In 🇮🇳 we have had the benefit of research conducted in the west. Masking, Dexamethasone, Lockdowns, Toci, etc have helped us manage the #COVID19 pandemic. But we like to do jugaad so we added to the mix Steam inhalation’s, multiple antibiotics, zinc, Vit C 1/n
Then there are kadhas, 💧 neeti, IVM, HCQ and so on and so forth. We have a high diabetic population which means we have a even higher prediabetic one which when sick with COVID19 can fiddle with our glucose homeostasis. This has probably resulted in a heady mix. 2/n
The west has given us #COVID19Vaccine to protect against #COVID19 We don’t yet have phase 3 data for the really 🇮🇳 one. Whether we like it or not our medical care depends on research done in the west - at least most of it. Now we have the #BlackFungus problem that no one has 3/n
And hence the west will not research leaving us to fend for ourselves. This is going to test our privileged institutions whether they can sort this issue fast because it seems it is a bigger issue than #COVID19 in terms of mortality and morbidity. 4/n
Even now the first semblance of data is coming from tier 2 cities and not privileged institutions. Would like to see more of our tax money generating better data and research to help us. We need to know rapidly why this is happening to put a stop to it. 5/n
This is critical research that needs to be done. We haven’t seen much of good work (PLACID trial exception) in the past year in original research that helped. Maybe now is the time to step up. Also maybe everyone can go easy on the steam, zinc, kadhas and #immunityboosters 6/End
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The budget director Ayush in 2021 is roughly 2300 crore rupees as compared to Health Research which is 1900 crore (2020). How has that worked out in pandemic times. Why am I doing this thread on Ayush and COVID19?
Last year when the pandemic began govt distributed 1/n
The GUJ govt distributed preventive Ayush meds across #Covid19 hospitals and healthcare workers as well as contacts were encouraged to utilize it. Mild cases also got it and the Principal Secretary Health actively promoted it as @narendramodi had endorsed it. 2/n
Initially it was fun for me as I saw colleagues take it and the sceptic in me could not be more sarcastic. As we hit the first wave and people began dying I almost forgot about this till April 2021 when my kids tested positive. I was shaken when the local PHC 🚐 pulled 🆙 3/n
The cost of non Evidence-Based treatment is phenomenal. When you add one extra drug in the ICU that has no value, it means preparing the drug, injecting it, thrombophlebitis, etc. Now multiply that by 500 patients and fewer doctors and nurses. This is one hospital. 1/n
Now make that drug expensive (Remdesivir), difficult to get (plasma) and imagine the energy that goes into procuring it and failing which guilt that might accompany it. Not everyone can afford these and many are selling their livelihoods to obtain it. 2/n
There are families with two individuals in the ICUs and another two infected at home. Those are home are also receiving drugs which are useless and might put them into hospital. Such as steroids at high doses when not required (in viral replication phase). 3/n
Thank you @DrBinoyVShah for the post. We are all thankful to many for guiding us in our career. These relationships are wonderful and develop over time. I have had the benefit of many and everyone guides you in different ways.1/n
We all remember our school teachers. Many who took time out to teach from regular schedules. I remember visiting Prof Ganihar many Sunday for class at his house (not paid tuitions) - used to have 🥗. Then we had many mentors in med school including seniors. 2/n
Some mentors have connected throughout and i still keep in touch with them. Academically and Professionally I have done much better than my mentors and many of my mentees have already done better than me. As my mentors are proud of me, so am i proud of my mentees. 3/n
Story from 2014 I think.
Was in a neonatal conference in Ahemdabad when a consultant from Canada was delivering a lecture on neonatal therapeutic hypothermia. In response to some question he gave an answer that was not consistent with available evidence at that time. 1/n
I was shocked and was not sure whether I should counter since he was an invited speaker. As I was debating with myself one young pediatrician (post DCh - vadodara and neo fellowship) got up and quoted figures from studies and told him point blank that he was wrong. 2/n
Eerie silence ensued and the chairperson tided over it saying (we can discuss in break) and that was it. Felt quite proud that a young student was able to say something which many would hesitate to do (I would hesitate even today). 3/n
The three prime blunders of managing #COVID19India in 2021 (many others too)
We would recognize two now because they contribute to our surge now. The third one is not yet known to the health system and the powers that run it.
1/n
The first one - the premature declaration of victory over #COVID19 in initial months despite UK & other countries still under a strict lockdown. This percolated down and many stopped taking precautions and worse - made fun of those who were careful. ✌️ was declared at the 🔝 2/n
Second one - mismanagement of #COVID19Vaccination - no orders in Jan, complicated approval, online registration & deliberate slow vaccination (words of task force member) - result is poor rates, unnecessary vaccine hesitancy, why vaccinate when we achieved ✌️ over COVID19 3/n
It means when #SARSCoV2 virus 🦠 enters our body we have a immune system that is prepared to take on the virus and reduce its effect over us. Remember the virus is getting into our body and is in our system. Our #Immunity needs a #ImmunityBooster to fight back. 3/n @drsunita02