Govt issues new directives to hospitals

Govt issues new directives to hospitals

TIMES NEWS NETWORK

Hyderabad: 02.07.2020

The state government on Wednesday issued certain guidelines while permitting hospitals with a 100-bed capacity to treat Covid-19 patients.

The guidelines state that the hospitals should set up separate admission and exit routes for suspected Covid-19 patients and must have exclusive wards and rooms to place them under isolation. The government has also instructed the staff to take necessary precautions while testing and treating suspects.

The guidelines alsostatethat the patients,whotest positivefor Covid-19, should be regularly examined by physicians. Cardiologists, pulmonologists and anesthesiologists have been asked to conduct regular video consultations. In case of a death due to infection, the hospital is to strictly follow the rules while shifting the body and performing the last rites. In other clinics and hospitals, only four patients per hour should be given appointments, the notification said. “If patients with symptoms are given an appointment in the outpatient department, they should be examined in a different room,” it said.

Young fatalities: Virus could be attacking heart

Young fatalities: Virus could be attacking heart

Sunitha.Rao@timesgroup.com

02.07.2020

Bengaluru: Globally less than 1% of Covid-19 fatalities are those below 40 years, a trend in Karnataka too. Over the past four days, four men below the age of 40 have suddenly died of acute breathlessness, prompting doctors to suggest it could be a sign of viral myocarditis.

A 32-year-old was brought dead to a hospital in Belagavi on Monday, while a 29-year-old died soon after being admitted in Mysuru the same day. A day previously, a 31-year-old from Ballari died of breathlessness soon after hospitalisation, and a 40-year old from Ramanagara died hours after being admitted. None of the four had comorbidities.

Doctors say patients suddenly collapsing and dying suggest viral myocarditis, a condition where the virus attacks heart muscles, disrupting electrical pathways that are vital for the heart to pump properly. While doctors suspect viral myocarditis, it cannot be scientifically established as autopsies of Covid-19 fatalities are not allowed.

To better understand cardiac manifestations in Covid-19 patients, Sri Jayadeva Institute of Cardiovascular Sciences and Research Institute (SJICSR) had provided Covid-19 dedicated hospitals of Bangalore Medical College and Research Institute with an ECG and Echo cardiogram machines each.

“It is possible that like other viruses, SARS-CoV-2 too is leading to viral myocarditis,” said Dr CN Manjunath, director, SJICSR. “First infection, followed by inflammation of the heart muscle and then clotting (thrombosis) is a typical pattern of viral myocarditis. In some patients, the virus may have caused acute respiratory distress due to infection in the lungs as well.”

Experts say host immunity matters in a viral infection and hence the experience of patients differs. The largest study to examine the association between cardiac involvement and Covid-19 was performed in Wuhan, China. Of 416 patients at Renman hospital in Wuhan University, 82 (19.7%) had cardiac injuries. Mortality among those with such injuries was significantly higher (51%).

“A heart biopsy will show inflammation in the heart muscle,” said Dr Rahul Patil, head of the project, Young Age Heart Attack, SJICSR. “Inflammation is secondary to viral infection. It might mimic a heart attack, but confirmatory tests are cardiac MRI, myocardial biopsy and Covid-19 testing if the patient is brought dead.”

Covid-19 hospitals here are not multispeciality centres, so we do not have a setup to constantly check Echo and ECG of patients. Studies done in the US say three of 1,000 patients had viral myocarditis and it could be true in India too. However, some brought dead cases had comorbidities, so we can’t draw definite conclusions

Dr Ramesh Revanna PULMONOLOGIST, B’LORE MEDICAL COLLEGE & RESEARCH INSTITUTE

We have so far seen at least 10 brought-dead cases. The virus has multiorgan involvement so we can’t categorically say death is due to viral myocarditis. There could have been concurrent renal failure or end stage sepsis

Dr KV Trilok Chandra NODAL OFFICER, CRITICAL CARE, TELE ICU TEAM

Probe test data leak, say doctors

Probe test data leak, say doctors

Sunitha.Rao@timesgroup.com

02.07.2020

Bengaluru: Ten employees of Sri Jayadeva Institute of Cardiovascular Sciences and Research (SJICSR), who had tested positive last week, received messages on their phones two days ago stating they were negative for the infection. Confused, the patients underwent a retest due and were found positive. The tests were done at Kidwai Memorial Institute of Oncology (KMIO).

“The negative result messages were not sent from the government portal and this has led to suspicion. We have no clue how lab data is being accessed by miscreants. It needs cybercrime police investigation,” said Dr CN Manjunath, director, SJICSR and nodal officer, Covid 19 taskforce for lab testing.

The staff tested positive on June 26 and they received contradictory messages two days later. “Mischief mongers appear to be hacking data. Because of the confusion, I made sure they were all tested again,” said Dr Manjunath.

A technician from Nimhans who tested positive also received a message on his phone saying he is negative. A re-test confirmed an infection. The lab faced a similar situation again on Wednesday, when a cancer patient from Kidwai, who tested positive on June 29, received a message later saying she was negative.

“We upload lab reports on the ICMR portal. We do not send messages,” said Manjunath Siddappa, director, Bangalore Medical System, who runs the lab in KMIO. “If there is a data leak, it is not from our end.”

The lab has conducted 48,000 tests since April 28 and tests 1,200 samples a day. When contacted, Dr C Ramachandra, director, KMIO, said he was unaware of the matter. The government recently issued a notification banning all labs from sharing Covid-19 results with patients. Labs were told that the report must be communicated to the patient only through district administration.

Personal data up for sale for just 5 paise

Personal data up for sale for just 5 paise

Chandrima.Banerjee@timesgroup.com

02.07.2020

Where you live, how much you make, which mail ID you use more often — unknown to you, your personal information is being mined from companies and apps by data brokers. And it’s feeding a growing Covid data industry, which can pass on your health data to advertisers, insurance companies and hospitals.

“It’s a very disturbing trend. Covid has come at a time of increased digital adoption… But premised on the vulnerability of people, data brokers have gathered large amounts of personal data, including healthcare data,” Apar Gupta, executive director of the Internet Freedom Foundation, told TOI.

It’s all legal though. The process starts with a basic database of personal details. When TOI approached a primary data broker, five samples were shared with data about 3,855 individuals. Another data broker came back with a sample sheet of 690. And the full database? “1 lakh data cost you Rs 5k,” the broker wrote back. About 5p per person. But how much of it is legit? TOI called up some of the numbers on the sample lists. The records matched. “Even my residence address is correct,” said one of them, who was alarmed his personal information was up for sale. These datasets, privacy experts said, often come from employees in sectors that have large customer databases — like credit, banking, car dealerships or hospitals — and are largely accurate.

The next step is to track location and purchases. That can be done with SDKs, software development kits, which are small tools that app developers can add to cover a function. But location SDKs can, and are sometimes required to, relay information without adding functionality. VenPath, for instance, pays app developers to use its SDKs in exchange for user data. “We love some location data… The best way to collect it is every minute in the foreground and every 5 minutes in the background… The SDK grabs everything it needs,” VenPath says in its permissions section. For purchase history, there is the Mobile Advertiser ID, assigned to every device by operating systems. It creates a buyer profile by tracking purchases, searches and movement. So if someone stops at a pharmacy and later searches for “Covid symptoms”, data gatherers know where things are headed before their doctor does.

But the data from multiple points needs to be put together and processed. This is where Covid data brokers come in. One Covid data broker, for instance, offers something called a “Covid Graph” and says it can “acquire” the device ID of a person who tests positive (without saying how it will know who tested positive) and track them. Another offers to analyse the impact of Covid-19 on spending patterns. “Medical data can lead to a form of profiling that can be very invasive. It can be commercially utilised without their consent by insurance companies, for instance, which opaquely price premiums, or by hospitals,” Gupta said. “One cannot estimate the amount of money which is flowing through it.”

Covid data brokers are passing on health data to advertisers, insurance companies & hospitals

DGHS: Can use plasma therapy in moderate cases

DGHS: Can use plasma therapy in moderate cases

New Delhi:02.07.2020

Convalescent plasma can be considered for treatment of moderate Covid patients who are not improving (oxygen requirement is progressively increasing) despite use of steroids, the directorate general of health services (DGHS) said on Wednesday, clearing the air on use of convalescent plasma therapy, reports Sushmi Dey.

Convalescent plasma therapy is allowed as an investigational therapy for use in Covid-19 patients. The clinical management protocol prescribed by the government recommends convalescent plasma by plasmapheresis as in Covid-19 patients with a few safeguards.

According to the DGHS, under the Central Drugs Standard Control Organisation, the special prerequisites while considering convalescent plasma include ABO compatibility and cross-matching of the donor plasma. Recipient should also be closely monitored for several hours post transfusion for any transfusion-related adverse events. “Use should be avoided in patients with IgA deficiency or immunoglobulin allergy,” it said.

The recommended dose for the therapy is variable ranging from 4 to 13 ml/kg (usually 200 ml single dose given slowly over not less than 2 hours).

The health ministry had recently revised blood transfusion guidelines to include collection of convalescent plasma under the clinical trials protocol from people who have recovered from Covid-19 infection.

The Indian Red Cross Society (IRCS) is also working to create a database of potential convalescent plasma donors for hospitals treating Covid-19 patients.

Full report on www.toi.in

HC tears into T’gana govt over failed Covid strategy

HC tears into T’gana govt over failed Covid strategy

‘State Resorting To Suppression Of Information’

SagarKumar.Mutha@timesgroup.com

Hyderabad:02.07.2020

The Telangana high court said on Wednesday that the state government had not only failed to control the spread of the Covid-19 virus but also kept people in the dark about its spread and did not implement important orders of the court.

A bench of Chief Justice Raghvendra Singh Chauhan and Justice B Vijaysen Reddy told advocate general B S Prasad on the one hand the chief secretary says the government is following ICMR guidelines on testing and on the other the director of public health stops testing. “The ICMR never said testing should be stopped,” the chief justice said.

The bench told chief secretary Somesh Kumar and other officials to either implement its orders by July 17 or appear before it on July 20. The judges were particularly upset about their orders about giving detailed media bulletins not being followed.

Hearing a bunch of PILs filed by Prof PL Visweswara Rao of Telangana Jana Samithi and others, the bench said public health director Dr G Srinivas misled the court about tests and dissemination of information to the people.

The judges directed the state to submit detailed information on tests conducted in the state along with tests done on asymptomatic and symptomatic people, and whether primary contacts of positive patients were being tested as per ICMR guidelines.

The judges found fault with the authorities for failing to conduct 50,000 tests in 10 days, as was promised, and for unilaterally stopping them for a few days on the grounds that they were unable to test the large number of samples. “You cannot stop things like this. This is contrary to ICMR guidelines,” the bench said.

“Instead of increasing tests, you are stopping the conduct of tests, the bench said, rejecting a report filed by the public health director. “Next time, let this director file a sworn affidavit along with his reports so that we can fix responsibility on such officials if they openly resort to perjury,” the bench added.

“Contrary to popular perception, young people in the 26-to-35 age group are most affected by the coronavirus in Telangana,” the bench said. “Instead of letting people know such information so that the younger lot will come out of the misconception that only old people have to be careful, the state is resorting to suppression of such information. None of the media bulletins carry details of age, gender, area, etc. though we gave an order on June 18 itself asking officials to reveal information to people,” the bench said.

“There is no containment policy. All containment zones were closed. There is total confusion as to the areas that were most affected by the virus. Though we have directed the state, its health officials to regularly publish details of affected people ward-wise, the authorities ignored our direction,” the bench said.

STRICT CHECKS: Health workers screen a policeman in

Visa process starts for 11 countries

Visa process starts for 11 countries

New Delhi: 02.07.2020

Amid the ongoing pandemic, foreign missions in India have gradually started resuming visa application processes. VFS Global on Wednesday said this process has restarted for specific categories for the UK, Ireland, South Korea, Turkey, UAE, Italy, Norway, Belarus, Denmark, Dominican Republic and Portugal in some cities, with the approval of respective embassies in India.

It is yet to announce visa resumption dates for big destinations like the US and Canada. VFS serves 51 client governments in India and had handled 60 lakh visa applications here in calendar year 2019.

The UK will begin accepting applications for all visa categories in 11 cities beginning July 6 and Ireland will do so only for student and long-stay categories for now. Turkey, Belarus and UAE (DVPC-eVisas for Emirates passengers only for travel from July 7) have started accepting applications for all categories in Delhi and online (for UAE). Italy, Denmark, Norway and Portugal will, for now, take only for some categories (see box) in Delhi alone. TNN