Lessons learned from COVID-19 in 2020

January 3, 2021

CMAAO CORONA FACTS and MYTH

Dr K Aggarwal , President CMAAO, HCFI, , With input from Dr Monica Vasudev

India

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New Delhi, January 03, 2021:

Minutes of Virtual Meeting of CMAAO NMAs on “Lessons learned from COVID-19 in 2020”

26th December, 2020, Saturday , 9.30am-10.30am

Participants : Member NMAs

  • Dr KK Aggarwal, President CMAAO
  • Dr Marthanda Pillai, India, Member World Medical Council
  • Dr Md Jamaluddin Chowdhury, Bangladesh Medical Association
  • Dr Marie Uzawa Urabe, Japan Medical Association
  • Dr Prakash Budhathoky, Treasurer, Nepal Medical Association

Invitees : 

  • Dr Russell D’Souza, Australia UNESCO Chair in Bioethics
  • Dr S Sharma, Editor IJCP Group

Key points from the discussion : 

  •  The pandemic has taught us the significance of cell and plant physiology.
  • It has taught us the anatomy of the thymus, the structure of the virus and the behavior of the virus.
  • We are shifting back from closed to open environment.
  • It has introduced a new terminology “inflammatory lifestyle”.
  • There are two types of blood clots – white clots and red clots. Covid-19 has helped to understand the difference between the two.
  • Rising CRP on Day 4 is a sign of continuing inflammation.
  • Overtreatment can lead to mutations.
  • The pandemic has taught us risk triage to reduce mortality.
  • In dengue, SGOT levels are more than SGPT, but now may also be due to coronavirus infection.
  • This pandemic has brought back conservative approaches. Streptokinase (STK) is back.
  • Postpone emergent surgeries.
  • There are two types of fever: Viral fever due to IL-6 (thermoregulatory dysfunction) and pyroptosis fever due to IL-1β.
  • Negative symptoms: Lymph node enlargement (other than mesenteric lymph nodes), effusions, joint involvement, hoarseness of voice rule out Coronavirus infection.
  • Rising d-dimer, reducing platelets and reducing LDL are markers of thrombosis.
  • Covid-19 has highlighted the importance of postprandial sugar. In these patients, postprandial sugar will increase first.
  • Fever more than 101, CRP>10 and ground glass opacities on CT scan are markers of pneumonia.
  • CRP is a marker of inflammation.
  • Bring CRP to less than 1 before, during and after the infection.
  • ESR is not important in the acute phase. It is important for recovery.
  • This pandemic has taught us the importance of subclinical diseases (thyroiditis, myocarditis).
  • Ct value on RT PCR is useful. The Ct value for the new UK variant is lower.
  • It has redefined contact as cumulative exposure time and not one time exposure.
  • It has taught us the advantages of prone ventilation/sleeping.
  • Typhoid antigen can be false positive in Covid-19.
  • A person who has tested negative on RT PCR may still have acute thrombotic events after 1-2 weeks due to delayed immunological reaction.
  • Persons with proven re-infection do not have neutralizing antibodies.
  • Cellular immunity tests (T cell tests) are now coming in the US.
  • We now know that faster development of vaccines is possible.
  • Isolation, quarantine and monitoring became familiar terms.
  • We learnt the significance of correct, consistent and continuous use of facemasks.
  • Face to face interactions have the risk of spread of the virus.
  • We learnt the importance of bitter and astringent foods in diet.
  • Loss of smell and taste are important symptoms of Covid-19.
  • Five systemic locations aside from lungs are involved: Eyes, skin, GI, heart, blood, liver.
  • Left eye conjunctivitis in this time is Corona unless proved otherwise.
  • Various terms like emergency use authorization, vaccine hesitancy, consortium, broader good came to be known.
  • Adult vaccination, vaccination priorities, vaccine storage temperature (-70 degree vs 2 degree) became the points of discussion.

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