Indian Govt. brings ordinance making attack on doctors, paramedic staff a non-bailable offence punishable with up to 7 years imprisonment

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Doctors, paramedics, and other healthcare professionals are “frontline warriors” in this war against COVID-19. Yet, they have been subject to violence and discrimination. The incidents of violence targeting doctors, nurses, healthcare workers are increasing even as they have been engaged in carrying out their duties.

Following a meeting today between the Union Home Minister and Health Minister and the office-bearers of IMA, led by Dr Rajan Sharma, National President, the government has brought in an ordinance to amend the Epidemic Diseases Act, 1897 which covers dangerous epidemic diseases.

Attacks on doctors, paramedic staff and ASHA workers have been made non-bailable and cognizable offences, which are punishable with imprisonment from 6 months up to 7 years and fine of one lakh up to Rs 5 lakhs. The police investigation will be complete within a month and the case will be fast-tracked with the final judgment to come within a year.

Those found to be damaging the private clinic or a vehicle belonging to a doctor will be asked to pay compensation amounting to twice the market value of the damaged property or assets.

This is a step in the right direction. It is a welcome relief to the medical fraternity and we thank the government for this decision. It has come at the right time when we are in the midst of the biggest public health crisis in modern history.

I hope that this amendment will follow another amendment of CEA or a special ordinance to cover non-epidemic situations also.

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

COVID Models to Know Future Numbers (For attention of Doctors)

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Case fatality rate:Number of deaths/number of cases, As on 5 pm 23rd March, 14924/345289 = 4.32 %
Correct formula: CFR = deaths at day.x /cases at day.x-(T), (where T = average time period from case confirmation to death, which is 14 days)
Deaths on 23rd March = 14924; Cases 14 days before 10th March = 114381

Correct CFR = 14924/114381= 13%

Deaths in symptomatic cases= 1-2%, Number of deaths X 100= expected number of symptomatic cases
Symptomatic casesx 50 =number of asymptomatic cases
Total expected number of cases: Italy scenario: 978/million population (0.1% of the population), China scenario: 56/million population, Switzerland scenario: 1000/million population, Average scenario 46 per million population, Average scenario India: 50 per million population
Expected Number of cases after seven days
Number of cases today x 2 (doubling time 7 days, normal spreader)

Number of cases x 6 (Doubling time 2 days, super spreader)

Number of cases expected in the community:We can look at the number of deaths occurring in a five-day period, and estimate the number of infections required to cause these deaths based on a 3.3% fatality rate.
We can then compare that to the number of new cases detected in the five-day period 17 days earlier to estimate the proportion of actual cases that were detected 17 days ago.

This will give us an estimate of the total number of cases, both confirmed and unconfirmed.

Lock down effect = reduction in cases after average incubation period (5 days)
Lock down effect in reduction in deaths: on day 14 (time to death)
Requirements of ventilators on day 9: 3% of number of new cases detected
Requirement of future oxygen on day 7: 15% of total cases detected today
Number of people which can be managed at home care: 80% of number of cases today; Requirements of ventilators: 3% of number of cases today
Requirement of oxygen beds today:15% of total cases today
Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

To comment on th

CMAAO COVID Guidelines for doctors

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Health care professionals should be flexible in their professional behaviour in face of the significant epidemic.
Readiness to work outside the comfort zone of clinical practice in the increasingly likely scenario of widespread community transmission of COVID-19.
Primary and secondary care undergoes extreme stress during significant epidemic state. This leads “inevitable exacerbation of staff shortages due to sickness or caring responsibilities” and hence represents a challenging scenario for the profession.
It may include working in unfamiliar circumstances or surroundings or clinical areas outside of their usual practice for the benefit of patients and the entire population.
Every patient entering the hospital should be considered as COVID positive and health care professionals should wear mask all the time.
Encourage tele or video conferencing or consultations as far as possible.
Inform through SMS all the patients to not visit the hospital/clinic if they have cough or fever. They should only do so after fixing an appointment.
All patients with cough and fever entering the hospital should be immediately provided with a surgical mask at the reception, and given priority getting lab or imaging tests. They should not be made to wait in queues.
All reusable equipment stethoscopes, BP instruments etc. should be frequently sanitised.
Minimise paper work as much as possible.
Learn the correct method of using and disposing surgical masks.
Read the updated MoH guidelines every day.
Best mask for coronavirus in Hindi ,Symptom of Coronavirus in India ,Prevention of coronavirus in Hindi

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

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