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‘Herd immunity doesn’t seem to work for Covid-19, need to be careful’

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Boost immunity

New Delhi, July 28 : After Delhi seemed to be overwhelmed by the Covid-19 catastrophe, a respite may be in sight with the number of cases beginning to decline consistently, and it appears that the curve may plateau soon. Could this become a ground for reopening schools and colleges in New Delhi so that students can achieve herd immunity against the coronavirus? Would it really work?

A specialist of infectious diseases Issac Bogoch, at University of Toronto, Canada, thinks otherwise. Bogoch insists that Covid-19 is an extremely contagious infection, and it can be devastating for people over 60 years of age.

What is exactly herd immunity? It is a kind of indirect protection from infectious diseases. ‘Herd immunity’ ensures that a large percentage of the population becomes immune to infections like Covid-19, and it can be achieved either through exposure to the infection or via vaccination.

India on Tuesday registered 47,703 fresh Covid-19 cases taking its tally to over 14.83 lakh cases while with 654 new deaths, fatalities crossed 33,425. The recovery rate has improved to 63.92 per cent.

“We have to be very careful with the concept of allowing people to get infected with this virus to develop natural (herd) immunity,” said Bogoch in an interview with IANS.

Below are excerpts from an exclusive chat:

Q: Recently, few experts recommended that schools may be reopened in New Delhi, as this may help in developing herd immunity. Do you think this concept of herd immunity is really going to work in bringing things back to normal? Would children not act as carriers of the virus infecting the adults in their family and neighbourhood?

A: We have to be very careful with the concept of allowing people to get infected with this virus to develop natural (herd) immunity. This approach does not seem to work (in this case). This is a very contagious infection, and it is clear that the virus can be devastating to those over the age of 60 or with underlying medical conditions. Also, in many areas that had widespread epidemic, once they have their epidemic under control, these areas are still far from what it may take to reach some degree of herd immunity.

Q: In India, a trend has been noticed that patients who have recovered from the viral infection have had their lungs in bad shape. Also, Covid-19 is considered responsible for strokes and neurological disorders; Could we say Covid-19 is no longer a respiratory disease?

A: Many respiratory infectious diseases, including COVID-19, have manifestations outside of the lungs. We are seeing examples of clinical issues outside of the lungs in those with COVID-19, such as blood clots, and smell and taste disturbances.

Q: Is it possible to eliminate Covid-19 anytime soon? How long do you think people would have to wear masks and adhere to social distancing norms, is the virus going to stay with us for a long time?

A: Unfortunately, in much of the world I do not think it is possible to eliminate COVID-19 in the pre-vaccine era.

That doesn’t mean we should not strive toward elimination — we should do everything possible to keep community transmission as low as possible, but for most places, elimination is an unrealistic goal.

Even if the infection is eliminated in some small region, it can be easily re-imported once travel resumes. A vaccine, even an imperfect vaccine, will significantly help with elimination strategies.

Q: Do you think the Oxford Covid-19 vaccine has the potential to be a real game-changer, not only for a Covid-19 vaccine but for the development of future vaccines?

A: The results of the Oxford COVID-19 vaccine from Phase 1 and Phase 2 clinical trials looks very promising, but we still need to be patient and wait for Phase 3 clinical trial results, which will inform us on if this vaccine reduces the chances of acquiring COVID-19.

This vaccine and others in development stages look extremely promising, but I do not want to get overly excited just yet — let’s see how these vaccines perform in larger clinical trials first.

Q: A potential coronavirus vaccine developed by Oxford University in association with pharmaceutical giant AstraZeneca has produced a promising immune response in a large, early-stage human trial. Do you think this is the step towards developing a vaccine providing long-lasting protection against Covid-19?

A: This is a major step forward. We still need to see the results of larger human trials, and these are ongoing for this vaccine and a few other COVID-19 vaccines too. An effective vaccine will be an essential step toward returning to life as we remember before COVID-19.

Health

8 risk factors that can lead to heart failure

People should also develop a habit of regular health screening to ensure that any possible heart disease could be diagnosed at an early stage, to ensure timely treatment.

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September 20, 2020 : Heart failure is one of the most under-diagnosed heart diseases in our country, contributing to a high number of death rates. The National Heart Failure Registry recently revealed its one-year data, which shows that close to 17 percent of patients die within 90 days of being diagnosed with heart failure. These high death rates are comparable to mortality associated with cancers of the breast and cervix.

There is lot of ambiguity when it comes to understanding heart failure. The disease is often confused with heart attack, or its symptoms are ignored as signs of old age or other diseases. Currently, it’s the leading cause of mortality and repeat hospitalisations amongst all CVDs, with close to 10 million patients in India, Dr Sandeep Seth, Professor of Cardiology, AIIMS, New Delhi told IANSlife.

What is Heart Failure?

Dr Seth explains, heart failure is a chronic and progressive disease in which the heart muscle weakens or stiffens over time, making it difficult for the heart to pump normally. This leads to symptoms like shortness of breath, need for elevated pillows to breath properly while lying down, swelling in the ankles, legs and abdomen, sudden weight gain and constant tiredness or fatigue.

What causes Heart Failure?

Several comorbid conditions and risk factors can cause heart failure. A prior heart attack is one of the key reasons. Sedentary lifestyle, lack of exercise, stress, smoking, excessive consumption of alcohol, drug usage etc., that leads to lifestyle diseases, increases the risk of developing heart failure in the future. Dr Seth lists the factors.

  • Hypertension or high blood pressure makes the heart work harder than it must. Over time, this puts pressure on the heart muscle responsible for the pumping action.
  • Coronary artery disease: Narrowed arteries limit the supply of oxygen-rich blood. The heart pumps harder to meet the need of the limited blood flow resulting in weakened heart muscle.
  • Heart attack: Heart attack and Heart Failure are not similar. Heart attack is a sudden cardiac event that has a direct effect on the basic functioning of the heart. A prior heart attack can majorly cause damaged and mean that the heart will never be able to pump as effectively as it did earlier, leading to Heart Failure.
  • Diabetes: Chronic condition like diabetes increases the risk of high blood pressure and coronary artery disease which in turn increases risk of acute heart failure.
  • Cardiomyopathy: Cardiomyopathy is a disease of the heart muscle caused due to alcohol consumption and/or smoking or drug abuse or other yet to be discovered causes.
  • Obesity: Being overweight increases risk for abnormal heart function and puts one at the risk of high blood pressure, diabetes etc. In the long run, excessive fat deposition can affect the flow of blood through heart muscle, leading to heart failure.
  • Heart Valves disease: In this ailment, one or more of the valves in your heart doesn’t work properly. This can cause the blood flow through your heart to your body to be disrupted and cause various complications in your body which can lead to heart failure.
  • Irregular heartbeats: Abnormal heart rhythms, especially if they are very frequent and fast, weakens the heart muscle and could cause heart failure.

It’s advisable to adopt an overall healthy lifestyle. One should exercise on a regular basis, refrain from smoking, drinking or drug abuse and eat healthy and nutritious meals. People should also develop a habit of regular health screening to ensure that any possible heart disease could be diagnosed at an early stage, to ensure timely treatment.

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Health Outreach Services during Covid-19

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Anganwadi Healths Outreach

New Delhi: The Government has been regularly reviewing the situation in consultation with States/UTs. In order to improve the nutritional status of Women and Children, Ministry of Women and Child Development is implementing Supplementary Nutrition Programme under Anganwadi Services and Scheme for Adolescent Girls under the Umbrella Integrated Child Development Services (ICDS) Scheme to children (6 months to 6 years), Pregnant Women, Lactating Mothers and out-of-school Adolescent Girls (11-14 years).

As per the directions issued by Ministry of Home Affairs, under Disaster Management Act, 2005, all the Anganwadi Centres across the country were closed to limit the impact of COVID-19. However, to ensure continuous nutritional support to Anganwadibeneficiaries, Anganwadi Workers and Helpers have been distributing supplementary Nutrition at the doorsteps of the beneficiaries. Further, this Ministry has issued necessary directions to the States/UTs to ensure distribution of food items and nutrition support by Anganwadi workers, once in 15 days, at the doorstep of beneficiaries. In addition, Anganwadi Workers and Anganwadi Helpers have been assisting the local administration in community surveillance, creating awareness or other works assigned to them from time to time.

Ministry of Health and Family Welfare issued the guidance note on “Provision of Reproductive, Maternal, Newborn, Child, Adolescent Health Plus Nutrition (RMNCAH+N) services during & post COVID-19 Pandemic” with States and UTs which states that campaign mode services such as – mass Vitamin a prophylaxis, campaigns for Intensified Diarrhea Control Fortnight (IDCF), National Deworming Day (NDD) and Anemia can be provided on an alternative mechanism like through home delivery of essential services & commodities etc. based on local situations. The continuation of outreach services through modified VHSNDs and Home visits by health workers was recommended in area beyond buffer zone and green zone. The activities in the containment and buffer zone were recommended through the routine visits of COVID workers. Essential medicine like IFA, ORS, calcium and Zinc are home delivered in containment zones. Specific guidance notes on the provision of the outreach services with all States and UTs to ensure continuity of essential outreach services has been issued and Webinars on implementation of outreach services related to Anemia, Nutrition Rehabilitation Centers (NRCs), Special Newborn Care Units (SNCUs), Diarrhoea prevention, NDD and IYCF practices etc have been organized.

This information was given in a written reply by the Union Minister of Women and Child DevelopmentSmt. Smriti Zubin Irani in Lok Sabha today.

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Mandatory daily antigen test for reporters, Parliament staff

Journalists covering the Monsoon session from press galleries of Lok Sabha and Rajya Sabha also have the option to undergo the RT-PCR test which is valid for 72 hours.

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New Delhi: Amid fresh cases of coronavirus among MPs, reporters and parliamentary staff entering the Parliament complex will have to undergo mandatory antigen test on a daily basis, according to a new protocol put in place.

Members of both Houses are undergoing RT-PCR test on regular intervals on a voluntary basis, said a senior Parliament official.

A member of Parliament can undergo RT-PCR test as many times he or she likes.

Journalists covering the Monsoon session from press galleries of Lok Sabha and Rajya Sabha also have the option to undergo the RT-PCR test which is valid for 72 hours.

Since the report of the much reliable RT-PCR takes time, antigen test has been made mandatory on a daily basis.

Government officials accompanying their respective ministers during bill discussions also have to show a negative report of RT-PCR test taken within the last 72 hours of their visit to the complex. – PTI

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COVID-19 affects different people in different ways. Most infected people will develop mild to moderate illness and recover without hospitalization.