A Study to Assess the Knowledge, Attitude and Practice Regarding Prevention o...ijtsrd
Objective To assess the knowledge, attitude and practice toward coronavirus disease COVID 19 Background The World Health Organization declared COVID 19 as a pandemic on the 11th of March 2020 and declared as a global health emergency. Since then, many efforts are being carried out to control the rapid spread of the ongoing COVID 19 epidemic in India. The control measures COVID 19 is affected by their knowledge, attitudes, and practices KAP towards COVID 19. Knowledge attitude and practice of people should be directed towards strict preventive practices in order to prevents the spread of the virus. Materials and Methods The aim of the current electronic cross sectional study is to assess the knowledge, attitude and practice among selected rural community. Structured questionnaire was created in the google forms, the link was generated and distributed among the people though email and other media to participate in the survey. A total 153 subject was enrolled through convenient sampling technique. Collected data was analysed using descriptive statistics including frequency, percentage, mean and standard deviation. Results Majority of participant 91.50 were having the adequate information regarding the covid 19 and most of participants, 52.28 were got the information from multimedia included television, radio and newspaper regarding COVID 19. About 52.28 participants were the aware about the online training program by the government .Among 153 participants, 115 had adequate knowledge, 23 had moderately adequate and 15 had inadequate knowledge. Most 75.16 of the participants had adequate knowledge, in 15.03 moderately adequate and in 9.80 inadequate knowledge found regarding prevention of COVID 19. The mean knowledge score was 15.54 with standard deviation of 2.93. Most of the 102 66.66 had most favourable attitude, 31 20.26 had favourable and 20 13.07 had unfavourable attitude . The mean attitude score was 34.76 with standard deviation of 2.86.Majority of the participants, 129 had good practice, 20 had average practice and 4 had bad practice . Most 84.31 of the participants had good practice, in 13.07 average practice and in 2.61 bad practice found regarding prevention of COVID 19. The mean practice score was 25.2 with standard deviation of 2.56. Lalan Kumar "A Study to Assess the Knowledge, Attitude and Practice Regarding Prevention of Novel Coronavirus (COVID-19): An Electronic Cross-Sectional Survey among Selected Rural Community" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-3 , April 2020, URL: https://www.ijtsrd.com/papers/ijtsrd30657.pdf Paper Url :https://www.ijtsrd.com/medicine/nursing/30657/a-study-to-assess-the-knowledge-attitude-and-practice-regarding-prevention-of-novel-coronavirus-covid19-an-electronic-crosssectional-survey-among-selected-rural-community/lalan-kumar
Coronaviruses are important human and animal pathogens. At the end of 2019, a novel coronavirus was identified as the cause of a cluster of pneumonia cases in Wuhan, in the Hubei Province of China. It is rapidly spreading, resulting in an epidemic throughout china, followed by an increasing number of cases in other countries throughout the world. In February 2020, the WHO designated the disease COVID 19, which stands for corona viruses 2019. The virus that causes COVID 19 is designated severe acute respiratory syndrome coronavirus 2 SARS COV 2 previously, it was referred to as 2019 nCoV. Anushka Bharti | Dr. Gaurav Kumar Sharma | Dr. Kaushal Kishore Chandul "COVID-19" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-6 , October 2021, URL: https://www.ijtsrd.com/papers/ijtsrd46439.pdf Paper URL : https://www.ijtsrd.com/pharmacy/pharmaceutics/46439/covid19/anushka-bharti
COVID-19: Knowledge Base, Attitudes and Practices among Practising Journalist...Premier Publishers
The Coronavirus pandemic is presently the topic of discussion among various segments of global society. From the developed North to the developing South, within economically poor and rich countries, the huge rates of infection and resulting deaths from the pandemic has surpassed anything seen for a long time. Health systems and economies in both developed and developing countries are challenged in ways never imagined. The global efforts to mitigate the effects of the pandemic are moving at a very fast pace. Public health information is one of the strategies being used to ensure that persons are knowledgeable about the pandemic and adopt practices and protocols that will stem infections within the community. This study was undertaken to gauge the knowledge levels of journalists in the Nigerian capital city of Abuja and the impact of the knowledge on their attitudes and practices. The knowledge, attitudes and practice study model were used to gauge the interrelatedness of these variables among the study group. Logit regression tests, t-tests, chi-square and descriptive analysis were used to determine knowledge levels as well as what factors influenced attitudes and practices towards COVID-19 within the group. Overall, knowledge level amongst the study group was good and had a positive impact on attitude patterns. However, there was no high positive correlation between knowledge and practices. It is suggested that journalists in Nigeria must adhere to public health protocols in order to be able to engage in multi-platform public health information awareness publications which will sensitize the public into observing the COVID containment protocols.
This topic is about Coronavirus FAQ: Covid-19 by Academic Assignments which is assignment writing service company, this post is about As indicated by the World Health Organization, COVID-19 is an irresistible ailment brought about by the most as of late found coronavirus.
A Study to Assess the Knowledge, Attitude and Practice Regarding Prevention o...ijtsrd
Objective To assess the knowledge, attitude and practice toward coronavirus disease COVID 19 Background The World Health Organization declared COVID 19 as a pandemic on the 11th of March 2020 and declared as a global health emergency. Since then, many efforts are being carried out to control the rapid spread of the ongoing COVID 19 epidemic in India. The control measures COVID 19 is affected by their knowledge, attitudes, and practices KAP towards COVID 19. Knowledge attitude and practice of people should be directed towards strict preventive practices in order to prevents the spread of the virus. Materials and Methods The aim of the current electronic cross sectional study is to assess the knowledge, attitude and practice among selected rural community. Structured questionnaire was created in the google forms, the link was generated and distributed among the people though email and other media to participate in the survey. A total 153 subject was enrolled through convenient sampling technique. Collected data was analysed using descriptive statistics including frequency, percentage, mean and standard deviation. Results Majority of participant 91.50 were having the adequate information regarding the covid 19 and most of participants, 52.28 were got the information from multimedia included television, radio and newspaper regarding COVID 19. About 52.28 participants were the aware about the online training program by the government .Among 153 participants, 115 had adequate knowledge, 23 had moderately adequate and 15 had inadequate knowledge. Most 75.16 of the participants had adequate knowledge, in 15.03 moderately adequate and in 9.80 inadequate knowledge found regarding prevention of COVID 19. The mean knowledge score was 15.54 with standard deviation of 2.93. Most of the 102 66.66 had most favourable attitude, 31 20.26 had favourable and 20 13.07 had unfavourable attitude . The mean attitude score was 34.76 with standard deviation of 2.86.Majority of the participants, 129 had good practice, 20 had average practice and 4 had bad practice . Most 84.31 of the participants had good practice, in 13.07 average practice and in 2.61 bad practice found regarding prevention of COVID 19. The mean practice score was 25.2 with standard deviation of 2.56. Lalan Kumar "A Study to Assess the Knowledge, Attitude and Practice Regarding Prevention of Novel Coronavirus (COVID-19): An Electronic Cross-Sectional Survey among Selected Rural Community" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-3 , April 2020, URL: https://www.ijtsrd.com/papers/ijtsrd30657.pdf Paper Url :https://www.ijtsrd.com/medicine/nursing/30657/a-study-to-assess-the-knowledge-attitude-and-practice-regarding-prevention-of-novel-coronavirus-covid19-an-electronic-crosssectional-survey-among-selected-rural-community/lalan-kumar
Coronaviruses are important human and animal pathogens. At the end of 2019, a novel coronavirus was identified as the cause of a cluster of pneumonia cases in Wuhan, in the Hubei Province of China. It is rapidly spreading, resulting in an epidemic throughout china, followed by an increasing number of cases in other countries throughout the world. In February 2020, the WHO designated the disease COVID 19, which stands for corona viruses 2019. The virus that causes COVID 19 is designated severe acute respiratory syndrome coronavirus 2 SARS COV 2 previously, it was referred to as 2019 nCoV. Anushka Bharti | Dr. Gaurav Kumar Sharma | Dr. Kaushal Kishore Chandul "COVID-19" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-6 , October 2021, URL: https://www.ijtsrd.com/papers/ijtsrd46439.pdf Paper URL : https://www.ijtsrd.com/pharmacy/pharmaceutics/46439/covid19/anushka-bharti
COVID-19: Knowledge Base, Attitudes and Practices among Practising Journalist...Premier Publishers
The Coronavirus pandemic is presently the topic of discussion among various segments of global society. From the developed North to the developing South, within economically poor and rich countries, the huge rates of infection and resulting deaths from the pandemic has surpassed anything seen for a long time. Health systems and economies in both developed and developing countries are challenged in ways never imagined. The global efforts to mitigate the effects of the pandemic are moving at a very fast pace. Public health information is one of the strategies being used to ensure that persons are knowledgeable about the pandemic and adopt practices and protocols that will stem infections within the community. This study was undertaken to gauge the knowledge levels of journalists in the Nigerian capital city of Abuja and the impact of the knowledge on their attitudes and practices. The knowledge, attitudes and practice study model were used to gauge the interrelatedness of these variables among the study group. Logit regression tests, t-tests, chi-square and descriptive analysis were used to determine knowledge levels as well as what factors influenced attitudes and practices towards COVID-19 within the group. Overall, knowledge level amongst the study group was good and had a positive impact on attitude patterns. However, there was no high positive correlation between knowledge and practices. It is suggested that journalists in Nigeria must adhere to public health protocols in order to be able to engage in multi-platform public health information awareness publications which will sensitize the public into observing the COVID containment protocols.
This topic is about Coronavirus FAQ: Covid-19 by Academic Assignments which is assignment writing service company, this post is about As indicated by the World Health Organization, COVID-19 is an irresistible ailment brought about by the most as of late found coronavirus.
A Perspective Approach of Community Medicine in Corona Virus Disease COVID 19ijtsrd
Coronavirus disease COVID 19 is an infectious disease caused by the SARS CoV 2 coronavirus, which has spread rapidly across the world. The World Health Organization WHO proclaimed the COVID 19 outbreak a pandemic in March 2020. The pandemic has wreaked havoc on global health systems, as well as economic and social development. The rate of transmission is relatively high.As a result, regardless of vaccine history or previous infection, the CDC recommends that anyone with any signs or symptoms of COVID 19 be checked. Everyday Preventive Actions, as well as having the Covid 19 Vaccine when it is safe, will protect you and your loved ones. Prof. Dr. Anup Kumar Das | Dr. Humani Sharma | Dr. Hitarth Mehta "A Perspective Approach of Community Medicine in Corona Virus Disease (COVID 19)" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd43677.pdf Paper URL: https://www.ijtsrd.comother-scientific-research-area/other/43677/a-perspective-approach-of-community-medicine-in-corona-virus-disease-covid-19/prof-dr-anup-kumar-das
Speedy variants power COVID-19 surge sweeping EuropeMartinBujdos
Genetic analysis confirmed what officials already suspected: The highly contagious coronavirus variant first identified in England was racing through the community, a densely packed city of nearly 40,000 with a chemical plant and Pirelli bicycle tire factory a 15-minute drive from the heart of Milan.
COVID-19 Facts vs Opinion: Nonchalant Responses of The Indonesian PeopleJosephineSurya2
This paper is submitted to fulfill the English 2 Final Exam Project study program Industrial Engineering 2nd semester Buddhi Dharma University, Tangerang. Lecturer: Dra. Harisa Mardiana, M.Pd.
Anxiety, Depression and Stress among General Population during Covid 19 Outbr...ijtsrd
On 11 Mar 2020, the WHO declared the outbreak a global pandemic. In times of an epidemic, people tend to experience fear of getting infected with the virus disease resulting in anxiety, stress, and depression, etc. The present study was a cross sectional survey with a convenience sampling technique. Data were collected through electronic means. Link to the survey was posted on various social media platforms and circulated through emails and instant messaging applications and data was collected by using Depression Anxiety Stress Scale DASS 21 . it was found that the overall DASS mean score of participants with positive history of corona virus disease was significantly higher than those with negative history. In depression subscale, anxiety subscale and stress subscale the mean score of depression subscale, anxiety subscale and stress subscale was significantly higher in participants with positive history of corona virus disease than those with negative history. Mrs. Pooja Dhasmana | Mr. Saurabh kumar "Anxiety, Depression and Stress among General Population during Covid-19 Outbreak: A Comparative Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd42585.pdf Paper URL: https://www.ijtsrd.commedicine/physiology/42585/anxiety-depression-and-stress-among-general-population-during-covid19-outbreak-a-comparative-study/mrs-pooja-dhasmana
Background- Multidrug-resistant tuberculosis (MDR-TB) is caused by strain of Mycobacterium tuberculosis, it is transmitted through air droplets from infected person and Close contacts of MDR-TB patients have a high potential to developing TB. This study aims to determine the profile of TB/multidrug-resistant TB (MDR-TB) among household contacts of MDR-TB patients. Material and Methods- The cases were recruited from the King George’s Medical University, Lucknow, India. In this cross-sectional study, Close contacts of MDR-TB patients were screened for tuberculosis. clinical, radiological and bacteriological experiments were performed to find out the evidence of TB/MDR-TB. Results- The cases were enrolled Between December 2015 to December 2016, a total of 100 index MDR-TB patients were recruited which initiated on MDR-TB treatment. A total of 428 contacts who could be studied, 11 (2.57%) were diagnosed with MDR-TB and 4 (0.93%) had TB. The most frequent symptoms observed in patients were cough, chest pain and fever. Conclusions- Tracing symptomatic contacts of MDR-TB cases could be a high yield strategy for early detection and treatment of MDR-TB cases to contribute to reduced morbidity, mortality and to cut the chain of transmission of infection in the community. The approach should be bringing about for wider implementation and dissemination. Key-words- TB, MDR-TB, Symptomatic, Household, Transmission
#Covid19: Information guide for general Public.MADHUR VERMA
We have talked about the measures that have to be taken by the general public during the lockdown and what are the dos and don'ts during this pandemic. Also, we have talked about various bits and facts related to Coronavirus Disease.
The Coronavirus Disease – 2019 (COVID-19) is officially now a pandemic and not just a public health emergency of international concern as previously labelled. Worldwide, the new coronavirus has infected more than 4.9 million people and leaving more than 300,000 people dead in 188 countries. As countries of the world get locked down in an effort to contain the widespread of the virus, experts are concern about the global impacts of the pandemic on individuals, countries and the world at large. Millions of people are currently under quarantine across the globe. Many countries have responded by proclaiming a public health emergency, closed their borders and restrict incoming flights from high risk countries. This has grossly affected the travel plan of many. Several international programs, conferences, workshops and sporting activities are either postponed or cancelled. As the number of confirmed cases continues to escalate across the globe, hospitals seems to be running out of medical supplies, hospital spaces and personnel. Health workers are being overwhelmed by the numbers of people requesting for testing and treatment. Many of such health workers have been infected with the coronavirus and even lost their lives since the fight against COVID-19 started. Public health experts are also concerned about the huge medical wastes coming from the hospitals at this time and the adverse effects associated with improper management of such medical wastes, both at the hospital and community levels. The pandemic has also impacted negatively on the global economy. There have been serious crises in the stock market, with gross fall in the price of crude oil resulting in inflation and economic hardship among the populace. Many are currently out of job and as a result, the level of crime, protest and violence have continued to escalate in different parts of the world. The deaths of loved ones due to the coronavirus has left many emotionally traumatized. Nigeria, like other African countries is not spared of the ravaging effects of the pandemic, even as the government take strict measures to contain the virus. No doubt, this is very challenging, but the country is capable of surmounting the virus with the needed help from her international partners and cooperation from the citizenry. But if we as a people, remain complacent and continue with business as usual, without taking measures to flatten the curve, the disease will escalate too quickly beyond our capacity to handle and our health system will be overwhelmed and may collapse eventually. We cannot therefore afford to be complacent in our response to containing the pandemic.
Correlation between Human Origin and the Severity of COVID19ijtsrd
It has been reported that the severity of coronavirus infectious disease COVID 19 is due to several factors such as age and the presence or absence of chronic disease. Furthermore, it has been reported that genetic factors affect the severity of COVID 19. A recently published study of the COVID 19 Host Genetics Initiative suggests that genetic manifolds in the region located on chromosome 3 may increase the risk of the severity of COVID 19. Takuma Hayashi | Ikuo Konishi "Correlation between Human Origin and the Severity of COVID19" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-6 , October 2020, URL: https://www.ijtsrd.com/papers/ijtsrd33684.pdf Paper Url: https://www.ijtsrd.com/medicine/other/33684/correlation-between-human-origin-and-the-severity-of-covid19/takuma-hayashi
Emergency management 11
Emergency Management
Abstract:
In the month of December, 2019 there was outbreak of pneumonia with unknown reason in Wuhan, China. Wuhan is the center of attention because of the respiratory disorder cause by a virus called Corona and also known as Novel COVID – 19. Validate the existence of this virus was also diagnosed in Wuhan. Then it start spreading all over the world due to the social gatherings. It ultimately take thousands of people towards death. Then after its huge destruction a final step of lockdown is taken up by the government of each country. The animal-to-human transmission was presumed as the main mechanism. It was concluded that the virus could also be transmitted from human-to-human, and symptomatic people are the most frequent source of COVID-19 spread. The virus-host interaction and the evolution of the epidemic, with specific reference to the times when the epidemic will reach its peak.
Introduction:
There is scanty knowledge on the actual pandemic potential of this new SARS-like virus. It might be speculated that SARS-CoV-2 epidemic is grossly underdiagnosed and that the infection is silently spreading across the globe. There are no comparable analogies to corona virus. This virus is not like any of the other epidemiological threats that have emerged in recent decades; it is less fatal but much more contagious.
Distribution of cases by the following:
· Time: The outbreak of 2019 novel coronavirus disease (COVID-19) was first reported on December 31, 2019.
· Place: the epidemiology of 2019 novel coronavirus disease (COVID-19) in a remote region of China, far from Wuhan, we analyzed the epidemiology of COVID-19 in Gansu Province
Explanation of the research topic (corona virus):
As the outbreak of coronavirus disease 2019 (COVID-19) is rapidly expanding in China and beyond, with the potential to become a world-wide pandemic, real-time analyses of epidemiological data are needed to increase situational awareness and inform interventions. The current most likely hypothesis is that an intermediary host animal has played a role in the transmission. Identifying the animal source of the 2019-nCoV would help to ensure that there will be no further future similar outbreaks with the same virus and will also help understanding the initial spread of the disease.
Numerator (cases of corona virus):
Deaths divided the total of deaths plus recoveries. In early days because of the exponential increase new cases significantly outpace recoveries. You’re dividing by new cases but the numerator hasn’t had a chance to catch up to the death toll yet to be associated with those cases. If you look at COVID 19 on Feb 17, you get the 2% number only if dividing by total cases. If you look vs recovered cases, it’s 13%.
The WHO’s fatality percentage, announced March 17, 2020, is based simply on the number of deaths g.
Travel-related infectious diseases on the rise
International travel has an important role in the transmission of emerging and re-emerging infectious diseases across geographical areas.
Since 1980, the world has been threatened by different waves of emerging disease epidemics.
In the twenty-first century, these diseases have become an increasing global concern because of their health and economic impacts in both developed and resource-constrained countries.
It is difficult to stop the occurrence of new pathogens in the future due to the interconnection among humans, animals, and the environment.
As many as 43%–79% of travelers to low- and middle-income countries become ill with a travel-related health problem.
Although most of these illnesses are mild, some travelers become sick enough to seek care from a health care provider.
A Perspective Approach of Community Medicine in Corona Virus Disease COVID 19ijtsrd
Coronavirus disease COVID 19 is an infectious disease caused by the SARS CoV 2 coronavirus, which has spread rapidly across the world. The World Health Organization WHO proclaimed the COVID 19 outbreak a pandemic in March 2020. The pandemic has wreaked havoc on global health systems, as well as economic and social development. The rate of transmission is relatively high.As a result, regardless of vaccine history or previous infection, the CDC recommends that anyone with any signs or symptoms of COVID 19 be checked. Everyday Preventive Actions, as well as having the Covid 19 Vaccine when it is safe, will protect you and your loved ones. Prof. Dr. Anup Kumar Das | Dr. Humani Sharma | Dr. Hitarth Mehta "A Perspective Approach of Community Medicine in Corona Virus Disease (COVID 19)" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd43677.pdf Paper URL: https://www.ijtsrd.comother-scientific-research-area/other/43677/a-perspective-approach-of-community-medicine-in-corona-virus-disease-covid-19/prof-dr-anup-kumar-das
Speedy variants power COVID-19 surge sweeping EuropeMartinBujdos
Genetic analysis confirmed what officials already suspected: The highly contagious coronavirus variant first identified in England was racing through the community, a densely packed city of nearly 40,000 with a chemical plant and Pirelli bicycle tire factory a 15-minute drive from the heart of Milan.
COVID-19 Facts vs Opinion: Nonchalant Responses of The Indonesian PeopleJosephineSurya2
This paper is submitted to fulfill the English 2 Final Exam Project study program Industrial Engineering 2nd semester Buddhi Dharma University, Tangerang. Lecturer: Dra. Harisa Mardiana, M.Pd.
Anxiety, Depression and Stress among General Population during Covid 19 Outbr...ijtsrd
On 11 Mar 2020, the WHO declared the outbreak a global pandemic. In times of an epidemic, people tend to experience fear of getting infected with the virus disease resulting in anxiety, stress, and depression, etc. The present study was a cross sectional survey with a convenience sampling technique. Data were collected through electronic means. Link to the survey was posted on various social media platforms and circulated through emails and instant messaging applications and data was collected by using Depression Anxiety Stress Scale DASS 21 . it was found that the overall DASS mean score of participants with positive history of corona virus disease was significantly higher than those with negative history. In depression subscale, anxiety subscale and stress subscale the mean score of depression subscale, anxiety subscale and stress subscale was significantly higher in participants with positive history of corona virus disease than those with negative history. Mrs. Pooja Dhasmana | Mr. Saurabh kumar "Anxiety, Depression and Stress among General Population during Covid-19 Outbreak: A Comparative Study" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd42585.pdf Paper URL: https://www.ijtsrd.commedicine/physiology/42585/anxiety-depression-and-stress-among-general-population-during-covid19-outbreak-a-comparative-study/mrs-pooja-dhasmana
Background- Multidrug-resistant tuberculosis (MDR-TB) is caused by strain of Mycobacterium tuberculosis, it is transmitted through air droplets from infected person and Close contacts of MDR-TB patients have a high potential to developing TB. This study aims to determine the profile of TB/multidrug-resistant TB (MDR-TB) among household contacts of MDR-TB patients. Material and Methods- The cases were recruited from the King George’s Medical University, Lucknow, India. In this cross-sectional study, Close contacts of MDR-TB patients were screened for tuberculosis. clinical, radiological and bacteriological experiments were performed to find out the evidence of TB/MDR-TB. Results- The cases were enrolled Between December 2015 to December 2016, a total of 100 index MDR-TB patients were recruited which initiated on MDR-TB treatment. A total of 428 contacts who could be studied, 11 (2.57%) were diagnosed with MDR-TB and 4 (0.93%) had TB. The most frequent symptoms observed in patients were cough, chest pain and fever. Conclusions- Tracing symptomatic contacts of MDR-TB cases could be a high yield strategy for early detection and treatment of MDR-TB cases to contribute to reduced morbidity, mortality and to cut the chain of transmission of infection in the community. The approach should be bringing about for wider implementation and dissemination. Key-words- TB, MDR-TB, Symptomatic, Household, Transmission
#Covid19: Information guide for general Public.MADHUR VERMA
We have talked about the measures that have to be taken by the general public during the lockdown and what are the dos and don'ts during this pandemic. Also, we have talked about various bits and facts related to Coronavirus Disease.
The Coronavirus Disease – 2019 (COVID-19) is officially now a pandemic and not just a public health emergency of international concern as previously labelled. Worldwide, the new coronavirus has infected more than 4.9 million people and leaving more than 300,000 people dead in 188 countries. As countries of the world get locked down in an effort to contain the widespread of the virus, experts are concern about the global impacts of the pandemic on individuals, countries and the world at large. Millions of people are currently under quarantine across the globe. Many countries have responded by proclaiming a public health emergency, closed their borders and restrict incoming flights from high risk countries. This has grossly affected the travel plan of many. Several international programs, conferences, workshops and sporting activities are either postponed or cancelled. As the number of confirmed cases continues to escalate across the globe, hospitals seems to be running out of medical supplies, hospital spaces and personnel. Health workers are being overwhelmed by the numbers of people requesting for testing and treatment. Many of such health workers have been infected with the coronavirus and even lost their lives since the fight against COVID-19 started. Public health experts are also concerned about the huge medical wastes coming from the hospitals at this time and the adverse effects associated with improper management of such medical wastes, both at the hospital and community levels. The pandemic has also impacted negatively on the global economy. There have been serious crises in the stock market, with gross fall in the price of crude oil resulting in inflation and economic hardship among the populace. Many are currently out of job and as a result, the level of crime, protest and violence have continued to escalate in different parts of the world. The deaths of loved ones due to the coronavirus has left many emotionally traumatized. Nigeria, like other African countries is not spared of the ravaging effects of the pandemic, even as the government take strict measures to contain the virus. No doubt, this is very challenging, but the country is capable of surmounting the virus with the needed help from her international partners and cooperation from the citizenry. But if we as a people, remain complacent and continue with business as usual, without taking measures to flatten the curve, the disease will escalate too quickly beyond our capacity to handle and our health system will be overwhelmed and may collapse eventually. We cannot therefore afford to be complacent in our response to containing the pandemic.
Correlation between Human Origin and the Severity of COVID19ijtsrd
It has been reported that the severity of coronavirus infectious disease COVID 19 is due to several factors such as age and the presence or absence of chronic disease. Furthermore, it has been reported that genetic factors affect the severity of COVID 19. A recently published study of the COVID 19 Host Genetics Initiative suggests that genetic manifolds in the region located on chromosome 3 may increase the risk of the severity of COVID 19. Takuma Hayashi | Ikuo Konishi "Correlation between Human Origin and the Severity of COVID19" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-6 , October 2020, URL: https://www.ijtsrd.com/papers/ijtsrd33684.pdf Paper Url: https://www.ijtsrd.com/medicine/other/33684/correlation-between-human-origin-and-the-severity-of-covid19/takuma-hayashi
Emergency management 11
Emergency Management
Abstract:
In the month of December, 2019 there was outbreak of pneumonia with unknown reason in Wuhan, China. Wuhan is the center of attention because of the respiratory disorder cause by a virus called Corona and also known as Novel COVID – 19. Validate the existence of this virus was also diagnosed in Wuhan. Then it start spreading all over the world due to the social gatherings. It ultimately take thousands of people towards death. Then after its huge destruction a final step of lockdown is taken up by the government of each country. The animal-to-human transmission was presumed as the main mechanism. It was concluded that the virus could also be transmitted from human-to-human, and symptomatic people are the most frequent source of COVID-19 spread. The virus-host interaction and the evolution of the epidemic, with specific reference to the times when the epidemic will reach its peak.
Introduction:
There is scanty knowledge on the actual pandemic potential of this new SARS-like virus. It might be speculated that SARS-CoV-2 epidemic is grossly underdiagnosed and that the infection is silently spreading across the globe. There are no comparable analogies to corona virus. This virus is not like any of the other epidemiological threats that have emerged in recent decades; it is less fatal but much more contagious.
Distribution of cases by the following:
· Time: The outbreak of 2019 novel coronavirus disease (COVID-19) was first reported on December 31, 2019.
· Place: the epidemiology of 2019 novel coronavirus disease (COVID-19) in a remote region of China, far from Wuhan, we analyzed the epidemiology of COVID-19 in Gansu Province
Explanation of the research topic (corona virus):
As the outbreak of coronavirus disease 2019 (COVID-19) is rapidly expanding in China and beyond, with the potential to become a world-wide pandemic, real-time analyses of epidemiological data are needed to increase situational awareness and inform interventions. The current most likely hypothesis is that an intermediary host animal has played a role in the transmission. Identifying the animal source of the 2019-nCoV would help to ensure that there will be no further future similar outbreaks with the same virus and will also help understanding the initial spread of the disease.
Numerator (cases of corona virus):
Deaths divided the total of deaths plus recoveries. In early days because of the exponential increase new cases significantly outpace recoveries. You’re dividing by new cases but the numerator hasn’t had a chance to catch up to the death toll yet to be associated with those cases. If you look at COVID 19 on Feb 17, you get the 2% number only if dividing by total cases. If you look vs recovered cases, it’s 13%.
The WHO’s fatality percentage, announced March 17, 2020, is based simply on the number of deaths g.
Travel-related infectious diseases on the rise
International travel has an important role in the transmission of emerging and re-emerging infectious diseases across geographical areas.
Since 1980, the world has been threatened by different waves of emerging disease epidemics.
In the twenty-first century, these diseases have become an increasing global concern because of their health and economic impacts in both developed and resource-constrained countries.
It is difficult to stop the occurrence of new pathogens in the future due to the interconnection among humans, animals, and the environment.
As many as 43%–79% of travelers to low- and middle-income countries become ill with a travel-related health problem.
Although most of these illnesses are mild, some travelers become sick enough to seek care from a health care provider.
The presentation covers known Variants Covid -19 of medical importance and the second wave Covid - 19 that hit in India. The factors that led to the abrupt raised number of cases in a short time.
After months of deliberation, the World Health Organization has
declared COVID-19 a pandemic. As it seemed clear for quite some time, the virus will likely spread to most (if not all) countries on the globe. However, actions can still limit its impact.
Running head: TUBERCULOSIS 1
TUBERCULOSIS 2
Tuberculosis
NRS-427VN | Epidemiology and Communicable Disease
8/26/18
Tuberculosis
About 33% in our existence's people is considered to have been tainted with tuberculosis (TB), new attacks are symbolized in no under 1% of the people every year". In 2016, a standard 1.5 million fatalities associated with TB have took place, the lion's talk about which are from younger looking countries over the world. As this quantity has been reducing, unnecessarily various have been sullied. The best center is situated in the Asian and African countries, at 80%. Within the USA, 5-10% of the individuals studies constructive. With tuberculosis taking after second behind HIV/Helps in most common deaths from powerful ailment, they have transformed into an over-all exchange. Understanding the annals, seeing the signals and appearances, evolved treatment alternatives, and neutralizing activity, will spread this disease to an even of control.
Since the start, tuberculosis has been accessible. Most quick unambiguous affirmation of the malady has been dated around 17,000 years before, in stays of a bison in Wyoming. Effective treatment of tuberculosis has finished up being bothersome and long. Chemical manifestations of the mycobacterium cell dividers and bizarre form, restricts most against microbial alternatives. Most typically used is Isoniazid and Rifampicin. Advised estimations of treatment, for new starting point, are half a year of blend hostile to infections operators. 8 weeks of rifampicin, isoniazid, pyrazinamide, and ethambutol drugs. Together with the latest four a few months of just rifampicin and isoniazid"(Wikipedia, 2015, p. 12).For the individuals who have idle TB receive only a sole against microbial.
This estimation ruins the inert TB to wrap up aspect. As this move out estimations of hostile to infections specialists can be difficult, direct observed treatment is preferred by WHO (World Health Corporation, 2015). Facts have exhibited that folks, who are depended after to adopt their medicine, will miss organized estimations. Immediate discernment treatment contains having an interpersonal protection employee watch the individual taking their remedies. As this is dreary, using diverse contraptions of acknowledgment is necessary. Such overhauls can sign up for booked calls or digital notices. By not doing medication regimens, put others at peril to finding this sickness.
Those in close closeness to specific with tuberculosis are in an especially high danger to finding the opportunity to be debased. Besides, with HIV/Supports hold the most hoisted risk element of all. Early on area and treatment, with fitted hindrances of these polluted is an integral.
Friendly determinants ...
Comparing the Coronavirus pandemic in New Zealand and Iraq: A Preventive Medi...Vedica Sethi
The first cases of COVID-19 pandemic were identified in people with pneumonia in Wuhan, China, in late December 2019. It is first and foremost the most publicized pandemic, which has taken the lives of many people. It has thrown everyone into doubt and has created a collective moment of contemplation about the future. The clinical enlistment organization MedWorld of New Zealand offered for resigned and low maintenance specialists to help endeavors by the health care division and Government to battle the spread of COVID-19, in New Zealand. ( ) Starting in April, more than 20,000 tests have been done in Iraq in general (counting the Kurdistan Region), with 1202 of them turning out positive. Of those tests, half of the,m were finished by the Kurdish Ministry of Health, which implies that the other tests were finished by the Iraqi Ministry of Health. ( ) While KRG populace has been tried, just 0.05% of the remainder of the nation has been tried, along these lines featuring the conceivable difference between absolute positive case numbers between locales. Iraq is considered "particularly powerless against the plague due to being desolated" – by war and United Nations sanctions, and by partisan clash in the course of recent decades.
This paper primarily focuses on analyzing the accessible information through research papers, peer- reviewed and non-peer reviewed to understand the pandemic affecting two different countries like New Zealand- a developed country and Iraq- a developing country.
Week 4: Week 4 - Epidemiology—Introduction
Epidemiology—Introduction
The study of epidemics is epidemiology. Its primary focus is on the distribution and causes of disease in populations. Epidemiology involves developing and testing ways to prevent and control disease by studying its origin, spread, and vulnerabilities.
As a discipline, epidemiologic research addresses a variety of health-related questions of societal importance. Epidemiologic research methods are used by clinical investigators and scientists who conduct observational and experimental research on the prevention and treatment of disease.
The Cholera epidemic, a case from the 19th century, was enabled by the global movement of people. Having appeared in India in 1817, it spread throughout Asia and the Middle East within a decade. It was reported in Moscow in 1830 and then spread to Warsaw, Hamburg, Berlin, and London in 1831 (Snow, 1855, 2002). When it crossed the Atlantic to reach North America, Cholera gained the notoriety of the first truly global disease.
The modern day world is dominated by free trade and rapid transportation. An unprecedented rate of global interchange of food, consumer products, and organisms—including humans—is occurring. The threat of pandemics in the 21st century has heightened the importance of epidemiology at national and international levels.
Although diseases such as Influenza A (H1N1), Severe Acute Respiratory Syndrome (SARS), Acquired Immunodeficiency Syndrome (AIDS), West Nile Virus, Salmonella, are commonly recognized as epidemics, as they cause large scale disruption of health in populations. The field of epidemiology also addresses epidemics of obesity (Ogden et al., 2007), diabetes (Zimmet, 2001), mental health (Insel & Fenton, 2005), and any other disease that may cause large scale disruption of health in populations.
In general, there are ten stages to an outbreak investigation:
1. Investigation preparation
2. Outbreak confirmation
3. Case definition
4. Case identification
5. Descriptive epidemiology
6. Hypothesis generation
7. Hypothesis evaluation
8. Environmental studies
9. Control measures
10. Information dissemination
Investigation preparation requires a health crisis manager to identify a team of professionals who will lead the outbreak investigation, review the scientific literature, and notify local, state, and national organizations of the potential outbreak.
Outbreak confirmation requires actual laboratory confirmation of the disease, which may involve the collection of blood, urine, and stool samples from ill people and performing bacteriologic, virologic, or parasitic testing of those samples.
Case definition is the process by which we establish a set of standard criteria to determine who is and is not infected with respect to a specific outbreak; that is, a protocol is developed to determine case patients.
Case identification requires the health crisis manager and team of professionals to conduct a systematic and organize.
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We live in a world that has gone through an incredible transformation in the last decades. Those transformations did not only impact our economy, but also our society and biosphere. Our biggest challenge is to build back better those different layers while leaving no-one behind. That will entail rebuilding strongly the trust between the different generations, the societal entities, and the ecosystem. Healthcare is a critical component to ensure harmony for the Younger and next generation.
" Digitalization offers transformational economic opportunities and represents an outstanding platform for lower income economies to reposition themselves on the global stage. However, accessing and maximizing on the potential available to them requires that they think without a box , and we are here to support them in their journey" Patricia Monthe
I have been described as a visionary, with a leadership style combining cognitive pluralism and integrity, both of which make me particularly fit for environments that require pioneering new models or engaging multi-disciplinary & multicultural groups to orchestrate new systems.
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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The prostate is an exocrine gland of the male mammalian reproductive system
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A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
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ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
2. Prof.Dr. Virasakdi Chongsuvivatwong 3
Fighting COVID-19 in Thai Styles
Reflections for the first three quarters of 2020
It takes time for COVID-19 to circulate to all countries. At
the early stage, we see only outbreaks in high- and middle-in-
come countries. Only a few cases are reported from India, African
countries and those neighbouring Thailand such as Myanmar,
Cambodia and Laos,
Countries are different in responding to this epidemic,
depending on their socio-political, technology and health system
background. The oriental countries like China, Singapore, Korea
and Japan have deployed all the technology and state power
they have to tackle the problems. However, they are still differ-
ent. China requires all their people to eliminate the disease. Even
though currently there are not many new cases, people who travel
across provinces are still required to undergo state quarantine.
They probably hypothesize that the disease can be eliminated,
which will be followed by quick economic recovery. Singapore
thinks differently. They depend mainly on case contact tracing.
They considered that strict control will lead to too many economic
problems. This strategy is similar to that in Korea, Japan, Indonesia
and many western countries. Information technology is heavily
deployed in Singapore, Korea and China. Information on people’s
3. Prof.Dr. Virasakdi Chongsuvivatwong
4 Fighting COVID-19 in Thai Styles 5
movement, which improves Public Health security, gets the priority
over individual privacy.
The United Kingdom is a country with many well known
scientific philosophers and epidemiologists. Dr John Snow was
praised as the founder of Epidemiology from his research to prove
that a cholera outbreak in London was linked to water supply.
After he disassembled the pump on Broad Street, cholera grad-
ually declined.
I don’t think that the current UK government follows John
Snow. They are more likely to have Malthus’ pessimistic viewpoint
that with increasing population, human catastrophes including a
pandemic are inevitable. They may take actions along the Adam
Smith’s “faith of the invisible hands”, which will manage the
society. The leaders may also take a Darwinian view on survival
of the fittest. It is hoped that COVID-19 survivors will have enough
immunity against the disease. When the proportion of the immune
population (so called ‘herd immunity’) is high enough, the virus
will not be able to transmit and the disease will be eliminated.
Were Smith, Malthus and Darwin alive, they would be proud
but that’s not the case for John Snow.
Epidemiological methods of disease control have moved
very far from Snow’s era. With advancement in sciences and tech-
nology, cases of atypical severe pneumonia in Wuhan, China were
rapidly proved to be caused by SARS CoV 2. Its RNA pattern is
an important marker of the infection, which is called Coronavirus
Disease 19 or COVID-19. Transmission was identified as inhalation or
mucosal contact of the infectious droplets emitted by an infected
person when sneezing, coughing or vocalizing. With advancement
of health systems, once a case is identified, persons who have
been recently contacting the case are identified, investigated and
self-quarantined.The process will cut the disease transmission and
prevent case spreading.
In high-income countries, this contact tracing is done by
public health officers and sometimes the police. In Thailand, early
case detection is facilitated by village health volunteers (VHVs).
This VHV system was first initiated in the late 1960s when leaders
of Public Health from Thailand visited and observed activities of
barefoot doctors in China. While the roles of Chinese barefoot
doctors included clinical treatment, the Thai VHV’s main role was
to interface between the health systems and the villagers. Each
VHV is closely linked to approximately 10 neighbours. In COVID-19
outbreak period, they play key roles in neighbourhood health edu-
cation and identifying COVID-19 suspects, especially among those
arriving in the neighbourhood cluster from a COVID-19 outbreak
area. With early identification of suspects by the VHVs and their
effective communication, transmission was then interrupted.
The number of COVID-19 cases in Thailand first surged in
Bangkok from a few super-spreading events in boxing stadia, pubs
and bars. When the government started to lock down Bangkok,
it was afraid that the disease would disperse to all parts of the
countries as people would flee out from the capital. This was the
case because the super-spreading events were attended by people
4. Prof.Dr. Virasakdi Chongsuvivatwong
6 Fighting COVID-19 in Thai Styles 7
from numerous outskirts. In reaction, the health system emergency
responses were then activated immediately to contain the outbreak.
All hospitals were partially closed and accepted only emergency
cases. Isolation wards were ready to admit COVID-19 patients.
All outpatients and accompanying persons were thermo-scanned.
Personal protective equipment is rapidly procured and distributed.
There was a lot of cheering on social media to encourage the
medical profession to fight against COVID-19.
But Thailand has proved that prevention is better than cure.
The VHV network worked so well to achieve timely detection and
isolation of all new cases in the peripheral areas that transmission
was eventually interrupted.
There is another epidemiological explanation on the success
of this transmission interruption. A well known term ‘reproductive
number’ or R indicates how many new cases will be transmitted
from one index case. This number had been initially high when the
level of population’s awareness of the epidemic was low. Under
the conditions of heavy crowdedness and close contact in closed
space in the afore-mentioned super-spreading setting, an infective
person can transmit the virus to infect several people in that set-
ting. The initial R or so called R0 (R zero) was extremely high. With
prompt suspect identification and contact tracing, subsequent Rs
were reduced. For example, a study by the investigator team of
the Department of Disease Control showed that an average case
usually had slightly more than two contacts in his/her household.
The probability of each contact getting infection (subsequently
having a positive RT-PCR test) is around 20 percent. Simple math
can show that this will result in R being less than one. For this
epidemiological reason, some weeks after the super spreading
events, the total number of cases in Thailand peaked at around
100 and declined to nil within a few months.
Epidemiology is the study of health status in the popu-
lation regarding its distribution, determination and intervention.
The subject is not only interesting but also an important tool for
outbreak control. Out of several epidemiological studies published
in academic journals, one carried out by the Thai National Contact
Tracing Team deserves mention here. Apart from field work, one of
the routine jobs of this team was to compile data from COVID-19
contact tracing from the whole country. The data set consists of
information on the index cases (who had a lab confirmed diag-
nosis of COVID-19) and the persons who were physically close to
them. During the interview of these contacts, information on their
potential risk behaviours was also noted. Among these contacts,
some of them would become diseased (having confirmed diagnosis
of COVID-19). The majority would remain to have negative tests.
These two groups (211 diseased vs 839 non-diseased) were then
retrospectively compared on their behaviour during the period
they were in contact with the index cases. The odds of having
a specific behaviour among those eventually getting the disease
were compared with that among those remaining non-diseased.
The ratio between these two odds is called odds ratio or, in brief,
OR. An OR of lower than 1 indicates that the behaviour is pro-
tective against getting COVID-19 during the contact period. An
OR being larger than 1 indicates that it is a risk factor. Pertinent
protective factors (and the OR) were shortest distance physical
5. Prof.Dr. Virasakdi Chongsuvivatwong
8 Fighting COVID-19 in Thai Styles 9
contact being more than 1 metre (0.15), duration of contact within
1 metre range less than 15 minutes (0.24), washing hands during
the contact period (0.34), wearing mask all the time of contact
(0.23). On the other hand, sharing cigarette and vaping device is
a risk factor (OR=3.4). Had all these protective behaviours been
practised and cigarettes had been abstained by all contacts, the
number of contacts who would become a case would be reduced
by 84%. All these suggest that even with contact real COVID-19
cases, the risk of getting the disease can be dramatically reduced
by strict hygienic practice. In fact, a reduction of 84% is only found
in highly effective vaccines. So prevention and control of COVID-19
does not need to await vaccine availability.
Here are some additional case studies in the field in the
southernmost part of the country, Chana District of Songkhla Prov-
ince, where insurgency erupted in 2004 and just recently declined
after one and a half decades. A majority of the local population
are Muslim, who have active religious connection with their coun-
terparts in nearby Muslim countries where the transmission of
COVID-19 was established. Returnees from religious ceremonies in
those countries brought back the disease and infected local resi-
dents in their community. While the local health systems panicked
about this new deadly disease, the VHV successfully persuaded
all the returnees to come to the hospital to get the lab test. Six
tested positive and were admitted at the community hospital fol-
lowing the national guideline. All of them were given good care
that satisfied both the patients and the relatives. Luck was on
their side, none of them developed any serious symptoms and
all were discharged 14 days after admission. The villagers highly
appreciated the local hospital. They brought in fishes caught from
the local seas to give to all hospital staff as an act of appreciation.
This did not only stop disease transmission but also strengthened
bonding between the community and the local health systems. It
should also be noted that long-term investment in the Thai rural
health systems has paid off here. As community hospitals could
take care of most of the cases and refer only a few complicated
one to the secondary and tertiary hospitals, the capacity of the
country to absorb the cases is well expanded. In a subsequent
bilateral technical conference between Thailand and China, we
learned that the health systems in Wuhan, the first affected city of
China, failed to initially contain COVID-19 because of the weakness
of the rural health system in that country. With inadequate quality
of personnel and health services in China, rural people distrust
the local systems. All fled to the city and overwhelmed the ma-
jor infectious disease hospital, which needed a call for help from
doctors from other provinces and a new emergency hospital to
be built up in a rush. Thailand does not have the wealth recently
acquired by China;.however, the Thai harmonious investment in
the systems has proved to bring health security to its citizens.
Another interesting case study was around 100 km south-
ward, in Yala province, the epicenter of insurgency violence in the
past and the hard-to-reach community for the current COVID-19
outbreak. Local VHV’s reported that there was a substantial number
of silent returnees in a few subdistricts. The head of the villages
showed up and requested the governors to send health teams
to do mass screening for the virus. This was done for nearly a
week in the nighttime during the Ramadan fasting period. Here
6. Prof.Dr. Virasakdi Chongsuvivatwong
10 Fighting COVID-19 in Thai Styles 11
the concept ‘Health as a Bridge to Peace’ was demonstrated. The
hard-to-reach communities have become more open due to the
trust in the health care provided.
Thailand was the forerunner among Low-Middle Income
Countries (LMICs) in setting a National Health Security Office to
ensure Universal Health Coverage (UHC). This started in 2002. Over
nearly two decades, the Thai UHC has demonstrated the three
dimensions of good health insurance, namely, breadth (covering
all citizens with inclusive policy), comprehensiveness (including all
forms of services) and depth (being an effective safety net against
financial catastrophe). Moreover, it incorporated quality systems
that take into account service standard, clinical outcome and
responsiveness to clients’ needs.
In the COVID-19 period, Thai UHC covers the costs of
laboratory screening for the population, confirmation test for
the suspect and of course case treatment. The next case study
illustrates the extension of UHC to cover uncommon activities in
a border area.
Sadao District of Songkhla Province is a border city next
to Malaysia. The cross-border checkpoint has the heaviest land
transport traffic in the Kingdom. Malaysia and Singapore both
have relatively strong economies. It was estimated that 200,000
Thai citizens worked in Malaysia. The outbreak in Malaysia was
followed by a lock down process, which caused the majority of
them to become jobless. The border was closed so there were a
lot of Thais waiting to get permission to enter their homeland. It
took about a week for Thai border provinces to set up a ‘State
Quarantine - SQ’ system to receive the returning citizens. At first,
schools were requested to provide the space for accommodation.
Later there was a better resolution. Hotels along the borders
were trained and inspected to get ready to serve as SQ facilities.
Food and other necessary services including Internet access, were
provided appropriately. The SQs are also looked after by health
personnel on health aspects including temperature taking, referral
to the hospital for testing for the virus etc. The whole 14-day
service costs for returnees with negative tests were charged to
the National Health Security Office. Also thanks to the Provincial
Administration Authority who financially contributed to the first
few days before the NHSO system was settled.
As an important border city, Sadao is also the most im-
portant transit point for illegal migrant workers from Thailand to
Malaysia and Singapore. With over 600 km of border, there are
many possible points for this trafficking. Sadao is a natural resting
point for illegal border crossers. Thus, there have been many illegal
immigrants arrested. Among seven detention centres taken care
by the Department of Immigration, Ministry of Interior, the one
in Sadao is the second largest. During the COVID-19 outbreak
period, there were more than a hundred detainees in this detention
centre. The outbreak in Sadao centre was the most remarkable.
The story started with a pneumonia patient who was an
immigration officer. He was admitted at Songklanagarind Teaching
Hospital and had a positive RT-PCR test for SARS CoV 2. A local
disease investigating team suspected that he might get the virus
7. Prof.Dr. Virasakdi Chongsuvivatwong
12 Fighting COVID-19 in Thai Styles 13
from the detainees. They performed contact tracing and found that
18 among 28 detainees in the second floor of the front section
of the detention centre had positive RT-PCR tests. Locally, it was
not easy to manage the infected detainees who stayed together
in a crowded and poorly ventilated condition with others who
had negative test results. According to the national guideline, all
RT-PRC positive COVID-19 cases are to be admitted in an isolation
room at a hospital to prevent further spread of the virus. In this
instance, as all cases had only mild symptoms, it was decided that
the detention section of these 28 persons should be modified into
a ward of a primary care hospital with health personnel in charge
24 hours a day. So this became a mixture of a hospital ward and
jail. A team of engineers was consulted to improve ventilation by
installing external exhaust fans. Another team of IT engineers was
consulted to use robots to take the temperature of all detainees.
Personnel were heavily shielded with PPE in delivering food, med-
ication and supplies and taking out the solid wastes.
Around 10 days after the outbreak was detected in the
first section, a second outbreak was detected in the second (rear)
section, where forty long-term illegal immigrants (Rohingya) were
detained. They had probably been infected soon after those in
the first section. Delay in detection of this group was attributed
to lack of cooperation of the second detainee groups. They are
more internationally vulnerable illegal migrants as they cannot
be deported like those in the first section, who are mostly ASE-
AN citizens. The second ward was then set up in this section.
A pregnant detainee was admitted at the tertiary hospital for
safety reasons. Fortunately none of these two groups developed
any complications. All had full recovery and continued their lives
in the centre. About six weeks later, eleven Myanmar detainees,
whose RT-PCR tests had become negative, were deported back
to their home country. Altogether, there were sixty people getting
confirmed infections at this centre. Around one hundred immigra-
tion personnel were required to self quarantine. No serious clini-
cal problem was observed. It was good to see that none of the
health personnel who worked very hard in this operation was
infected.
Thailand not only is an international transit for migrant
workers. It also serves as a destination to find work for a few
million from Myanmar, Laos and Cambodia. It is not known how
many migrant workers returned home and how many remained
in Thailand in response to the COVID-19 outbreak. The borders
with all neighbouring countries were officially closed. Yet there are
numerous passing points along the over 5,000 km borders, making
it hard to prevent people illegally entering and exiting. Singapore
and Malaysia both reported a series of COVID-19 outbreaks among
the migrant worker camps. There have been a series of screenings
for the coronavirus among thousands of the migrant workers at
various worker camps in Greater Bangkok. None of them showed
any positive test. There have been strong requests from the business
sectors to import new lots of labour but the demands were not
met. Some Thai argued that the vacant work opportunities could
be offered to either Thai residents of retained migrant workers who
are waiting for jobs inside Thailand. The Department of Labour
showed that there are many jobs not receiving any interest from
these two groups such as sea-fearers.
8. Prof.Dr. Virasakdi Chongsuvivatwong
14 Fighting COVID-19 in Thai Styles 15
Socio-economic problems are serious COVID-19 complica-
tions worldwide. Thailand has been hardest hit as international
tourism is one of the main sources of the country's income. Many
related businesses such as airlines, hotels and restaurants have
become inactive. The government must launch different kinds of
direct and indirect financial support for jobless people.
The country has had an internal COVID-19-free period
for about 100 days. People are encouraged to travel inside the
country. Yet the internal market is too small to make substantial
economic recovery. Industrial exports are also badly hit by the
global shortage of purchasing power. Apart from government
officers whose jobs are still quite secure, the least hit sector was
agriculture. Thai farmers generally have their own food security.
The prices of food and farm products have also been relatively
stable. Socio-economic and psychological stresses were then most
heavy among those who lost their jobs or businesses.
Worldwide, children are expected to be the hardest hit
age group from the COVID-19 pandemic. Starting from 2020,
serious famine is expected by international relief organizations.
Day-care centres and schools for young children have been closed
for nearly 6 months in response to the pandemic. For children of
poor families, these day-care centres/schools are their safe haven
to escape from home violence to shelter in a peaceful and clean
place, get enough food and rest while their parents/guardians can
have more free time to carry on necessary earning or household
tasks. A survey carried out by a research team in the southern
border province revealed that during the lockdown period, young
children had 10% increase chance of experiencing physical abuse
and 20% increase in receiving verbal abuse. Qualitative in depth
interview indicated that food is less available and there are sporadic
events of sexual abuse carried out by some unemployed household
visitors. We are waiting to see the changes in nutritional status of
the children who have returned to the day-care centres/schools.
More global bad news from UNESCO informs us that around
one-third of children undergoing compulsory education may not
return to school in the second half of 2020, perhaps due to eco-
nomic hardship of the government and the household. We do not
have this kind of statistics from Thailand but there are reports of
such cases by NGO in the border southern region.
Among households whose children continue with formal
education, COVID-19 has brought in another financial constraint,
on-line education. They have to invest in hardware such as com-
puter and Internet access to their homes. This can be more than
10% of the income of many households in that month, a cut-off
value for financial catastrophe were the expense to be on health.
Certainly, on-line gives a new opportunity for affordable families
to learn new things at a low cost. However, in the pandemic
period, this ‘Digital Divide’ has been widened among the ‘Have
Net’ (affordable to pay for the on-line education) and the ‘Have
Not’ (the unaffordable).
Throughout the first half of 2020, mainland ASEAN countries
including Myanmar, Thailand, Laos, Cambodia and Vietnam could
prevent or handle the COVID-19 outbreak quite well. In August,
9. Prof.Dr. Virasakdi Chongsuvivatwong
16 Fighting COVID-19 in Thai Styles 17
Vietnam after being case free for about 100 days had an outbreak
in a tourist spot. It took them about a month to get the situation
under control. Then there has been an influx of cases from the
Bangladesh border to Myanmar, who then entered the main city,
Yangon. In addition to this regional pressure, in September 2020,
there were sporadic confirmed cases of COVID-19 among those
never who had never left the country and foreigners who were
suspected of getting infected while staying in Thailand. This may
be an indication that the country is not absolutely free from this
virus. On the other hand, the pressures from business to import
migrant labour and to partially open the country for international
tourism are increasing.
Globally, the second wave of COVID-19 pandemic has
arrived. More cases are being reported but fortunately with lower
mortality. This follows the pattern of man-made myxoma virus epi-
zootic (outbreak of a communicable disease among wild animals)
to contain the population of wild rabbits. The initial fatality rate
of the rabbits was very high but then subsided and was followed
by a series of less serious outbreaks. This has been explained by
co-evolution of the virus and the rabbits. Virulent strains of the
virus killed the host too quickly and lessened its chance to infect
the next host compared to the less virulent strains. The strains
of rabbit that can develop immunity against the virus also have
better chance to survive and reproduce. Thus the ecology will end
up with less serious outbreak. For the COVID-19 pandemic, we
still have to see whether the myxoma virus-rabbit analogy works.
Information on how the level of virulence to the new SARS CoV
2 strain has changed is still awaited. Several studies showed that
the infected populations do not develop enough antibodies to
eliminate the transmission but human-being’s evolution is faster
on the social than the biological side. We hope that the global
health systems will improve. We are asking for strong global lead-
ership and collaboration to fight and eliminate this coronavirus
the same way we defeated smallpox.
Being desperate to control the COVID-19 in their countries/
regions, many rich countries are racing and betting on vaccine
development. The wish is that if an effective vaccine is available,
it can be the ultimate solution for the pandemic. In theory, this is
not the case. As COVID-19 is a very contagious disease and there
is no natural immunity, we need a very highly effective vaccine (say
more than 90% protection) and a very high coverage (say more
than 90% of the population being immunized) to suppress the
transmission. The former condition depends on the advancement
of bio-medical technology. The latter is a social problem. There
is poor coverage for a similar airborne disease, measles. Measles
outbreaks occur periodically and kill many people worldwide.
Regardless of these limitations, the level of demand for
such vaccines is very high while the supply is not yet known to be
possible. In Thailand, there are a few vaccine development groups.
Using a shortcut technology ‘m-RNA’, the conditional series of
answers (can ask the next questions and carry on the next step
of research only when the answer to the current question is satis-
factory) are expected to arrive much sooner than the conventional
vaccine development can do. The initial answers are that this
vaccine produces high levels of antibody in mice and monkeys.
10. Prof.Dr. Virasakdi Chongsuvivatwong
18 Fighting COVID-19 in Thai Styles 19
The safety test for a small group of human volunteers (Phase I)
is underway. If this initial safety satisfies the reviewing scientists
(Data Safety Monitoring Board), a larger group of volunteers will
undergo the same safety trial (Phase II). The results will not be
known before the end of 2021. Then a more difficult question
(Phase III) is waiting, whether the vaccine can really prevent the
vaccinee from getting the disease if he/she contacts the virus. This
needs a large number of participants who are at high risk in the
high incidence area, which cannot be Thailand if the incidence
is well contained as it has been. The Thai vaccine development
can end at any stage. Its pace of development and testing is not
comparable with those done in more developed countries. Yet it is
a very admirable effort. So, Thailand still definitely requires access
to global vaccines, not necessarily made in Thailand.
We will end this discussion with the issue of access to
the desirable vaccine if it is available in the market. Billions of
the world population need effective and safe vaccines. There are
mixed motivations for this development and production: human
security and profits. If one or more vaccines could be developed
and show sufficient safety and efficacy, and the ideology of hu-
man security wins, the technology can be transferred to all rich
and some middle income countries to have their own production
to serve the needs of their countries. In this case, Thailand will
be a good candidate to be the transferee and a regional point
of production to serve the regional needs. If the ideology loses
and does not win in time, there will be more deaths and political
chaos, which is an uncommon consequence of this pandemic.
Thailand therefore has to properly position and steer itself in this
troubled water.
For the first three quarters 2020, Thailand has joined
some of the countries to prove that this deadly COVID-19 can
be defeated by simple knowhow, people participation and good
leadership without the need to wait for the dramatic vaccine. Yet
the pandemic is a global issue which no country can escape. This
uncommon pandemic, like many other disasters, arrived swiftly and
caused intense global damage and will have its effects for years.
Human beings, however, can adapt and learn how to cope with
it and eventually overcome most of the problems. It is too early
to see how and how well Thailand can recover from this crisis
and stand up again to regain its well being. This document only
touches a few facets of the problems faced and lessons learned.
More issues and new developments should be sought from further
participation in discussion with relevant people in the 2021 Prince
Mahidol Award Conference.
Virasakdi Chongsuvivatwong
Prince of Songkla University, Thailand
2020-9-14.