[Merril]

Originally Posted by Thad E Ginathom

But still I have another doubt: doesn't such evolution take a long time?

Evolution does not necessarily require time. What it does require are iterations through generations and iterations through numbers within each generation. Each individual within a generation would have a change that may or may not aid natural selection of that change into the next generation of that individual. This allows for propagation of that change. Hence your ‘idea’ that less virulent and more infectious viruses are more likely is correct. These allow humans to live longer to transmit more of the viruses and hence is a positive change.

To this context, viruses can evolve really quickly because of their sheer numbers and the smaller lifespan per generation.

[AZT]

Originally Posted by Durango Dude

That said I'm not too confident that the vaccine is actually working. People who have received the vaccine have got Covid.

I would disagree here, I think vaccines failing is more of a QC issue at the factory than a problem with the vaccine itself. It could be a bad batch or just a higher than global error rate. These batch sizes themselves are in the millions.

Another reason could be the newer variants, the more people the virus infects the more chances it has of mutating. Tanzania is a good case study here where they refused to take covid seriously leading to some very weird variants. South Africa also has a mutation which AZ vaccine doesnt work on. For us with all the massive gatherings this month, next 2 months will be when we see where things head.

A brilliant article by Bloomberg - The World Needs the Not-for-Profit AstraZeneca Vaccine, Minus the AstraZeneca Drama

[Thad E Ginathom]

Originally Posted by Merril

Hence your ‘idea’ that less virulent and more infectious viruses are more likely is correct. These allow humans to live longer to transmit more of the viruses and hence is a positive change.

Thanks for clearing up some of my misunderstanding

On the It's-airborne thing: I think even one of our docs said in a previous post, aren't all respiratory infections airborne?.

On the masks: I see a lot of masks around that look more decorative than useful. Even when they are worn over the nose and mouth, the bits that count, they hang loosely. I doubt that they offer much protection to the wearer or to others, which is a shame as the wearer has taken the trouble to wear them

So I have a boxfull of N95s. I can't vouch for the spec: I don't think that they have any standards-institution mark on them. They fit better and are more comfortable, to me, than other kinds. I doubt that they fully seal, although that probably depends on the wearer as much as the mask.

[haria]

Came across this article, which has some useful links.. Might be useful for some who is in urgent need for these.

Check this out.

Empty hospital bed or Remdesivir injections, these websites are helping covid patients find them

https://www.indiatoday.in/technology...653-2021-04-16


Some of the useful info found in this article :

Following websites are assisting the people in need with the given helpline numbers:
Dr. Reddys -- Readytoffightcovid.in --- 1800-266-708-- Dr Reddys has launched a website to track the availability of Remdesivir injection in real-time.
https://docs.google.com/spreadsheets...t9fLU/htmlview

https://mumgis.mcgm.gov.in/Resources...edTracker.html


Cipla -- www.cipla.com ---- info.availability@cipla.com -- 8657311088 --


Cipla is currently giving Remedesivir injections directly to the hospital where a patient has been admitted in order to avoid the black marketing of the medicines.


https://blog.indianhelpline.com/2021...-fights-covid/ blog of consolidated information on empty hospital beds, oxygen cylinders, information on plasma etc


https://delhifightscorona.in/ -- Delhi government's website to keep track of beds.


https://coronabeds.jantasamvad.org/beds.html


Hetero -- www.heterohealthcare.com -- 04040473535


https://covidhelplinebangalore.com/ -- website specifically for Bangalore with information about resources for covid.

https://localsay.in/beds -- website specifically for Ranchi with information about resources for covid.

appointment@nanvatihospital.org -- For patients with mild systems, some hospitals are giving nursing facilities and online appointments with doctors. This website is specific to Mumbai.

You can find consolidated resources for plasma on covidplasma.online/ The following websites have information on how and where plasma can be donated to users. Some platforms also connect doctors to plasma donors and those in need of plasma.


https://dhoondh.com
http://plasmadonor.in/
http://needplasma.in/
https://plasmaline.in/

Instagram, Telegram and Twitter pages working towards consolidating information on resources:
@pandemicreliefistindia (Instagram)
https://t.me/fightagainstcovid19 (Telegram channel)
https://twitter.com/switchindiaorg (Twitter handle)

Note: I have not personally verified these links. Though some of my friends have told that it is quite useful.

[guru_max]

Originally Posted by Thad E Ginathom

Thanks for clearing up some of my misunderstanding

On the It's-airborne thing: I think even one of our docs said in a previous post, aren't all respiratory infections airborne?.

On the masks: I see a lot of masks around that look more decorative than useful. Even when they are worn over the nose and mouth, the bits that count, they hang loosely. I doubt that they offer much protection to the wearer or to others, which is a shame as the wearer has taken the trouble to wear them

So I have a boxfull of N95s. I can't vouch for the spec: I don't think that they have any standards-institution mark on them. They fit better and are more comfortable, to me, than other kinds. I doubt that they fully seal, although that probably depends on the wearer as much as the mask.

If the host human lives the virus variant also has more chances of surviving. If two variants with same infecting potential but differing potential of harming a human, the less harmful version will always propagate than the more harmful version. The person who got the severe version may die. The person who got the less harmful version maybe out and about and will infect more people. This is the crux of it. Sars was one of the few cases of an airborne virus being extremely deadly. It kind of slowed due to its deadly nature. Other dangerous viruses such as ebola, nipah etc are not transmitted airborne.

The airborne nature of this virus was more or less a scientific consensus long back but I guess a research paper has confirmed it only recently. This does not mean it cannot transmit via fomites. Back when cases were only in China all precautions were taken to stop the spread of this virus. So this included guidelines for even for unlikely transmission through touching. Situation now is obviously different.

The way we wear masks and the kind of masks absolutely matter. It should be worn tightly with little or no visible gap between the skin and mask, which is also not followed by many.

[AZT]

A friends uncle in Baroda is critical and unable to find Tocilzumab injection. Does anyone have any source that can help.

[AltoLXI]

Dr. Pramesh C S, Director at Tata Memorial has tips to be safe:

On wearing mask :

How can you optimally use an N95? Get 5 masks, and rotate their use – this is safe, burns less of a hole in your pocket, and is environment-friendly. The next best option is to use two masks – wear a surgical mask first, and a cloth mask over it for a snugger fit.

On when to get medical help:

When should you be concerned and seek medical help? If your baseline saturation falls under 94% or if your fall in saturation before and after the 6-minute walk is 4% or more. Contact a hospital, and start proning yourself (lie chest down, back up)

On medicines:

What medicines help for #COVID_19? Unfortunately, very few. What definitely works is proning and oxygen (when saturation is low), and steroids (Dexamethasone) for moderate to severe disease.

But what about Remdesivir, Tocilizumab and ConvalescentPlasma?

Remdesivir doesn’t help much, and certainly not in all patients; there is probably a small subgroup in which it helps – those requiring oxygen, but not sick enough that they require ventilation. And even here, it doesn’t reduce mortality, probably helps earlier recovery

Tocilizumab also helps only in very specific subgroups – those sicker than described above, requiring rapidly increasing levels of oxygen or rapidly deteriorating respiratory parameters

My plea here is to please allow your physician to decide when Remdesivir/ Tocilizumab is required – there are very limited situations when they are beneficial & please don’t pressurize them to prescribe it – much of the shortage today is because of unnecessary prescriptions

Read more at:

https://threadreaderapp.com/thread/1...659535873.html

https://twitter.com/cspramesh/status...48068659535873

[fhdowntheline]

I would like to make one disclaimer here: Please do not take this as a cue for Self Medication : But

one of my uncle & aunt have been taking Ivermectin once a week as a prophylactic for the past couple of months. This was based on medical advice from their physician. They have also vaccinated themselves, of course.

My uncle is no medical expert, but a pharma veteran retired from the same company that produces the drug.

But just a point to ponder for the Docs on this forum like @Zen2001.

[Ankur@VNS]

All India Institute of Medical Sciences' (AIIMS) director Dr Randeep Guleria, speaking at the NDTV Solutions Summit on Sunday, said second waves of pandemics have always been more dangerous historically.

Referring to the use of Remdisivir, a drug that is increasingly being seen to have key role in treating critical cases of Covid-19, Dr Guleria said :

"Remdesivir is an antiviral drug and was developed for Ebola. The first paper in China showed it had no effect on Covid-19. Subsequently studies showed, it could reduce hospitalisation, but could nothing about mortality,".

Apart from speaking on many misconception on Covid-19 medications, the veteran doctor was also candid enough to accept :-

"As of now, we don't have a good antiviral drug. We don't have any good treatment for Covid."

https://youtu.be/eqaQ4bhjTs4

[vivek95]

Doctor @Zen2001, what do you think about this NONS ( Nitric Oxide Nasal Spray ) making big claims from UK. I did always read during my MBBS regarding the multiple properties of Nitric Oxide. Presently, the trials are conducted on a small number of people, but they claim it to be a breakthrough. Doctors and nurses should be included in large numbers in their phase 3 trial if its conducted in India, as we are continuously exposed to the virus.

[Akshay6988]

Attaching contact numbers for enquiring about remdesivir medicine:
Please note this control room is for Pune District.

[Zen2001]

Originally Posted by vivek95

Doctor @Zen2001, what do you think about this NONS ( Nitric Oxide Nasal Spray ) making big claims from UK. I did always read during my MBBS regarding the multiple properties of Nitric Oxide. Presently, the trials are conducted on a small number of people, but they claim it to be a breakthrough. Doctors and nurses should be included in large numbers in their phase 3 trial if its conducted in India, as we are continuously exposed to the virus.

Heard about this trial and checked the same with a colleague consultant in the UK. Apparently they're not very excited. Nitric oxide (NO) is a naturally produced high reactive free radical in human tissues - it naturally acts by scavenging all bacteria, viruses etc. Even without a spray, we still have NO in our bodies.
A UK study on 79 and Canadian one on 100 odd cases - sample size is too small, and reporting appears more biased towards the microbiological/virological parameters in the nose. While all complications are due to lower respiratory migration.
At this (nasal) stage, most may not even know they are INFECTED - by the time respiratory symptoms set in, the virus would have already cleared from the upper respiratory tract and moved lower.
If this really works, the next challenge is to identify cases very early for this to work. Secondly, NO is a very very very potent vasodilator - what about that? Even prophylactically, how long can one keep inhaling it on a regular basis. These trials have only studied the effects for 2 days. I personally would not rush into believing any such new claims on covid (which crop up almost everyday), even if the sources claim trial evidence - we all know the quality of trials, now that everyone wants to push for EUA of their products. On the other hand, what might succeed (by inducing local immunity at the port of entry, similar to the OPV) is the intra nasal COVI-VAC (single dose, as of now, live attenuated), which SII is working on.
Tried googling NONS - see the results!

[Zen2001]

Some immunity boosters could harm liver': ILBS director cautions.

https://www.hindustantimes.com/india...838931857.html

Wish we had common sense boosters! We need those more than dubious immunity boosters.

[Indian2003]

In October I was in close contact with a couple in Romania and 3 more persons who were in quarantine because they had been in contact with a person who was infected.
On my drive home I got a call to test myself as the couple had tested positive.

I took the test and tested negative. After the heart attack in December, they tested me when the ambulance came to fetch me, once more before I was moved into the helicopter. The third test was done before being wheeled into surgery and yet a fourth before being admitted to the monitoring ward.

The next day I was moved to a hospital closer to home and went through the same again. Test before the ambulance and again before I was admitted to the hospital. They were just paranoid.

3 weeks later I had to go for another stent and had to show yet another valid negative test. I total I was tested 8! times.

[Miyata]

https://www.nytimes.com/2021/04/14/w...rking-out.html

regular exercise — whether it’s going for a swim, walk, run or bike ride — can substantially lower our chances of becoming seriously ill if we do become infected.

aerobically fit people are less likely to catch colds and other viral infections and recover more quickly than people who are out of shape, in part because exercise can amplify immune responses. Better fitness also heightens antibody responses to vaccines against influenza and other illnesses.

this study, because it was observational, does not prove that exercise causes severe Covid risks to drop, but only that people who often exercise also are people with low risks of falling gravely ill. The study also did not delve into whether exercise reduces the risk of becoming infected with coronavirus in the first place.