ABSTRACT
This planet has witnessed several pandemics earlier in its history. The last pandemic, Spanish flu which was far more deadly, happened about a century ago and apart from a few centenarians, nobody who is alive today has any experience of living during the time of pandemic. COVID-19 discovered about 9 months back has reached almost every continent and country. With around 29 million known COVID-19 infected people, about a million deaths and with billions are affected due to quarantines, lockdowns, and restrictions on movement of person and goods, and social distancing measures. This has resulted in adversities and hardships in the areas such as financial, employment, school, family, and health. All these directly affect the mental health and well-being of an affected individual as well as their family members. Some of the common mental health conditions observed are anxiety about coronavirus infection, and worries about stigma, well-being, and future of the family members. In addition, the prevailing situation has further worsened people with already existing mental health conditions, such as inability to consult the mental health professionals due to COVID safety measures and fear of contamination in the mental health institutions. To mitigate mental health issues and to improve psychosocial well-being, NIMHANS, with the help of the government and other institutions, adopted several measures, such as creating IEC materials for the general public, counseling people who are quarantined, and starting a national telephone free helpline. This chapter will discuss the efficacy of online counseling, related issues, experiences, lessons learned and offer suggestions for the future. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Taylor and Francis Pte Ltd. 2022.
ABSTRACT
Background. Geographical Information Surveillance (GIS) is an advanced digital technology tool that maps location-based data and helps in epidemiological modeling. During pandemics a rapid analysis of patterns of spread can help put in place strategies for containment and infection control. We applied GIS to analyze patterns of spread and hotspots of COVID-19 infected cases in Vellore district in Tamil Nadu, South India. Methods. Laboratory-confirmed COVID-19 patients from Vellore district and neighboring taluks from March 2020 to June 2021 were geo coded (based on addresses) and spatial maps generated. These were then layered as points on the base map to illustrate the distribution of all COVID-19 cases. Time trends exploring urban-rural burden with age-sex distribution of COVID-19 cases and other variables were correlated with outcomes of death, symptoms and complications. Map of undivided Vellore district showing rural and urban settlements. Results. A total of 45,401 cases of COVID-19 were detected between 28 March 2020 to 31 June 2021 with 20730 cases during the first wave (28 March 2020 to 31 March 2021) and 24671 cases during the second wave (1 April 2021 to 30 June 2021). The overall incidence rates of COVID-19 across the study region was 462.8 per 100,000 and 588.6 per 100,000 population during the first and second waves respectively. Pattern of spread revealed epicentres in densely populated urban areas with radial spread, sparing rural areas, Heat maps also confirmed higher densities at these epicentres, however, the second wave had more peri-urban and rural area involvement. Case fatality rate was 1.89% and 1.6% during the first and second waves and increased with advancing age, i.e., 7.38% were aged more than 60 years in the first wave and 5.02% in the second wave. Incidence was higher in men, 2.40%, and 1.76% as compared to women who had 1.16% and 1.38% in the first and second waves respectively. Overall, case fatality rates were the highest among those who had >2 comorbidities (9.52%). Subdistrict level incidence of COVID-19 during the first and second waves. Epidemic curve of the COVID-19 pandemic during the first and the second waves. Conclusion. Modern surveillance systems like GIS can accurately predict the trends of the outbreak and pattern of spread during future respiratory pandemics. Employing this in real time can help design risk mitigation strategies improving health care access and monitoring with prevention of spread to rural areas.
ABSTRACT
Despite the contemporary advancements in the field of science and medicine, combating the coronavirus disease 2019 (COVID-19) is extremely challenging in many aspects as the virus keeps spreading and mutating rapidly. As there is no effective and conclusive drug therapy to date, it is crucial to explore plant-based natural compounds for their potential to inhibit SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). Recent research highly focuses on screening various phytochemicals to elucidate their anti-viral efficacy. However, very few studies were published investigating the anti-viral efficacy of ginsenosides. Hence, the main aim of this study was to investigate the inhibitory potential of the available 122 ginsenosides from Panax ginseng against SARS-CoV-2-related proteins using a molecular docking and molecular dynamics approach. The major bioactive compounds "ginsenosides" of P. ginseng were docked to six vital SAR-CoV-2 host entry-related proteins such as ACE2, Spike RBD, ACE2 and Spike RBD complex, Spike (pre-fused), Spike (post-fused), and HR domain, with lowest binding energies of -9.5 kcal/mol, -8.1 kcal/mol, -10.4 kcal/mol, -10.4 kcal/mol, -9.3 kcal/mol, and -8.2 kcal/mol, respectively. Almost all the ginsenosides have shown low binding energies and were found to be favourable for efficient docking and resultant inhibition of the viral proteins. However, ACE2 has shown the highest interaction capability. Hence, the top five ginsenosides with the highest binding energy with ACE2 were subjected to MD, post MD analysis, and MM/PBSA calculations. MD simulation results have shown higher stability, flexibility, and mobility of the selected compounds. Additionally, MM-PBSA also affirms the docking results. The results obtained from this study have provided highly potential candidates for developing natural inhibitors against COVID-19. Copyright © The Author(s) 2022.
ABSTRACT
Background: N95 respirators have prevented transmission among health-care workers during the COVID-19 pandemic. During times of intense shortage of respirators and border closures during the pandemic, re-use strategies with available decontamination methods were necessitated. This in-house experimental study evaluated the effect of hydrogen peroxide gas-plasma sterilization on respirators and helped establish an evidence-based protocol for their re-use in a resource-poor setting. Materials and Methods: A three-dimensional experimental model using saline nebulization as the aerosol exposure and a particle counter to measure the filtration of particles through the mask pre- and post-sterilization was used. Multiple cycles of plasma sterilization were done till the physical integrity/fit was lost. Total filtration volume was used as a surrogate marker to assess the filtration efficiency (FE). Results: The total volume of particles filtered on a 3M respirator was 99.9%. Unused Halyard and Venus respirators were compared against 3M and found to have FE of 99.9% and 60.5%, respectively. After repeated sterilization cycles, the total volume of particles filtered was 59.3% for Halyard in the seventh cycle and 36.2% for Venus in the fifth cycle. When the physical integrity and fit was tested, the appropriate fit was lost after eight cycles of sterilization for Venus and was not lost for Halyard even after the tenth cycle. Conclusion: This low-cost experimental study helped implement an effective and safe decontamination strategy for safe re-use of N95 respirators in an emergent situation with no access to commercial testing in a resource poor health-care setting during the pandemic.
ABSTRACT
Background and Objectives: The COVID-19 pandemic has highlighted the risk of airborne transmission of infections in health-care facilities such as dental clinics. In this experimental study, methods to control airborne particles in a simulated dental clinic setting were measured and compared using a low cost and convenient technique. Materials and Methods: Particles representing inhalable airborne particles were generated using smoke from incense sticks and their concentration measured by handheld particle sensors whereas using different engineering controls for the particle removal in dental clinic equivalent settings. Measurements were made at short (<3 ft) and intermediate (between 3 and 6 ft) distance from the source. The particle filtration through surgical masks and N95 masks was also studied. Results: Natural ventilation, by keeping windows open, can reduce intermediate range particles (removal of 4.7% of ambient particles/min). However, in closed facilities without natural ventilation, particle removal by air purifier combined with overhead fan or with high volume evacuators was found most suitable for intermediate range particles (25.9%/min) and for short range particles (27.6%/min), respectively. N95 masks were found to filter out 99.5% of the generated PM 2.5 particles. Conclusions: Potentially inhalable airborne particles can persist in the air of a dental clinic. The use of N95 masks and environmental controls is essential for the dental team's safety. The choice of an engineering control is governed by multiple factors explained in the study. Smoke particles generated by incense sticks and measurement by handheld particle sensors are low-cost methods to estimate the effectiveness of airborne particle controls.