News Analysis India

Tag: AIIMS

  • ‘Third wave can be bigger than second wave if all curbs are lifted’: AIIMS Director sounds warning bell

    By PTI
    NEW DELHI: Waning immunity, the emergence of a more transmissible coronavirus variant capable of escaping the immunity shield and lockdown relaxations can be the likely causes of a possible third wave of COVID-19, AIIMS Director Randeep Guleria said Thursday.

    Speaking at an event, he said the third wave can be mitigated by following Covid-appropriate behaviour such as maintaining social distancing, using masks, and taking vaccine.

    He said several studies and modelling have been conducted to project the trajectory of a possible third wave of the pandemic under different scenarios.

    “One such model from an IIT shows that if all restrictions are lifted and if a virus (variant) is also able to escape immunity then the next wave can be bigger than the second wave.”

    “If some restrictions are kept and the virus also remains stable then cases will not be much and if we keep more restrictions then cases will further reduce,” he said.

    Guleria said even if new variants emerge, the available vaccines can be tweaked.

    Guleria said the third wave of COVID-19 is being seen in other countries but hospitalisation has come down, indicating that the vaccines are working.

    Listing possible reasons that can precipitate the third wave, Guleria said waning immunity — which restores previously exposed individuals to a susceptible state — the emergence of a new more transmissible variant of the virus capable of escaping immunity, and relaxation of current lockdowns can be the likely causes.

    He said that apart from Covaxin, Covishield and Sputnik V, several other vaccines are in the pipeline in the country.

  • Dera chief Gurmeet Ram Rahim Singh taken to AIIMS in Delhi for tests

    By PTI
    CHANDIGARH: Dera Sacha Sauda chief Gurmeet Ram Rahim Singh, who is lodged in Sunaria jail in Haryana’s Rohtak district, was on Tuesday taken to AIIMS in Delhi under heavy police escort for some tests, an official said.

    According to sources, Singh was taken to the All India Institute of Medical Sciences as the required tests were not available in Rohtak.

    Notably, the Dera chief has been facing some health issues recently.

    Last month, he was taken to Medanta Hospital in Gurugram for some tests.

    He spent a few days at the private facility.

    Days before that, Singh underwent some tests at the Post Graduate Institute of Medical Sciences (PGIMS) in Rohtak after he complained of abdominal pain.

    Earlier in May, he was admitted to PGIMS after he complained of dizziness and blood pressure fluctuation.

    He was discharged after an overnight stay at the hospital.

    Singh, 53, is serving a 20-year jail term for raping two of his women disciples in his ‘ashram’ in Sirsa.

    He was convicted in August 2017 by a special CBI court in Panchkula.

  • Higher COVID fatality reported in patients below 50 compared to 65+ age group, suggests AIIMS study

    By ANI
    NEW DELHI: COVID-19 fatality in people under the age of 50 is higher than those above the age of 65, a single-center retrospective study by the All India Institute of Medical Sciences (AIIMS), Delhi has suggested.

    A study published in the Indian Journal of Critical Care Medicine, authored by AIIMS Director Dr Randeep Guleria, Chief of the AIIMS trauma center Dr Rajesh Malthotra, and several others, covered deceased adult patients who were admitted between April 4 to July 24, 2020.

    This study aimed to describe the clinic epidemiological feature and the causes of mortality of patients admitted in dedicated covid centres in India.

    During the study period, a total of 654 adult patients were admitted to the ICU, out of which, 247 died. A mortality per cent of 37.7 per cent was recorded (247 out of 654). Adult patients were further divided into age groups of 18 to 50, 51 to 65 and above 65, to compare their clinical characteristics and outcomes.

    The study shows 42.1 per cent were between 18-50, 34.8 per cent from 51-65 and 23.1 per cent above 65.

    The most common comorbidities were hypertension, diabetes mellitus and chronic kidney disease along with the most common presenting features being fever cough and shortness of breath.

    Data of all the patients who died in the ICU were collected from their electronic medic report, patients daily progress chart as well as nursing notes.

    In different studies, ICU mortality among covid patients varies between 8.0 pc to 66.7 pc.

    “In our center, however, the hospital mortality was 18.2 pc and ICU mortality was 36.1 per cent,” the study noted. Similar mortality rates were reported from other countries such as the US, Spain, Italy.

    46 Pediatric were admitted during this period out of which six died of Covid. The ICU mortality among the Pediatric group was 13 per cent. 

  • Availability of COVID vaccine for kids will pave way for school reopening: AIIMS chief Dr Randeep Guleria

    By PTI
    NEW DELHI: Making COVID-19 vaccine available for children will be a milestone achievement and pave the way for reopening of schools and resumption of outdoor activities for them, AIIMS Chief Dr Randeep Guleria has said.

    He said the data of phase two and three trial of Bharat Biotech’s Covaxin on two to 18 years age group is expected by September.

    The vaccine can be available for children in India around that time following approval from the drug regulator, he said.

    “If the Pfizer vaccine gets approval before that, then it can also be an option for children,” Dr Guleria told PTI on Saturday.

    According to a senior government official, pharmaceutical major Zydus Cadila is also likely to soon apply to the Drugs Controller General of India for emergency use authorisation for its COVID-19 vaccine ZyCoV-D, which it claims can be given to both adults and children.

    “So, if the Zydus vaccine gets approval, it will be another option,” Dr Guleria said.

    ALSO WATCH: How Mumbai, India’s most crowded city, beat the odds, and the coronavirus

    He stressed that though children mostly have mild infections of COVID-19 and some even are asymptomatic, they can be carriers of the infection.

    Underscoring that there has been a major loss in studies in the last one-and-half years on account of the COVID-19 pandemic, the AIIMS chief said, “Schools have to be reopened and vaccination can play an important role in that.”

    Vaccination is the way out from the pandemic, he said.

    The government has recently cautioned that even though COVID-19 has not impacted children greatly till now, that can increase if there is a change in the behaviour of the virus or in epidemiology dynamics.

    It said that preparations are being made to deal with any such situation.

    A national expert group has been formed to review COVID-19 infections among children and approach the pandemic in a new way and reinforce the nation’s preparedness for it.

    On the issue of vaccinating children, NITI Aayog member (Health) Dr V K Paul recently said, “Child cohort is not a small one. My rough guess is that if it is between 12 to 18 years, this itself is about 13 to 14 crore population for which we will need about 25-26 crore doses.”

    He further shared that not only Bharat Biotech’s Covaxin, Zydus Cadila’s vaccine is also being tested on children.

    “So when Zydus comes for licensure soon, maybe we have enough data to take a view on whether the vaccine can be given in children,” Paul said.

  • Single dose sufficient for those who recover from mild Covid, says AIIMS study

    By Express News Service
    NEW DELHI:  Single-dose immunization with Covid-19 vaccine may be sufficient for protecting patients who have recovered from mild bouts of the disease, as the immunological memory that they develop keeps its imprint for a few years, says a study conducted on Indian patients.

    The study comes when the country is looking at vaccinating everyone above 18 by year end. The vaccine is considered as the most effective preventive measure to protect from the pandemic that has become a major threat globally.

    However, how long the vaccine will protect, whether it will protect against all recently circulating and future variants of the virus, and what should be the vaccination schedule and dosage for individuals recovered are questions that need answers for successful implementation of vaccination.

    A study by Dr Nimesh Gupta’s group at the National Institute of Immunology in collaboration with Dr Ashok Sharma, Biochemistry Department, and Dr Poonam Coshic, Department of Transfusion Medicine at the All India Institute of Medical Sciences (AIIMS), New Delhi, reveals that Indians recovered from mild Covid have durable immunological memory in most important arms of protective immunity — T cells and B cells.

    The team believes the immunological memory, which can last a few years, is predominantly associated with the Spike protein of the virus. These responses are mainly targeted at the Spike protein, and it also gives high hopes to the current vaccines.

    The research supported under the Intensification of Research in High Priority Areas (IRHPA) scheme of the Science and Engineering Research Board (SERB), a statutory body of the Department of Science and Technology (DST), says if the vaccine can induce the immune response like seen in mild patients, then we will have an effective and long-lasting cellular immunity against SARS-CoV-2.

    The study also indicated that almost 70 per cent of the examined Indian cohort had high to very high levels of SARS-CoV-2 reactive type of white blood cells that are an essential part of the human immune system (CD4+ T cells).

  • SC says fixing June 16 for holding INI CET 2021 is arbitrary, postpones test by a month

    By PTI
    NEW DELHI: The Supreme Court Friday termed as “arbitrary” the fixing of June 16 for conducting INI CET 2021 and directed All India Institute of Medical Sciences (AIIMS) to hold the post graduate medical entrance test after one month.

    A vacation bench of Justices Indira Banerjee and M R Shah disposed of a plea filed by doctors seeking admission in PG medical and challenging the notification of fixing June 16 as date of INI CET 2021.

    The bench said that having regard to the difficulty faced by the candidates due to the examination and many placed far way due to COVID duty from the examination centre, the exam needs to be postponed.

    Around 80,000 candidates are vying for 815 seats in the national level examination which is being held by AIIMS.

    The 815 seats are spread across 8 institutes of AIIMS and JIPMER, Puducherry, NIMHANS, Bengaluru and PGIMER, Chandigarh.

    The INI CET 2021 was initially scheduled to be held on May 8 but was rescheduled to June 16 due to the COVID pandemic.

  • Unplanned vaccination can promote mutant strains: Health experts in a report to PM Modi

    By PTI
    NEW DELHI: A group of public health experts, including doctors from AIIMS and members from the national task force on COVID-19, have said that mass, indiscriminate and incomplete vaccination can trigger the emergence of mutant strains and recommended that there is no need to inoculate those who had documented coronavirus infection.

    In their latest report, the experts from the Indian Public Health Association (IPHA), Indian Association of Preventive and Social Medicine (IAPSM) and Indian Association of Epidemiologists (IAE) said vaccinating the vulnerable and those at risk, instead of mass population-wide inoculation including children, should be the aim at present.

    “The present situation of the pandemic in the country demands that we should be guided by the logistics and epidemiological data to prioritise vaccination rather than opening vaccination for all age groups at this stage.

    “Opening all fronts simultaneously will drain human and other resources and would be spreading it too thin to make an impact at the population level,” the experts said in the report which has been submitted to Prime Minister Narendra Modi.

    Highlighting that vaccination of young adults and children is not supported by evidence and would not be cost-effective, they said unplanned inoculation can promote mutant strains.

    “Mass, indiscriminate, and incomplete vaccination can also trigger the emergence of mutant strains. Given the rapid transmission of infection in various parts of the country, it is unlikely that mass vaccination of all adults will catch up with the pace of natural infection among our young population,” they said in the report.

    There is no need to vaccinate people who had documented COVID-19 infection. These people may be vaccinated after generating evidence that vaccine is beneficial after natural infection, the recommendations stated.

    Evidence-based flexibility in vaccine schedules may need to be considered for areas or populations experiencing surge on account for specific variants; for example, a reduced interval for the second dose of Covishiled for areas with surge due to the delta variant.

    “Vaccine is a strong and powerful weapon against the novel coronavirus. And like all strong weapons, it should neither be withheld nor used indiscriminately; but should be employed strategically to derive maximum benefit in a cost-effective way,” they said.

    While it makes perfect sense to vaccinate all adults, the reality is that the country is in the midst of an ongoing pandemic with limited availability of vaccines, the report said.

    In this scenario, the focus should be to reduce deaths, the majority of which are among older age groups and those with co-morbidities or obesity. Vaccinating young adults, given the present constraints, will not be cost-effective, they stated.

    The report suggested implementing repeated local level serosurveys in real-time at the end of the second wave to map the vulnerability at the district level to guide vaccination strategy and long term follow up of the cohort of recovered COVID-19 patients to document re-infection, severity and outcome to provide an evidence base on the duration of immunity after natural infection.

    Ongoing research on vaccine effectiveness under field conditions by following cohorts of vaccinated and unvaccinated in different age strata should be prioritised.

    Stating the current wave is largely attributable to multiple variants, the experts pointed out that India has done genome sequencing of less than 1 per cent of its positive samples and also lags behind other high incidence countries in another crucial measure, sequence per 1,000 cases.

    Achieving a target of genomic sequencing of 5 per cent positive samples looks challenging at the moment, but all efforts should be made to reach at least 3 per cent mark, they recommended while appreciating setting up of the Indian SARS-CoV-2 Genomics Consortium (INSACOG) of 10 national laboratories timely and addition of 17 more laboratories.

    The molecular epidemiology investigations need to be accelerated with INSACOG scientists, field epidemiologists and clinical specialists working in synergy to delineate the epidemiological features of the variants with specific reference to transmissibility and fatality.

    Genetic sequences need to be tracked to delineate virus transmission both across the community and in health care settings. It can detect outbreaks that may otherwise be missed by traditional methods, the experts pointed out.

    They also recommended that the syndromic management approach should be rolled out in a planned manner after sensitisation of healthcare staff, along with the optimum utilisation of laboratory testing. There is an acute shortage of testing facilities for SARS-CoV-2 in rural and peri-urban areas.

    The sensitivity of RAT is quite low; there are chances that some truly positive cases would remain unidentified and thus continue to spread the disease.

    “Timely testing of each and every symptomatic patient is not possible and will put a huge burden on the health system and will delay the isolation and treatment. The optimal solution in such a situation is to adopt a syndromic management approach. It should put focus on making diagnosis based on clinical symptoms and epidemiologically linked suspects,” they said.

    They further recommended that the vaccination status of all individuals tested for COVID-19 must be entered into the sample referral form in the RTPCR app both for individuals tested by RTPCR and RAT. The collected information must be analysed periodically to know the status of vaccinated individuals with regards to COVID-19 and its severity including mortality.

    As way forward, the experts said that district level sero surveillance may be planned with the methodology of EPI cluster sampling.” If the seroprevalence at district level, is more than 70 per cent (on account of a combination of natural infection and vaccination,) there should not be any lockdown and return to normalcy should be attempted.

    “This will also help in prioritizing the districts for vaccination i.e. districts with lower seroprevalence should be given priority for vaccination. A fine balance is needed to be maintained between life and livelihood.”

    The experts also said that if a very large number of individuals are vaccinated at a fast pace with limited resources for monitoring of adverse events following immunization (AEFI), some adverse events and deaths will be missed. Also, while some of these AEFI may be coincidental, they may end up contributing to vaccine hesitancy.

  • Resident doctors of AIIMS, Safdarjung hold candle march in solidarity with protesting MP doctors

    By PTI
    NEW DELHI: Resident doctors of the AIIMS and Safdarjung Hospital here on Sunday held a candlelight march in support of the protesting doctors in Madhya Pradesh, who have been demanding a hike in stipends and beds for them and their families in case they contract COVID-19.

    The doctors from the two hospitals marched to Sri Aurobindo Marg and shouted slogans demanding justice for their fraternity members in Madhya Pradesh.

    Representatives of the Federation of Resident Doctors Association (FORDA) also met National Human Rights Commission (NHRC) Chairman Justice Arun K Mishra (retd) and appraised him about the concerns of the agitating doctors in Madhya Pradesh.

    “We are enraged to learn about the atrocities and callousness of the government of Madhya Pradesh. The resident doctors are protesting for their rightful demands which were denied outrightly and the outraged administration is headed to spoil the careers of thousands of trainee doctors,” a FORDA statement read.

    “Our healthcare system is anyways in shambles and any further reduction in manpower will affect it adversely,” it added.

    An office-bearer of the All India Institute of Medical Sciences (AIIMS) Resident Doctors’ Association said the chief minister of Madhya Pradesh should schedule an urgent meeting with the protesting doctors and solve the issue within next 24 hours, “failing which a nationwide protest will be held”.

    The Madhya Pradesh government had on May 6 said steps will be taken for the safety and security of doctors in hospitals, treatment to ‘corona warriors’ and their families will be provided on priority basis, and a stipend hike of about 6 per cent per year from 2018 along with Covid incentives will be provided to them, he said.

    “It is really sad that all these demands fell on deaf ears of the Madhya Pradesh government, forcing the resident doctors to go on indefinite strike from May 31,” the official said.

    Nearly 3,000 doctors in Madhya Pradesh had resigned from their posts after the Madhya Pradesh High Court directed the striking junior doctors in the state to resume their duties within 24 hours, terming the protest “illegal”.

    The state government had on Saturday sent eviction notices to the doctors who had resigned, asking them to vacate their hostels.

  • Young AIIMS, Patna doctor succumbs to COVID-19

    By PTI
    PATNA: A young doctor at AIIMS, Patna has died after battling for life for about a month at the hospital where he had been serving at the COVID ward and was admitted upon testing positive, authorities said on Thursday.

    According to Dr Sanjeev Kumar, the nodal officer for COVID-19 at AIIMS, Patna, Pradeep Kumar, a 32-year-old junior resident who hailed from Sheohar district in north Bihar, breathed his last on the intervening night of Tuesday and Wednesday.

    “He was specialising in urology. Before testing positive on April 26, he had been offering his services at the COVID ward. He was admitted to the isolation room of the ward immediately after contracting the disease,” Sanjeev Kumar said.

    “The young doctor was shifted to the ICU about a week later after his condition deteriorated. For the past 10 days, he had been on ventilator support. All measures, including tracheotomy, were tried to resuscitate our young colleague,” he added.

    According to the Indian Medical Association, more than 500 doctors have lost their lives while attending to their duties during the second COVID-19 wave.

    Bihar accounts for the second-highest number of fatalities, next only to Delhi.

    Meanwhile, the Faculty Association of AIIMS, Patna has issued a statement demanding an ex-gratia of Rs 50 lakh to the family members of the deceased ‘corona warrior’ and suggested that the money could be drawn from funds set aside under the Pradhan Mantri Suraksha Bima Yojana.

  • COVID doesn’t remain active in nasal, oral cavities 12-24 hours after death: AIIMS forensic chief

    By PTI
    NEW DELHI: Coronavirus doesn’t remain active in nasal and oral cavities 12 to 24 hours after the death of an infected person as a result of which the risk of transmission from the deceased is highly unlikely, AIIMS Forensic Chief Dr Sudhir Gupta said.

    A pilot study was conducted over the last one year in the Department of Forensic Medicine at AIIMS on COVID-19 positive medico-legal cases which were subjected to post-mortem.

    “Around 100 bodies were re-tested for coronavirus infection in an interval of 12 to 24 hours after death and the result was negative. The virus does not remain active at all in nasal and oral cavities 24 hours after death,” Dr Gupta told PTI.

    “The risk of transmission of coronavirus 12 to 24 hours after the death of an infected person is highly unlikely,” he said.

    For safety purposes, he said, nasal and oral cavities should be plugged to prevent leakage of body fluids or other orifices or punctures resulting from removal of catheter, drains, tubes should be disinfected.

    Also as a precautionary measure, people handling such bodies should wear protective gear such as masks, gloves and PPE kits.

    “Collection of bones and ashes is completely safe as there is no risk of transmission of infection from the mortal remains,” Gupta said.

    “The study was conducted in the interest of preserving the dignity of the dead,” he stated.

    The ICMR in its ‘standard guidelines for medico-legal autopsy in COVID-19 deaths’ issued in May, 2020 advised that invasive techniques should not be adopted for forensic autopsy in COVID-19 deaths as mortuary staff are exposed to potentially dangerous health risks due to organ fluids and secretions even after taking the highest precautions.

    The waiving of a post-mortem will prevent the spread of infection to doctors, mortuary staff, police persons and all the people involved in the chain of dead body disposal.

    Non-invasive autopsy techniques, as described in guidelines, should be used, if at all required, to prevent the risk of spreading the infection to mortuary staff, police personnel and contamination of mortuary surfaces, the guidelines stated.

    “If the autopsy surgeon feels that he will not be able to conclude cause of death or any other related issue without dissection, then he can proceed with minimal invasive/limited internal dissection.

    “However, the dissection has to be performed keeping in mind that the conduction of autopsy is a high-risk procedure which is potentially as hazardous as any other procedure performed on the body of a COVID-19 patient,” the guidelines said, listing the precautions to be followed while conducting an autopsy by adopting proper infection control measures. According to the procedure of conducting forensic autopsy, “.

    “Along with external examination, multiple photographs and verbal autopsy (as depicted by WHO). The post mortem should be conducted strictly avoiding any invasive surgical procedures and avoiding splashing of body fluids contact for staffs, body handlers and doctors conducting post mortem.”