THREAD: On Saturday morning, Dr @akshaygn, a Mumbai-based eye surgeon, was waiting to operate on a 25-year-old woman who had recovered from a bout of Covid-19 three weeks ago. 1/8 #COVID19India
Inside the surgery, an ear, nose and throat specialist was already at work on the patient, a diabetic. He had inserted a tube in her nose and was removing tissues infected with mucormycosis, a rare but dangerous fungal infection. 2/8 #COVID19India
This aggressive infection affects the nose, eye and sometimes the brain.
After his colleague finished, Dr Nair would carry out a three hour procedure to remove the patient's eye.
"I will be removing her eye to save her life. That's how this disease works." 3/8 #COVID19India
Even as a deadly second wave of Covid-19 ravages India, doctors are now reporting a rash of cases involving a rare infection - also called the "black fungus" - among recovering and recovered Covid-19 patients. 4/8 #COVID19India
Doctors believe mucormycosis, which has an overall mortality rate of 50%, may be being triggered by the use of steroids, a life-saving treatment for severe and critically ill Covid-19 patients. 5/8 #Covid19India
Steroids reduce inflammation in the lungs for Covid-19 and help stop some of the damage that can happen when the body's immune system goes into overdrive to fight off coronavirus. But they also reduce immunity and push up blood sugar levels in Covid-19 patients. 6/8 #COVID19India
It's thought that this drop in immunity could be triggering these cases of mucormycosis. Diabetics appear to be more prone to this disease. India has an estimated 77 million adult cases of diabetes, the country's fastest growing epidemic.. 7/8 #COVID19India
Mucormycosis is one of the most dangerous complications in diabetics with mortality rates of 40-80%. And now hospitals in Delhi, Mumbai, Bengaluru, Rohtak and Gujarat are reporting a growing number of cases. My story bbc.com/news/world-asi… 8/8 #Covid19India#Mucormycosis
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THREAD: In 1894, Waldemar Haffkine, a Russian Jew trained in Paris, travelled to Calcutta armed with a cholera vaccine. The slums were battling an outbreak of the disease. The 33-year-old man began his vaccination drive,
'sitting by an oil lamp in the slum'. 1/11 #vaccine#India
The results were encouraging enough for Calcutta authorities to fund a wider trial, but convincing people to be vaccinated was easier said than done. Haffkine's solution was to work with a team of Indian doctors and assistants in Calcutta's villages (below) 2/11 #vaccine#India
Haffkine's work in the Calcutta placed him among a select group of scientists who pioneered a profound shift in the way disease was understood and treated. In 1896, he travelled to Bombay, facing a plague pandemic, to come up with a vaccine for the disease. 3/11 #vaccine
THREAD: Delhi is seeing an intense Covid-19 winter surge, driving the total number of cases to more than 540,000 and fatalities to over 8,600. Doctors fear the capital may well become the epicentre of India's first wave of winter infections 1/10 #COVID19#DelhiFightsCorona
Hospitals are flooded with patients and intensive care beds are filling up fast. People are struggling for beds. Even I cannot get a bed for my friends or family, it is so bad," @DrHarjitBhatti, a private hospital doctor, said. 2/10 #Covid19#DelhiFightsCorona
My colleague, @BBCVikas, who went to admit a relative at a prominent private hospital last week, found there was a "waitlist" of 250 patients for Covid-19 beds. "It's worse than in the summer. It's insane." 3/10 #COVID19#DelhiFightsCorona
THREAD on why the Pfizer vaccine might not work for India:
The vaccine has to be kept in ultra-cold temperature at below -80C. bbc.in/3pfso2a .This could pose major logistical challenges for countries like India. 1/5 #COVID19#Pfizer
The WHO says Covid-19 vaccines under development can be categorised in three storage temperature requirements: 2-8C, -20C and -70C. Many will require an "ultra cold chain" at temperatures which will "definitely prove a challenge to many countries." 2/5 #COVID19#Pfizer
B Thiagarajan, MD of Blue Star, which has a major share of pharma cold chain products, told me: When it comes to vaccines to be stored at temperatures between 2 to 8C, we are well equipped. If the vaccine has to be kept at -40C, there will be a problem. 3/5 #COVID19#Pfizer
THREAD on my interview with Dr Manmohan Singh who said India was looking at a “deep and prolonged economic slowdown” #Manmohansingh#India#economy 1/16
Dr Singh suggested 3 steps to fix the economy: significant direct cash transfers to protect livelihoods and boost spending power; government-backed credit guarantees for businesses; and cleaning up financial sector through institutional autonomy & processes. #Manmohansingh 2/16
Dr Singh pointed to a consensus forming among economists over an economic contraction in India in nominal terms, "which if it happens, will be the first time in independent India".
"I hope the consensus is wrong," he said. #Manmohansingh 3/16