Hegde apologises in LS for his remark against Constitution, says his words were twisted

Bengaluru, May 15: With lockdown-3 coming to an end in a couple of days, Karnataka Chief Minister B S Yediyurappa on Friday expressed confidence about the Centre announcing relaxation to "many things" after May 17.

"After May 17, the government of India is going to relax so many things, let us wait for it," he said in response to a question from reporters here. "According to me they (centre) will relax everything.... maybe for things like five-star hotels and others they may not give permission for the time being, but for other things they are going to give permission. Let's wait and see."

The nationwide lockdown was initially imposed from March 25 to April 14, then extended to May 3 and again to May 17 to prevent the spread of the novel coronavirus. Karnataka Tourism Minister C T Ravi on Wednesday had hinted at the state government permitting the opening of gyms, fitness centres and golf courses, also certain hotels for local tourism purpose after May 17, when the third phase of the COVID-19 induced lockdown comes to an end.

The Muzrai department (in charge of the administration of temples) was also planning to have a Standard Operating Procedure (SOP) in place, that needs to be followed at temples once they are opened for the public, officials have said. They said the opening of temples for the public is however subject to the MHA (Ministry of Home Affairs) guidelines.

During the recent video conferencing Prime Minister Narendra Modi had with Chief Ministers of various states, Yediyurappa had proposed doing away with district wise colour-coding and instead advocated strict cordoning of containment zones to control the spread of the pandemic.

He had pitched for resuming all economic activities in stand-alone establishments while continuing the restrictions on malls, cinema halls, dining facilities and establishments with centrally controlled air-conditioning. The CM had suggested that 50 to 100 meters around known clusters be declared as containment zones and commercial activities, including public transport, to be allowed in non- containment zones.

Feb 26: China’s massive travel restrictions, house-to-house checks, huge isolation wards and lockdowns of entire cities bought the world valuable time to prepare for the global spread of the new virus.

But with troubling outbreaks now emerging in Italy, South Korea and Iran, and U.S. health officials warning Tuesday it’s inevitable it will spread more widely in America, the question is: Did the world use that time wisely and is it ready for a potential pandemic?

“It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen — and how many people in this country will have severe illness,” said Dr. Nancy Messonnier of the U.S. Centers for Disease Control and Prevention.

Some countries are putting price caps on face masks to combat price gouging, while others are using loudspeakers on trucks to keep residents informed. In the United States and many other nations, public health officials are turning to guidelines written for pandemic flu and discussing the possibility of school closures, telecommuting and canceling events.

Countries could be doing even more: training hundreds of workers to trace the virus’ spread from person to person and planning to commandeer entire hospital wards or even entire hospitals, said Dr. Bruce Aylward, the World Health Organization’s envoy to China, briefing reporters Tuesday about lessons learned by the recently returned team of international scientists he led.

“Time is everything in this disease,” Aylward said. “Days make a difference with a disease like this.”

The U.S. National Institutes of Health’s infectious disease chief, Dr. Anthony Fauci, said the world is “teetering very, very close” to a pandemic. He credits China’s response for giving other nations some breathing room.

China locked down tens of millions of its citizens and other nations imposed travel restrictions, reducing the number of people who needed health checks or quarantines outside the Asian country.

It “gave us time to really brush off our pandemic preparedness plans and get ready for the kinds of things we have to do,” Fauci said. “And we’ve actually been quite successful because the travel-related cases, we’ve been able to identify, to isolate” and to track down those they came in contact with.

With no vaccine or medicine available yet, preparations are focused on what’s called “social distancing” — limiting opportunities for people to gather and spread the virus.

That played out in Italy this week. With cases climbing, authorities cut short the popular Venice Carnival and closed down Milan’s La Scala opera house. In Japan, Prime Minister Shinzo Abe called on companies to allow employees to work from home, while the Tokyo Marathon has been restricted to elite runners and other public events have been canceled.

Is the rest of the world ready?

In Africa, three-quarters of countries have a flu pandemic plan, but most are outdated, according to authors of a modeling study published last week in The Lancet medical journal. The slightly better news is that the African nations most connected to China by air travel — Egypt, Algeria and South Africa — also have the most prepared health systems on the continent.

Elsewhere, Thailand said it would establish special clinics to examine people with flu-like symptoms to detect infections early. Sri Lanka and Laos imposed price ceilings for face masks, while India restricted the export of personal protective equipment.

India’s health ministry has been framing step-by-step instructions to deal with sustained transmissions that will be circulated to the 250,000 village councils that are the most basic unit of the country’s sprawling administration.

Vietnam is using music videos on social media to reach the public. In Malaysia, loudspeakers on trucks blare information through the streets.

In Europe, portable pods set up at United Kingdom hospitals will be used to assess people suspected of infection while keeping them apart from others. France developed a quick test for the virus and has shared it with poorer nations. German authorities are stressing “sneezing etiquette” and Russia is screening people at airports, railway stations and those riding public transportation.

In the U.S., hospitals and emergency workers for years have practiced for a possible deadly, fast-spreading flu. Those drills helped the first hospitals to treat U.S. patients suffering from COVID-19, the disease caused by the virus.

Other hospitals are paying attention. The CDC has been talking to the American Hospital Association, which in turn communicates coronavirus news daily to its nearly 5,000 member hospitals. Hospitals are reviewing infection control measures, considering using telemedicine to keep potentially infectious patients from making unnecessary trips to the hospital and conserving dwindling supplies of masks and gloves.

What’s more, the CDC has held 17 different calls reaching more than 11,000 companies and organizations, including stadiums, universities, faith leaders, retailers and large corporations. U.S. health authorities are talking to city, county and state health departments about being ready to cancel mass gathering events, close schools and take other steps.

The CDC’s Messonnier said Tuesday she had contacted her children’s school district to ask about plans for using internet-based education should schools need to close temporarily, as some did in 2009 during an outbreak of H1N1 flu. She encouraged American parents to do the same, and to ask their employers whether they’ll be able to work from home.

“We want to make sure the American public is prepared,” Messonnier said.

How prepared are U.S. hospitals?

“It depends on caseload and location. I would suspect most hospitals are prepared to handle one to two cases, but if there is ongoing local transmission with many cases, most are likely not prepared just yet for a surge of patients and the ‘worried well,’” Dr. Jennifer Lighter, a pediatric infectious diseases specialist at NYU Langone in New York, said in an email.

In the U.S., a vaccine candidate is inching closer to first-step safety studies in people, as Moderna Inc. has delivered test doses to Fauci’s NIH institute. Some other companies say they have candidates that could begin testing in a few months. Still, even if those first safety studies show no red flags, specialists believe it would take at least a year to have something ready for widespread use. That’s longer than it took in 2009, during the H1N1 flu pandemic — because that time around, scientists only had to adjust regular flu vaccines, not start from scratch.

The head of the World Health Organization, Tedros Adhanom Ghebreyesus, said the U.N. health agency’s team in China found the fatality rate between 2% and 4% in the hard-hit city of Wuhan, the virus’ epicenter, and 0.7% elsewhere.

The world is “simply not ready,” said the WHO’s Aylward. “It can get ready very fast, but the big shift has to be in the mindset.”

Aylward advised other countries to do “really practical things” now to get ready.

Among them: Do you have hundreds of workers lined up and trained to trace the contacts of infected patients, or will you be training them after a cluster pops up?

Can you take over entire hospital wards, or even entire hospitals, to isolate patients?

Are hospitals buying ventilators and checking oxygen supplies?

Countries must improve testing capacity — and instructions so health workers know which travelers should be tested as the number of affected countries rises, said Johns Hopkins University emergency response specialist Lauren Sauer. She pointed to how Canada diagnosed the first traveler from Iran arriving there with COVID-19, before many other countries even considered adding Iran to the at-risk list.

If the disease does spread globally, everyone is likely to feel it, said Nancy Foster, a vice president of the American Hospital Association. Even those who aren’t ill may need to help friends and family in isolation or have their own health appointments delayed.

“There will be a lot of people affected even if they never become ill themselves,” she said.

Bengaluru, Jan 21: A private hospital in Bengaluru, the capital of Karnataka, on Tuesday claimed that it has successfully performed a live liver transplant on a Jehovah's Witness from Nigeria, by not using blood or blood products, in order to protect the patient's religious beliefs.

It is said that Jehovah's Witnesses are followers of a Christian faith that prohibits the use of blood or blood products during their treatment. Gehojadak (37), a Jehovah's Witness follower, had developed decompensated liver disease and visited more than three countries seeking treatment over the last four years but was turned away by most doctors due to the highly risky nature of surgery, Aster CMI Hospital said.

The surgery was challenging compared to a normal liver transplant because in order to protect the patient's religious beliefs, the medical team could not use blood or blood products (Fresh frozen plasma, Cryoprecipitate, Platelets etc), it said in a release, adding that very few such surgeries have been successfully conducted worldwide.

The patient's brother was the donor, the hospital said, adding, without a liver transplant, Gehojadak's chances of survival were less than 10 per cent over the next two years. A team of liver specialists from the Hospital thoroughly reviewed the patient's medical history before recommending a bloodless liver transplant and charted out a feasible pathway to make the surgery a success.

"This transplant was especially challenging as we did not have the safety net (of using blood) even if the patient's life was at risk due to their advance directive. We have performed other non-transplant liver surgeries in Jehovah's Witnesses and this gave us the confidence to take on Gehojadak's transplant," Dr Rajiv Lochan, Consultant Liver Transplant Surgeon, said.

The critical surgery took a 12-hour period to complete where two teams of specialists with close to 25 doctors including anaesthetists, intensivists worked in absolute sync with each other and Gehojadak finally received a life-saving liver transplant, the Hospital said. In a period of two weeks, the patient and his brother were fit enough to go home and were discharged from the hospital.

"Even if their haemoglobin levels dropped to life-threatening levels, the patients were clear that they would not accept a blood transfusion. Keeping the limitations in mind, the most effective treatment path was planned, and we spent close to two months preparing the patients for surgery," Arun V, Consultant Anesthesiologist said. The hospital arranged customised artificial products like synthetic drug molecules, to conduct a bloodless liver transplant, he added.