do we test corona?
Q) why are we testing at rapid phase for corona??
To minimize available Health and other Resources and prioritize health resources as to
1. whom to isolate/Quarantine
2. whom to aggressively treat
3. whom to let in community for developing Herd immunity.
Q) How to categorize??
Three set of people
1. who has the Disease and active infection
2. who has asymptomatic infection,recovered
3. who has immunity recent or past for Corona .
Q) What all types available now ?
1. molecular testing
2. serological testing
3. neutralizing antibody testing
Q) Any other type of categorizing tests?
Yes where it is done
Laboratory tests(tedious and time taking but accurate) and point of care tests(easy,Rapid and less accurate)
Q) insights of molecular testing?
These detect viral antigen(RNA or DNA copies after Replication) or protein particle of virus.
Ex:quantitative RT PCR (lab based),Rapid RT-PCR tests(point of care based)
Q) where do we stand now?
Tissue swabs ,secretions nasal or throat are taken multiple locations for at least 15 seconds and analyze for DNA copies of genome by PCR.
FDA approved in emergency 22 companies and 55 more in pipeline for point of care Rapid RT PCR tests
Ex:for swab -ABBOT result in 5 mts,Mesabiotech results in 30 mts,Cepheid results in 45 mts,saliva in Rutger 24 ro 48 hrs.
Q) what does these Rapid tests tell you ?
Positive means active infection
Negative does not mean free of infection ,either low viral load or not adequate.
These tests have been introduced on emergency certificate need validation and lots of trails,due to shortage of time and high infectivity had to take a call.
Flip side :Worried about false positive (test positive but no infection),false negative(has infection with negative test result), a serious cause for concern and fear.
Q) what about serological tests?
Detect immune response antibody,IgM (Recent )or Ig G(late).
Technique:Elisa, Time 10 to 15 minutes.
What it tells me ?Recent infection,latent infection, how immune to virus(quantitative)recovery from virus(serial testing).
Q) How long immunity for COVID lasts?
No authenticated trails yet
Q) Are they useful in reinfection?
No authorized data yet
Q) Cross reactivity to other family of corona virus?
No data or trails authorized.
Q) Do you recommend serological testing at this juncture?
No…! Not reviewed and complete FDA approval,negative does not rule out SARS, what if no detectable antibodies are detected?never be used as alternative to molecular testing.
Q) Too much confusion?
I advise prioritize who need
1. symptomatic
2. people over 55 years
3. highly suspicious points
4. High risk and co morbid patients
5. Hospitalized patients
6. Healthcare providers
7. First contact Res-ponders -police,sanitation
Get qualitative RT PCR molecular testing only lab based. Second Set
1. Late detectors of contact
2. General population
3. Clusters of infection
4. Rapid epidemiological assessment
Rapid RT pCR tests preferably. After approval serological tests
Q) Controversy of Rapid RT PCR kits?
Emergency clearance by FDA given ,accuracy in vivo not tested on large populations,spain returned tests,Britan refused,China made kits many shipments returned for lack of accuracy varies as low as 10 percent.
Pre final words: Rapid RT PCR kits are no way superior to molecular testing.When Time and rapid infectivity of COVID is testing the world,if stuck in middle of nowhere allways to go in some direction than to stand still.These depend on quantifiable active/carrier/latent /Recovered disease, immune response, Time of infection,viral load and ease of logistics available. Even with very low accuracy ,sensitivity and specificity they do have Pros and cons.Dead clock also shows time twice accurately.
Final word: Till we move on to next phase of pandemic
1. Cases decrease for 14 days straight
2. Hospitals ready to safely treat all
3. Enough testing capacity.
4. Actively monitor all contacts and confirmed cases
Rapid RT PCR tests are stop gate methods ,effectiveness only time will tell by extensive Trails and pooled Data ,
Till either measurable Herd immunity develops or we eradicate by vaccine or anti viral medications we have to collectively take a call on RT PCR kits for mass testing as we are looking for 85 to 94% mild cases meanwhile we need to develop more accurate kits as suggested by approval authorities.
I am off for a cup of Elaichi chai/Tea meanwhile.
Dr.Shafi. M.D
Consultant Omega BIBI services,Tulips clinic,Hyderabad.
COVID19 dairies
by Dr.Shafi M.D
Consultant infectious Diseases
Published on : 06th June 2020
Hurry!!! Now What??? Religious places opening from June 8.
Because the businessmen of religion know very well that No God will not save us from the novel corona-virus. If anyone can, it’a cure from scientists and “”THE SHOW MUST GO ON””
The ones who should be truly surprised by such a turn of events when Corona struck and mankind was in peril ,people who live on Gods name were the first to abandon and flee. The ones who flock together like sheep and follow the herd without asking where or why. Neither do they ever seek proof of god’s existence, nor do they have any faith in rational and free thought. Are they not curious today as to why their religious institutions, the ones that are supposed to help them find refuge against disease, have shut their doors? Is serving the common people not the main purpose of any religion.
From Vatican to temples, mecca to madina,contagion have not seen the religion ,caste or creed to infect
Funny is the faith when it wanted to fall back and show civic sence,i often find basic common sense lacking.
Apparently, the Pope can communicate with god. But why is he not doing that now?cant he find magic drug.We have seen many pastors curing on stage by just giving healing touch,why cant they now???
Few priests have put masks on the idols of gods and goddesses too.Even declared gaumutra will prevent COVID-19. Some have chosen to cover, even bathe, themselves in cow dung because apparently cow dung acts as a shield against corona.
Few maulanas and mullas have openly declared washing hands in wazu khana will make covid vanish,Asked people to Roam free without masks as almighty has the power to give and take.
The popes,priests, Maulanas Mullahs ,clerics and sundry religious heads of the world.
What is the use of such people and all these religions done than causing harm? Other than perpetuating abuse of women, riots, partitions, bloodshed and pervasive hate?
My opinion : when i assumed that these people will stand out to help the poor with food,debilitating souls with hope,migrants with transport,Ailing with medicines and more so front-line staff a hope and protection ,All have failed .
Religious structures should be repurposed for the betterment of people into hospitals, museums,community halls where logic should prevail over blind faith and beliefs.
Humanity for god’s sake is the key to succeed in this world,there is no place for hatred for the short lived life.
And now with the corona-virus pandemic spreading like fire People who would otherwise run to their nearby temples, mosques, churches and other places of worship to seek protection from illnesses and diseases have nowhere to go — except hospitals and isolation centers.
So, the facts Religious people are no longer waiting for benevolence from their respective gods; they are waiting for a vaccine.
What i urge all so called religious tprch bearers who stand for worlds 84% believers in some religion ,We can all bring about change by putting humanity first,caring irrespective of religion and stop hatred and bring change.Help Those in hunger,help those migrants,help those destitute,help those widows,help those who lost their livelihood during these times and not rooting for hatred,bigotry and irrational-ism.
Dr. Shafi. M.D
Disclaimer: author’ s own opinion and not to hurt religious sentiments.
