#Covid #healthcare
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First 🌊 of Covid was pure shock for all health systems and societies.

We had little knowledge of what hit us.

People died by large number in developed nations.
By the end of first few weeks we sized up the enemy very well. We also knew that there would be more waves.

As they say in 🎾 you are only as good as your second serve.
And this turns out to be truth about health care.

After doing okayish (?luck) in first 🌊, how is India facing second wave?
What has directed our response, if we can call that?

How do we compare with the world in terms of managing second 🌊,

You are the judge and the victim.
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More from @docbhooshan

23 Apr
Getting psychological help for children locally.
Indians settled in developed countries.
#Thread
Focus - mal treatement of child by a family member
Since I started practice in 2000, every year I receive 5-10 calls from Indians settled in EU, UK and north america about help for a child who is at risk from a family member (mostly father but occasionally mother too).
This involves the parent being emotionally and physically abusive towards child (almost always under 10 years of age).
These families are highly educated and well settled.

One of the parent usually has an anger issue/alcohol problem or long standing mental health issue.
Read 13 tweets
19 Apr
If you are worried about catching Covid while at home, you can try these simple steps to reduce your worry -

1. Use small chunks of time (15-30 min) by allocating to specific activity

2. Do not re-work plans - e.g. if you are buying grosseries once a week stay with it.
3. Stop looking for more info - avoiding crowd + closed spaces and wearing mask all the time is enough.

4. Washing hands ONCE after returning home is good enough.
5. Watch your emotions - distract yourself from worry, anger, sadness by involving in physical activity, art, music, etc.
Read 9 tweets
17 Apr
#Thread
Yesterday @EricTopol tweeted about @TheLancet publication reporting "trasmission of SARS CoV 2 mainly via airborne route"

Little did he know that his sphere of influence reaches a city called Nashik in India and pensioners living in my housing complex in Pune, India.
By midnight, i started receiving questions and worried messages from my relatives in Nashik quoting this.
"Now Covid is airborne! we are doomed" was universal concern.
Then a neighbor called in the morning with same concern. Messages on her whatsapp group predicted doom.
Everyone wanted to know - What to do next?

Some had already closed their windows and ventilator gills to protect themselves from "virus air".
This is peak summer in India, temperatures are nearing forties (Celsius).My relatives don't live in air-conditioned homes.
Read 8 tweets
16 Apr
Dear Shri @maheshmkale ,

Congratulations to your father for making complete recovery from Covid.
Your video on plasma donation is doing rounds on social media.

Pl read thru this thread -
Plasma therapy in covid is of almost no additional benefit, prohibitively expensive, human resource intensive.

Here is excellent quality, published research on this issue - health.economictimes.indiatimes.com/news/diagnosti…
Countless relatives are now DEMANDING this therapy for their loved ones.

You can understand their plight to arrange for this therapy. You have been thru same recently.
Read 5 tweets
14 Apr
Last evening my eldest sister in law had a long chat with my wife on phone.

She asked her "how are you? This work is so difficult. How do you handle all this?"

My wife is Intensive Care Specialist. Doing Covid work since April 2020.

This is the first time anyone from extended
family asked about her well being.

She gets numerous calls everyday from multiple relatives and friends asking about medical advice, second opinion for their friends, vaccine queries, and what not.
At all times of day and night.

This is on top of her exhausting Covid work.
Whole of last year, like most of my doctor colleagues in India, she hasn't had unbroken 4 hours of sleep.

It is unimaginably difficult. Her hospital @symbiosistweets supports her really well and her own innate resilience has seen her thru so far.
Read 5 tweets
9 Apr
Remdesivir-
As headlines scream shortage and photos of hapless relatives standing in long lines are on front page,
public impression is that scores of people are dying as this life saving elixir is in short supply.

Nothing could be further from truth.

A thread.
If remdesivir was the fabled "Sanjivani buti" we wouldn't see millions of deaths all over the world.

After initial enthusiasm in Feb/March 2020, well designed clinical trials put question mark on superiority of Remdesivir over standard care.
As even more data gathered, clinicians suspected that a small subset of patients may benefit from remdesivir. (There are enough papers to support every claim and more)
Read 11 tweets

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