CMAAO Coronavirus Facts and Myth Buster – Coronavirus variant in India

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1576: Which variant of coronavirus are we most likely to encounter in India?

In Punjab and Delhi, it is more likely that the variant will be B.1.1.7, which is also known as the Kent or the British mutant. In Maharashtra and neighboring states, one is more likely to encounter the B.1.617 variant, also known as the ‘double mutant’. Although this variant was first reported from India, it has now been identified in the UK, the USA, Australia, Singapore, Belgium, Germany, New Zealand, Namibia and South Africa.

The N440K variant reported from Kerala has also been identified in Andhra Pradesh and Telangana. This variant has been detected in 16 countries. The South African and Brazilian variants have also been reported in small numbers in the country.

1577: Do vaccines work against the variant found in India?

The B.1.617 variant carries a mutation component – E.484Q – which is like E.484K that has been reported to have lower efficacy of immune response to the AstraZeneca vaccine in South Africa.

1578: Do vaccines produce IgA?

No, the vaccines do not produce IgA which is a secretory antibody with the potential to remove the virus from mucosal surfaces of the nose and throat. Therefore, a mild infection is still possible.

[Source: News18]

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

CMAAO Coronavirus Facts and Myth Buster – Steroids and Vaccine

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With input from Dr Monica Vasudev

  1. There appears to be no direct evidence to state that corticosteroid injection prior to or after an adenovirus vector-based COVID-19 vaccine diminishes vaccine efficacy. Yet, clinicians may want to give elective corticosteroid injections at least two weeks before or after receiving this vaccine, reported a group of doctors writing on behalf of the Spine Intervention Society.
  2. The two-week rule is based on the known timeline of hypothalamic-pituitary-adrenal (HPA) axis suppression after intraarticular and epidural corticosteroid injections, noted researchers in a paper published in Pain Medicine.
  3. The two week rule is also based on the timeline of reported peak efficacy of the Janssen and AstraZeneca adenovirus-vector-based vaccines against COVID-19.
  4. An interim analysis of phase 1-2a and phase 3 trial data revealed that the Janssen COVID-19 vaccine elicited cellular and humoral immune responses and conferred clinical protection as early as 14 days following administration, while the AstraZeneca vaccine elicited response 15 days following the second dose.
  5. The Janssen phase 3 trial allowed corticosteroid use at or below the equivalent of 20mg/day through ocular, topical or inhaled administration
  6. Topical or inhaled steroids were allowed in the AstraZeneca trial for up to 14 days.

[Source: https://bit.ly/3gFPHAl Pain Medicine, online April 11, 2021.]

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

CMAAO Coronavirus Facts and Myth Buster: Status in India

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With input from Dr Monica Vasudev

India has been reporting the worlds highest daily tally of coronavirus cases for past few days, surpassing 3 lakh new cases.
Daily deaths have also crossed the 2000 mark, while officials across northern and western India cautioned that most hospitals were full and facing a scarcity of oxygen.
A fire broke out in a hospital in a Mumbai suburb treating COVID-19 patients that killed 13 people.
On 21 April, 22 patients died at a public hospital in Maharashtra when they ran out of oxygen supply due to a leaking tank.
There has been a dearth of medical oxygen and beds, with major hospitals putting up notices that they can’t admit any more patients and police fanning out to secure oxygen supplies.
“We regret to inform that we are suspending any new patient admissions in all our hospitals in Delhi … till oxygen supplies stabilise,” Max Healthcare said on Twitter, appealing for oxygen.
In New Delhi, people losing their loved ones are turning to makeshift facilities for mass burials and cremations.
According to health experts, the country got complacent in the winter, when there were around 10,000 new cases a day and the situation appeared to be under control. Restrictions were lifted to allow big gatherings.
A more infectious variant of the coronavirus that originated in India may have contributed to the surge, experts said.
Several countries have banned flights from India.
(Reuters)

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

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