Home Blog

Dr PP Bose on Mental Health in Covid

0

You are invited to a Zoom webinar.
When: Aug 1, 2020 04:00 PM India
Topic: Mental Health in COVID – “A Journey from Illness to Wellness””
By: Dr PP Bose, Senior Consultant and Fonder SAANS Foundation

Register in advance for this webinar:
https://us02web.zoom.us/webinar/register/WN_CKrWbBy_RRiTlWgXCIOJvg

WEBINAR ID – 853 5967 0336
PASSWORD – LMONTUS

After registering, you will receive a confirmation email containing information about joining the webinar.

Don’t Use Reusable Face Masks

0
N95 Mask
N95 Mask

The Coronavirus is extremely small, around 0.1nm. The pores between the fibers of a cloth mask are at least 1000 times bigger! They may help in protecting other people from being infected if you are infected, but it has as much chance of blocking a coronavirus as a football goal post stretched to THRICE its size has of stopping a football!

A N95/KN95/ surgical face mask has a middle layer of melt-blown polypropylene, which not only forms a very fine mesh with pore size 0.1- 1 nm, but also has fibers that are electrically charged to attract and trap the virus.

The difference between a reusable cloth mask and N95/ Surgical face mask is that between being alive and dead. Think about it, if your house was at risk, would you rather leave the front door wide open or set up an electrically charged barbed-wire fence for protection? Don’t be a #Covidiot. Don’t wear a Reusable/Cloth Face Mask.

Don’t wash your N95/ KN95/ Surgical Face Mask because it clumps the fibers together and destroys the charge. It is like short circuiting your electrically charged barbed-wire fence by joining the wires together. Don’t be a miserly #Covidiot, don’t wash your mask, throw it away! #FaceMaskIsTheNewCondom – you wouldn’t wash and reuse your condom, why do it with a face mask?

Face Shield vs Face Mask: The Answer My Friend is Flying In The Wind

0

As we have reiterated earlier the COVID-19 pandemic is as much a pandemic of viral mis/dis information as of the virus. One of the pieces of mis/ dis information which has been flying around and infecting people is that Face Shields are a good replacement or even better than Face Masks.

At the heart of the controversy lies the question of whether COVID-19 infections are caused by droplets which fall soon after being coughed out or by aerosols which are very small particles That hang around in the air for a much longer time

Let us unpack this argument. Face Shields are made of clear plastic and cover not only the mouth and nose like Face Masks do but also the eyes which are an important port of entry for the virus. Wearing a Face Shield will also prevent the wearer from touching their face very often. It doesn’t cause as much suffocation as Face Masks and can be disinfected, used and reused with ease. Proponents often quote parts of a study Efficacy of Face Shields Against Cough Aerosol Droplets from a Cough Simulator” published in the Journal of Occupational Medicine in 2014 to prove that a Face Shield is better.

At the heart of the controversy lies the question of whether COVID-19 infections are caused by droplets which fall soon after being coughed out or by aerosols which are very small particles which hang around in the air for a much longer time and do not fall to the ground. This is like a world series play off with the WHO (with UK, Canada and Australia) on the one side and Rest of the World on the other! In the face of clear and persistent evidence to the contrary the WHO has insisted that COVID-19 infections are principally caused by droplets.

The evidence for Airborne route of infection has become so substantial and the frustration with WHO’s stance so widespread that 239 of the world’s top researchers wrote an open letter to WHO in the Journal – Clinical and Infectious Disease (https://academic.oup.com/cid/article/doi/10.1093/cid/ciaa939/5867798?searchresult=1 ), I quote- “ “Most public health organizations, including the WHO, do not recognize airborne transmission except for aerosol-generating procedures performed in healthcare settings,” the letter states, “Hand-washing and social distancing are appropriate, but in our view, insufficient to provide protection from virus-carrying respiratory microdroplets released into the air by infected people.”

Face Shields are good to be used Along With Face Masks, they are NOT a replacement for Face Masks!

The evidence for Airborne route of transmission is has been established in numerous articles in reputable journals for example “Evidence of Airborne Transmission of the Severe Acute Respiratory Syndrome Virus” in the New England Journal of Medicine (https://www.nejm.org/doi/10.1056/NEJMoa032867) and in the same journal “Visualizing Speech-Generated Oral Fluid Droplets with Laser Light Scattering” (https://www.nejm.org/doi/full/10.1056/NEJMc2007800 ). The mounting evidence has finally compelled the WHO to make this admission: “ Based on the available evidence, including the recent publications mentioned above, WHO continues to recommend droplet and contact precautions for those people caring for COVID-19 patients. WHO continues to recommend airborne precautions for circumstances and settings in which aerosol generating procedures and support treatment are performed, according to risk assessment.13 These recommendations are consistent with other national and international guidelines, including those developed by the European Society of Intensive Care Medicine and Society of Critical Care Medicine and those currently used in Australia, Canada, and United Kingdom.

At the same time, other countries and organizations, including the US Centers for Diseases Control and Prevention and the European Centre for Disease Prevention and Control, recommend airborne precautions for any situation involving the care of COVID-19 patients, and consider the use of medical masks as an acceptable option in case of shortages of respirators (N95, FFP2 or FFP3).”

Coming back to the article which is often quoted partially in the Journal of Occupational Medicine, let us quote it more extensively “We used a coughing patient simulator and a breathing worker simulator to investigate the exposure of health care workers to cough aerosol droplets, and to examine the efficacy of face shields in reducing this exposure. Our results showed that 0.9% of the initial burst of aerosol from a cough can be inhaled by a worker 46 cm (18 inches) from the patient. During testing of an influenza-laden cough aerosol with a volume median diameter (VMD) of 8.5 μm, wearing a face shield reduced the inhalational exposure of the worker by 96% in the period immediately after a cough. The face shield also reduced the surface contamination of a respirator by 97%. When a smaller cough aerosol was used (VMD = 3.4 μm), the face shield was less effective, blocking only 68% of the cough and 76% of the surface contamination. In the period from 1 to 30 minutes after a cough, during which the aerosol had dispersed throughout the room and larger particles had settled, the face shield reduced aerosol inhalation by only 23%. Increasing the distance between the patient and worker to 183 cm (72 inches) reduced the exposure to influenza that occurred immediately after a cough by 92%. Our results show that health care workers can inhale infectious airborne particles while treating a coughing patient. Face shields can substantially reduce the short-term exposure of health care workers to large infectious aerosol particles, but smaller particles can remain airborne longer and flow around the face shield more easily to be inhaled. Thus, face shields provide a useful adjunct to respiratory protection for workers caring for patients with respiratory infections. However, they cannot be used as a substitute for respiratory protection when it is needed.” Face Shields are good to be used Along With Face Masks, they are NOT a replacement for Face Masks!

10 Tips For Going Back To School During the COVID-19 Pandemic

0

Schools have begun to reopen across the world as the COVID-19 Pandemic enters it’s seventh month and parents willingly and unwillingly are sending their children back to school. There have been numerous experiments with school reopening across the world and numerous advisories issued on HOW to reopen schools from various organizations- national and international. We recognize that all policies including school reopening are dictated by numerous concerns- political, social, economic, ideological and health. We on the other hand are not into Public Health as much the Best Health for YOU. At Gear for Safety, we recognize that your mind is the best piece of gear which you have to keep you safe. Use It.

point out to your kids that all Superheroes are masked- Superman, Wonder woman, Batman …..

So here are 10 tips for school reopening from the point of view of the best health advice for you and your family:

Don’t Go: Unless it is absolutely necessary for you child to attend school physically, the best way to keep your child healthy (and you) is to stay at home and sign up for e-education. There is no absolutely safe way to go to school. Period.

Personal Responsibility: Children may not fall severely ill themselves but can definitely get their parents and grandparents killed. We are living in a Culture of Denial and Minimization when illness and death is all around us. As National and International Organizations fine tune their messages for the “Public Good” we are focused on what is Best for You, how do you come out on the other side of this Pandemic alive. Tell your kids to listen to YOU. The school may or may not have the best practices regarding distancing, masks and disinfection. You are responsible for your own health. Take pride in standing out and doing the best thing, the HEALTHY thing. If someone tries to shame you into conformist stupidity- ignore, educate them, fight back or report as the situation demands.

Education: the whole purpose of school is to give your child an education. TALK to them about the coronavirus, give them the right information. We have always said that Coronavirus is a piece of bad code which is made worse when there is other bad code- mis/ dis information in the environment. The first IMMUNIZATION against Coronavirus is the CORRECT information (not the POLITICALLY CORRECT information). Tell them how the virus is transmitted, what it is and show them videos of people who are affected by it. Politics can get you killed. In this non-war on Coronavirus our children are being marched off to the battle front aka schools to the drum beat of denial and minimization. Sorry, there is no polite way to put this. If you have to be dragooned into this army at least know that you have been! Open your eyes and open their eyes.

Masked Superhero: point out to your kids that all Superheroes are masked- Superman, Batman, Spiderman (and their female counterparts). They are going to be masked superheroes as well. To be different from others is not something to be ashamed of, it is something to be proud of. Superheroes have to do things to keep themselves and others safe. By wearing a mask they protect others and themselves. It is important to buy kids masks for kids rather than use adult masks. Adult masks do not fit the child’s smaller face snugly, defeating the purpose of wearing a mask! Teach your kids how to wear a mask properly and how to take it off properly and dispose it. A mask is gear and gear must be treated with respect. Do not reuse masks. A mask a day keeps the doctor (and needles) away.

Hand Sanitization and Washing: It is important that children and adults sanitize their hands hourly. If possible set a discreet alarm attuned to the breaks in between classes which reminds them to use a hand sanitizer. Wash hands at least in the recess and after playing.

Eyes: Coronavirus lives in our throats and lungs but can enter not only through the nose and mouth but also through the eyes. If your child is wearing spectacles tell them to keep them on and sanitize them after coming back from school. If your child isn’t wearing spectacles get them a pair if non- powered spectacles preferably in a cool colour. Tell them to keep the spectacles on in school and not to take them off.

Distancing: our masked superhero doesn’t engage in futile battles. Fight the battles which can be fought. Trying to keep children distanced from each other is an exercise in futility. Tell them instead to keep contact safer by keeping their masks on in public spaces and regularly disinfecting their hands.  The best way to distance is to FOCUS ON ONESELF.

Transport: Try and drop your kid to school in your own vehicle if possible. The less contact with others the better. If your kid must be bussed make sure she wears a mask in the bus and sanitizes her hands immediately after getting down from it.

Debriefing: your kids are going into a risky situation every day. It is important to talk to them every day to find out what happened at school. Were they exposed to any risky situations- was anyone in their class ill- students, teachers, other staff; are they themselves feeling ill, were students and staff observing precautions, did they wash their hands regularly.

Assessment: assess the risk parameters when your child comes home and rate yourself every day. You can use the chart which we have made or make your own. Identify where possible exposure could have happened and plan against it.

BUS RIDE

Did you wear your mask all the time

Did you disinfect your hands after getting down

CLASS

Did you disinfect your hands after each class?

Did you take off your glasses?

Did you rub your eyes with your hands?

Did you wash your hands when you visited the restroom?

RECESS

Did you disinfect your hands before recess?

Did you disinfect your hands after recess?

PUBLIC SPACES

Did you wear your mask in public spaces?

Did you come into contact with any adults other than your teachers?

Did you see anyone who looked ill? (Was having fever, coughing or breathless)

Mental Health during Covid

0

In these difficult times, we must learn to take care of not just our physical health, but our mental health as well. In this video, Dr. Mamta Shah explains not only the importance of taking care of our mental health but the tips we can follow during these times to do so.

Surgical Mask vs (K)N95 Mask

0

If ever there is a symbol of the COVID-19 Pandemic it would be the (K)N95 Face Mask, a simple unglamorous device which not many people outside the pollution hot spots of the world had heard about. (K)N95 mask is a face mask designed not only to filter out at least 95% of all particles with a diameter greater than 0.3 micrometers but also to achieve a close facial fit. A surgical mask is designed to protect the patient from the droplets of the doctor! It wasn’t designed to protect the doctor from the patient. They are not effective in blocking particles less than 100 micrometers but more importantly they aren’t designed to have a close facial fit so air leaks through the gaps between the mask and the face.

An older, pre‑SARS‑CoV‑2 Chinese study in 2013 half found that twice as many health workers (17%), contracted a viral respiratory illness (like influenza or rhinovirus), when wearing a surgical mask while treating sick patients, compared with 7% of those who continuously used an N-95.

People often prefer to use a surgical face mask, it is “surgical” after all, isn’t it? The word “surgical” carries with it an aura of asepsis and clinical cleanliness but unfortunately it is misleading. The artificial debate around Surgical vs (K)N95 masks centers around the debate around the possible ways of transmission of the Coronavirus. The WHO and other national and international bodies insisted for a long time that transmission was solely through droplets, then when confronted with the evidence of increasing number of medical staff falling ill despite wearing surgical masks they revised their opinion to say that transmission could also be due to aerosols but that aerosols were produced only through medical procedures, hence only medical staff should wear (K)N95 masks and that in fact other people shouldn’t wear them so that more masks would be available for medical staff! It took an open letter from 239 scientists from 32 countries to make the WHO reconsider and recant (to a limited extent).

The WHO has clung to an outdated definition of airborne transmission and made an artificial distinction between droplets and aerosols. People produce both aerosols and droplets when they talk and sneeze, you don’t have to look beyond “Super spreader” events be convinced of that! Nature doesn’t distinguish between droplets and aerosols!

Scientists may have the luxury of not making recommendations till they have the evidence to back it up which is the principle of “Evidence Based Medicine” but real life situations demand that you make life and death decisions based on the information which you have. In the case of the Coronavirus, scientists have found themselves suddenly thrust into the spotlight being called upon to recommend measures which impact every aspect of the nation that they belong to. They have found themselves pulled in all directions by different and powerful factions with deep economic and political interests in the recommendations which they would make.

Droplet transmission means that less precautions need to be taken and the economy may be opened up with greater ease whereas aerosol transmission implies more stringent measures need to be taken to protect people’s lives and the economy needs to be opened up more gradually with more money spent on safeguarding citizen’s health.

Surgical Face Masks may make you feel good about yourself but don’t really protect you from the coronavirus, they may protect others from you if you aren’t very infectious at the moment, (K)N95 masks not only protect others from you (particularly if they don ‘t have an exhalation valve) but also protect you from others. The way to stop this pandemic is the way to do anything, one small step at a time, consistently- wear your (K)N95 mask every time you go out. Use common sense, it will save your life.

Breathe like a tortoise, live like a king

0

By Partha Pratim Bose, senior consultant, National Heart Institute, Founder, SAANS Foundation

More breathe per breath…. Tortoise breathing

Right breathing techniques are for optimum health. We breathe 20 per cent less oxygen as we grow older or when we are sedentary in our activities. There are benefits of “more breath per breath” through abdominal breathing. More breath per breath increases your oxygen delivery to vital organs and reduces oxidative stress which makes you calm and tranquil.

Abdominal breathing is parasympathetic; it decreases heart rate and relaxes you. Breathing pattern changes in different emotional situations. During anger our breath becomes chaotic, during depressive state our breath becomes sluggish and if we are anxious the breathing becomes rapid and shallow.

Our breathing centre is in the brain stem, the lower part of cerebrum, the thinking brain. We human beings breathe unconsciously throughout our lives. For example, breathing during deep sleep. But breathing in or inhalation is an effort. So we need to consciously breathe unconsciously; that’s the paradox. For example, during anger, if we take deep breaths and then take a pause, anger disappears because you change your breath from chest to abdomen pattern, that is converting sympathetic to parasympathetic way. Similarly during anxiety and depressive states if you take deep rapid breathing it increases your minute ventilation (ventilation per minute). This washes carbon dioxide, keeps you in respiratory alkalosis (increases pH of the body) and makes you feel tipsy.

Tortoise breath is a more breath per breath technique. The tortoise breathing exercise comes from the Chinese meditative practice known as Qigong or chi kung, which combines breathing and exercise to achieve a higher state of awareness. Tortoise breathing, also known as kuei hsi or “swallowing the breath” aims to mimic the slow, deliberate breathing of the tortoise, which is a symbol of longevity in China. Using the tortoise breathing technique, with time and practice we should be able to comfortably slow down your breathing rate to our three or four breaths per minute.

1. Begin by either sitting or lying down on your back. Take a long breath, inhaling slowly and deeply until you feel the air inside your neck.

2. Swallow your breath by taking the air in your neck and forcing it down, as if you were swallowing a piece of food.

3. Exhale deeply and slowly through your nostrils, not your mouth, immediately after swallowing. Repeat this inhale-swallow-exhale cycle seven times.

4. Swallow the saliva in your mouth following the seventh breath. Move your tongue around the inside of your mouth to collect it and swallow several times.

Benefits of deep conscious breathing are

1. Breath = life. The better (fuller) you breathe, the more energy you will have. Taking deeper breaths will bring in more oxygen into the body and improve your energy levels.

2. Deep breaths = less stress and better digestion. Slow deep breaths help to activate parasympathetic nervous system which is when the body gets the chance to recuperate, regenerate, and heal.. 

3. Deep breaths = less inflammation. Deep breathing is said to reduce the acidity level of the body making it more alkaline reducing your risk of infection

4. Deep breath = more awareness. The more awareness you have in the present moment, the more likely you are to connect with your intuition or internal teacher.  It is a matter of learning to listen to that voice and understand it.

5. Slower breaths = better relationships. Most relationships would be better if people were less reactive. Can you imagine if instead of saying something mean, you were able to mentally step back and chill before talking?

Wearing the Fashionable Version of Safety

0

Face masks have become a necessity in humanity’s fight against the Coronavirus.

I like to believe that there are 4 types of people that have their very own methods of staying safe:

  1. The Anti-Mask Crusaders: These people don’t like to wear masks, and some possibly even actively advocate not wearing one. They insist that public spaces must not require people to wear masks. They may believe that: (a) The Coronavirus doesn’t exist and that all the deaths reported by media are a part of a different problem (b) The threat is hugely overblown by unreliable media. I feel as though these people live in their own world, with their own beliefs; however, in reality, it is harmful to the rest of the world.
  2. The Non-Mask Wearers: These people believe that Covid-19 is a real virus that is affecting many. However, at the same time, they also believe that the threat is being exaggerated, and even that masks are unnecessary.
  3. Mask Wearers: People who take the trouble to find out about masks and how they can protect them. They would be seen to be wearing a surgical face mask/N95. These people will probably be safer than the ones that do not like to wear masks and, or, are not taking the right precautions.
  4. Fashion Mask Wearers: These kinds of people are aware of the risks of coronavirus, however, the “fashion” masks that they enjoy wearing do not serve the same purpose as wearing a KN95 or an N95. The fact is that cloth masks have no use against the coronavirus and poison gas. The virus tends to stick to the cloth and when brought into a house and wash it in their washing machines, the virus spreads.

#FaceMaskIsTheNeCondom

Masks cannot be washed. If they are, they lose whatever little efficacy they had. They are not underwear even if they are made of the same cloth. Masks are surgical clinical equipment. You wouldn’t want your surgeon to operate on you wearing his underwear on his face, would you?

A mask is not a fashion statement, it is a necessity to everyday life. Face masks are made through and through with several layers, such as melt-blown polypropylene. The middle layer cannot be inserted in a reusable face mask because you should never touch the outer layer of the mask (let alone wash it!)
but also because inserting a middle melt-blown layer is like having a condom with only the tip made of latex and the rest made of cloth, and that would be VERY painful.

#FaceMaskIsTheNewCondom Wear a safe mask, not a fashionable one.

Use your judgment, not reusable cloth masks

0

The Coronavirus is extremely small, around 0.1nm. The pores between the fibers of a cloth
mask are at least 1000 times bigger than the virus
! They may help in protecting other people from being infected if you are infected, but it has as much chance of blocking a coronavirus as a football
goal post stretched to THRICE its size has of stopping a football!


An N95 /KN95 / surgical face mask has a middle layer of melt-blown polypropylene, which not
only forms a very fine mesh with pore size 0.1- 1 nm, but also has fibers that are electrically
charged to attract and trap the virus.


The difference between a reusable cloth mask and an N95 / Surgical face mask is that between
being alive and dead. Think about it, if your house was at risk, would you rather leave the
front door wide open or set up an electrically charged barbed-wire fence for protection?


Don’t wash your N95 / KN95 / Surgical Face Mask because it clumps the fibers together and
destroys the charge. It is like short-circuiting your electrically charged barbed-wire fence by
joining the wires together. Just don’t wash or reuse your N95/KN95, it just becomes useless. Keep others and yourself safe because guess what, FaceMaskIsTheNewCondom – you wouldn’t wash and reuse your condom, why do
it with a face mask?

COVID19 Preparation and Supplies

0

Here are the supplies you should have and the steps you should take:

  • Masks- surgical as well as N95, children’s masks for children, available online at An Active Life
  • Thermometer
  • Oximeter , available online at An Active Life
  • Face visor
  • Medicines – Acetaminophen/Paracetamol/Tylenol, Dexamethasone
  • Keep all other medicines which you usually use
  • Gloves – box of 100- nitrile
  • Hand soap
  • Shampoo
  • Hand sanitizer, available online at Amazon
  • Surface sanitizer
  • Disposable tissue for surface wiping
  • Disposable tissue for hand wiping
  • Separate dustbin with dust bin liner
  • Phone number list – Covid19 testing , ambulance, nearest COVID treating hospital
  • Prepare separate room for possible isolation in case someone gets infected – with toilet and balcony, ac should ventilate outside
  • One set of complete PPE – in case anyone does get infected
  • Oxygen cylinder if possible
  • Prepare will
  • Insurance papers
  • Keep bank documents and financial papers in order
  • Avoid central AC that you have to share with people other than immediate family
  • Try and stay away from crowded areas where you cannot maintain social distancing