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How COVID-19 has Affected General Surgical Practice in India

How general surgery is being conducted post COVID

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by coronavirus 2 (SARS-CoV2) extreme acute respiratory syndrome, which was first identified during an outbreak in Wuhan, China.

With fever, cough, and trouble breathing, COVID-19 disease manifests itself. Pre-dominant digestive symptoms (lack of appetite, loose stools, vomiting, and abdominal pain) can also be present in 50 percent of these patients. COVID-19 has been declared by the World Health Organization (WHO) as a Public Health Emergency of International Concern (PHEIC) affecting 197 countries/territories, including India, to date. On 11 March 2020, WHO described COVID-19 as a Pandemic. As early as 31 December 2019, Taiwan’s scientists pointed to the WHO about the transmission of the virus from human to human.

In most pandemics, social distancing and other non-pharmaceutical strategies have proved to be useful methods. The government of India ordered a nationwide lockdown for 21 days on 24 March. Mathematical models have been used to predict the COVID-19 outbreak in India with mitigatory social distancing in different lockdown scenarios. The three-week lockdown beginning on 25 March would not prevent a revival following its suspension. The models say that predicted case numbers below 10 would be reduced by a single lockdown of more than 44 days. Thus, a longer lockout period that stretches past 21 seems unavoidable and advisable.

Do Indians benefit from fighting this pandemic?

 In contrast, Indians bring more natural killers (a form of white blood cell) that control viruses. As a result of living in an area that was confronted with more infective agents, these cells were acquired. There is proof, then, that we have a stronger intrinsic first-line defense. In Indian infants, the BCG vaccine is used to modulate immunity against tuberculosis. With the aid of this Innate Immunity, BCG vaccination has been shown to minimize 30 percent of viral infections in different ways. A single study in China has found that the transmission of viruses is better at a temperature of 8.72 degrees Celsius and decreases the rate of transmission per 1-degree rise. The warm temperature we encounter will thus reduce the rate of transmission. While the WHO notes that the evidence to date indicates that the COVID-19 virus can be transmitted in hot and humid weather regions.

For its poor record of evaluating individuals to diagnose COVID-19, India has been criticized. With the ready availability of kits at reasonable price points, that, however, is expected to change.


Caring for caregivers: security for professionals in the healthcare sector

 The message is clear in all this- Stay home, be safe. But now more than ever, there are many people the country needs, including healthcare professionals. To care for the anticipated rise in patients, we need healthcare professionals. Instead of being victims and carriers of the disorder themselves, how do we keep them looking after victims? Full-body safety clothing, including goggles, full head covers, N95 particle filtering masks, and hazmat-style suits should be worn. Do we have a sufficient supply of all our protective equipment? The government has promised ample supply, but it does not seem to be ample. But what happens when a healthcare worker is exposed without sufficient protection to a COVID-19 disease patient? For home quarantine, they have to be sent home. Think about it, we can have none if any healthcare worker who comes into touch with COVID-19 is sent for home quarantine.


Safety in Operation Theater 

 In these extraordinary times, other healthcare professionals are faced with the question of what to do. Do they go ahead and, as recommended for a high-risk population, take toxic hydroxy-chloroquine for SARS-COV-2 infection prophylaxis? 80 percent of COVID-19 patients have or are asymptomatic with moderate symptoms. Then the false negative tests are there! The virus can spread in the operation theatre (OT) if these false negative or asymptomatic carriers are operated on. Those viruses live on metal and plastic for 72 hours. After being sucked by the exhaust fan, these virons will blow into the OT as an aerosol through the HEPA philtre / Ventilation system. This hazard should be eradicated by fumigating the OT.

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