Karnataka cabinet okays B R Shetty's super speciality hospital in Udupi

Mangaluru, May 23: Criticising the Karnataka government's fresh protocol for management of Covid-19 as expensive, a prominent physician in the city has demanded its withdrawal.

According to Dr B Srinivas Kakkilaya, the protocol released by the Health and Family Welfare Department on May 15 enlists unnecessary and unconfirmed tests and treatments. 

The protocol has classified Covid-19 cases into three categories and has provided for hospitalisation of all three categories of patients, from asymptomatic to the most severely ill.

In a letter to the government, Dr Kakkilaya said: "The protocol suggests several investigations to be done right on the day of admission, including blood counts, liver and renal function tests, chest X Ray, ECG, CT scan of the chest, and other special investigations, all of which, if done, will cost Rs 25,000 per patient."

"In the coming days when lakhs of patients are likely to be infected with SARS CoV2, is it necessary and feasible to hospitalise and test all these patients at Rs 25,000 per person," he questioned.

The treatment options suggested in the protocol are also surprising, he pointed out. "The protocol recommends choloroquine, azithromycin, oseltamivir, zinc and vitamin C for all patients, from asymptomatic to the severely ill, and also anti coagulant injections for many patients. All these would cost at least Rs 5,000 per patient. For severe cases of Covid-19, many unproven and experimental treatments have been suggested, which are very expensive and highly questionable," Dr Kakkilaya notes.

Therefore, this protocol, he asserted was not evidence based and likely to do more harm than good. He said these unnecessarily expensive tests and allowing private companies to conduct trials on Covid-19 patients is likely to be misused by vested interests and must be immediately withdrawn, and instead, a protocol that is evidence-based, simple and avoiding unnecessary expenses, must be developed.

The current physical distancing guidelines provided by the World Health Organisation (WHO) and by the US Centers for Disease Control and Prevention (CDC) may not be adequate to curb the coronavirus spread, according to a research which says the gas cloud from a cough or sneeze may help virus particles travel up to 8 metres. The research, published in the Journal of the American Medical Association, noted that the the current guidelines issued by the WHO and CDC are based on outdated models from the 1930s of how gas clouds from a cough, sneeze, or exhalation spread.

Study author, MIT associate professor Lydia Bourouiba, warned that droplets of all sizes can travel 23 to 27 feet, or 7-8 metres, carrying the pathogen.

According to Bourouiba, the current guidelines are based on "arbitrary" assumptions of droplet size, "overly simplified", and "may limit the effectiveness of the proposed interventions" against the deadly pandemic.

 She explained that the old guidelines assume droplets to be one of two categories, small or large, taking short-range semi-ballistic trajectories when a person exhales, coughs, or sneezes.

However based on more recent discoveries, the MIT scientist said, sneezes and coughs are made of a puff cloud that carries ambient air, transporting within it clusters of droplets of a wide range of sizes.

Bourouiba warned that this puff cloud, with ambient air entrapped in it, can offer the droplets moisture and warmth that can prevent it from evaporation in the outer environment.

"The locally moist and warm atmosphere within the turbulent gas cloud allows the contained droplets to evade evaporation for much longer than occurs with isolated droplets," she said.

"Under these conditions, the lifetime of a droplet could be considerably extended by a factor of up to 1000, from a fraction of a second to minutes," the researcher explained in the study.

The MIT scientist, who has researched the dynamics of coughs and sneezes for years, added that these droplets settle along the trajectory of a cough or sneeze contaminating surfaces, with their residues staying suspended in the air for hours.

"Even when maximum containment policies were enforced, the rapid international spread of COVID-19 suggests that using arbitrary droplet size cutoffs may not accurately reflect what actually occurs with respiratory emissions, possibly contributing to the ineffectiveness of some procedures used to limit the spread of respiratory disease," Bourouiba wrote in the study

Bengaluru, May 26: Karnataka chief minister BS Yediyurappa has been urged to cancel the proposed SSLC examinations in Karnataka and allow “mass-pass” for every student in the wake of covid-19 crisis. A group of intellectuals and educationists have put forth this demand.

In the letter released by educationist VP Niranjan Aradhya, said that they were listing the scientific reasons to the CM for cancellation of exams which are slated to be held from June 25 to July 4th.

In the letter, the intellectuals have elucidated a number of reasons for cancelling the upcoming exams. “There are close to 8.5 lakh students and 2.5 lakh staff involved. If we include parents who would drop their kids at the exam centre, around 30 lakh people will be involved in the process, making it a risky affair. Though the government has said that it will separate the students with fever or other ailments, will students admit to having fever? What if they consume paracetamol and come to write exams?” asks the letter. 

Added to this, the question papers have to be sent from the district and taluk centres and there may be chances of transmission.

“Even if we conduct exams, then what about the students who have failed? Every year, around 2.5 lakh students fail in the exam. Will the government conduct the supplementary exams again? The whole process of conducting exams comes at a huge cost of Rs 20 cr to Rs 25 crore. Hence, we are suggesting that the government cancels the exams and pass the entire group of student en masse,” said the letter.