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The stress that the COVID-19 pandemic has placed on health systems internationally has forced difficult decisions concerning the rationing of medical care and has put the bioethical structures that inform those choices under scrutiny. Often, ethical approaches to pandemic circumstances center around utilitarianism, dehumanizing the treatment process and ignoring the plurality of other philosophical doctrines that inform non-Western bioethics, which could be of use in addressing the pandemic. This paper focuses on philosophical Taoism, as developed in the Tao Te Ching and Zhuangzi, in order to suggest an alternative approach to medical care when medical capacity is limited, grounded in the concept of wu-wei, or inaction. [ABSTRACT FROM AUTHOR]

Over the years, healthcare system in India has been largely centralized, expensive and impersonal. In a country where expenditure on healthcare is low, most healthcare expenditure is out‑of‑pocket and where most of the population continue to live in rural areas or in urban fringes, such a care is inaccessible, unresponsive and unaffordable. COVID pandemic exposed these realities further. Based on experiences of directly managing health services during COVID‑19 pandemic in different settings and across different levels, authors of this paper argue for a decentralized, distributed and responsive health systems for India, that is likely to be more effective and sustainable in normal times, and in times of crisis. [ABSTRACT FROM AUTHOR]

COVID-19 pandemic has challenged and overwhelmed most healthcare institutions and healthcare workers, across the world. Despite being unprepared for this pandemic, frontline workers have worked relentlessly to provide the much-needed care to these patients. Doctors from different branches of medicine, including dermatologists, came forward and played a substantial role in mitigating the impact of this pandemic on the general population. Sadly, in the process, these healthcare workers faced many personal, social, psychological, economic, and health-related issues. The psychological burden and health-related issues received due attention in the main-stream news as well as scientific research papers. With most frontline workers isolated from their families, social media became the new platform to reduce the sense of isolation and share their anxiety, insomnia, and fatigue. This article is aimed at highlighting various challenges faced by healthcare workers during the ongoing COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The first Mohalla or Community clinic was set up in July 2015 in Delhi, India. Four hundred and eighty such clinics were set up in Delhi, since then. This review was conducted to synthesize evidence on access, utilization, functioning, and performance of Mohalla clinics. A desk review of secondary data from published research papers and reports was conducted initially from February–May 2020 and updated in August 2020. Eleven studies were included in the final analysis. Studies have documented that more than half to two-third of beneficiaries at these clinics were women, elderly, poor, and with school education up to primary level. One-third to two-third of all beneficiaries had come to the government primary care facility for the first time. A majority who attended clinics lived within 10 min of walking distances. There was high rate of satisfaction (around 90%) with overall services, doctor–patient interaction time and the people were willing to return for future health needs. Most beneficiaries received consultations, medicines, and diagnostics at no cost. A few challenges such as dispensing of medicines for shorter duration, lack of awareness about the exact location of the clinics, and services available among target beneficiaries, and the incomplete records maintenance and reporting system at facilities were identified. Mohalla Clinics of Delhi ensured continuity of primary care and laboratory services during COVID-19 pandemic in 2020. In summary, Mohalla Clinics have made primary care accessible and affordable to under-served population (thus, addressed inequities) and brought attention of policy makers on strengthening and investing on health services. The external evaluations and assessments on the performance of these clinics, with robust methodology are needed. The services through these clinics should be expanded to deliver comprehensive package of primary healthcare with inclusion of preventive, promotive, community outreach, and other public health services. [ABSTRACT FROM AUTHOR]

Telemedicine and related e-health facilities facilitate care from a distance through electronic information systems. COVID-19 pandemic is establishing telemedicine in the health care delivery system of countries. Telehealth is contributing significantly in health care delivery during the COVID-19 crisis. For mild-to-moderate symptoms of COVID-19 or any illness, telehealth services might represent a better, efficient way to receive initial care and perform triaging. Telemedicine also has a significant role in screening for COVID-19 symptoms and delivering routine needs and follow-up care. The large-scale adoption of telemedicine in public health care delivery is still not visible in low- and middle-income countries like India. Adoption by patients and healthcare professionals is limited and their concerns need to be addressed to ensure its utilization in future of the care continuum. In the current paper, we aim to review recent measures of Telemedicine adopted during the course of pandemic and its impact on public health in lower-middle income countries like India. [ABSTRACT FROM AUTHOR]

Cataract is the second leading cause of preventable blindness on the globe. Several programs across the country have been running efficiently to increase the cataract surgical rates and decrease blindness due to cataract. The current COVID-19 pandemic has led to a complete halt of these programs and thus accumulating all the elective cataract procedures. At present with the better understanding of the safety precautions among the health care workers and general population the Government of India (GoI) has given clearance for functioning of eye care facilities. In order to facilitate smooth functioning of every clinic, in this paper, we prepared preferred practice pattern based on consensus discussions between leading ophthalmologists in India including representatives from major governmental and private institutions as well as the All India Ophthalmological Society leadership. These guidelines will be applicable to all practice settings including tertiary institutions, corporate and group practices and individual eye clinics. The guidelines include triage, use of personal protective equipment, precautions to be taken in the OPD and operating room as well for elective cataract screening and surgery. These guidelines have been prepared based on current situation but are expected to evolve over a period of time based on the ongoing pandemic and guidelines from GoI. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has threatened the humanity at a global level to a large extent by the burden of the disease with significant mortality and to a certain extent as a byproduct of the necessary efforts to contain the same. There is a significant impact on the health care system, as we not only have to contain pandemic, but continue to treat our non-COVID-19 patients in a safe and responsible manner. Ophthalmology practice in general and glaucoma in particular needs certain modifications and additional precautions while examining as well as managing these patients keeping their and our safety in mind. As the lockdown relaxations are in vogue we need to learn how to deal with our regular patients as well in addition to emergency care. This paper presents the consensus-based guidelines by an expert panel on how to restart glaucoma practice during this COVID-19 time. These guidelines will be applicable across the country and should help ophthalmologists and glaucoma specialist to restart their practices while safeguarding the patients and their own selves from getting infected. [ABSTRACT FROM AUTHOR]

Health systems are adapting to the unique challenges posed by the COVID-19 pandemic. Social distancing has forced clinicians to provide their services through online platforms in high income countries. Similar trends have been noticed in Low and middle-income countries (LAMIC). Digital health can help LAMIC address traditional barriers to care by overcoming issues related to stigma, discrimination, staffing, and physical and geographical resource constraints. Mobile phone subscriptions exceed 80% of the population in many LAMICs. Mobile platforms represent a viable resource in overcoming the significant mental health gap in LAMIC. This paper discusses the enormous potential that digital health has to transform healthcare delivery in LAMICs, as well as numerous challenges to implementation. We also discuss the need to develop national digital health strategies and suggest solutions to some of the barriers. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has forced substantial changes in the practice of psychiatry, including that of electroconvulsive therapy (ECT). There is higher risk of transmission of the SARS-CoV-2 virus during ECT unless due care is taken. However, in many cases, ECT cannot be avoided. In this paper, we discuss various measures that may be adapted to reduce the risk of transmission of the virus during ECT. We also suggest certain modifications to the practice of ECT in order to achieve a balance between risks and benefits of the procedure during the pandemic. [ABSTRACT FROM AUTHOR]

Background: Health care systems worldwide have rapidly responded to manage the COVID-19 pandemic by providing screening tests, contact tracing, treatment, and vaccination. However, the long duration of the pandemic has had an enormous load on the health care systems, which disrupted continuity of the essential non-covid services, long waiting time for appointments, and increase in the utilization of telemedicine services. Primary health care was established as an essential foundation for the global response to the COVID-19. In Qatar, Primary Heath Care Corporation (PHCC), the main primary care services provided played a major role in the response to the pandemic. However, its services were affected and disrupted, and new services were added. Hence, the aim of this analysis is to understand the long-term impact of the COVID-19 on the services provided by PHCC in Qatar in terms of PHCC pandemic response, change in utilization of the core, and preventative services, and the introduction of new alternative services. Methods: A retrospective data analysis was conducted for all the appointments and visits for all the PHCC health centers in the years of 2020 and 2021. The study conducted a comparison of the services utilizations using the utilization figures of PHCC services between 1st of January and 31st of December 2019 as a reference year. The differences in the utilization per service were presented in frequencies and percentages. Results: The in-person services dropped drastically in 2020 at 36% reduction in compassion to 2019. However, the newly introduced virtual consultation services in 2020 reached their highest utilization figures in 2021 at 908,965 virtual visits. The COVID-19 specific related services ranging from the COVID-19 drive-through testing to vaccine administration constituted a total number of 2,836,127 visits corresponding to 44% of the total PHCC services utilization visits in 2021. In 2021, PHCC dental services dropped by 25.2%. The most noticeable utilization drops in 2021 were among the preventative services with 53.2% and 78.9% in colorectal screening and non-communicable diseases (NCDs) risk factors annual screening services, respectively. However, mental health services have witnessed a surge in utilization at 134.1% increase in 2021 in comparison to 2019. Conclusion: The COVID-19 pandemic caused a disruption in the PHCC utilization of core services, namely dental services. Additionally, PHCC preventive services utilizations were affected drastically including cancer and NCDs risk factors annual screening. Nevertheless, PHCC managed to provide alternative virtual services and played a vital role in responding to the pandemic by leading the COVID-19 vaccination campaign in Qatar. However, future research is needed to establish which vulnerable patient groups were most affected by the pandemic, to continue to inform strategies and policies directed at mitigating the impact of future potential pandemics. [ABSTRACT FROM AUTHOR]

Introduction: Government runs teaching hospitals to impart a high-quality medical education to budding medicos and paramedical students in training. The experiences these trainees at various tenure positions get then and there shape their worldview for rest of the life and have an indelible impression. The Covid-19 pandemic disrupted all the routines at the hospitals around the world—including ours—and we make an attempt to measure it in one dimension in this study. Materials and Methods: We obtained attendance data of patients at out patient department and in patient department of our hospital. During the pandemic for a certain duration offline (physical) registrations were closed and they were attended only by online ones. Hence that data (actually a part of it) got captured electronically and we analyzed it to get an idea of the traversed course of the scourge. Results: When the pandemic surged during the spring and summer of 2021, our hospital was turned into a Covid facility. Hence average routine attendance of patients got reduced to a significant extent, elective surgeries/interventions and procedures were postponed and this data is reflected in an electronic system, perhaps making a long-lasting effect on the budding trainees. This fact needs to be realized so as to take appropriate action. Conclusion: We need to realize that the effects of the viral communicable disease may be enduring, not only for the infected patients and their families but also for those who learn on those patients. Therefore, the transmissible diseases disabled not only our society, economy, and health care services when they ascended but pedagogy too. Online learning came to rescue but only up to a certain extent and with several caveats and limitations. [ABSTRACT FROM AUTHOR]

Background: Many developed countries have switched from conventional outpatient psychiatric services to tele mental health-based alternatives because of the COVID-19 pandemic. However, similar transitions might be difficult for countries like India because of a shortage of necessary resources. Therefore, the feasibility and acceptability of converting to a home-based tele mental health (HB-TMH) service during the pandemic were examined in an Indian hospital. Materials and Methods: A new and expanded version of an HB-TMH service was operated for all outpatients following the onset of the pandemic. Feasibility outcomes included operational viability, service utilization, service engagement, the need for additional in-person services, and the frequency of adverse events. Patients' and clinicians' satisfaction with different aspects of the service were evaluated using Likert-style questionnaires to ascertain acceptability. The outcomes during the prepandemic and pandemic phases were also compared. Results: The switch to HB-TMH services took 6 weeks during the pandemic. Patient numbers increased greatly following this transition. Attendance improved, the requirement for in-person services was low, and no serious adverse events were reported. However, patients' satisfaction levels were relatively low during the pandemic. Clinicians were more satisfied than the patients with HB-TMH treatment during the pandemic. Differences between them were less marked but still present before the pandemic. Pre- and postpandemic comparisons revealed that both patients and clinicians were more satisfied with all aspects of HB-TMH care before the pandemic than during it. Conclusions: Though conversion to HB-TMH services was feasible during the pandemic, such services need to be improved to enhance patient acceptability. [ABSTRACT FROM AUTHOR]

Humanities are an integral part of health professions. However, with educational focus shifting gradually toward knowledge, information, evidence-based medicine, and technology, it has taken a back seat and become a part of the "hidden curriculum." Humanities are hardly ever taught upfront to students of the health profession, let alone its assessment. With the need of its inclusion in health professional education now recognized and established through competency-based education, we need to be aware of the tools and strategies which can be used to teach and assess it. In this article, we share selected tools with relevant readily usable examples for teaching humanities to students of the health profession. Faculty may find it useful to plan sessions around related competencies. Incorporation of such experiential teaching and learning methods can help us achieve the transition from "high-tech" to "high touch" health professions education. [ABSTRACT FROM AUTHOR]

The whole world was shaken with the pandemic of Coronavirus Disease (COVID-19) in end of the year 2019. Due to its novel origin, it was required to follow all precautions possible. Dealing with the massive amount of infectious healthcare waste became an enormous challenge. This review identifies the impacts of the pandemic on biomedical waste management. This systematic review was made by using keywords "biomedical waste" and "COVID 19" in open access databases like PubMed, Science Direct, Scopus, Google Scholers etc. 2124 articles downloaded and 765 found duplicate and 634 not related to the topic. after scrutiny with inclusion criteria 102 articles were considered to analyze the practices related to biomedical waste management during pandemic using PRISMA guideline.. The COVID-19 waste segregation, collection, storage, transportation, and disposal are a big challenge with all stakeholders. In order to control the virus spread, strict monitoring of the complete waste management cycle is required. Adoption of appropriate guidelines is paramount to worker safety and containment of infection. Sustainable recycling methods are needed to deal with the ever-increasing plastic waste resulting from mandatory personal protective equipment (PPE) usage. The situation also demands a rethinking of the healthcare system. Overall, there was an increase in BMW generation, and municipal waste had increased globally. Pandemic preparedness requires a global public health strategy and long-term investments. This will be vital for making a robust community capable enough to fight against any public health pressures in the future, as well as the pandemic tremors. Systematized efforts from all stakeholders, at all levels, not only refines epidemic preparation but also helps to attain a sustainable development of health for a healthier future. [ABSTRACT FROM AUTHOR]

A sequence of unexplained pneumonia cases was reported in December 2019 in Wuhan, China. After several analyses, in January 2020, the World Health Organization temporarily named this new virus as the 2019 novel coronavirus (2019-nCoV). It is found that 2019-nCoV is abundantly present in nasopharyngeal and salivary secretions of affected patients and it is found to be transmitted through the saliva and the feco–oral routes since its spread is through potential person-to-person transmission route which is predominantly thought to be respiratory droplet/contact in nature. Dental surgeons are at tremendous risk of 2019-nCoV infection due to the face-to-face communication and the exposure to aerosols, saliva, blood, and other body fluids and the handling of sharp instruments and also may encounter patients with suspected or confirmed severe acute respiratory syndrome coronavirus 2 infection and will have to act diligently not only to provide care but also at the same time prevent nosocomial spread of infection. The significance of this review is that oral health providers must be aware and be prepared to tackle any imminent infectious diseases like the present coronavirus disease 2019 outbreak, which can be life threatening to susceptible patients. This review provides a brief outline of the epidemiology, symptoms, mode of transmission, specific recommendations for dental practice that are suggested for patient screening, infection control strategies to block the person-to-person transmission routes in dental clinics and hospitals, and patient management protocol since there are certain chances of encountering oral emergencies such as acute pulpitis, periapical periodontitis, abscess, dental trauma, children's oral emergencies, and oro-maxillofacial infections during this period. [ABSTRACT FROM AUTHOR]

Ambient air pollution is one of the treacherous and malign problems facing humanity and other living beings on the earth today. Although the air pollutants such as particulate matters (PM) and microscopic contaminants have been associated with widespread morbidity and mortality, studies have also indicated those pollutants as a potential synergist to respiratory infirmities in both adults and children. Many viral contaminants have also been reported as potential detriments of respiratory distresses. Exposure to poor grades of ambient air can lead to numerous health consequences, such as adverse effects on the lung, heart, and other vital organs. In recent years, many studies infer that pollution along with viral contaminants impart substantial worldwide burden of diseases on human beings. Excessive air suspended pollutants such as micro or nanoparticulate matters bring down the life expectancy of human beings in many ways. Regardless of the passage of entry, fine and ultrafine PM that enter into systemic circulation affect vascular endothelial cells by producing local oxidative stress and have the capacity to cross biological barriers, thereby creating numerous deleterious effects on vital organs. Pollution-induced systemic inflammation is mediated by proinflammatory cytokines such as interleukin-6, interleukin-1 β, and tumor necrotic factor-α. These systemic inflammatory mediators are implicated in causing or exacerbating many complications in the human body. This article is an attempt to accentuate the pollution-linked health impediments, as well as the fountainheads of ambient air pollution so that some effective strategies can be developed to manage this global peril. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 outbreak poses a global crisis in health care delivery system, including habilitation and rehabilitation services. In this study, we shared our experiences on telerehabilitation services established primarily for students with visual disabilities (SwVD) amidst COVID-19 pandemic and its outputs. Methods: Following the lockdown declared on March 23, 2020, the rehabilitative team of a tertiary eye center in north India received information that many visually challenged students (VCS) were stranded in schools for the blind in Delhi, and feeling with anxiety and panic in absence of teachers. Shortly, the room for vision rehabilitation clinic was set-up for telefacilities. The intended services were explained while disseminating the mobile numbers. A semi-structured questionnaire consisting of closed and open-ended was developed to record COVID-19 knowledge and concerns. Inductive content analysis was used to report the qualitative information. Results: As of June 30, 2020, a total of 492 clients contacted the team, with maximum from Delhi (41.5%), and predominantly males (78.8%). Around 80.3% of callers were VCS with age range of 11 to 30 years. The two most frequently encountered health needs were itching in eyes (36.1%) and headache (29%). Television news was the most used medium among callers to get COVID-19 information. Cough is a less frequently known mode of transmission (28%), similarly handwashing as a less known for prevention (17.2%). Eight concerns were recorded based on qualitative data analysis. Conclusion: Telerehabilitation provides valuable insights and has the potential to address various concerns, uncertainty, anxiety, and fear among VCS during the pandemic. [ABSTRACT FROM AUTHOR]

Background: COVID-19 pandemic has resulted in disruption to routine health services delivery as strict lockdowns were implemented in India and health workforce redeployed for COVID-19 focused responses. We assess the perceptions about COVID-19, the impact of the lockdown on access to health services and continuum of care for Non-communicable diseases (NCDs) among a cohort of adults in rural India. Methodology: Since 2018, we have been following up a cohort of persons with non-communicable diseases in a high NCD burden region in Srikakulam District of Andhra Pradesh under the STOP CKDu study. We conducted this mixed methods study, administered through a structured telephonic questionnaire and interview to determine the awareness, perceptions and their compliance to ongoing treatment schedules. Results: Overall, 68% of the participants exhibited adequate knowledge of symptoms of COVID-19, while 43% were not aware of the mode of transmission of the virus. In all, 822 (36.1%) participants reported at least one NCD condition. Among them, 115 (14%) missed their follow-up visit, 110 (13.4%) reported facing challenges in medication procurement and 11.6% either developed new complaints or experienced worsening of pre-existing symptoms. A total of 233 (28.5%) used a telemedicine facility and took telephonic advice from (private) physicians. As the access to medicines was restricted due to the lockdown, majority of the respondents were depending on rural medical practitioners (RMPs) for the procurement of medication. Conclusion: Our finding implies the need for the future guidelines on adaptation of telehealth approaches within health systems to maintain the continuum of care, digital health tools to facilitate the patient's appointments including virtual follow-up visits for those with NCDs coupled with regular engagement by frontline healthcare workers at the local levels, evidence informed public health messaging taking into consideration the social and behavioural aspect and uninterrupted essential primary healthcare services. [ABSTRACT FROM AUTHOR]

COVID-19 pandemic has involved nations and incapacitated the health systems globally. The pandemic preparedness has been tested with immense losses. Universal health coverage is needed more than ever to recuperate from the effects of the current pandemic. Post pandemic, many lessons need to be learnt especially for developing economies like India where public healthcare system is grossly inadequate to take care of health needs of citizens. World Health Organization's framework of six health system building blocks was utilized to study the lessons learnt and actionable points in the post pandemic period. Participation in Global Health Security Alliance has to be stepped up with involvement in Joint external evaluation and development of epidemiological core capacities. National Health Security Action Plan needs to drafted and available for health emergences. Ayushman Bharat scheme should incorporate elements to address surge capacity at the time of health emergencies and measures to deliver care at the time of pandemic. Technology through telemedicine, m-health, and digital platforms or apps should contribute to trainings, supervision, and facilitation of healthcare delivery at remote locations. Open data sharing policies should be developed for the practice of evidence-based public health. Public healthcare system and health manpower trained in epidemiology should be given a boost to have system readiness to respond in case of future pandemics. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19), like any other pandemic, has imposed an unprecedented threat to physical and mental health to all nations, worldwide. There is no enough evidence in the literature in this area. The present study has been done to explore the organization of psychiatric services in Bosnia and Herzegovina (BH) to meet mental health needs of BH citizens during the particular restrictive measures caused by COVID-19 pandemic. Materials and Methods: This online survey has been done for BH psychiatric institutions. Data were collected from psychiatric institutions in the mental health network of BH. A total of 38 complete responses have been received. Results: Of 38 study participants, three were the departments of psychiatry in university clinical centers, two were psychiatric hospitals, four were psychiatric wards in general hospitals, 27 were community mental health centers, and two were institutes for alcoholism and drug addiction. During the pandemic, all services functioned on a reduced scale, adhering to measures to protect and self-protect both staff and service users. Protective equipment was provided to staff in some institutions in a timely and complete manner and in some in an untimely and incomplete manner. Consultative psychiatric examinations were mainly performed through telephone and online, where it exists as a standard patient monitoring protocol. The application of long-acting antipsychotics was continuous with adherence to restricted and protective measures. In opiate addiction replacement therapy services, substitution therapy was provided for a longer period to reduce frequent contacts between staff and patients. Individual and group psychotherapy continued in reduced number using online technologies, although this type of service was not administratively regulated. An initiative has been given to regulate and administratively recognize telepsychiatry by health insurance funds in the country. A number of psychological problems associated with restrictive measures and fear of illness have been reported by patients as well as by the professionals in mental healthcare teams. There were no COVID-19-positive patients seeking help from institutions that responded to the questionnaire. In one center, infected people with COVID-19 from abroad sought help through the phone. Only one involuntary hospitalization was reported. The involvement of mental health professionals in the work of crisis headquarters during the design of the COVID-19 pandemic control measures varies from satisfactory to insufficient. Education of staff, patients, and citizens was regular with direct instructions through meetings, press, and electronic media. Conclusions: During the COVID-19 pandemic in BH, all psychiatric services functioned on a reduced scale, adhering to measures to protect and self-protect staff and service users. All patients who asked for help have been adequately treated in direct inpatient or outpatient mental healthcare or online, despite telepsychiatric services not being recognized in health system in BH. There were neither infected patients nor staff with COVID-19 in the psychiatric institutions who responded in this research. A large-scale, multicenter study needs to be performed to get a broader picture and to guide us for future better service planning and delivery. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) is a global pandemic. Knowledge, attitude, and practices (KAP) influence the adherence of elderly to COVID-19 mitigation measures. Aim: To measure the effect of an educational program via WhatsApp on KAP of elderly toward COVID-19. Patients and methods: A quasi-experimental research design (pre-post intervention study) study was done on 102 older adults, able to communicate via smart phone and participating in the WhatsApp group members of El-Sadaa elderly club in Mansoura city, Egypt. Data collection took a period of 1 month from the first to the end of April 2020. Tools: Demographic data and health history of the elderly questionnaire, knowledge related to COVID-19 and its preventive measure questionnaire, attitude related to COVID-19 questionnaire, and practices related to COVID-19 questionnaire were collected. Results: The postimplementation scores were significantly higher than the preimplementation ones. The mean scores were 30.1 versus 20.4 for knowledge, 10.6 versus 8.2 for attitude, and 11.4 versus 9.1 for practice. The median practice score is significantly higher among the elderly with enough income compared with those without enough income. Conclusions: Participants had a significant improvement in KAP about COVID-19 after the implementation of the educational program. Recommendations: Education via WhatsApp can be an effective teaching method that enables the elderly to enhance their KAP toward COVID-19. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease-19 (COVID-19) pandemic caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) is a novel disease. Objectives: Our healthcare sector is at the epicentre of this unprecedented global pandemic challenge and we are not fully aware of it's management. Here we have discussed our learning experience in managing and tackling the COVID-19 pandemic at our institute which will set an example for other hospitals as well as instill confidence in our primary care physicians who are the frontline warriors. Methods and Results: For combating COVID-19, dedicated teams for its management including logistic support was streamlined. Our capacity was built up for 200 isolation beds including 40 ventilator equipped beds and 645 defined quarantine rooms, to be implemented in phased manner. Till date more than 200 COVID-19 patients have been admitted here. Fever and cough were common presentations. Mortality was high in patients with advanced age or who had multiple co-morbid conditions. Efficient training and infection prevention control have resulted in a satisfactory outcome. Conclusion: In the wake of this pandemic all hospital setup, with collective responsibility should follow a specified protocol so that our hospital is not converted to the hotspot. COVID-19 has imposed a new challenge where not only patients have to be managed but our health care workers also need to be protected. Telemedicine and our primary care physicians will play a crucial role. Here at a medical institute, medical teaching, and learning atmosphere has to be created amidst the pandemic apprehension for our budding medicos. [ABSTRACT FROM AUTHOR]

The aim of this review was to propose multi-pronged resumption strategies for lacrimal practice in an effort to plan a sustainable recommencement of elective surgeries after we emerge from the peak of COVID-19 pandemic. The strategies for lacrimal practice were classified into 7 subtypes, and each of the blueprints were reassessed based on existing information on resumption strategies of elective surgeries from other specialties in COVID-19 era. The specific needs of lacrimal practice were then added to construct algorithms summarizing the resumption strategies. The basic principle of 'primum non nocere' needs to be followed. The overall proposed plan advocates the transition to a more sustainable health care reality in a world where we would still co-exist with COVID-19. A comprehensive effort involving screening, laboratory testing, appropriate triage, effective personal protection and specific precautionary measures for lacrimal clinics and operating room are needed to be able to safely resume elective surgery when the pandemic peak declines. To predict the timing of the resumption of elective surgeries is quite complex and influenced by several geographic, political and economic factors. It is equally important to remember that COVID-19 crisis is a dynamic situation and constantly evolving, hence the strategies provided are subject to change. Strict adherence to standard COVID-19 guidelines combined with effective testing and personal protection strategies can ensure slow yet smooth and safe return to full lacrimal practice after the COVID-19 pandemic calms down. The local government directives, individual and institutional discretion are advised. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has brought new challenges to the health care community. Many of the super-speciality practices are planning to re-open after the lockdown is lifted. However there is lot of apprehension in everyone's mind about conforming practices that would safeguard the patients, ophthalmologists, healthcare workers as well as taking adequate care of the equipment to minimize the damage. The aim of this article is to develop preferred practice patterns, by developing a consensus amongst the lead experts, that would help the institutes as well as individual vitreo-retina and uveitis experts to restart their practices with confidence. As the situation remains volatile, we would like to mention that these suggestions are evolving and likely to change as our understanding and experience gets better. Further, the suggestions are for routine patients as COVID-19 positive patients may be managed in designated hospitals as per local protocols. Also these suggestions have to be implemented keeping in compliance with local rules and regulations. [ABSTRACT FROM AUTHOR]

For the last several weeks, the Indian media both newspapers and the TV have been reporting patients who developed mucormycosis (majority rhino-orbital-cerebral mucormycosis (ROCM)), wrongly called as "Black fungus", within short time of COVID-19 recovery or during the disease itself. While there is no difference in the efficacy of a variety of corticosteroids, dexamethasone is preferred.[[5]] Regardless of the preexisting diabetes, it is recommended to monitor blood glucose and in patients with diabetes, corticosteroids should be used for controlling the cytokine storm under insulin control. Role of uncontrolled diabetes: Without a doubt uncontrolled diabetes is a major risk factor in the current spurt of mucormycosis in COVID-19 patients. [Extracted from the article]

The COVID virus and the pandemic are defying the general laws of epidemiology and virology. The pandemic shows how the economy can be crippled due to health care. Health is a key area which directly drives the economy. Incapacity in health policy leaves us vulnerable as a country. Global organizations and development partners have been too keen to lend technical help, policies, and procedures to India. Gone are the days when India used to receive any international funding in the health sector but at present most of the money is our own. We often take stewardship for implementation of these surrogate policies and procedures countrywide. The International donors and development partners pushed India on the path of selective primary care - disease based vertical programs. It was part of a geopolitical strategy. It is not resources but capacity. Capacity to make any innovation or change. There is a need for a new public health order in India. A massive change; a massive reform. Covid is an opportunity to think, push for institutional capacity building. As far as COVID pandemic is concerned, we need to strengthen the general health system in India, and not yet another vertical National Covid Control Program (NCCP) - Eliminate Covid by 2050; committing all national resources to one disease only. There is an urgent need for India to shift from selective primary health care to a comprehensive health care model. We have capacity and resources, we only need a national resolve! It is time to protect national interest. We cannot keep ourselves artificially vulnerable for ever. [ABSTRACT FROM AUTHOR]

The article presents a developing nations' perspective Tele-child neurology in the era of Covid 19 pandemic. Topics include rapid pace of progression of the pandemic has forced many nations to institute strict containment measures; and examine the potential of the emerging tele‑child‑neurology practices in meeting the brisk demands in developing countries.

Resident physician exposure to novel coronavirus (2019-nCoV, SARS-CoV-2) within New York City during exponential phase of COVID-19 pandemic: report of the New York City residency program directors COVID-19 research group. It was indeed the young ophthalmologists and women ophthalmologists who suffered the most. Commentary: Impact of COVID-19 pandemic on income and opportunities of ophthalmologists in India. [Extracted from the article]