The document discusses the Omicron variant of SARS-CoV-2. It begins by explaining that Omicron has over 30 mutations on the spike protein, which has increased its transmissibility and ability to evade immunity. It was first reported in South Africa and Botswana in November 2021 and was designated a variant of concern by the WHO due to its high number of mutations and rapid spread internationally. The document then provides recommendations to reduce transmission which include vaccination, masking, physical distancing, testing, isolation, hand hygiene, and monitoring for symptoms.
WHO declares Omicron as variant of concern?
It was 26 November 2021 that WHO declared that the world was facing a new variant of concern: Omicron.21K (omicron) is of primarily concern because of the detection of large number of mutation in its spike gene Figure 1. Most of these variants plays an important role in antibody recognition and ACE2 binding and are in the N-terminal or receptor-binding domain.
WHO declares Omicron as variant of concern?
It was 26 November 2021 that WHO declared that the world was facing a new variant of concern: Omicron.21K (omicron) is of primarily concern because of the detection of large number of mutation in its spike gene Figure 1. Most of these variants plays an important role in antibody recognition and ACE2 binding and are in the N-terminal or receptor-binding domain.
The 2019–20 coronavirus pandemic is an ongoing pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).[4] The outbreak was first identified in Wuhan, Hubei, China, in December 2019, and was recognized as a pandemic by the World Health Organization (WHO) on 11 March 2020.[5] As of 25 March, more than 422,000 cases of COVID-19 have been reported in more than 190 countries and territories, resulting in more than 18,900 deaths and more than 109,000 recoveries.
A little understood but devastating viral disease fought with political means for economic destruction and gains. With so many vaccines to be used at the face of the pandemic to violate all norms of disease control. Masses are panicked to make useless buying and hoarding to stimulate blackmarketing.
This webinar is organized by MyICID and Institute for Clinical Research (ICR), NIH, Ministry of Health in conjunction with Neglected Tropical Disease Day 2022. The purpose of this webinar is to refresh and update our knowledge on Dengue fever, which has been overshadowed by COVID-19 since the beginning of the pandemic.
Presenter: Dr Ong Hang Cheng, Infectious Disease Physician at University Malaya Medical Center
#dengue #WorldNTDDay #BeatNTDs #BestScienceforAll
Everything you should know about omicron variantRasmiShah
A new Covid-19 variant named Omicron has been identified in South Africa. Read to know what it is, its symptoms, how it differs from other variants and more.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
The 2019–20 coronavirus pandemic is an ongoing pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).[4] The outbreak was first identified in Wuhan, Hubei, China, in December 2019, and was recognized as a pandemic by the World Health Organization (WHO) on 11 March 2020.[5] As of 25 March, more than 422,000 cases of COVID-19 have been reported in more than 190 countries and territories, resulting in more than 18,900 deaths and more than 109,000 recoveries.
A little understood but devastating viral disease fought with political means for economic destruction and gains. With so many vaccines to be used at the face of the pandemic to violate all norms of disease control. Masses are panicked to make useless buying and hoarding to stimulate blackmarketing.
This webinar is organized by MyICID and Institute for Clinical Research (ICR), NIH, Ministry of Health in conjunction with Neglected Tropical Disease Day 2022. The purpose of this webinar is to refresh and update our knowledge on Dengue fever, which has been overshadowed by COVID-19 since the beginning of the pandemic.
Presenter: Dr Ong Hang Cheng, Infectious Disease Physician at University Malaya Medical Center
#dengue #WorldNTDDay #BeatNTDs #BestScienceforAll
Everything you should know about omicron variantRasmiShah
A new Covid-19 variant named Omicron has been identified in South Africa. Read to know what it is, its symptoms, how it differs from other variants and more.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
3. Why do Variants occur?
• Mutation is a natural process, normal part of evolution.
• But not all variants are dangerous, and most often we don’t notice them.
• As long as the virus is able to infect, replicate and transmit, it has to continue to
evolve.
• Usually, viruses keep updating itself called Mutation, but after several
mutation(30) this variant became a concern because of its transmission rate and
severity of infectivity.
• Only when they are more infectious, can reinfect, can cause severe
disease/death etc, they gain prominence.
• To avoid generation of variants: is to reduce the number of infections.
4. • Omicron variant has shown a very large number of mutations, especially
more than 30 on the viral spike protein, which is the key target of the
immune response & have been associated with increased infectivity,
increased reinfection and immune evasion, resulted in sudden rise in
positive cases in South Africa, and WHO declared Omicron as a Variant of
Concern(VoC).
• “S gene drop out”: most accepted & widely used diagnostic method is RT-
PCR, which detect specific genes in the virus. Spike(S), Envelop(E) &
Nucleocapsid(N) to confirm the presence of virus.
• In case of Omicron S gene is heavily mutated, some of the primers may lead
to results indicating absence of the S gene(S gene drop out).
• This particular S gene drop out along with the detection of other viral genes
used as diagnostic feature of Omicron. Technically, for final confirmation of
Omicron variant, Genomic sequencing is required.
5. Brief history of Emergence of B.1.1.529
variant(Omicron)
• Specimen collected on 11 Nov 2021 at Botswana and
on 14 Nov 2021 in South Africa.
• On 24 Nov 2021: South Africa reported to WHO about new variant of SARS-
CoV-2 i.e. B.1.1.529, and there after number of cases of this variant
continues increasing to almost all provinces in South Africa.
• 26 Nov 2021: WHO named the B.1.1.529, Omicron & classified it as VOC.
• 30 Nov 2021: widely recognised & accepted & designated Omicron as a VOC
by most of the country.
6. Naming of Virus
• Viruses are named based on their genetic structure to facilitate the development
of diagnostic tests, vaccines, and medicines.
• Virologists and other wider scientific community do this work, so virus are named
by the ICTV (International Committee on Taxonomy of Viruses).
• Diseases are officially named by WHO in the ICD(International Classification of
Diseases).
• SARS-CoV-2: 11/02/2020 after SARS outbreak 2003.
• COVID-19: 11/02/2020
7. WHO also have “WHO Virus Evolution Working group” (called Technical
Advisory Group on Virus Evolution)
SARS-CoV-2 variant B.1.1.529, is named Omicron by TAG-VE(Technical
Advisory Group on Virus Evolution) of WHO, the virus that cause
COVID-19.
8. Reuter’s data of COVID-19 infection shows (2-1-22)
• Infections rising in 101 countries.
• Country reporting most new infection each day:
US 3,26,455
UK 1,49,513
France 1,21,566
Spain 82,391
Italy 79,716
India 27,553
• Data: Russia & Poland : reporting most deaths each day.
9. Indian Scenerio
• Till date 34.8 million infections and 480290
deaths so far.
• First Omicron case in India: on 2 Dec 2021, 2
Patients (66 yr. old male and 46 yr. old male)
from Karnataka, confirmed after genomic
sequencing.
• 7 Jan 2022:
Total active cases: 35,226,386(3.5 Cr)
Covid-19 new cases: 1,17,100
Total Recovered: 34,371,845 (3.4 Cr)
Total Death: 4,83,178
Total Omicron cases 1892; recovered 766.
Jharkhand: 365,222; Reco: 345814; Death: 5153
• Country is preparing to deal with the another
massive outbreak of this new heavily mutated
variant.
10. Why “OMICRON” has become VOC/VOI
• Most changes have little or no impact on the virus properties.
• However, some changes may affect the virus’s properties.
• It has also been observed and demonstrated that this variant has a significant degree of global
public health concern due to its increased transmissibility, increase in virulence, change in disease
presentation, immune escape.
• Omicron has been identified as causing significant community transmission & multiple COVID-19
cluster in multiple countries, which have increased heavily in number of cases over time, and
epidemiological impacts to suggest it as an emerging risk to global public health.
• Simultaneously decrease in public and social measures effectiveness, available diagnostics,
vaccines, therapeutics.
14. WHO plan of Action
Presently, WHO is coordinating with a large number of researchers around the
world to better understand Omicron.
Current study of concern:
1. Assessments of transmissibility.
2. Severity of infection.
3. Performance of vaccine.
4. Performance of diagnostic tests.
5. Effectiveness of treatments.
15. Further area of Study
• Effectiveness of prior SARS-CoV-2 infection: Preliminary evidence suggests there may be
increased risk of reinfection with Omicron as compared to other variants.
• Effectiveness of vaccine: with the available date, WHO is working with technical partners
to understand the potential impact of this variant on the existing vaccine, and more likely
current vaccines remain effective against it.
• Effectiveness of current tests: widely used PCR tests continue to detect infection like other
variants.
• Effectiveness of current treatments: Corticosteroids, Remdesivir & IL-6 receptor blockers is
still effective for severe COVID-19.
16. WHO recommendation to take actions for
“Country”
• Enhance genomic surveillance and sequencing of cases to better
understand circulating SARSCoV-2 Variants.
• Field investigation and Lab assessments to better understand disease
characteristics, transmission, vaccine effectiveness, therapeutics,
diagnostics, public & social health measures.
• Reporting of initial cases or clusters to WHO.
17. • Sharing & connect genomic sequences data on CDC, WHO, Public health
laboratories, commercial diagnostic laboratories publicly accessible
databases maintained by like-
• 1. GISAID(Global Initiative on Sharing Avian Influenza Data) and
• 2. NCBI(National Center for Biotechnology Information).
• Report says, if a variant is circulating at 0.1% frequency, there is a >99%
chances that it will be detected in genomic surveillance.
18. WHO recommended action for “People”
• To keep physical distance of at least 1 meter from other(2meter, 6feet, 2arm
distance), idea is to keep reasonable distance between two people.
• Wear a well fitting mask
• Open windows to improve ventilation, and Avoid poorly ventilated or crowded-
spaces.
• Keep hands clean.
• Cough or sneeze into a bent elbow or tissue.
• Get vaccinated when turn.
19. Significantly less severe disease (South Africa JAMA Dec 30-12-21)
• Some infectious ds. experts & clinical microbiologists says Omicron cause
“Significantly less” severe ds. as compared to DELTA variant.
• Study says that comparatively there were younger pts. in Omicron group and
outcome could be better due to “prior infection & induced immunity.
20. Omicron evades immunity better than Delta variant
(Danish study)
• Danish study shows that Omicron is better at circumventing vaccinated
peoples immunity than Delta variant, helping explain why Omicron is
spreading more rapidly.
• There is 2 Question, since the discovery of heavily mutated Omicron variant in
Nov., than the previously dominated Delta variant:
1. Why appear more contagious?
2. whether it comes less severe ds.?
• Study suggests that variant is more contagious due to reasons—
1. Time it lingers in the air
2. Its ability to latch onto cells.
3. Its evasion of the body’s immune system.
21. Symptoms
• 1. Most common symptoms: fever, cough, tiredness, scratchy throat,
fatigue, loss of taste or smell.
• 2. Less common symptoms: sore throat, headache, bodyache,
diarrhoea, rashes on skin, redness of eye.
• 3. Serious symptoms: SOB, Loss of speech or mobility, confusion,
chest pain/discomfort.
23. 1. Vaccines & Booster:
Tools to fight Omicron
• Best public health measure to protect from COVID-19, slow transmission, reduce
the likelihood of new variants emerging.
• Vaccines are highly effective at preventing severe illness, hospitalization and death.
Age: anyone above 5 year can take vaccine.
above 18 years should get a booster dose at least 2 month of J&J vaccine or 6
months after COVID-19 vaccination of Pfizer, BioNTech, or Moderna.
24. Vaccine development
• 548 Vaccines under trials.
• 31 Approved vaccine by at least one country.
• 196 Countries with approved vaccines.
• 62 Countries with vaccine trial.
• 10 Vaccine approved by WHO.
25. 10 WHO Approved Vaccines
Name DEVELOPED by Component Approved in
Country
Conducti
ng trials
1. COVOVAX(Novavax) SII(Serum Institute of India) Protein subunit 3 1
2. mRNA-1273 MODERNA RNA 83 9
3. BNT162b2 Pfizer/BioNTech RNA 130 23
4. Ad26.COV2.S J&J Non Replicating Viral
Vector
99 18
5. NVX-CoV2373 Novavax Protein Subunit 30 7
6. AZD1222 Oxford/AstraZeneca Non Replicating Viral
Vector
134 23
7. Covishield
(Oxford/Astra Zeneca)
SII Non Replicating Viral
Vector
47 1
8. Covaxin Bharat Biotech Inactivated 12 1
9. BBIBP-CorV(Vero Cells) Sinopharm(Beijing) Inactivated 80 10
10. Coronavac Sinovac Inactivated 48 8
26. 4 approved vaccine in
India
• 1. Covishield (90% in circulation)
• 2. Covaxin
• 3. Sputnik V
• 4. Zydus Cadila (ZyCov-D)
27. Newly Approved Vaccines in ‘India’
Government approved 2 new vaccine (both are Protein-based vaccines)
India’s bet for booster dose: phase 3 trial have been done for both vaccines,
likely to be approved.
1. Corbevax (Biological E’s, Hyderabad-based)
2. Covovax (SII)
Both are Protein-based vaccine can be produced in very large amounts &
are perfect for booster doses.
28. Booster dose & Children Vaccination (Health Ministry Guidelines)
• Vaccine for Children (15-18 yr., Birth year 2007 & before): register on Co-WIN from
1 Jan 2022, Bharat Biotech’s Covaxin would be only option for beneficiaries.
Booster dose : 1. Frontline worker,
2. People >60 yr. with comorbidities,
From 10 Jan 2022, Govt. will send SMS to eligible elderly population(>60 yr.,
comorbidity, 2 dose received, doctor advice) to remind for taking dose through their
existing Co-WIN account. Details of booster dose will be reflected in the vaccination
certificates.
Prioritization & Sequencing of dose: would be based on completion of 9 month/39
weeks from the date of second dose.
29. Concerns regarding Booster dose ( Indian Virologist & SARS CoV-2 Genomics Consortium)
1. Vaccine Manufacturer concern for booster (scientific & ethical)
2. Incomplete vaccination of major population:
• Africa: only 8% fully vaccinated of its total population.
• Europe: 59% fully vaccinated.
• North America: 56% fully vaccinated.
• India: 37% fully vaccinated of its population.
• Concern is allowing booster, means that you are taking those doses away from people
who only have one or none. Priority should be to get 2nd dose who already have one
dose & Get 2 doses for people who have no dose. Worldwide data shows that you get
protection from ds. with 2 dose of the COVID-19 vaccine doses.
• But it doesn’t mean, booster should be ignored.
30. 2. MASKS: Tools to fight Omicron
Offer protection against all variants. Adviced to wear mask in public indoor
or outdoor settings of high community transmission regardless of vaccination
status.
31.
32.
33. 3. TESTING: Tools to fight Omicron
Testing tells you if you are currently infected with COVID-19.
• 2 types of tests are used for current infection: NAATs(RT-PCR) & Ag
tests. Both tests can only tell you if you have a current infection.
• Over the counter Self-test can be used at home or anywhere are easy
and produce rapid results. If positive, stay at home or isolate for 10
days, wear a mask or call health care provider.
34. New Invention: OmiSure
• Tata Medical Diagnostic, India, developed by Dr V Ravi, HOD R&D, Tata MD.
can detect Omicron variant with 100% sensitivity (validated by ICMR).
• Test run time 85 min, total TAT 130 min.
35. • Principal: Based on two S-gene viral targets to reliably identify Omicron
1. S-gene drop out/S-gene target failure (SGTF)
2. S-gene mutation amplification (SGMA)
• S-gene target failure is indicative of Omicron, but other gene (SGMA)
detection indicates absolute sure of Omicron presence. That’s how it is
OmiSure. So it is 2 check process for Omicron detection.
• Plan is to deliver 2 lakh kits per day.
37. PREVENTION: How to protect yourself and other
• 1. Get Vaccinated: should get ASAP.
• 2. Wear a mask: everyone should wear especially in high cases zone, crowded
area or close area, during activities with close contacts, health care area,
during public transportation or travelling either for short or long distance like
planes, trains, buses or other modes, etc.
• 3. Physical distance: 2meter or 6 feet or 2 arm distance (idea is to avoid close
contacts).
• 4. Avoid crowds & poorly ventilated spaces: like station, bus stands, markets,
bars, restaurants, fitness center, movie theater or other public places.
• 5. Avoid indoor spaces that do not offer fresh air from outdoors (open the
windows and doors), all these puts on high risk for COVID-19.
38.
39. • 6. Wash your hands often: with soap and water for at least 20 seconds, especially
after have been in a public places or after blowing nose, coughing or sneezing.
Should consider hand wash-
Before eating or preparing food
Before touching face
After using washroom
After leaving public places
After blowing nose, coughing, or sneezing
After handling your mask
After caring sick
40. • 7. Coughing & Sneezing practices: If wearing mask– can cough or sneeze in your
mask then put on a new clean mask ASAP and wash your hands.
If not wearing mask: always cover your mouth and nose with tissue or use inside
of your elbow and do not spit. Throw the used tissue in the trash and wash your
hands.
• 8. Hand Sanitizer: if soap and water are not readily available, use a hand
sanitizer containing at least 60% alcohol.
• 9. Avoid touching your eyes, nose, and mouth with unwashed hands as
much as possible.
• 10. Test to prevent spread to others: testing can give information about risk
of spreading COVID-19(if positive can isolate himself and inform close
contacts or health care providers).
41. • 11. Clean and Disinfect: Clean high touch surfaces regularly or as needed
and after have visitors in your home, includes tables, doorknobs, light
switches, handles, desks, phones, keyboards, toilets, and sinks. If surfaces
are dirty, clean them using detergents or soap and water prior to
disinfection.
• 12. Monitor your health daily: watch for symptoms like fever, cough,
malaise, bodyache, headache, SOB or others.
42. SELF CARE : for Home Isolation Pts.
• Isolate yourself in well ventilated room.
• Use triple layered medical mask. And discard after 8 hr or after become wet or soiled,
discard after disinfecting it with 1% Sod. Hypochlorite.
• Take rest & drink lots of fluids to maintain adequate hydration.
• Follow coughing etiquettes & do regular exercise.
• Hand washing or use alcohol-based hand sanitizer.
• Ensure surface cleaning & most touched area with 1% Sod. Hypochlorite.
• Supportive treatment: PCM, Anti-histamine, Inhalational budesonide 600/800 mcg if
distressing cough, Avoid steroid at home.
• Monitor Temperature, Oxygen saturation & inform doctor SOS.
43. Instruction for Care givers
• 1. Mask: triple layer medical mask/N95 mask.
• 2. Hand Hygiene: by soap-water or by alcohol-based hand sanitiser.
• 3. Avoid exposure to Pt.: avoid direct contact with body fluids of patients,
particularly oral or respiratory secretions.
• 4. Use disposable Gloves while handling pts.
44. TREATMENT
• Corticosteroids: Dexamethasone used for hospitalised pts. with severe COVID-19
ds., Supplemental Oxygen requirement, Mechanical ventilation. If Dexamethasone
not available, Prednisolone, Methylprednisolone, Hydrocortisone can be used.
• Remdesivir: work better in early phase of COVID-19. Dose- 200mg IV on day 1,
followed by 100 mg IV on day 2 & 3. Can be given in pts. of >12 yrs. of age.
• Convalescent plasma with high Ab level : It is blood donated by people who have
recovered from COVID-19. It can be given to hospitalised pts. with weekend or
impaired immunity.
45. Warning signs/ Admission criteria
• Severe cough or SOB
• Persistent/High grade pyrexia >7
days
• Chest tightness/Palpitation
• Low SpO2 (<94%)
• Resp. rate >24/min
• Low BP (systolic <100mmHg)
High risk group(need monitoring)
• Age >60 yr.
• Obesity
• DM
• HTN/IHD
• COPD/Chr. Lung ds.
• CKD
• CLD
• Cancer
46. Anti-SARS-CoV-2 monoclonal Ab (mAbs) or Monoclonal Ab Cocktail therapy:
• Study shows positive results, recovering within
48 hrs.
• Efficacy: study shows 85% reduction in
hospitalisation or death.
• Line of treatment is same for both types of
COVID-19 pts. (Delta & Omicron).
• Recently also approved mAbs for children above
12 yrs. of age.
• Administration: 500mg single IV infusion, upto 4
shots.
• Single dose costing up to 56000 Rs.
• Widely used is ‘SOTROVIMAB’by
GlaxoSmithKline: combination of Bamlanivimab
+ Etesevimab.
47. New Drugs
• 1. MOLNUPIRAVIR 2. PAXLOVID
• It has been found safe & effective at reducing the risk of hospitalisation and death in people with
mild to moderate COVID-19 infection who are at an increased risk of developing severe ds.
• 1. Molnupiravir (Merck & Co.): Oral Antiviral, US FDA, DCGI (Drug Controller General of India)
approved for restricted emergency use in COVID-19 ds., Acts in early stage of ds. (within 4-5
days), reduce progression to severe ds. which might reduce hospitalisation. Dose 800mg orally BD
for 5 days. Researchers point out it may create new variant of SARSCoV-2 that escape immunity
& prolong pandemic, not included in health guidelines yet.
MOLFLU(Dr Reddy’s Lab) will be marketed in India to treat COVID-19.. Cost Rs 35/cap. 10
cap/strip, total 40 caps for 5 days would cost Rs 1400/pt.
48. • 2. Paxlovid (Pfizer): Oral antiviral, combination of active ingredient
Nirmatrelvir(PF-07321332)300mg & Ritonavir 100mg, acts by inhibiting protease
enzyme(required for viral replication) orally BD for 5 days, most effective in early
phase of ds., >12 yr., mild to moderate ds., risk factors- obesity, >60 yr. of age,
DM, Heart ds.
• 3. Ritonavir: antiviral, used in HIV as protease inhibitor since long, inhibit viral
replication.
49. Supportive care for mild COVID-19 illness
Aimed to relieve symptoms-
Pain killer/Antipyretics (Ibuprofen, Acetaminophen)
Cough syrup or similar medication
Adequate Rest
Fluid intake to maintain adequate hydration.
Antibiotics if needed.
50. How concern should be about Omicron?
• WHO declared variant as a VoC (Variant of Concern) after assessment.
1. Increased transmissibility or detrimental change in epidemiology,
2. Increased virulence,
3. Change in clinical disease presentation,
4. Decrease effectiveness in available diagnostic, therapeutics and
vaccines.(Source:WHO)
51. Will the existing vaccine work against Omicron
• No evidence that it will not work.
• Mutation reported on Spike gene may decrease the efficacy of existing vaccines.
• However, vaccine protection is also by Abs as well as Cellular immunity, which is
expected to be better preserved. So it will still offer protection against severe
disease.
• Vaccination is crucial, those eligible should get vaccinated.
(Source: WHO & MoHFW,GoI)
52. Will there be a third wave?
Omicron cases are increasing & being reported from many countries, and
given its characteristics, it is highly transmissible.
• 1. Further, given the fast pace of vaccination in India,
• 2. High exposure to Delta variant as evidenced by high seropositivity,
severity of the disease is anticipated to be low.
However, scale & magnitude of rise in cases & most importantly the severity
of disease is still not very much clear and scientific evidence is still evolving.
(Source: WHO & MoHFW, GoI)
53. Is Omicron a blessing for mankind?
• Due to its high transmissibility & less severity (less hospitalisation, very less
O2 requirement, less ICU/CCU admission, less critical cases requiring
intubation, ventilation or other support) everyone will be exposed & will get
it. It will create mass herd immunity & consequently will replace DELTA
variant.
• Researchers says, mankind will get natural immunity that will provide better
protection than vaccine & last longer.
• It can be a blessings for many underprivileged country like India, where
reasonable % of people have not fully vaccinated.