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Natl Med J India ; 33(5): 298-301, 2020.
Article in English | MEDLINE | ID: covidwho-1289146


India has the largest global burden of new cases of tuberculosis (TB) and deaths due to TB. These occur predominantly in the poor who suffer catastrophic costs during diagnosis and treatment. The National Tuberculosis Elimination Programme has ambitious goals of 80% reduction of incidence of TB, 90% reduction in mortality due to TB by 2025 and 0% occurrence of catastrophic costs to households affected by TB by 2020. The Covid-19 pandemic and the resulting disruption to TB services are expected to worsen the situation. There are gaps in case finding at the peripheral level and access to care at the higher level for patients with TB. An estimated 32% patients with active TB do not access diagnostic services, while catastrophic costs associated with hospitalization are a barrier to access for seriously ill patients. Deaths due to TB in India occur largely at home and not in medical facilities, and are preventable with appropriate inpatient care. The Ayushman Bharat scheme with its Health and Wellness Centres (HWCs) and coverage for inpatient care under the Pradhan Mantri Jan Arogya Yojana (PM-JAY) can facilitate, the achievement of the goals of TB elimination. The HWCs provide an opportunity to close the case-finding gap as first point of contact by enabling sputum transport services to the designated microscopy centres. This will facilitate case detection, reduce diagnostic delays, and decrease community transmission and the incidence of TB. The benefit package of PM-JAY can cover patients with pulmonary TB, inpatient evaluation for other forms of TB, enhance the allocation for treatment and cover management of comorbid conditions such as severe undernutrition, anaemia, HIV and diabetes.

COVID-19 , Communicable Disease Control/organization & administration , Early Diagnosis , Hospitalization , Patient Care Management , Tuberculosis , Universal Health Insurance , COVID-19/epidemiology , COVID-19/prevention & control , Health Expenditures , Health Services Accessibility/standards , Health Services Accessibility/statistics & numerical data , Health Services Needs and Demand , Humans , India/epidemiology , Mortality , Patient Care Management/methods , Patient Care Management/organization & administration , Patient Care Management/trends , Public Health/methods , Public Health/trends , Quality Improvement/organization & administration , SARS-CoV-2 , Time-to-Treatment , Tuberculosis/diagnosis , Tuberculosis/economics , Tuberculosis/mortality , Tuberculosis/therapy
Current Science ; 118(9):1335-1336, 2020.
Article in English | GIM | ID: covidwho-1005449


Obesity, a comorbidity not well documented in the COVID-19 pandemic, is now being identified as a risk factor for severe COVID-19 infection, including in those less than 60 years of age. We discuss parallels of increased severity, prolonged viral shedding of influenza A (H1N1) which are relevant, and the mechanisms which link obesity to inflammation and severity of infections. We suggest that weights and heights be recorded in all case-record forms and epidemiologic surveillance tools to assess the associations of body mass index with infection status and disease outcomes. Obese individuals should be closely monitored in view of the risk of increased severity of COVID-19 infection.

J Prev Med Hyg ; 61(3): E321-E323, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-881539


The novel corona virus (SARS- CoV2) pandemic has created an unprecedented public health problem and a mental health crisis looms ahead. The isolation, socio-economic disruption, uncertainty and fear of contagion have led to a spike of health anxiety in the general public. Individuals with health anxiety may get dismissed as the "worried well" in this pandemic due to disruption of mental health services and inability of healthcare systems to understand the psychosocial factors in the background. Education of general public, training of healthcare workers in cognitive behavioural model of health anxiety and timely referral to mental health professionals in severe cases is need of the hour.

Anxiety/psychology , Coronavirus Infections/psychology , Pneumonia, Viral/psychology , Social Isolation/psychology , Betacoronavirus , COVID-19 , Health Education , Humans , Mental Health Services , Pandemics , Referral and Consultation , SARS-CoV-2 , Uncertainty