COVID-19 patients undergo surgery at increased death risk: Lancet study

News Network
May 30, 2020

May 30: Patients undergoing surgery after contracting the novel coronavirus are at an increased risk of postoperative death, according to a new study published in The Lancet journal which may lead to better treatment guidelines for COVID-19.

In the study, the scientists, including those from the University of Birmingham in the UK, examined data from 1,128 patients from 235 hospitals from a total of 24 countries.

Among COVID-19 patients who underwent surgery, they said the death rates approach those of the sickest patients admitted to intensive care after contracting the virus.

The scientists noted that SARS-CoV-2 infected patients who undergo surgery, experience substantially worse postoperative outcomes than would be expected for similar patients who do not have the infection.

According to the study, the 30-day mortality among these patients was nearly 24 per cent.

The researchers noted that mortality was disproportionately high across all subgroups, including those who underwent elective surgery (18.9 per cent), and emergency surgery (25.6 per cent).

Those who underwent minor surgery, such as appendicectomy or hernia repair (16.3 per cent), and major surgery such as hip surgery or for colon cancer also had higher mortality rates (26.9 per cent), the study said.

According to the study, the mortality rates were higher in men versus women, and in patients aged 70 years or over versus those aged under 70 years.

The scientists said in addition to age and sex, risk factors for postoperative death also included having severe pre-existing medical problems, undergoing cancer surgery, undergoing major procedures, and undergoing emergency surgery.

"We would normally expect mortality for patients having minor or elective surgery to be under 1 per cent, but our study suggests that in SARS-CoV-2 patients these mortality rates are much higher in both minor surgery (16.3%) and elective surgery (18.9%)," said study co-author Aneel Bhangu from the University of Birmingham.

Bhangu said these mortality rates are greater than those reported for even the highest-risk patients before the pandemic.

Citing an example from the 2019 UK National Emergency Laparotomy Audit report, he said the 30-day mortality was 16.9 per cent in the highest-risk patients.

Based on an earlier study across 58 countries, Bhangu said the 30-day mortality was 14.9 per cent in patients undergoing high-risk emergency surgery.

"We recommend that thresholds for surgery during the SARS-CoV-2 pandemic should be raised compared to normal practice," he said.

"For example, men aged 70 years and over undergoing emergency surgery are at particularly high risk of mortality, so these patients may benefit from their procedures being postponed," Bhangu added.

The study also noted that patients undergoing surgery are a vulnerable group at risk of SARS-CoV-2 exposure in hospital.

It noted that the patients may also be particularly susceptible to subsequent pulmonary complications, due to inflammatory and immunosuppressive responses to surgery and mechanical ventilation.

The scientists found that overall in the 30 days following surgery 51 per cent of patients developed a pneumonia, acute respiratory distress syndrome, or required unexpected ventilation.

Nearly 82 per cent of the patients who died had experienced pulmonary complications, the researchers said.

"Worldwide an estimated 28.4 million elective operations were cancelled due to disruption caused by COVID-19," said co-author Dmitri Nepogodiev from the University of Birmingham.

"Our data suggests that it was the right decision to postpone operations at a time when patients were at risk of being infected with SARS-CoV-2 in hospital," Nepogodiev said.

According to the researchers, there's now an urgent need for investment by governments and health providers in to measures which ensure that as surgery restarts patient safety is prioritised.

They said this includes the provision of adequate personal protective equipment (PPE), establishment of pathways for rapid preoperative SARS-CoV-2 testing, and consideration of the role of dedicated 'cold' surgical centres.

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News Network
February 5,2020

Feb 5: Tesla is making Elon Musk a lot richer without paying him a dime.

A blistering stock rally has bolstered the value of CEO Musk's 19% stake in the electric car maker by $16 billion since the start of 2020, to $30 billion.

Tuesday's steep climb in the share price could sweeten Musk's payday under his record-breaking compensation package, which is built on stock options that rely on market value targets. Two milestones have now been achieved that could see Musk unlock options worth $1.8 billion.

The controversial chief executive, who is also the majority owner and CEO of rocket maker SpaceX, recently testified that he did not have a lot of cash as he successfully defended himself in a defamation lawsuit. He previously has taken loans using his Tesla shares as collateral.

Musk does not take a salary, choosing instead a risky options package that envisions the stock market value of Tesla rising to $650 billion over 10 years, a prospect that was derided by some investors when the deal was announced in 2018.

That target now looks less crazy. Shares of Tesla have rallied over 50% since the company posted its second consecutive quarterly profit last Wednesday, which was viewed as a major accomplishment for a company competing against established automotive heavyweights including General Motors Co  and BMW.

Tesla shares have climbed about 400% since early June, helped by the company's better-than-expected financial results and ramped-up production at its new car factory in Shanghai.

On Tuesday, Tesla surged as much as 24% before falling back in the final minutes of the trading session to end the day up 13.7%. That put its market capitalization at $160 billion, almost twice the combined value of Ford Motor and General Motors.

The shares had also rallied on Monday, partly fueled by Panasonic Corp's 6752.T saying its automotive battery venture with Tesla was profitable for the first time.

The options Musk was awarded in 2018 vest incrementally based on targets for Tesla's stock market value and its financial performance. The market capitalization would have to sustainably rise by $50 billion increments over the agreement's 10-year period, with the full package payout reached if the market cap reaches $650 billion, as well as the company's meeting revenue and profit targets.

Musk is on his way to seeing his first two tranches of options vest. He achieved operational targets on revenue and adjusted earnings last year.

The rise in Tesla's market capitalization last month to a target of $100 billion opened the way for Musk's first tranche of options to vest. With Tuesday's surging share price, the market capitalization blew past the second target of $150 billion, opening the way for the second tranche to vest. Tesla's market capitalization must stay at or above each target level for one- and six-month averages for each set of options to vest.

Tesla was valued at about $52 billion when shareholders approved the pay package in March 2018, a time when the company faced a cash crunch, production delays and increasing competition from rivals.

A full payoff for Musk would surpass anything previously granted to U.S. executives, according to Institutional Shareholder Services, a proxy advisor that recommended investors reject the pay package deal at the time.

Musk currently owns about 34 million Tesla shares, and his compensation package would let him buy another 20.3 million shares if all his options tranches vest.

When Tesla unveiled Musk’s package, it said he could in theory reap as much as $55.8 billion if no new shares were issued. However, Tesla has since awarded stock to employees and last year sold $2.7 billion in shares and convertible bonds, diluting the value of the stock.

Musk has transformed Tesla from a niche car maker with production problems into the global leader in electric vehicles, with U.S. and Chinese factories. So far it has stayed ahead of more established rivals including BMW and Volkswagen.

Many investors remain skeptical that Tesla can consistently deliver profit, cash flow and growth. More Wall Street analysts rate Tesla "sell" than "buy," and the company's stock is the most shorted on Wall Street.

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Agencies
February 5,2020

San Francisco, Feb 5: After a German artist, Simon Weckert, demonstrated how he "hacked" Google Maps with 99 smartphones and a wagon to create "virtual traffic jams" on the streets of Berlin, Google responded to the incident saying it "appreciates" creative use of maps.

Admitting that it has not quite cracked travelling by wagon, the tech giant also hinted that it might use cases like this to improve how its maps work.

"We appreciate seeing creative uses of Google Maps like this as it helps us make maps work better over time," 9to5Google quoted a Google spokesperson as saying.

In a YouTube video, Weckert showed that he put 99 smartphones with Google Maps onto a small wagon cart and then wheeled that cart around various streets in Berlin, including outside the Google office, Android Authority reported on Monday.

The smartphones "apparently fooled Google Maps" into thinking that there was a high concentration of users on those streets.

Because the second-hand phones were in a cart, Maps was further tricked into believing that the traffic was slow-moving.

As a result, the navigation app started showing virtual traffic jams by turning green streets to red in the online navigational tool, showcasing how digital technology can have a real impact on the real world.

"Traffic data in Google Maps is refreshed continuously thanks to information from a variety of sources, including aggregated anonymised data from people who have location services turned on and contributions from the Google Maps community," the Google spokesperson said.

"We've launched the ability to distinguish between cars and motorcycles in several countries including India, Indonesia and Egypt, though we haven't quite cracked travelling by wagon," the statement added. After a German artist, Simon Weckert, demonstrated how he "hacked" Google Maps with 99 smartphones and a wagon to create "virtual traffic jams" on the streets of Berlin, Google responded to the incident saying it "appreciates" creative use of maps.

Admitting that it has not quite cracked travelling by wagon, the tech giant also hinted that it might use cases like this to improve how its maps work.

"We appreciate seeing creative uses of Google Maps like this as it helps us make maps work better over time," 9to5Google quoted a Google spokesperson as saying.

In a YouTube video, Weckert showed that he put 99 smartphones with Google Maps onto a small wagon cart and then wheeled that cart around various streets in Berlin, including outside the Google office, Android Authority reported on Monday.

The smartphones "apparently fooled Google Maps" into thinking that there was a high concentration of users on those streets.

Because the second-hand phones were in a cart, Maps was further tricked into believing that the traffic was slow-moving.

As a result, the navigation app started showing virtual traffic jams by turning green streets to red in the online navigational tool, showcasing how digital technology can have a real impact on the real world.

"Traffic data in Google Maps is refreshed continuously thanks to information from a variety of sources, including aggregated anonymised data from people who have location services turned on and contributions from the Google Maps community," the Google spokesperson said.

"We've launched the ability to distinguish between cars and motorcycles in several countries including India, Indonesia and Egypt, though we haven't quite cracked travelling by wagon," the statement added.

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Agencies
March 13,2020

Amid the rapid spread of the novel coronavirus (COVID-19), which has infected 73 people in India and killed more than 4,500 individuals globally, doctors have advised that in addition to regularly washing hands, one should also disinfect their smartphone every 90 minutes with alcohol-based hand sanitizer.

Ravi Shekhar Jha, Head of Department at Fortis Escorts Hospital in Faridabad said the best method to disinfect your smartphone is to use regular doctor spirit or the alcohol-based hand sanitizer at least every 90 minutes.

"Avoid touching your eyes, mouth, or nose. The best option is to use a phone cover or a Bluetooth device and try to touch your phone as less as possible. We would also recommend cleaning your phone at least twice a day," Jha told IANS.

According to research, published in 2018 by Insurance2Go, a gadget insurance provider, revealed that smartphone screens have three times more germs than a toilet seat.

One in 20 smartphone users was found to clean their phones less than every six months, said the study.

"In the time of fear of coronavirus, smartphones should also be disinfected with alcohol-based sanitizer rub. Pour few drops of sanitizer on a tiny clean cotton pad and rub it safely on your entire phone," said Jyoti Mutta, Senior Consultant, Microbiology, Sri Balaji Action Medical Institute in New Delhi.

"You can repeat this process every evening coming back home after an entire day out at work and once in the morning before going out," Mutta added.

"Maintain basic cleanliness, and try to avoid using other's phones especially if suffering from respiratory illness or flu-like symptoms as there is no other way to disinfect these regular gadgets," she stressed.

Another study from the University of Surrey in the UK, also found that the home button on your smartphone may be harbouring millions of bacteria - some even harmful.

The World Health Organisation (WHO) declared the novel coronavirus as a global pandemic on Wednesday. The death toll of COVID-19 has crossed the 4,500 marks and confirmed cases globally have touched one lakh as per the reports.

According to Suranjeet Chatterjee, Senior Consultant in Internal Medicine Department of Indraprastha Apollo Hospitals in New Delhi, "We should frequently wash our hands, cover our coughs and it is important to adapt to other good hygiene habits that are most important in such a situation."

"Coronavirus and other germs can live on surfaces like glass, metal or plastics and phones are bacteria-ridden. It is necessary that we sanitize our hands frequently and make sure that our hands are clean all the time," Chatterjee told IANS.

"The emphasis should be laid on sanitising our hands rather than sanitizing the phone - once in a while the phone can be sanitized under the guidance of the makers of the phone," Chatterjee stressed.

According to the global health agency, the most effective way to protect yourself against coronavirus is by frequently cleaning of your hands with alcohol-based hand rub or washing them with soap and water.

The WHO's report showed the virus infects people of all ages, among which older people and those with underlying medical conditions are at a higher risk of getting infected.

People should eat only well-cooked food, avoid spitting in public, and avoid close contact, the WHO said, adding that it is important for people to seek medical care at the earliest if they become sick.

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