The #COVID19 pandemic has imposed catastrophe in the #urban areas. It’s simply an index of urban vulnerability. Poor primary health care services in urban areas & neglect of public health in general are the fundamental reasons resulting in this situation universally. 1 of n
It is merely noticeable now due to the attention attracted by the #pandemic. The long-standing manifestation of urban specific health #inequities are merely getting exposed due to the fatalities attributed due to COVID-19 in urban areas. 2 of N
1 in 3 adults in India have high blood pressure. One in 10 have type 2 diabetes mellitus. The long-standing complications of these two diseases affect millions of Indians. Nearly half of the diabetics are blind by the time they know that they have diabetes. 3 of N
Lack of primary health care services for screening & managing these diseases results in long term adversities. Following healthy lifestyle with better alternatives is a luxury. You simply do not have health friendly urban ecosystem. Stress & pollution add to urban woes. 4 of N
Predominance given to curative healthcare services with neglect of public health adds complex challenges. It’s ironical that surgery for heart attack gets covered by government funded insurance program while treatment for hypertension & diabetes is not equalily prioritized. 5of N
Invest in strengthening skilled #Publichealth workforce & strengthen primary health care services in urban areas. Whether it’s #contacttracing or #NCD screening, they are first responders & saviors. This is common learning and universally applicable globally. #COVID19 N of N
I stress in @the_hindu on why strengthening primary healthcare is imperative as we expect a surge in most urban areas. Short term solutions would not help. What we need are strengthening #publichealth and address health #inequities.
However mild #Omicron is, it is not a vaccine. There are deaths and hospitalizations due to this variant.
Stay away from misinformation.
Compared to Vaccination, natural infection could not protect population (against death or hospitalization) against any variant (Alpha, Beta, Gamma or Delta).
Proponents of Herd immunity are saying it again; #Omicron would provide herd immunity.
Evidence matters, not opinions
During delta wave, this is what we knew based on #Epidemiology of infectious diseases.
-This is not the last variant.
-There will be another wave.
More actions points can be following :- 1. Since day of 1st case of #Omicron#B.1.1.529, establish travel history & identify secondary transmission throughout world. If primary case was in early November, not difficult to miss areas of circulation.
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2. Botswana, South Africa & Hong Kong cannot be the only areas where #Omicron has travelled. These areas are the ones that have probably better surveillance and genomic sequencing and hence have reported in timely manner. Absence of reporting is not absence of circulation.
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3. Imposing travel restrictions, restricting entry from few countries is NOT going to help either prevent or control the spread of #Omicron. It’s akin to closing stable door after horse has bolted. Instead, identify cluster of cases of recent origin & do genomic sequencing.
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Brilliant study done in China, If scaled up, blood pressure reduction (-26.3 mmHg) achieved by training lay health workers can reduce significant mortality in LMICs.
-Globally, >17.9 million people die each year CVDs.
-Hypertension related CVDs contribute a significant proportion
-Chinese study shows some of these deaths & disability are preventable.
-Train lay village workers in BP measurement, counseling & provide affordable drugs.
Sudden cardiac arrest & Sudden cardiac death (SCD) refer to the sudden cessation of cardiac activity with hemodynamic collapse, typically due to sustained ventricular tachycardia/ventricular fibrillation; mostly occur in patients with previously undiagnosed diseaes.
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Results from Framingham heart study suggests that more men are affected with increasing age.
Not rare, 15 percent of the total mortality in the United States & other developed nations is due to SCD. (pubmed.ncbi.nlm.nih.gov/11684624/)
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-It is the initial clinical manifestation of 15% of coronary heart diseases (CHD).
-SCD is the mechanism of death in over 60% of patients with known CHD.
-Risk increases by a number of factors: Age, underlying cardiac diseases, post-menopausal women, CHD risk factors
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This tweet thread is about the results from the second serosurvey done in the #Karnataka state. Ahead of sharing the link, some caveats first. 1. The @DHFWKA has used the data from this round of serosurvey in late March to update testing and surveillance strategies.
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2. The study found Lower levels of IgG seroprevalence, mostly due to antibody waning. 3. A substudy was done to confirm the antibody waning. This study was delayed due to rapid surge of cases in April. 4. We found near 0 prevalence of active cases during mid-February 2021.
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5. There was a subsequent surge seen in Karnataka state due to a mix of alpha, delta which was picking up speed in April, and a large susceptible population were infected. 6. Results from the substudy on antibody waning was necessary for releasing the final report & paper.
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Polio anywhere could be a threat to countries that had eradicated it. It took decades to eradicate polio in most parts while some are yet to eradicate. Not just this necessity, it was possible mostly due to a collaborative approach & strong leadership at the global level. 1/N
Lessons from Polio Eradiation, Cochi S et al
-Strong political & social support in each country
-Strategic planning & policy development
-Partnership management & donor coordination
-Program operations & tactics
-Oversight and independent monitoring.
If there was high polio circulation in one region, other countries could prevent the possibilities of its import by vaccinating the children in their countreis. Therefore, all countries are continuing polio vaccination till other regions accomplish eradication.
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