Railways run ‘Shramik Specials’ to ferry stranded

02/05/2020

The five ‘Shramik Special’ trains planned are: Nasik (Maharashtra) to Lucknow (Uttar Pradesh), Aluva (Kerala) to Bhubaneswar (Odisha), Nasik (Maharashtra) to Bhopal (Madhya Pradesh), Jaipur (Rajasthan) to Patna (Bihar) and Kota (Rajasthan) to Hatia (Jharkhand). 

A Railways official stressed that these were special trains planned for people identified and registered by the State governments, and that the Railways would not issue any tickets to any individual or group. “We will allow only those passengers to board whom State government officials will bring to Railway Stations,” said the official, speaking on the condition of anonymity.

“These special trains will be run from point to point on the request of both the concerned State governments as per the standard protocols for sending and receiving such stranded persons,” the Indian Railways said in an official statement.

The passengers would have to be screened by the sending States and only those found asymptomatic would be allowed to travel. In addition, the sending State governments would have to arrange to bring these people in batches in sanitized buses, following social distancing norms and other precautions. “It will be mandatory for every passenger to wear face cover. Meals and drinking water would be provided to the passengers by the sending States at the originating station.”

A Railway official said the fare for these special trains would be based on the fare for Sleeper Mail Express trains, plus ₹30 superfast charge and an additional charge of ₹20. This includes meals and drinking water for long-distance trains. However, passengers are not required to buy the ticket. The fares would be paid by the State governments.

The Railways said the cancellation of all passenger train services would be extended till May 17.

Recovering early

An improved recovery rate is positive news, but reducing new infections is crucial

02/05/2020

Data for COVID-19 is still a long way from giving a complete picture, but it is encouraging that the basic metric of the number of those recovering as a share of confirmed infections is showing improvement in India. The Health Ministry has said that the percentage of recoveries currently stands at just over 25, almost double of what it was two weeks ago. National data on other parameters appear similar to disease trends witnessed globally, with the worst outcomes encountered among elderly patients — translating into a case fatality rate of 51.2% for Indians older than 60. What is important to note, however, is that whether it is recovery or death, not all cases are recorded for a variety of reasons. There may be untested people who have recovered. Also, in the long term, most recover from the infection. It is therefore imperative to find positive cases early and assess the pace of recovery accurately. Among the countries moving to a mass-testing strategy after a measured lockdown and successful control over viral transmission is New Zealand. In terms of deaths, there could be unknown fatalities caused by COVID-19 outside hospitals. Doctors in the United States have made a contrasting determination: of people who had the virus, but died of unrelated causes. These findings and trends underscore the importance of research on the progression of the pandemic in India.

The comparatively low death rate from COVID-19 in India, officially estimated at 3.2%, remains a topic for systematic study. Even accounting for inability to identify all virus-caused deaths and misclassified fatalities, the absence of a large number of severely distressed patients in hospitals stands in contrast to the experience abroad, notably in the U.S., as well as many countries in Europe. The Johns Hopkins database gives the fatalities per 100 confirmed cases as 15.7% for the U.K. and Belgium, for example. There are many hypotheses for the less dismal outcome in India based on the impact of climate, benefits of immunisation, and other possible factors, but they remain untested. While India’s fatalities may be low, and an improved recovery rate will help revive the economy, there is genuine worry that patients with non-COVID-19 conditions are at greater risk for poor health outcomes due to lack of access to care during the pandemic. The public health strategy for COVID-19 has to sharply focus on helping people determine their infection status through widely available testing. This will enable selective quarantining, planning of welfare measures and participation of people who have recovered in trials for potential therapies such as convalescent plasma transfusion. With a relaxation of the lockdown, India’s strategy will need precise and intensive measures to drive down the reproduction number for the virus.

Adopt a cobra for ₹2,000, an elephant for ₹1.75 lakh

Bengaluru’s Bannerghatta Biological Park offers animals for adoption for a year

02/05/2020, PRESS TRUST OF INDIA,BENGALURU

A file photo of a zoo employee feeding ostriches at the Bannerghatta Biological Park. Deepa Kurup

Would you like to adopt an Indian cobra for as low as ₹2,000 per annum or an Asiatic elephant ₹1.75 lakh? Bengaluru’s Bannerghatta Biological Park (BBP) has a new programme for people with an interest in conserving wildlife by adopting animals at the zoo.

Certain privileges such as gift voucher for a zoo visit and the display of names on an adoption board would be extended, depending on the amount donated.

“The animal adoption programme is an opportunity for you to get involved with supporting feed and veterinary care expenses for zoo animals with provision for Income Tax rebate under Section 80G. There are 21 elephants that can be adopted online,” said zoo officials.

The BBP has released a list of animals that can be adopted.

Patrons can adopt a King cobra and Indian rock python for ₹3,500 per year, or a jungle cat and the Assamese Macaque for ₹5,000. Adoption of a black buck and sambar will cost you ₹7,500 per year, an emu is billed at ₹10,000, and a spot-billed pelican at ₹15,000.

“The purpose of the adoption programme is to create awareness and connect with people involved in conservation activities, not just generating revenues,” the Executive Director of the government-run BBP, Vanashree Vipin Singh, told PTI on Friday. “We don’t run this programme with a profit motive.”

The zoo, which sees an annual footfall of around 15 lakh persons, has been closed since the middle of March following the lockdown declared in the wake of the COVID-19 pandemic. It received a record 23,000 people on a single day on January 1 this year.

The animal adoption initiative is part of the BBPs outreach programme as people are not able to visit the zoo due to the lockdown. In other times, visitors to the zoo can sign up to adopt animals, Ms. Singh said.

Special trains ferry workers home

Labourers leave Kerala, Telangana

02/05/2020, SPECIAL CORRESPONDENT,HYDERABAD

Going home: Police checking papers of workers who want to travel on the train from Aluva on Friday. Vibhu HThe Hindu

In a move to help migrant workers return home, Kerala and Telangana operated special trains on Friday.

One train to Jharkhand was run by the South Central Railway (SCR) and the Telangana government from Hyderabad. In Kerala, the first ‘Shramik Special’ left Aluva for Odisha. The Railways will similarly operate five special trains from Kerala on Saturday.

The train from Hyderabad was arranged for 1,225 labourers hailing from Jharkhand. It had 22 sleeper coaches and left Lingampally in the western suburbs for Hatia, in Ranchi district, at 4.50 a.m.

The workers were brought in 56 buses from construction sites on the Indian Institute of Technology-Hyderabad (IIT-H) by the police and the Sangareddy district administration. They were then screened, and their details collected.

Station barricaded

The Lingampally station was barricaded to prevent outsiders from getting in. SCR officials said the operation was taken up at the request of the Telangana government and secrecy was maintained after incidents in Mumbai where rumours brought thousands of labourers to railway stations.

SCR General Manager Gajanan Mallya asked the authorities to arrange food and water en route for the 24-hour non-stop journey. In each bogie, about 52 people were accommodated, maintaining social distancing, and Railway Protection Force and Government Railway Police personnel were deputed as escort, said Chief PRO Ch. Rakesh.

Tickets were issued to workers, and officials indicated that the Telangana government would meet the expenditure.

Train to Bhubaneswar

The non-stop special carrying 1,140 migrant workers from Aluva in Kerala left for Khurda Road (near Bhubaneswar) on Friday night. It was the first such train for migrant workers stranded in the State. The train with 24 carriages took in 35 to 50 workers per coach as per social distancing norms. Agriculture Minister V.S. Sunil Kumar, District Collector S. Suhas, and District Police Chief (Ernakulam Rural) K. Karthik were present.

Workers from Odisha account for nearly 12% of the migrant workforce in the district. “Migrants from Perumbavur, Muvattupuzha, Kothamangalam and Kuruppampady were screened and issued medical certificates,” said C. Jayakumar, inspector, Perumbavur.

(With inputs from Kochi Bureau)

Don’t ignore abdominal symptoms

02/05/2020

The abdomen is a Pandora’s box” is a well-known phrase described by many surgeons around the world. Abdominal pain has always been a tricky symptom to assess. And now, during this lockdown, we are getting a lot more calls from our patients complaining of abdominal symptoms. These may vary from simple gastritis-like pain to acute/severe abdominal pain. These symptoms need to be evaluated and their medical history studied before the diagnosis and appropriate treatment.

Abdominal discomfort has been identified as one of the less common symptoms of the COVID-19 infection. Recent literature has revealed that about 20% of patients report to the hospital with a digestive symptom, such as diarrhoea, vomiting and/or pain, accompanying their respiratory symptoms. And roughly 5% show up with abdominal complaints alone. A study in China found that a third of the people with mild COVID-19 experienced diarrhoea that lasted, on an average, five days. It took them longer to clear the virus from their bodies, compared to those without gastrointestinal symptoms.

So, when should a patient with abdominal symptoms visit a hospital? If the pain or associated symptoms like vomiting, diarrhoea, bloating or fever show an increasing trend over a few hours since the onset, it is better to consult a specialist at the hospital.

Any acute abdominal pain could mean that the patiet may have an intestinal obstruction, infection or inflammation of the appendix, gallbladder stones causing infection and pus within the biliary tract, intestinal perforations and more. These signs would be intolerable and will limit regular activity or movement.

How do we diagnose once we see you? It’s a combination of complete history taking and clinical examination with blood tests and radiological tests like USG abdomen or CT abdomen. Once diagnosed, treatment choices are offered which may be medical or surgical in nature. In some situations, emergency surgery may be recommended to avoid further sepsis as this may hamper the overall outcome of the treatment and life of a person.

Delayed consultation

About 90% of these procedures can be completed by laparoscopy (keyhole surgery) which is a minimally-invasive method of performing surgeries. Most of these patients get discharged within two days and are able to do their routine work soon. When there is a significant delay between onset of symptoms and arrival at the hospital, that is where the chances of performing these procedures through the keyhole method decreases and the rate of complication rises. But during this current situation, I am sure you are probably wondering how safe it is for people to visit the hospital. All hospitals are taking utmost precautions to safeguard the health and safety of their patients and, of course, the healthcare workers. Effective screening of every person, including doctors and staff, is performed as they enter the hospital on a daily basis. All patients are screened and their attenders screened. If anyone has any suspected symptom related to COVID-19, they are isolated and admitted in specialised isolation suites till the test results are out.

All patients undergoing surgery are tested for COVID-19 and all healthcare staff dealing with the patients wear full personal protective equipment while treating or handling these patients, even if the results of tests for COVID-19 are negative. Patients who are recuperating from surgery must take extra precautions as their general immunity will be a bit more compromised.

People must stay at home if they are fine and healthy, eat healthy food and indulge in some form of exercising like walking and breathing exercises within the house to keep themselves fit. Physical distancing is a very important principle to follow during this period but in the case of an abdominal or a gastrointestinal (GI) emergency, healthcare distancing need not be practised. The best outcomes in all these GI emergencies can be fully achieved if the patient reports early to the hospital.

(The author is the Clinical Lead of the Department of Minimal Access and Bariatric Surgery at MGM Healthcare)

Search Committee for VC post the hindu 2.5.2020

23 year-old house surgeon found dead in KMC hostel

02/05/2020, SPECIAL CORRESPONDENT ,CHENNAI

A 23-year-old woman house surgeon was found dead in her hostel room at the Government Kilpauk Medical College Hospital on Friday.

Since the lockdown has been in force, she came from her house in Perambur and was staying in the hostel from April 14. According to hospital authorities, she was a CRRI and joined duty on April 18.

On Friday, she did not come out from her room nor respond to anyone. Police personnel broke the door down and rushed her to the hospital, where she was declared brought dead.

Hospital authorities confirmed that her swabs tested negative for COVID-19. However, post-mortem findings were inconclusive, they said, and added, “The cause of death is not immediately known.”