HOW DELTA PLUS CAN UNLEASH ANOTHER WAVE ON INDIA - The Daily Guardian
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HOW DELTA PLUS CAN UNLEASH ANOTHER WAVE ON INDIA

Why Delta Plus is a variant of concern? Top healthcare experts and doctors share their opinion on this and more.

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The Delta Plus variant, a variant of concern, has already been identified in 11 countries and 12 states in India. It is the mutated form of the Delta variant of Covid-19 which was first detected in India. This variant is concerning since it spreads more rapidly than the other Covid-19 variants India has witnessed. It shows a greater affinity towards lung cells. Reportedly Delta Plus also has the ability to fight some vaccines and therapies being offered in various countries. But it has to be studied in the Indian context to know whether or not vaccines available in India will be effective against Delta Plus. 

The Indian Council of Medical Research (ICMR) and the National Institute of Virology (NIV) have decided to carry out a study to check if Delta Plus can be neutralised by the vaccines present in India.

The highest number of cases is being seen in Maharashtra, Madhya Pradesh, and Kerala. Thus, the states are planning to tighten Covid restrictions. As per the data provided to the Centre by the ICMR, 48 cases of Delta Plus have been identified from over 45,000 samples collected during April, May, and June. The ICMR also mentioned that the Delta variant is very localised in India, and it has been isolated and cultured at the NIV in Pune.

Top doctors Dr Navin Kumar, Consultant Clinical Microbiology and Head of Laboratory services, HCMCT Manipal Hospital New Delhi; Dr Rajeev Boudhankar, Internal Medicine (MD) & CEO, Bhatia Hospital, Mumbai; Dr Shuchin Bajaj, Internal Medicine (Founder Director), Ujala Cygnus Group of Hospitals; Dr Arunesh Kumar, HOD, Paras Chest Institute & Sr. Pulmonologist, Paras Hospital, Gurugram; and Dr Piyush Goel, Senior Consultant- Pulmonary and Critical Care, Columbia Asia Hospital, Palam Vihar, Gurugram answer some queries related to Delta Plus variant.

Excerpts:

Q. What is the difference between Delta and Delta Plus variant?

Dr Rajeev Boudhankar: Delta Plus is a sub-lineage of the Delta variant first detected in India, which has acquired the spike protein mutation called K417N. There is a high chance that the mutation could make it more transmissible.

Q. How harmful can the Delta Plus variant prove to be in comparison to the earlier Covid-19 variants? 

Dr Navin Kumar: The Delta Plus variant has stronger binding to receptors in the lungs but it does not signify that it has increased transmissibility and causes more severe disease. At present, there is a limited number of cases localised in few districts of the country. We need to closely monitor its spread to know more about its transmission ability. 

Q. Are there any symptoms that can be specifically seen amongst patients infected by this Delta variant? 

Dr Navin Kumar: The clinical symptoms are similar to other variants and available evidence suggests that it does not cause more severity. At present, the number of cases is less and we need more scientific data to understand its future potential. 

Q. Why is the Delta Plus variant being called a ‘variant of concern’?

Dr Arunesh Kumar: Delta Plus variant has been instrumental in causing a new wave of Covid pandemic in the UK and parts of the US. This is a virus of concern because of its high infectivity and can cause severe disease. There are concerns that it can bypass vaccine immunity a phenomenon called immune escape. A country like India with big population size is always at risk of having an extensive effect. This strain is likely to cause the third wave. It is therefore important that people follow Covid appropriate behaviour.

Dr Shuchin Bajaj: The Delta Plus variant is a variant of concern because of a few reasons. One is the increased infectivity, which is much more than the previous one, the second is increased binding to lung cells, which may give rise to more severe disease, and the third is a potentially reduced response to monoclonal antibodies, which may interfere with the vaccine response as well as medicines like the monoclonal antibody cocktail, as well as previous infections. So, even previously infected or vaccinated individuals may suffer from the disease, as well as the fact that monoclonal antibody cocktail may be less effective against the Delta Plus variant. Due to all these reasons, there is a definite risk that the new Delta Plus variant will be more widespread as well as more severe if it causes the third wave.

Q. What are your views regarding the efficacy of the vaccines available in India on this Delta variant? 

Dr Rajeev Boudhankar: Multiple studies are ongoing in India and globally to test the effectiveness of vaccines against the Delta Plus Covid-19 mutation. However, some virologists of the Indian Sars-CoV-2 Genomic Consortia (INSACOG), have recently expressed concerns regarding the Delta Plus variant. They believe that the new mutant variant may just be capable of dodging immunities, both from Covid-19 vaccines as well as from earlier infections. This is because the Delta Plus variant not only has all the symptoms that the original Delta variant had but also carries symptoms from its partner Beta variant (K417N mutation). The South African Government had returned a consignment of AstraZeneca (named Covishield in India) vaccines in the recent past as it discovered that in South Africa the Beta variant evades Covid-19 vaccines much better than the Alpha or the Delta variants. This raises a red flag. But the hypothesis that “Delta Plus variant could dodge Indian Covishield vaccine” still needs studying in the Indian context. However, the Indian Government, on the other hand, has quoted studies stating that the Covishield and Covaxin are ‘broadly effective’ on the Delta Plus variant. Further studies are required in this area to properly ascertain these claims.

Dr Navin Kumar: The Delta variant which is a variant of concern with 15 to 17 mutations was first reported in October 2020. The data suggest that both vaccines Covishield and Covaxin work against the delta variant of SARS CoV2 with a slight reduction in neutralising antibody response. The Delta Plus variant has the potential to escape our immune response. We need laboratory and more clinical evidence to know the efficacy of vaccines against Delta Plus variant. 

Q. Why has the Delta Plus variant become a matter of concern in India & abroad?

Dr Rajeev Boudhankar: The mutation K417N has been of interest as it is present in the Beta variant (B.1.351 lineage), which was reported to have immune evasion property.

Some virologists have claimed that the K417N was known to reduce the effectiveness of a cocktail of therapeutic monoclonal antibodies.

As of 16 June 2021, at least 197 cases had been found from 11 countries — Britain (36), Canada (1), India (8), Japan (15), Nepal (3), Poland (9), Portugal (22), Russia (1), Switzerland (18), Turkey (1), the United States (83).

As of 26 June 2021, the first death due to Delta Plus variant has been reported in India of an 80-year-old female, whose oxygen saturation fell down drastically. Index cases of the Delta Plus variant need to be traced and tracked for their health status.

WHO is tracking this variant as part of the Delta variant, as it is doing for other Variants of Concern with additional mutations. The WHO says, as of now, this variant does not seem to be common, currently accounting for only a small fraction of the Delta sequences. Delta and other circulating Variants of Concern remain a higher public health risk as they have demonstrated increases in transmission.

There are worries in the scientific community that the Delta Plus variant would inflict another wave of infections on India after it emerged from the world’s worst surge in cases.

While the earlier version had largely been blamed for the second wave of the coronavirus pandemic in India, the new, more virulent Delta Plus variant is being feared ahead of a potential third wave.

The emergence of the Delta and Delta Plus variants of the Covid-19 has once again put India and by extension the world in a state of high alert. Delta Plus, reportedly a variant with increased transmissibility, is the latest in a long list of new mutant forms of the Delta Covid-19 strain which was first detected in India. With the Delta Plus Covid-19 variant being detected in as many as 11 countries so far, it is a concern for the entire world.

Q. What can be the way forward in tackling this Delta variant?

Dr Piyush Goel: As more than two dozen cases have been detected in three states of Madhya Pradesh, Kerala, and Maharashtra, the Delta Plus variant of coronavirus is surely a cause of concern now. On 14 June, the World Health Organisation classified the variant ‘Delta’ and the offshoots — AY.1 and AY.2 — Variant of Concern. Considering the impending third wave of Covid-19, it becomes important to strictly follow the directions of the Health Ministry to engage in immediate containment measures. Large-scale vaccination drives and their tracking must be facilitated along with testing in districts and affected clusters. This must be done to ensure that “adequate samples” of positive persons be speedily sent to designated laboratories of INSACOG to conclude the clinical epidemiological correlations.

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Kashmiri ASHA worker serves as inspiration by donating blood 28 times

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A 32-year-old woman named Bilqees Ara, an ASHA worker, has donated blood 28 times since 2012. She has served as an inspiration to others across the nation.

Bilqees, who is from the Handwara Tehsil in the Kupwara area of North Kashmir, stated that she understands the “importance of blood”.

She said that by donating a pint of blood, she not only saves a precious life but an entire family.

She began donating blood in 2012 and has since given 28 pints.

She expressed her gratitude and pride at being the saviour of so many patients in the Kashmir valley.

I’ve seen people cry helplessly as they try to get blood to save their loved ones, but I’m proud of myself because I’ve arranged blood for them as well. “I felt an inner joy after that,” she said.

In Kashmir, she is known as the “Blood Woman of Kashmir”.

She is a registered blood donor. Whenever a need arises, the officials at the Blood Bank at Handwara hospital call her and, within the shortest span of time, she makes herself available to donate blood.

Women should come forward and do this as there is nothing to be afraid of. This is to be done for society, she said. She also said that she wondered who else would do it if she refused.

If a person has blood and courage, why can’t he give it to someone else in a time of need? She asked.

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Covid facilities to reduce in Delhi amid drop in cases

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The Delhi government has closed 11 Covid care facilities because to a consistent reduction in cases. Two Covid Care Centers are operational at Ambedkar Nagar Hospital, which has 50 beds, and Balak Ram Hospital, which has 25 beds, according to a government report. Only five admissions were registered at Ambedkar Nagar Hospital over the past three months, while there were none at Balak Ram Hospital.

The number of patients has steadily decreased at the remaining CCCs as well, according to reports.

According to officials, the Delhi Disaster Management Authority on Thursday decided to scale back the medical staff and infrastructure that had been deployed for COVID management in a planned manner. The health department will now formulate an action plan in response to this decision.

“The deven CCCs were closed and dismantled by Delhi government and one by the Centre and three others with total 4000 bed capacity- Radha Saomi Satsang ,Chattarpur, Sawan Kirpal, Burari , and Sant Nirankari, Burari- were closed but not yet dismantled”, officials said.

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India’s daily covid tally falls below 5k with 4,858 new cases

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India reported 4,858 new Covid-19 cases in the last 24 hours, 806 fewer than yesterday, bringing the total to 4,45,39,046, according to data released by the Union health ministry on Monday. On the other hand, according to the health bulletin, the number of active cases rose to 48,027.

India has 0.11 percent of the infections that are still active, and the Covid recovery rate has risen to 98.71 percent. 2.76 percent was the daily positivity rate, while 1.78 percent was the weekly positivity rate.

Infections with the coronavirus are currently most common in Kerala, followed by Tamil Nadu, Maharashtra, Karnataka, Assam, and West Bengal.

The health ministry stated that as many as 18 fatalities were reported today, taking the death toll to 5,28,355. This included eight deaths reconciled by Kerala.

According to the data available, 2.16 billion doses of vaccines have been administered in the country so far under the nationwide Covid vaccination drive.

On December 19, India’s Covid-19 total had reached one billion. On May 4 and June 23, respectively, last year, it reached the depressing milestones of two and three crore. On January 25 of this year, the number of Covid cases in the nation surpassed four crore.

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Over 100 people suffer food poisoning in Manipur

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Since Tuesday, over 100 people, including children, have been admitted to hospitals in the Senapati district of Manipur due to a possible case of food poisoning linked to a birthday celebration in the hilly state.

According to medical officer Dr. Th Veidai Shuru of PHC Paomata on Thursday, the majority of the patients, who are from the villages of Tungjoy and Tunggam, were admitted at the Public Health Centre (PHC) Paomata while some were in the Public Health Sub-Centre (PHSC) at Tungjoy.

From Tuesday onward through Wednesday, patients with complaints of loose motion, fever, and bodily soreness were admitted to health centres.

“Now most of the patients are getting relatively better, “said Dr Veidai.

According to reports from medical facilities, about 83 people have been released, and the 31 others are anticipated to leave soon.

According to the specialists, food poisoning is a possibility. According to locals, the primary cause may be the drinking of fermented fish chutney during birthday festivities.

“However, it will take at least 7 to 14 days to get the results for the samples which we collected and sent for testing and we’ve also collected blood samples to check other diseases, Dr Veidai said.”

Meanwhile, representatives from the food safety agency visited a village in the Senapati district to determine what was causing the widespread illness.

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Does Medicaid Pay for Air Purifiers?

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Medicaid services, as convenient as it sounds, might not be fulfilling enough to live a comfortable life for low-income families. Air purifiers are no more a luxury and have become a requirement to stay healthy. When we come to this, the real question is: does Medicaid pay for air purifiers?

The answer to this simple question is no. Medicaid does not cover air purifiers until and unless it is prescribed by a doctor if you are medically ill. This is not just enough to know; read on to have a better idea of how medicare works and what are your other options.

Does Medicaid Pay for Air Purifiers?

Medicaid is an insuranse plan which does not cover equipment lik air purifier, room heater, humidifier, dehumidifier, and air conditioner. The plan is only entitled to cover only those devices, which are Durable Medical Equipment.

For instance, Medicare is shown to provide Positive Airway Pressure machines if you are medically proven to have obstructive sleep apnea. However, in some cases, Medicaid may reimburse you with an air purifier and humidifier if you are medically proven for its need.

To do so, you must provide a proof showing authentication of your medical need, like a prescription or a letter of medical necessity. The plan only covers medical grade air purifiers and Air Purifier Mag has shared some of the best options that may help you get your air purifier cost covered under Medicaid easily.

Why Original Medicaid does not Include Air Purifier in their Part B?

Original Medicaid part B only covers the equipments under the DME category and since the plan does not categorize air purifiers as a DME, it’s not in the list. They rather believe it to be an environmental control equipment and not primarily medical in nature.

Same is the case with the other such appliances like humidifiers and room heaters  that are designed to improve or manage health conditions.

Can you Ask a Doctor to Prescribe you An Air Purifier?

You can request your doctor to prescribe you an air purifier only if you really think it could bring a difference in your health status. Medical grade air purifiers, which use HEPA filters are usually prescribed by the doctors to look after health condiitons like asthma. In some cases, doctors can refuse to sign you a prescription considering its short term benefits.

Does Medicaid Advantage Plus Pay for Air Purifiers?

Medicaid Advantage Plus is a long-term health management solution for people with chronic condition who need health devices and tools in their homes and have access to both Medicare and Medicaid plans.

The MAP plan is offered by the companies associated with Medicaid to cover all the services laid down by the original Medicaid plan.

Unlike the original plan, as allowed by the fall enrollment of 2020, the Advantage plan is more likely to be helpful in covering the cost of health equipment like air conditioners and air purifiers. Coverage plans and type of health devices covered in the Advantage plan vary from one provider to another.            

Which Durable Medical Equipment does Original Medicaid Part B Cover?

Medicaid, in general, covers the major chunk i.e. 80% of the Medicaid approved health equipment also called, durable medical equipment, to be used at home. To consider it a DME, Medicaid believes the equipment should be able to be repeatedly used, must only be useful for the sick, and restricted to home usage.

The equipment the plan will cover is based on the plan you choose and your health condition. Here’s a list of equipment Medicaid plan covers:

● Hospital beds

● Seat lifts

● Pacemaker monitors

● Blood glucose monitors

● Canes

● Wheelchair lifts

● Crutches

● Heating pads

● Oxygen regulators

● Face masks

● Alternating pressure pads, mattresses

● Motorized wheelchair

● Heat lamps

● Oxygen

● Sitz baths

● Ventilators

● Bedpans

● Walkers

Other Ways To Get Inssurance or Pay for an Air Purifier

Either when time is running out or there is no way out to get your prescription approved by Medicaid, you can opt for other ways to cover the expenses for your DME.

Private insurance: Even though FSA or HSA debit card isn’t allowed to be used on purchase of equipments, you can reimburse the amount by FSA after buying it from your own money. Most of the insurance providers cover air purifier as long as a proof is provided in terms of prescription or letter of medical necessaity.

Second Hand: You can always pay for the the equipment from your pocket. However, one needs to understand the cost difference if one opts for an insurance plan. You can directly pay and get second hand DME at half price from Facebook Market place, eBay, or any good thrift store.

Veterans Health Care: With the help of Department of Veterans Affairs, veterans and their spouses have the benefit of getting Medicaid copayment or the complete cost of DME.

Nonprofit Assistance: There are a number of nonprofit foundations and state programs, which help elderly with DME through low or interest-free loans and different programs. Visit your state’s site to have a better idea on the available programs.

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India reports 5,108 new Covid cases in 24 hours

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India reported 5,108 new Covid-19 cases in the previous 24 hours on Wednesday, bringing the total number of infections to 44,510,057. According to data from the union health ministry, the country’s active caseload is 45,749, accounting for 0.1 per cent of total cases.

So far, a total of 4,39,36,092 people have been recovered, with 5,675 recovered in the last 24 hours. The recovery rate in the country stands at 98.71 per cent.

The weekly positivity rate is 1.70 per cent, while the daily positivity rate is 1.44 per cent.

According to official data, approximately 89.02 crore samples have been tested for coronavirus in the country so far, with 3,55,231 tests conducted in the last 24 hours.

Meanwhile, India’s vaccination coverage has reached 215.67 crores, with 18.70 crores being precautionary (booster) doses. The vaccine doses have been administered to 19,25,881 people in the last 24 hours.

4.06 crore people aged 12-14 received their first dose, and 3.09 crore received their second. Over 6.18 crore people aged 15 to 18 received their first doses, with over 5.27 crore receiving a second dose.

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