The Indian Express | 5 days ago | 06-08-2022 | 07:45 pm
The Central government has asked Delhi and six other states to ramp up testing, vaccination and promote Covid-19 appropriate behaviour as several parts of the nation report a rising trend in Covid-19 cases.Union Health Secretary Rajesh Bhushan in a letter to Delhi, Kerala, Karnataka, Maharashtra, Odisha, Tamil Nadu and Telangana said the upcoming festivals and mass congregations may potentially increase the transmission of the virus.The states must closely monitor the districts reporting higher cases, positivity rates and clusters to prevent further spread of infection and effective case management, Bhushan stressed in the letter dated August 5. The Health Secretary added it is critical to ensure adequate testing is undertaken.Delhi has been witnessing a rise in daily Covid-19 cases with the city reporting 2,419 cases and a positivity rate of 12.9 per cent on Friday, according to the government’s daily health bulletin. The national capital also contributed to 8.2 per cent of India’s weekly new cases in the week ending August 5.Citing district-wise data, Bhushan also mentioned that while Maharashtra reported 2,135 average cases per month in July, Kerala’s tally was 2,347.He requested the states to ensure effective compliance with the revised surveillance strategy for COVID-19.“In view of some changes in symptoms and clinical manifestation of the disease, it is crucial to monitor and report district-wise influenza-like illness (ILI) and SARI cases in all health facilities as per the guidelines, on a regular basis for detecting early warning signals of the spread of infection. This will enable us to take pre-emptive action if required, in any areas of concern,” he said.Stressing the importance of genome sequencing of prescribed samples of the international passengers and collection of samples from local clusters of new Covid-19 cases, the Health Secretary said that such samples must be sent promptly by the states and union territories to the designated lab of the INSACOG network for genome sequencing.He said the states should ensure to accelerate the pace of free administration of precaution doses for eligible population that is being administered in all government facilities till September 30 under the ‘COVID Vaccination Amrit Mahotsav’.With PTI inputs
Dr. Atul Patel is a director and chief consultant for the Department of Infectious Diseases, Sterling Hospital. He is a visiting assistant professor at the Medicine Division of Infectious Diseases at the University of South Florida, Tampa, US. He has a special interest in HIV/TB co-infections. His group is researching on an effective programme to prevent mother-to-child transmission at the ID Clinic, AhmedabadThe past two years were largely uneventful with respect to swine flu and/or seasonal influenza cases and related mortality. We are again witnessing a surge this year. What is driving it?The term, swine flu, is used for the 2009 H1N1 strain, which was a recombinant of influenza viruses in birds, pigs and humans. The strain evolves every year, which is why these subsequent strains are termed under the broad category of seasonal influenza. The surge in seasonal influenza cases in a specific year depends on the general population’s immunity to the specific strain circulating in a specific year. We are seeing swine flu patients and seasonal influenza patients at present as both the viruses are in circulation. If we look at the epidemiology of seasonal influenza, it circulates in the community in tropical countries throughout the year with two big spikes — first in winter and the second in the monsoon. So this is the time when we expect an increase in the number of seasonal influenza cases. This is a major difference compared to temperate countries such as the US or Europe where only one surge is seen in the year that is winter.Right now we can say we are seeing an equal number of Covid-19 and seasonal influenza patients. In fact, the number of seasonal influenza cases is more compared to the last two years. That may be because we are not strictly wearing masks and sanitising hands, something that we did consistently through the two years during Covid-19. These are two important non-pharmaceutical interventions, which reduce the susceptibility to seasonal influenza as well as Covid-19. Furthermore, routine vaccination for seasonal influenza has gone down. It is not being highly recommended in high-risk groups by the government unlike pre Covid-19 years and has now taken a backseat following Covid-19. We can control the number of seasonal influenza patients in the community through vaccination and post-exposure prophylaxis with Oseltamivir (Tamiflu). We should promote an annual shot of the seasonal influenza vaccine in the media also.How does seasonal influenza impact an individual’s morbidity risk?Like Covid-19, those with co-morbidities are at a high risk of disease progression and complication when it comes to seasonal influenza. We are seeing that there is mortality in patients with significant co-morbidities. The sensitivities are almost the same as those for Covid-19 — haemato-oncological problems, malignancy, post-transplant cases, chronic obstructive lung disease, obesity, diabetes and so on.In terms of susceptibility to seasonal influenza, it is more or less equal across all age groups, except in paediatric patients and those aged above 65 years. These two groups are such that even without any co-morbid conditions, they are more prone to disease severity. For a majority of youngsters, most of whom are immuno-competent, seasonal influenza is a self-limiting disease. Symptoms include high grade fever, throat pain, headache, body pain, runny nose, which last for five to seven days or so. Then they report spontaneous and uneventful recovery. Taking fever-reducers such as Paracetamol work for healthy immuno-competent individuals but for paediatric and aged people, and those with comorbidities, we generally prescribe the antiviral drug Tamiflu, a very effective agent for influenza.With fever being the first symptom and the monsoon known for the resurgence of viral infections, seasonal influenza, vector-borne diseases, and now Covid-19, what should one look out for?With most viral infections, including dengue fever, the first episode is usually self-limiting in immuno-competent people. Such individuals report an uneventful recovery without much medical intervention. But those in high risk and co-morbid groups, should not ignore their fever, visit their doctor, get tested and secure a definite diagnosis.They should get a diagnostic evaluation done on the first day of the onset of symptoms rather than waiting for a few days as by then the disease can progress and complications may crop up. For healthy individuals who do not have many symptoms, except for fever and body pain, there is not much cause for worry. Their assessment and evaluation should be symptom-driven.With Covid-19 and seasonal influenza circulating in the population, how do we go about the diagnosis, given that most individuals just opt for a Covid-19 test? Surely a negative Covid-19 test doesn’t rule out an individual’s probability of seasonal influenza instead?We usually recommend the RT-PCR for both COVID-19 and seasonal influenza. In clinical practice, we have multiplex PCR. This assay includes a target panel of all the common viruses producing respiratory symptoms. So a single multiplex PCR can confirm whether it’s influenza A, influenza B, parainfluenza, COVID19, swine flu or other respiratory viruses. But it is very expensive, costing around Rs 11,500 or so, as it checks multiple pathogens. The results come within two-and-a-half hours and are highly reliable.How is a confirmed diagnosis of the type of seasonal influenza one is afflicted with significant for health management?Knowing the final and confirmed diagnosis is very important, as for the three viruses — influenza A, B and swine flu — Tamiflu is highly effective. Besides, most of these patients will respond to the antiviral drug within 48 hours of taking it. This is also one of the diagnostic traits that can be an indicator. So basically if someone improves markedly after taking Tamiflu, it can be said that he/she has been affected by one of the three viruses. That apart, a PCR test can tell you which kind it is because symptoms are more or less the same for seasonal influenza, swine flu or influenza B virus. From a clinical examination perspective, one can say that an individual has seasonal influenza but for the specific virus, only a PCR test can give a final and confirmed diagnosis.
New Delhi: Mumbai on Wednesday recorded 79 per cent surge in COVID cases as the city witnessed 852 fresh cases in the last 24 hours, according to an update by the Brihanmumbai Municipal Corporation (BMC). Daily coronavirus cases have been climbing steadily in Maharashtra, especially in Mumbai, for the last few days.Also Read - Amid Rise In COVID Case, More Transmissible Omicron Sub-Variant Detected In Delhi's LNJP Hospital; Alert Sounded
With the game of numbers set to begin in Bihar, the one man whose actions will be most closely watched is Speaker Vijay Kumar Sinha. The BJP MLA – who has had run-ins with Chief Minister Nitish Kumar in the past — has already given one sign of what might be coming when, amidst much raised eyebrows, he was reported to be Covid positive when the JD(U) and RJD made their first moves on Monday, only to report Covid-negative within 24 hours as the dice appeared to have been rolled.Then, on Monday night, following his fast-track recovery from Covid, one of the first people Sinha met was members of the Ethics Committee of the Assembly, headed by BJP leader Ram Narayan Mandal. While Mandal declined to divulge details, sources in the BJP said the report was about an incident of March 2021, when RJD MLAs had held the Speaker “hostage” and police had to be called to the Assembly. Sources said the report indicts about 18 MLAs.As per procedure, these MLAs will receive a notice on the advice of the Speaker, who may decide further action, and even order disqualification. With 79 MLAs, the RJD is the single-largest party in the Assembly. Any change in numbers will, of course, have repercussions on which government takes over.The incident dates back to March 23, 2021, when the Assembly had passed the Special Armed Police Act, giving more powers to police to search people, without a warrant, and make arrests, amid protests by Opposition MLAs. RJD MLAs had rushed to Speaker Sinha’s chair, torn papers and laid siege to his chambers, virtually holding him hostage inside. Police had to be called in, to remove the protesting MLAs, with many of them dragged and carried out on stretchers.A Bhumihar leader, an engineer by qualification and a dedicated RSS worker, Sinha is the BJP’s first-ever Bihar Speaker. He was a surprise choice for the post, and believed to have been picked essentially to keep the upper caste leadership of the party happy. A three-time MLA and former state minister, he has been winning from the Lakhisarai Assembly seat since 2010.In the latest instance of tension between them, Nitish had taken exception to Sinha omitting his name in the invitations sent out to mark anniversary celebrations of the Bihar Vidhan Sabha. As per JD(U) sources, that was one of the triggers for Nitish to end his alliance with the BJP.However, before that too, the Assembly was witness to an unusual showdown between the usually calm Chief Minister and the Speaker. On March 14, a heated exchange took place between the two on whether a matter being probed by the government, which had also been referred to a privilege committee, could be raised on the floor of the House time and again. Nitish made his displeasure evident when Sinha asked Cabinet minister Bijendra Yadav to apprise the House of the steps taken in an incident involving police action in Lakhisarai, for the second time. Lakhisarai is Sinha’s constituency.The incident involved alleged violation of the liquor prohibition law in Lakhisarai during Saraswati Puja by people with links to the BJP. Sinha claimed that “mere spectators” were rounded up by police, while organisers with reportedly JD(U) links were let off. BJP MLAs moved a privilege notice against Lakhisarai DySP Ranjan Kumar and two SHOs for alleged misconduct with Sinha when he raised the issue.Following the altercation with Nitish, Sinha had excused himself from the Chair, with the CM later meeting him in the day for a reconciliation. The next day, the Speaker had said the “kaala adhyaya (dark chapter)” must be closed and forgotten, while quoting from a poem by the late prime minister Atal Bihari Vajpayee ‘Kadam milakar chalna hoga (We must march together)’.Weeks later, Lakhisarai got a new Deputy Superintendent of Police.However, Sinha has often rubbed own party leaders the wrong way. In March 2021, Deputy Chief Minister Tarkishore Prasad had accused the Chair of extending “sanrakshan (patronage)” to Tejashwi, the Leader of the Opposition. Sinha had reacted, saying: “Those who resolve to act in a transparent manner, cannot keep all happy.”The same month, the Bihar House witnessed a confrontation between JD(U) Panchayati Raj Minister Samrat Chaudhary and the Speaker. Sinha had complained about online replies not reaching his office. Chaudhary contested this, adding: “Vyakul hone se kaam nahin chalega (Getting restless will not do)”.After Sinha stayed away when the House reassembled following an adjournment over the remarks, Chaudhary had offered an apology.
Although more pregnant women with symptomatic Covid-19 were admitted during the Omicron wave, the severity of disease and mortality were lower than during the pre-Delta and Delta waves, a new Indian Council of Medical Research (ICMR) study has found.Previous research demonstrated a higher frequency of severe Covid-19, ICU/HDU (high dependency units) admissions, and maternal deaths during the Delta-dominant wave in Mumbai. However, there was no information on the impact of the Omicron variant on pregnant women.Researchers from the PregCovid registry team of the ICMR-National Institute for Research in Reproductive and Child Health (NIRRCH) analysed the data of 2,058 Covid-positive pregnant and postpartum women admitted to Mumbai’s BYL Nair Hospital during the pre-delta, Delta and Omicron waves of the pandemic.Of the 1,143 positive pregnant and postpartum who were admitted between April 2020 and January 31, 2021, there were 27 patients with moderate to severe symptoms and eight died. During the Delta wave from February 1, 2021 to December 10, 2021, of the 597 positive pregnant and postpartum women studied, 86 had moderate to severe symptoms while eight died. In the Omicron wave, of the 318 positive pregnant and postpartum women, two had moderate to severe symptoms and one died.The PregCovid Registry was launched in April 2020 by ICMR-NIRRCH, the municipal corporation-run hospital and Maharashtra’s Medical Education and Drugs Department to document the impact of Covid on pregnant and postpartum women and their newborns.A total of 19 tertiary care teaching institutions in the state contributed to the PregCovid registry. The registry has data from more than 9,000 pregnant and postpartum women with Covid and the evidence generated from the registry was useful for making policy decisions on coronavirus vaccination among pregnant women in India.“Our analysis showed that there was a rapid surge in admissions of Covid-positive pregnant women during the initial four weeks of the Omicron wave, suggesting a different epidemiological pattern from the pre-Delta and Delta waves,” said Dr Niraj Mahajan, from BYL Nair Hospital and the lead author of the study. Findings of the study were published in the International Journal of Gynaecology and Obstetrics, the official journal of the International Federation of Gynecology and Obstetrics (FIGO), in the last week of July.“We reported seven major differences on the impact of SARS-CoV-2 infection among pregnant and postpartum women during the Omicron wave as compared to the pre-Delta and Delta waves. A greater number of younger women were affected during the Omicron wave compared to the two earlier waves. Although there was a higher proportion of pregnant women with symptomatic Covid-19 admitted during the Omicron wave, the severity of disease and mortality were lower than the pre-Delta and Delta waves,” Dr Rahul Gajbhiye, principal investigator of the PregCovid Registry and corresponding author, told The Indian Express.“The spontaneous preterm birth rate per 1,000 births was lower during the Omicron wave compared to the two earlier waves. There was a higher spontaneous abortion rate per 1,000 births during the Omicron wave compared to the pre-Delta and Delta waves. During the Omicron wave, gestational diabetes mellitus was lower compared to the Delta wave and eclampsia (onset of convulsions) was reported to be higher during the Omicron wave,” Dr Gajbhiye said.Overall, there was a reduction in the severity of disease and maternal mortality during the Omicron wave than during the pre-Delta and Delta waves in the Mumbai metropolitan region. Similar observations are also reported from the US, South Korea, the researchers said. The increase in the number of symptomatic Covid cases could be down to immune evasion, they explained.The decrease in severity may be explained by the fact that Omicron infection was mainly limited to the upper respiratory tract. However, more data is required to better understand the factors responsible for higher symptomatic cases and the decline in disease severity during the Omicron wave, according to Dr Geetanjali Sachdeva, director of the ICMR-NIRRCH and a co-author of the study.“We do not have any control over the nature of the next SARS-CoV-2 variant, but pregnant and lactating women do have control over receiving Covid-19 vaccine and protecting themselves and their babies. Covid-19 vaccination has been proven to help prevent severe illness and reduce mortality and pregnancy complications. Pregnant and lactating women in India have been eligible for Covid-19 vaccination since July 2021 and they must be counselled to get the vaccines,” Dr Smita Mahale, a former director of the ICMR-NIRRCH and co-author, said.
Sculptors in Goa have been observing an increase in demand for small idols of Lord Ganesh for installation at home during the 10-day festival, which they attribute to the steady rise in the number of Maharashtrians settling in the state of late.Artists say that natives of Goa usually opt for idols of the elephant-headed god that are average of two feet in size, while people from Maharashtra — those who have made the state their new home — want idols sized less than a foot.Buy Now | Our best subscription plan now has a special priceThere is a growing trend of people from Maharashtra, particularly Mumbai, settling in Goa after the pandemic broke out and made work-from-home the new normal.Like Maharashtra, Goa has a rich tradition of celebrating the Ganesh festival, which is known as ‘Chovoth’ here. This year, the festival will start on August 31.Ritesh Chari, an artist, who is taking ahead his family business of making idols, says there has been a perceptible rise in the demand for smaller Ganesh idols over the past couple of years as compared to the pre-pandemic period.“There has been an increasing trend of demand for small idols – as tiny as 10 inches. This was never witnessed in the past,” said Chari, who keeps the Ganesh idols in a makeshift structure in Margao town for display and sale.He said that his unit makes Ganesh idols in Ponda town in North Goa district, his native place, from where they are transported to Margao in South Goa.The buyers of smaller Ganesh idols are mostly Marathi-speaking, which indicates that they are not natives of Goa, Chari said, adding that Goan families usually prefer idols that are two feet or more in size.Another idol maker, Ramakant Amonkar, who is from Marcel village in North Goa, said, “There is tradition in Mumbai to install and worship smaller Ganesh idols at home during the festival, whereas the idols in Goa are bigger in size.” He said that the demand for smaller Idols is across Goa, especially in the urban areas like Panaji, Margao, Ponda and Mapusa.“Many families have shifted to Goa during COVID-19, especially those who are retired are preferring to make home in Goa, away from the fast-paced and crowded city like Mumbai,” he said.Many families have stopped going to their ancestral villages and prefer to celebrate the Ganesh festival at their home in Goa, due to which they prefer to have smaller idols, Amonkar said.“Smaller idols can also be easily transported for immersion,” he added.The art of making Ganesh idols has been preserved by many families in the state.Chari, 29, recalls how he learnt this skill from his uncle and would like to pass it on to the future generation.He said the rise in the prices of raw material has forced them to increase the rates.“The cheapest idols are priced at Rs 800, while the expensive ones are valued at Rs 12,000. Average middle class family buys Idol costing Rs 2,500 to Rs 2,800, which is a price of two foot Ganesh,” he said.Chari has made 200 clay idols this time.Rajendra Deshpande, a photographer by profession, is among the rising number of people who have made Goa their new home after the COVID-19 pandemic broke out in 2020.Deshpande, who will be celebrating Chovoth with his family members here, said lower real estate prices and the option to work-from-home made him shift his base to Goa from Mumbai.“Life in Goa is very peaceful. We shifted here when COVID-19 was at its peak. Now we have settled here permanently,” he said.Goa Information Technology Minister Rohan Khaunte said the government is promoting the state as a destination where people from outside can come and work. 📣 For more lifestyle news, follow us on Instagram | Twitter | Facebook and don’t miss out on the latest updates!