Thread by @anupampom

A new research shows- COVID-19 could easily escape even surgical mask in case of explosive cough and and there is increased transmission/aersolisatiom with loud singing.So this virus is a lot more transmissible.

https://twitter.com/drjohnm/status/1247249167510122497?s=20

In absence of working treatment ; No Good Antivirals, Vaccine . We are just Fending the Coronavirus Scare. Our Hospitals becoming a Health Care risk due to risk of cross infection.
So what we don't do is as important as what we do.

As we struggle today despite a century of rapid advances since Influenza pandemic in 1918.And perhaps as powerless. We will try to absorb some lessons from what worked a century back in 1918 influenza epidemic .

Social Distancing works in 1918 as well as 2020 and And countries which failed to lock down were too confident are facing grave risks(US/UK/Italy). Philadelphia also paid the price a century back.

A less talked about feature of epidemic is therapy:
Camp Brook Hospital in Brookline/Boston
led a great and successful campaign against Pandemic.
weapons of Choice : Air(Ventilation), improvised Face masks (with shields), Sunlight and Triage(Temporary Hospitals)

Infection Control Practices and Therapy is interesting: Lots of gargles,mouth swashes

brooklinehistory.blogspot.com/2009/06/brooki…

Improvised Mask and cleanliness Practices!

This has relevance today. Good Ventilation was an essential part of Hospital Design in earlier part of century.

But as Hospital care became complicated, Hospitals started resembling Hotels .

ncbi.nlm.nih.gov/pmc/articles/P…

While ventilation is good in bigger Hospitals,in many smaller ones/government hospitals it remains exceedingly poor
(Despite infrastructure required
4 number of air exchanges , negative pressure rooms are absenct. most ICUs only have a split AC with limited air exchanges

In absence of good antiviral therapy , good Ventilation and inappropriate PPE. Patient and Health care workers can drown in aerosol/droplet load. We will be harming more than we can help.
While treating in existing infrastructure not designed for this it must be kept in mind.

We in India are blessed with good Sunlight and Air. Coronavirus loves to thrive in AC chambers . Posh looking rooms with inappropriate Ventilation. To Friends/Doctors here,COVID is going to be there for sometime now. Ask your Hospital for Fresh Air and Sunlight in meantime

So How we can leverage this with our existing infrastructure;
1.Minimize Patient/Health care worker interaction(WhatsApp Groups/LAN)
2.Patient Controlled Oxygen Supplies,HFNC,CPAP,Non Rebreather Masks

3. IV drip sets Outside Room. Pulse Oximeter.Hand Held ECG at bed side. Inhalers,Cough Syrup. Common Drugs at bed side.

4. Highly Ventilated Semi-ICUs for mild/moderate risk patients rather than poorly Ventilated ICU without negative pressure rooms

science.thewire.in/health/coronav…

Till we reach to ventilators stage (with 20-40% survival) of COVID. What we don't do is perhaps as important as what we do.
Hence we must leverage our strengths to fight COVID.