COVID-19 pandemic in India

The COVID-19 Pandemic in India is a part of global and widespread pandemic of corona virus disease (COVID-19) spread by severe acute respiratory syndrome Corona-virus 2 (SARS-CoV-2). On 17th August 2021, as per data & records, India has second excessive and high-rise cases World-Wide, U.S. was the first one with approximately, 32.2 million reported cases of COVID-19 infection and the third enormous number of COVID-19 deaths. Brazil attains third position in the World after U.S., approximately 4,32,079 deaths. However, these reports indicated severe under-reporting.

The first case of COVID-19 in India were seen in South towns of Kerala on January 2020, with three medical students who had returned from Wuhan, China, the mainland and epicenter of COVID-19 pandemic. The government announced lock-down in Kerala on 23rd March and rest of the India on 25th March. On 10th June, India's rehabilitation exceeded active cases first time. Active cases started to drop in September along with the number of new and active cases. Regular cases peaked in mid-September with over 90,000 cases reported per day, Dropping to below 15,000 in January 2021. A second wave started in March 2021 was more devastating than the first, with the deficiency of medical treatment includes hospital beds, oxygen cylinders, ventilators, vaccines, and other medical supplies in all urban and rural areas of an India. By late April, India led the World by new and active cases. On 30th April, India became the first country to report 4,00,000 cases in a day. Scientists and researchers recommended that the Virus can reach an epidemic stage in India instead of completely recovered in  late April 2021.

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Avoiding crowded indoors spaces and ventilation in Corona virus (COVID-19)

The CDC recommends that crowded indoors spaces should be avoided. When indoors, increasing the rate of air change, decreasing recirculation of air and increasing the use of outdoor air can reduce transmission. The WHO recommends ventilation and air filtration in public spaces to help clear out infectious aerosols.

Exhaled respiratory particles can build-up with enclosed spaces with inadequate ventilation. The risk of  COVID-19 infection increases especially in spaces where people engaged in physical exertion and raise their voice. For example : Exercising, Singing & Shouting as this increases exhalation of respiratory droplets. Prolonged exposure to these conditions, typically more than 15 minutes, leads to higher risk of infection.

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Face mask and respiratory hygiene for Corona virus (COVID-19)

The WHO & US CDC recommend individuals wear non-medical face coverings in public settings where there is an increased risk of transmission and where social distancing measures are difficult to maintain. This recommendation is meant to reduce the spread of disease by asymptomatic and pre-symptomatic and is complementary to established preventive measures such as social distancing.

Face coverings limit the volume and travel distance of expiratory droplets dispersed when talking, breathing and coughing.

Masks are also strongly recommended for those who may have been and those taking care off someone who may have the disease. When not wearing the mask, the CDC recommends covering the mouth and nose with a tissue when coughing or sneezing and recommends using inside of the elbow if no tissue is available. Proper hand hygiene after any cough or sneeze is encouraged. Healthcare professionals interacting directly with people who have COVID-19 are advised to utilize respirators at least as protective as NIOSH-certified N95 or equivalent, in addition to other protective equipment.

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Vaccination of Corona Virus (COVID-19)

VACCINATION :

A COVID-19 Vaccine is a vaccine intended to provide acquired immunity against severe acute respiratory syndrome Corona virus 2 (SARS-CoV-2), the virus that causes the corona virus disease in 2019, (COVID-19). Prior to COVID-19 pandemic, an established body of knowledge existed about the structure and function of coronaviruses causing disease like severe acute respiratory syndrome (SARS) & Middle East respiratory syndrome (MERS). The COVID-19 are widely credited for their role in reducing the spread, severity, and death caused by COVID-19.

Many countries have implemented phased distribution that prioritize those of higher risk of complications such as the elderly, and those of higher risk of exposure and transmission, such as healthcare workers. Single doze interim use is under consideration to extend vaccination to as many people as possible until vaccine availability is improves.

As of 15th September 2021, 5.82 billion dozes of COVID-19 has been administrated World - Wide based on official reports from National Public Health Agencies. AstraZeneca anticipated producing 3 billion doses in 2021, Pfizer Bio-NTECH 1.3 billion doses and Sputnik V, Sinopharm, Sinovac and Janssen 1 billion doses each. Moderna target producing 600 million doses and Convidecia 500 million doses in 2021. By December 2020, more than 10 billion vaccine doses had been preordered by countries, with about half of the doses purchased by high-income countries  comprising 14% of World's population.

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Prevention of Corona virus (COVID-19) Disease

"PREVENTION IS BETTER THAN CURE"

Preventive measures to improve reduce the chances of infection include getting vaccinated, staying at home, wearing a mask in public, avoiding over-crowded places, keeping distance from others, ventilating indoors places, managing potential exposure duration, washing hands with soap and water often and for at least 20 seconds, practicing good respiratory hygiene and avoiding touching eyes, nose or mouth with unwashed hands.  

Those diagnosed with COVID-19 who believe they can be infected are advised by CDC to stay home except to get medical care, call ahead before visiting a health care provider, wear a face mask, before entering the health care provider's office and when any room or vehicle with another person, cover cough and sneezes with the tissue, regularly wash hands with soap and water and avoid sharing personal household items.   

The first COVID-19 vaccine granted regularly approval on 2nd December on UK medicines regulator MHRA. It was evaluated for emergency use authorization (EUA) status by US FDA, and in several other countries. Initially the US National institutes of health guidelines do not recommended any meditation for prevention of COVID-19, before or after exposure to the SARS-CoV-2 virus, outside a setting of clinic trial. Without a other prophylactic measures, or effective treatments, a key part of managing COVID-19 is trying to decrease and delay the epidemic peak known as "Flattening the curve". This can be done slowing the infection rate to decrease the risk of health services being overwhelmed, allowing for better treatment of active cases and delaying additional cases until effective treatment or a vaccine become available.

....... in next article, we'll discuss a about vaccination of COVID-19... 😜 😜 😜

Viral-Testing for Corona Virus (COVID-19)

The standard methods of testing for presence of SARS-CoV-2 are nucleic acid test, which detects the presence of virus RNA fragments. As these tests detects RNA but not infectious virus, it's "ability to determine the duration of infectivity of patients is limited. The test is typically done on respiratory samples obtained by nasopharyngeal swab; however, a nasal swab or sputum samples may also be used. Results are generally available in hours. The WHO has published several testing protocols for the disease.

Several laboratories and companies have developed serological tests which detect antibodies produced  by the body in response to infection. Several have been evaluated by Public Health England and approved for the utilization in UK.

On 7th September, UK government issued "guidance for procedures to be implemented in laboratories to provide assurance of positive SARS-CoV-2 RNA results during period of low prevalence, when there is a reduction in the predictive value of positive tests results. 

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Transmission of Corona virus (COVID-19)

The COVID-19 disease is mainly transmitted via the airborne route when people inhale droplets and small airborne particles (that form a aerosol) that infected people when breath out as they breathe, talk, cough, sneeze or sing. Infected people are more likely to transmit COVID-19 when they are physically close. Infection can occur over longer distance, particularly indoors.

Infectivity begins as early as three days before symptoms appear and people are most infectious just prior to and during the onset of symptoms. It declines after a first week, but infected people remain contagious for up to 20 days. People can spread the disease even if they are asymptomatic.

Infectious particles range in size from aerosols that remain suspended in the air for long periods of time to larger droplets that remain airborne or fall to the ground. Various groups utilize terms such as "airborne" and "droplet" both in technical and general ways leading to confusion around terminology. Additionally, COVID-19 research has defined the traditional understandings of how respiratory viruses are transmitted. The largest droplets of respiratory fluids do not travel far and can be inhaled or land on mucous membranes on the eyes, nose, or mouth to infect. Aerosols are higher in concentration when people are in close proximity, which leads to easier viral transmission when people are physically close, but air borne transmission occur at longer distances, mainly in locations that are poorly ventilated; in those situations particles can remain suspended in the air for minutes to hour.

The number of people generally infected by one infected person varies; as only 10% - 20% people are responsible for the disease's spread. It often spreads in clusters, where infection can be tracked back to an index case or geographical location. Often in these instances, superspreading events occur where people are infected by one person. 

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Signs and symptoms of COVID-19

Symptoms of Corona virus (COVID-19) are variable, ranging from mild symptoms to severe illness. Common symptoms include headache, loss of smell and taste, nasal congestion and runny nose, cough, muscle pain, sore throat, fewer, diarrhea and breathing difficulties. People with same infection may have different symptoms and their symptoms change over time. The common clusters of symptoms have been identified : One respiratory system cluster with cough, sputum, shortness of breath and fever, a musculoskeletal symptom cluster with muscle and joint pain; headache and fatigue; and a cluster of digestive systems and abdominal pain, vomiting and diarrhea. In people without prior ear, nose and throat disorders, loss of taste combined with loss of smell is associated with COVID-19.

Most people recover from acute phase of disease. However, some people - over half of cohort of home-isolated with young patients - continue to experience a range of effects such as fatigue after a month of recovery, a condition called long COVID, long-term damage to organs have been observed. Multi-year are underway to further investigate the long-term effects of the disease.

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How does the Corona virus (COVID-19) spread/caused ?

COVID-19 transmits when people breathe in air contaminated by droplets and small airborne particles containing the virus. The risk of breathing these in is highest when people are in close proximity, but they can be inhaled over longer distances, particularly indoors. Transmission can also occur if splashed or sprayed with contaminated fluid in the eyes, nose or mouth and rarely via contaminated surfaces. Several testing methods or techniques have been developed to diagnose the disease. The standard diagnostic method is by detection of the virus by nucliec acid by real time reverse transcription polymerase chain reaction (rRT-PCR) transcription-meditated amplification (TMA), or by reverse transcription loop-meditated isothermal amplification (RT-LAMP) from a nesopharyngeal swap.

Preventive measures include physical and social distancing, quarantining, ventilation of indoors spaces, covering cough and sneezes, hand-washing and keeping unwashed hands away from the face. The use of face mask or coverings has been recommended in public settings to minimize the risk of transmission.

While working to underway to develop drugs that inhibit the virus (and several vaccines for it have been approved and distribution in various countries, which have since initiated mass vaccinations campaigns), the primary treatment is symptomatic. Management involves the treatment of symptoms, supportive care, isolation and experimental measures.

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Coronavirus disease 2019 (COVID-19) - Pandemic disease

Coronavirus disease 2019 (COVID-19) is deadly epidemic disease spread by severe acute respiratory syndrome coronavirus 2(SARS-COV 2). It's mainland, engendered and implanted found in Wuhan, China, December 2019. This disease has since caused globally and internationally, leading to ongoing pandemic - it's about to 3rd wave come.

Symptoms of COVID-19 are variable, but mainly include fewer, cough, headache, fatigue, breathing difficulties and loss of smell and taste. Symptoms may begin one to fourteen days after exposure of the virus. At least a third of people who are infected do not develop noticeable symptoms. One who develop noticeable symptoms are enough to be classified as patient, most (81%) develop mild to moderate symptoms while 14% develop severe symptoms (more than 50% lungs involvement on imaging & 5% suffered critical symptoms. Older people are higher risk of developing severe symptoms. Some people are continue to experience the range of affects for the months after recovery and to the organs are observed.  

Signs and symptoms of Spanish Flu

 

The majority of the affected experience only the typical flu symptoms of sore throat, headache and fewer, especially during the first case. However, during the second case, disease was more serious, often complicated by bacterial pneumonia, which was often the cause of death. This more serious type could cause hellotrope cycanosis to develop whereby the skin would first develop two mahogany spots over the cheekbones which would then over the few hours spread to color the entire face blue followed by black coloration first in the extremities and then further spreading to the limbs and torso. After this, death would follow within a hours or few days coz of lungs would filled with fluid. Other signs and symptoms reporting included spontaneous mouth and nosebleeds, miscarriages for pregnant women, a peculiar smell, teeth, hair falling, dizziness, insomnia, loss of hearing and smell, blurred vision, impaired color vision.

The majority of deaths were from bacterial pneumonia, a common secondary symptoms associated with influenza. The pneumonia by itself caused common upper respiratory-tract bacteria, which were able to get into the lungs via the damaged bronchial tubes of the victims. The virus also killed the people directly by causing massive hemorrhages and edema in the lungs. Modern analysis shows the virus is particularly deadly coz it triggers a cytokine storms (overreaction of the body's immune system). The animal suffered rapidly progressive respiratory system and death through the cytokine storm. The strong immune systems of young adults were postulated to have ravaged the body, whereas the weaker immune reaction of children and middle-aged young adults resulted in fewer deaths in those groups.

FOURTH WAVE - Spanich Flu

 

In spring 1920, The fourth wave, occurred in isolated areas including New York, Switzerland and some South American Islands. New York city alone reported 6,374 deaths between December 1919 - April 1920, almost twice the number in first wave in 1918. Other US cities including Detroit, Kansas city, St. Louis and other cities as well were hit particularly hard, with deaths rate higher than of all 1918. Peru experienced the late wave of early 1920, and Japan had one from late 1919 to 1920, with the late cases in March. In Europe five countries ( Spain, Denmark, Finland, Germany and Switzerland.) recorded a late peak of January - April 1920.

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THIRD WAVE - Spanich Flu

 Third wave of 1919 :

In January 1919, the third wave of Spanich Flu hit Australia, where it killed around 12,000 people following the lift of maritime quarantine, and then spread quickly through Europe and United States, where it lingered through the spring and until June IN 1919. It primarily affected Spain, Serbia, Mexico and Great Britain; resulting in hundreds of thousands of deaths. It was less severe than the second wave still much more deadly than the initial first wave. In United States, isolated outbreaks occurred in some cities including Los Angeles, New-York city, Memphis, Nashville, San-Francisco and St. Louis. Overall American morality rates were in the tens of thousands during the first six months of 1919's.

......in next article, we'll discuss regarding fourth wave of SPANICH FLU .. 😜 😜 😜