Everyday brings more complexity and more confusing information in public and professional domain.
Here I make an attempt to bring some clarity in my own understanding of this issue.
Basics -
In a complex, complicated, evolving, changing, poor-data situation, best policy is to stick to absolute basics to minimise harm caused by foolish intervention.
What does it mean in practical terms for Covid?
1. Focus on prevention - mask up all the time, avoid socialization and closed spaces, avoid places where you meet mask-less people.
2. Long term - lose extra weight, get blood sugar in normal range, keep other illnesses in good control. This reduces risk if you get Covid.
3. Get vaccine if possible. Keep 1 & 2 going even after vaccination.
4. If you get Covid exposure or symptoms - isolate yourself even from family if possible for 5-7 days. Get tested with dr's advice.
5. If tested positive - follow isolation, monitoring of oxygen saturation and treat only symptomatically as per medical advice.
6. If saturation drops/ 6 min walk test is positive, talk to doctor immediately.
7. DO NOT load yourself with "immunity boosters" they are fake.
8. Running after remdesivir, tocilizumab, plasma puts more people in harm's way than benefiting patient.
Have a trusted doctor to treat you.
9. Once again - focus on prevention by mask, social distancing.
10. Once again - immunity boosters are fake.
May force be with us all.
Proven therapies as of now - 1. Symptomatic treatment - paracetamol, antibiotics if indicated 2. Oxygen therapy, ventilation, prone position as advised by doctors. 3. Blood thinners, low dose steroids on medical advice. 4. Rest all on individual's medical assessment.
1. Fact - Someone needs to manage.
Due to complex nature of society, politics and modern medicine, that person has to be full time manager. Essentially unable to treat individual patients. 2. This person needs training in Public health and managing complex systems.
So all glorious clinical specialities are out of question.
3. Understanding finance is really the key. So is supply chain management !
Looking at all of this it is unlikely that basic/specialist medical training is enough for the job.
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.
#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.