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Exposure to second-hand smoke down in India, but remains major concern – Here are survey details

Agencies
June 9, 2018

New Delhi, Jun 9: Exposure to second-hand smoke remains a major concern in India even though there has been a reduction in such exposure at home and public places since 2009-10, as per the Global Adult Tobacco Survey 2 (GATS 2), released here by the Health Ministry. However, exposure to second-hand smoke at healthcare facilities has increased in this period. The survey showed that little more than one-third (35 per cent) of the non-smokers were exposed to second hand smoke (SHS) at home in India. In urban areas 25 per cent of non-smokers and in rural areas 40.4 per cent of non-smokers were exposed to SHS at home, respectively.

Among all adults, 5.3 per cent were exposed to second hand smoke in government buildings, 3.6 per cent at private work places, 5.6 per cent in healthcare facilities, 7.4 per cent in restaurants, 13.3 per cent in public transport, 2.1 per cent in bar/night club and 2.2 per cent in cinema halls. In all 25.7 per cent of adults were exposed to second hand smoke in any of these seven public places.

Nationally, 37.7 per cent pregnant women were exposed to SHS at home during the one month preceding the survey while 21.0 per cent pregnant women were exposed to SHS at their workplace and 25.9 per cent were exposed to SHS at any of the seven in public places. “The proportion of households in which smoking is allowed has decreased significantly from 60.4 per cent in GATS 1 (2009-10) to 48.8 per cent in GATS 2 (2016-17).

The proportion of non-smokers exposed to SHS at home has decreased significantly from 48 per cent in GATS 1 to 35 per cent in GATS 2,” the report stated. Among all adults, exposure to SHS at government buildings/offices has decreased significantly from 6.6 per cent in GATS 1 to 5.3 per cent in GATS 2 while at restaurants it has decreased from 11.3 per cent to 7.4 per cent.

In public transports, exposure to SHS has decreased significantly from 17.5 per cent in GATS 1 to 13.3 per cent in GATS 2. However, exposure to SHS at healthcare facilities has increased from 5.4 per cent in GATS 1 to 5.6 per cent in GATS 2. The survey showed that 28.6 per cent of people, aged 15 and above, currently use tobacco in some form in India even though the prevalence of tobacco use has declined significantly over the last seven years.

It also showed that every third adult (32.5 per cent) from rural areas and every fifth adult (21.2 per cent) from urban area reported current use of tobacco with the prevalence among men being 42.4 per cent and among women it was 14.2 per cent.

From GATS 1 in 2009-10 to GATS 2 in 2016-17, the prevalence of any form of tobacco use has decreased significantly by six percentage points from 34.6 per cent to 28.6 per cent. The prevalence of daily tobacco use has decreased by 4.2 percentage points (relative decrease of 14.4 per cent) and the prevalence of occasional tobacco use has decreased by 1.7 percentage points (relative decrease of 31.5 per cent).

The decrease in both is statistically significant. ? There is a significant increase of one year in the mean age at initiation of tobacco use from 17.9 years in GATS 1 to 18.9 years in GATS 2, the report highlighted. According to the report, khaini, a tobacco, lime mixture, is the most commonly used with every ninth adult (11.2 per cent) in India using it followed by bidi, which is smoked by 7.7 per cent of adult Indians.

In urban areas, khaini (6.8 pc ) and gutka (6.3 pc ) are the two most commonly used tobacco products, whereas in rural areas khaini (13.5 pc) and bidi (9.3 pc ) are the most prevalent tobacco products. GATS 2 was carried out in 30 states of India and in the two union territories of Chandigarh and Puducherry from August 2016 to February 2017.

The analysis is based on 74,037 completed interviews, among which 33,772 were with men and 40,265 with women. Of these, 47,549 interviews were conducted in rural areas and 26,488 in urban areas.

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Agencies
July 4,2020

The Union health ministry on Friday revised the dosage of anti-viral drug remdesivir to be administered to coronavirus patients in the moderate stage of illness from the earlier six days to five days as it issued an updated 'Clinical Management Protocols for COVID-19'.

The drug, administered in the form of injection, should be given at a dose of 200 mg on day one followed by 100 mg daily for four days (total five days), the new treatment protocols stated.

The Health Ministry on June 13 had allowed the use of remdesivir for restricted emergency use in moderate cases under "investigational therapies".

"Under emergency use authorisation, remdesivir may be considered for patients in moderate stage requiring oxygen support," the document stated.

It is not recommended for those with severe renal impairment and high level of liver enzymes, pregnant and lactating women, and those below 12 years, it said.

The ministry also okayed off-label application of tocilizumab, a drug that modifies the immune system or its functioning, and convalescent plasma for treating COVID-19 patients in the moderate stage of illness as "investigational therapies".

It also recommended hydroxychloroquine for patients during the early course of the disease and not for critically-ill patients.

On June 27, the ministry had included an inexpensive, widely used steroid dexamethasone in treatment protocols for COVID-19 patients in the moderate to severe stages of their illness among other therapeutic measures.

The ministry advised use of dexamethasone, which is already used in a wide range of conditions for its anti-inflammatory and immunosuppressant effects, as an alternative choice to methylprednisolone for managing moderate to severe cases of coronavirus infection.

India's COVID-19 cases soared by over 20,000 in a day for the first time taking the country's total tally to 6,25,544 on Friday while the death toll climbed to 18,213 with 379 new fatalities, according to the Union Health Ministry data updated at 8 am.

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Agencies
August 2,2020

Washington, Aug 2: Children under the age of five have between 10 to 100 times greater levels of genetic material of the coronavirus in their noses compared to older children and adults, a study in JAMA Pediatrics said Thursday.

Its authors wrote this meant that young children might be important drivers of Covid-19 transmission within communities -- a suggestion at odds with the current prevailing narrative.

The paper comes as the administration of US President Donald Trump is pushing hard for schools and daycare to reopen in order to kickstart the economy.

Between March 23 and April 27, researchers carried out nasal swab tests on 145 Chicago patients with mild to moderate illness within one week of symptom onset.

The patients were divided into three groups: 46 children younger than five-years-old, 51 children aged five to 17 years, and 48 adults aged 18 to 65 years.

The team, led by Dr Taylor Heald-Sargent of the Ann & Robert H. Lurie Children's Hospital, observed, "a 10-fold to 100-fold greater amount of SARS-CoV-2 in the upper respiratory tract of young children."

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The authors added that a recent lab study had demonstrated that the more viral genetic material was present, the more infectious virus could be grown.

It has also previously been shown that children with high viral loads of the respiratory syncytial virus (RSV) are more likely to spread the disease.

"Thus, young children can potentially be important drivers of SARS-CoV-2 spread in the general population," the authors wrote.

"Behavioral habits of young children and close quarters in school and daycare settings raise concern for SARS-CoV-2 amplification in this population as public health restrictions are eased," they concluded.

The new findings are at odds with the current view among health authorities that young children -- who, it has been well established, are far less likely to fall seriously ill from the virus -- don't spread it much to others either.

However, there has been fairly little research on the topic so far.

One recent study in South Korea found children aged 10 to 19 transmitted Covid-19 within households as much as adults, but children under nine transmitted the virus at lower rates.

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Agencies
June 11,2020

The World Health Organisation (WHO) Director-General Tedros Adhanom Ghebreyesus said that more research needs to be done to better understand the extent to which COVID-19 is being spread by people who don't show symptoms.

"Since early February, we have said that asymptomatic people can transmit COVID-19, but that we need more research to establish the extent of asymptomatic transmission," the WHO chief said at a virtual press conference from Geneva on Wednesday, Xinhua news agency reported.

"That research is ongoing, and we're seeing more and more research being done," he added.

Saying that the world has been achieving a lot in knowing the new virus, the WHO chief told reporters that "there's still a lot we don't

"WHO's advice will continue to evolve as new information becomes available," he said.

Tedros stressed that the most critical way to stop transmission is to find, isolate and test people with symptoms, and trace and quarantine their contacts.

"Many countries have succeeded in suppressing transmission and controlling the virus doing exactly this," Tedros said.

Meanwhile, Michael Ryan, executive director of WHO Health Emergencies Program, said Wednesday that the COVID-19 pandemic is still evolving.

"If we look at the numbers... this pandemic is still evolving. It is growing in many parts of the world," he said. "We have deep concerns that health systems of some countries are struggling, under a huge strain and require our support, our help and our solidarity."

He said "each and every country has a different combination of risks and opportunities, and it's really down to national authorities to carefully consider where they are in the pandemic."

In Europe, the risk issue now are about travels and the opening of the schools, around risk management, mass gathering, surveillance and contact tracing, said the WHO official.

In Southeast Asian countries, where to a great extent transmissions have been under control, governments are more concerned about the re-emergence of clusters, while in South America, the issue of PPE for health workers has not gone away, said Ryan.

As regards Africa, Ryan said the death rates have been very low in the past week, but the health system can be overwhelmed, as it would have to cope with other diseases such as malaria.

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