‘Ventilators not panacea for making Covid-19 mortality rate zero’

By Sfoorti Mishra

New Delhi, April 16 (SocialNews.XYZ) Till some time back, people were not much aware about viruses and their characteristics. However, that has changed ever since the coronavirus pandemic started to wreck havoc across the globe.

Every other day now, researchers are unearthing a new angle with regard to SARS-CoV-2, commonly known as Covid-19.

Arvind Kumar, founder trustee of the Lung Care Foundation and Chairman of Chest and Robotic Surgery at the Sir Ganga Ram Hospital in Delhi told IANS about the various aspects of the dreaded virus which has infected over 12,000 people in India besides claiming more than 400 lives. Here are the excerpts of the interview:

Q. Can dust storm aggravate the spread of Covid-19?

Past experiences cannot be applied to this disease. Every virus has a different character. SARS had caused 7,000 deaths in the world, but this virus has already killed more than 1,25,000 people. We do not know where it will stop.

This is a heavyweight virus. The infectivity of this virus is very high. Old people are more vulnerable. Scientists in their latest research have found that this virus can survive even in 45-50 degree Celsius temperature. In our country, the maximum temperature hovers over 45 degree Celsius and that too for a very short period of time and in limited geographical areas. Therefore, expecting this virus to be less effective in summers is misleading.

It's good to be hopeful about the theory of rising temperature, but scientific facts do not point towards this theory as of now. As far as wind is concerned, there is not much danger of spreading this virus due to wind because it spreads through droplets and there is no evidence of it travelling far via wind as yet.

Our knowledge about this virus is so dynamic that it is changing on a daily basis... What is true today may not be true tomorrow. Till today, there is no evidence of it becoming less or more efficient due to temperature, humidity or wind. If any evidence emerges tomorrow... I cannot comment on that now.

Q. Does pollution increases the spread of coronavirus or its mortality rate?

The answer is a very clear cut YES. There is enough data available from Italy and from very intense study conducted across the US by the Harvard School of Public Health in which they have clearly shown that this virus can get attached to particulate matter. Through the particulate matter there is a possibility of the spread of this virus.

In North Italy, they have shown that the areas which were having very high levels of vehicular pollution, the virus spread there much faster than it did in the non- polluted areas, and also a higher mortality was recorded in those areas.

They also showed that for every one microgram increase in PM 2.5, there was a 15 per cent increase in the mortality rate. They have studied a death pattern from nearly 300 counties across the US and have found that there is a direct relation between PM 2.5 level and chances of death. Therefore, this Covid-19 virus will affect pollution affected communities much faster and with more severity.

Q. Some say that Covid-19 patients put on ventilator mostly succumb to the disease and therefore it is preferable to put them on oxygen. Is this true?

There are three stages of this disease. Eighty-five per cent of the people are in a stage where they do not need anything more than paracetamol and they become alright with it. In 15 per cent cases, lungs get involved and need oxygen. Out of this, 10 per cent people will do by oxygen only and about 5 per cent of the total will go on ventilator. Of the 5 per cent who go on ventilator, 50 to 90 per cent will die.

The number depends on your age and associated diseases and therefore if the patient is old and is on ventilator with pre-existing diseases, chances of death are as high as 90 per cent, giving an overall 15 to 20 percent mortality, as has happened with the 70 plus population in Italy.

Therefore, use of ventilator in Covid-19 cases is a hyped up thing. You do need ventilators but if somebody thinks that having 1 lakh ventilator in the country means there will be no death, it is a misunderstanding.

If ventilators could save people from death, there would not have been any death in the US. When someone is on a ventilator, a tube is put into his windpipe and it is attached with a machine which pushes air underpressure into the windpipe and through the windpipe into the lungs. Therefore, a foreign body lying inside your body is an invitation to more infection. You also have a chance of contracting secondary pneumonia due to more diseases, as your lungs give up.

On the other hand, oxygen is given from outside by mask and chances of secondary infection are less and those 10 per cent people have higher chances of survival. Therefore ventilators are not the panacea for making Covid-19 mortality rate zero, but breaking the chain of transmission, identifying and testing and confining them to isolation and quarantining the contacts through tracing are more important.

Q. Why is Hydroxychloroquine suggested in Covid-19 cases, which is a viral infection, while this drug is given to malaria patients, which is caused by protozoa?

Hydroxychloroquine (HCQ) is used for malaria but it is also used for another group of diseases which are called Auto-Immune diseases where the body starts acting against its own organs. There it is supposed to be immunomodulator and helps in those diseases.

Therefore, people want to use this immunomodulator role of HCQ to increase immunity of the body, thereby decreasing the chances of contracting the infection or curing the infection quickly from your body if you are already infected.

The fact is that this result has come from France where it was used on a small number of patients, but the conclusive evidence is still very weak. There are many side-effects of this medicine and that's why the ICMR has still not permitted it for mass consumption for the public but only for healthcare workers or family members who look after Covid-19 patients and have high chances of contracting the virus.

However, people are taking it on their own without even knowing about its doses. It can cause irregularity in heart rhythm. If everybody starts consuming HCQ, there will be no medicine left for the malaria patients. Therefore, its misuse should be stopped.

Q. Does this virus share some characteristics of HIV also?

Virus is a generic term. Every virus belongs to a different family and has different characteristics. This virus is from a little difficult category like SARS and MERS. This virus has nothing to do with HIV or Polio vaccine. There are few reports on Bacille Calmette-GuErin vaccine (BCG), but there is no final decision on that also.

Source: IANS