Originally posted by: Sutapasima
A message from Delhi based Doctor ...
Hi, this is Dr. Ambarish Satwik .
Allow me to state a few elementary facts. Community transmission of COVID is properly underway and the epidemic is just about taking off in Delhi. The numbers are rapidly increasing and itâs expected to peak in July, which means that on its downturn, the curve is likely to drag on till September. And there will possibly be a second wave in the winter. At some point in early July (if not earlier), weâre likely to observe a complete breakdown of our healthcare infrastructure, which in simple terms would mean that hospitals in NCR will have run out of beds to treat COVID, even if we recruit every last hospital bed available to us (to the exclusion of treating all other ailments). I sincerely hope that it doesnât come to that, but I donât believe in divine intercession or any theory that accords inherent innate immunity to Indians. And more importantly because, as doctors, weâre in the thick of this and can see (in real time) the vector and the trajectory of these infections. I urge you to read the following with a great deal of responsibility and disseminate as widely as possible.
1. Weâre not getting a vaccine till next year, possibly not even for a year and a half. There is no evidence whatsoever that any medicine or therapeutic intervention can prevent or treat COVID infection. What can definitely and very effectively prevent COVID infections are non-pharmacological interventions that youâre all already aware of. But more of that in a bit.
2. In the absence of a drug or a vaccine, most of us are going to get infected over the next few weeks / months. To believe that we can dodge this would be a form a self-deception. That said, COVID isnât the plague or Ebola. In about 80% cases this infection would be completely harmless. Even in the elderly, getting COVID isnât the equivalent of getting a death sentence. There are scores of people in Delhi above the age of 65/70 who have been infected and have been asymptomatic or have had very mild symptoms and have fully recovered. But, of course, the elderly and those with co-morbid conditions are the most vulnerable and have to be protected. Itâs usually the young, the restless and the earning members who acquire the virus from their daily excursions and come back and give it to the home-bound elderly. Itâs entirely possible and probable that a few people in Gulmohar Park have had a previous unsolicited encounter with the virus. Itâs possible that a few of us are currently asymptomatic carriers, without having any knowledge of it. Thereâs no way of finding out unless we start extensive testing for antibodies, and thatâs not going to happen for a while. The trouble with all these statistics is that it gives you no information about whether you or your loved ones will be safe. Itâs fundamentally a roulette. Thereâs no way of predicting who is going to fall. There have been instances of healthy, young people ending up in ICUs and even dying from COVID pneumonia and its sequelae.
3. The only way forward is to ride the storm. COVID isnât going to magically disappear. About 70% of us will have to get infected for the community to acquire herd immunity.
4. Herd immunity isnât real immunity acquired by osmosis: itâs a form of statistical immunity where the uninfected are protected by the previously infected (and cured) individuals around them. This really is the key to understanding how this is going to end. As a crude example, consider all the people in Gulmohar Park as a community. Imagine a time in September when about 70% of us have had COVID one way or the other and have acquired immunity against it. 30% of us are still preserved and uninfected. The virus, remember, needs a human host to survive; it canât survive outside humans for very long. When a new, uninfected individual now gets infected, the virus wants to move on, wants to jump to a fresh host. This individual in Gulmohar Park is now surrounded mostly by previously infected (and now immune) individuals. There is also a minority of uninfected individuals, but the statistical probability of the virus encountering an an immune individual (70%) is much higher. It cannot infect (and thrive in) these immune individuals in its immediate milieu and withers way. The uninfected minority in a community is therefore protected by a shield made up of a herd of the previously infected. The infected gentleman in the B block is the first member of this shield. Remember this.
5. Now, some actionable things: no matter who you are and how old you are, do not step out without a mask. A simple mask is good enough, an N95 is even better, but please do not use N95 masks or Vogmasks with exhaust valves. The valve provides âbreathabilityâ when you exhale by releasing your breath and its contagion carrying respiratory droplets. These masks protect no-one. For the duration of the pandemic, these masks should be banned. If youâre using a cotton or a fabric mask, make sure itâs not sieve-like or honeycombed. This leaks air and respiratory droplets. Make sure the mask covers your nose and mouth. Itâs instructive to note that even if youâre in the presence of a COVID infected individual and theyâre masked and not coughing and you are yourself masked, the probability of you getting the infection is minuscule. The virus doesnât fly out into your lungs.
6. Learn optimal mask hygiene. Consider the outer surface of your mask contaminated and carrying the virus if youâve been in close proximity of other people. Do not touch the outer surface of the mask. Remove the mask by disengaging the earloops without touching the outer surface and discard it (if disposable) or wash it immediately on return.
7. Treat every individual you meet as an asymptomatic COVID carrier. Treat every surface you touch as potentially contaminated. That is the meaning of community transmission. Carry a sanitiser on your person. Frequently sanitise your hands after touching surfaces or objects. As we go about our lives, try your best not to get infected. Remember, easing the lockdown doesnât diminish the virulence or the transmissibility of the virus. On the contrary, it increases it. Your chance of getting infected today is fifteen times more than what it was in the beginning of May. It will be a hundred times more by June-end. Avoid stepping out, as much as possible, particularly for non-essential activities. Give Delhiâs healthcare apparatus a fighting chance. We all have to avoid falling sick at the same time. Weâll all be scampering for hospital beds at the same time. No-one will get it. âLiving with the virusâ is not the same thing as socialising in the middle of a pandemic. For all our sakes, behaviourally, assume that the lockdown persists unabated. Please do not be complacent.
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