Changing trends in Covid-19 publication in India by bibliometrics analysis.

Objective: The purpose of this research is to compare over the developing trend in Covid-19 research publications between 2020 and 2021 in India, overall in respect of age groups, health conditions, funding support, institutions, and research design. Background: Covid-19 is a contagious disease caused by severe acute respiratory syndrome coronavirus (SARS-CoV), first cited in Wuhan, China in December 2019. And has affected the entire world rapidly and still ongoing. The symptoms are fever, cough, weakness, and breathlessness; the infected individual develops pneumonia that sometimes leads to respiratory failure. The older population with co-morbidities is at higher risk. Methodology: This is a cross-sectional study done by Scopus, Web of Science, and Pubmed Indexed journals, with the Covid-19, SARS-CoV, Pandemic, Coronavirus, India, and Outburst as keywords. Yearly publication data were extracted through 'Bibliometrix R studio' and relative percentage was computed and linear or exponential regressions examined the yearly growth in the proportion to research publications on Covid-19.

An Analysis of the COVID-19 Situation in India in Terms of Testing, Treatment, Vaccine Acceptance and National Economic Performance.

Objectives: This study aims to provide a comprehensive review on the analysis of COVID-19 pandemic in India and address economic impact, diagnosis approaches, and vaccine acceptance and hesitation. Method: We retrieved articles published in 2020 and 2021 and current data from official websites that narrate the strategy for COVID-19 testing, issues, and challenges, healthcare system insufficiency, statistics of cases, deaths, vaccination, and vaccine acceptance barriers, and beliefs. Results: India being the 2nd largest populated country with a population of 1.4 billion faced massive difficulty in controlling the transmission of SARS-CoV-2. This crisis dramatically impeded the economy of the nation. India witnessed 2nd highest number (43,019,453) of confirmed cases and 3rd highest number of deaths (521,004) across the world. Conclusion: The major cause of the collapse of COVID-19 is the high population of India, pre-existing weak healthcare system, and the lack of awareness among the people. The fall, rise, and statistics provided in the review will help in comparing the current status with other countries and in making strong strategies to combat future calamities.

Establishment of a Rapid Response, 100-Bedded COVID-19 Hospital With General Wards and Intensive Care Unit Within 35 Days in North Karnataka, India: Report From the Field.

In the state of Karnataka, India, the first case of coronavirus disease (COVID-19) was diagnosed on March 9, 2020. As stated by the WHO, around 15% of COVID-19 patients require treatment in the Intensive Care Unit (ICU). Keeping this in mind, along with the increase in COVID-19 patients in Karnataka, it was predicted that the prevailing general wards and ICUs would be overburdened with the added non-COVID-19 diseases and infirmities. Hence, it was decided to set up a separate infrastructure to reduce the chances of transmission among the patients within the hospital. Thus, the board at SDM College of Medical Sciences & Hospital, Dharwad, Karnataka, took the responsibility to establish a fully equipped 100-bedded hospital in its premise as part of the national and state services to combat the outbreak. The aim of the study was to establish an isolated, fully functional hospital, equipped with all necessary diagnostic and critical care facilities to treat patients diagnosed with COVID-19 in North Karnataka, India.

Impact of COVID-19 lockdown on self-harm and violence among patients presenting to the emergency department.

IMPORTANCE: Considering the resurgence of COVID19 and the rapid spread of new and deadlier strains across the globe understanding the incidence and pattern of violence and self harm tendencies during this period might help in formulating better contingency plans for future lockdowns. A deeper look at the available data shows that there is a significant dearth of research into self-harm & violence during the COVID-19 pandemic. OBJECTIVE: To identify the incidence and sociodemographic characteristics of self-harm and violence during the COVID19 lockdown and compare with a control group from the previous year. DESIGN: A cross-sectional retrospective observational study. SETTING: Tertiary care teaching hospital. PARTICIPANTS: All patients presenting to the emergency department (ED) with self harm and violence during the COVID-19 lockdown period between March 24-June 30, 2020 and March 24-June 30, 2019. EXPOSURE: The COVID-19 lockdown period. MAIN OUTCOME (S) AND MEASURE (S): The hypothesis being tested was formulated before the study. The null hypothesis tested was a decline in number of self-harm and violence cases during the lockdown. RESULTS: A total of 828 patients were analysed over both the time periods, out of which 30% (248) were females while 70% (580) were males. Increases in self-harm and violence were 12.71% and 95.32% respectively per 1000 ED admissions. A significant correlation was found between the COVID-19 lockdown and the increased incidence (X2 (1, N = 828) = 9.2, p < .05). An increase of violence by known individuals and between partners was seen. Intimate partner violence also increased to 7%. X2 (3, N = 662) = 21.03, p < .05. In the self harm dataset an increase in mortality, ICU admissions and decision to leave against medical advice was noted (X2 (4, N = 166) = 24.49, p < .05). Increase in the use of alcohol prior to acts of self harm and violence was noted. CONCLUSIONS: Increase in the incidence of cases of self-harm and violence reported to the ED was noted during the lockdown period. Upgradation of health-care and law enforcement infrastructure maybe needed to deal with similar circumstances in a more efficient manner. TRIAL REGISTRATION: N/A.

Modified Negative Airflow Aerosol Prevention Box for COVID-19 Patients.

The importance of this intubation box has come to light recently in view of the coronavirus disease-2019 (COVID-19) pandemic and the fact that intubation is an aerosol-generating procedure (AGP). Risks of the healthcare worker attending to the airway of COVID-19 patients is high and the intubation box aims to minimize that and reduce contamination of the environment. To address this objective of decreasing transmission during AGP, we created a negative airflow aerosol box with a leak-proof airway handling system using readily available and affordable materials. The dimension of this box was 24 × 17.5 × 17.5 cm and it was made of high-quality 4 mm transparent acrylic sheet with two arm holes of 10 cm diameter. The caudal end of the negative airflow aerosol prevention box is wrapped with disposable plastic sheet and the both hand slots are sealed using camera cover and latex hand gloves and it decreases the risk of contamination. How to cite this article: Kumar N, Kumar A, Kumar A, Sinha C. Modified Negative Airflow Aerosol Prevention Box for COVID-19 Patients. Indian J Crit Care Med 2020;24(10):981-982.

COVID-19 preparedness among public and healthcare providers in the initial days of nationwide lockdown in India: A rapid electronic survey.

BACKGROUND AND AIMS: The COVID-19 Pandemic has been raging across continents in recent months. Public health measures are crucial in preventing COVID-19. The Government of India declared a nationwide lockdown on 24 March, 2020. The objective of this study is to assess preparedness among general public and healthcare providers against COVID-19 by way of adopting public health measures at the very beginning of the nationwide lockdown in India. SETTINGS AND DESIGN: A rapid cross sectional electronic survey was conducted across the country between 25 and 27 March, 2020. METHODS AND MATERIALS: Participants were general public and healthcare providers. Online questionnaire was generated in Google Forms. This included precautionary measures such as staying home, hand hygiene, wearing masks, cough hygiene and advisory against face touching. The web link to the form was shared through WhatsApp. STATISTICAL ANALYSIS USED: Descriptive data analysis was done using Epi Info software (version-7). RESULTS: A total of 226 persons (general public = 183; healthcare providers [HCPs] = 43) participated in the study. During the lockdown, HCPs spent more time outside than the general public (p = 0.009). Only 47% of the participants claimed to practise frequent hand washing and majority (72%; n = 163) did not wear masks while outdoors. Almost a half (45%) of the participants touched their face frequently and very few (8%) participants covered their mouth or nose while coughing or sneezing. There was no significant difference between HCPs and general public in frequent hand washing (p = 0.456), wearing masks (p = 0.255), face touching (p = 0.632) or covering mouth/nose while coughing or sneezing (p = 0.428). CONCLUSION: There is lack of preparedness among general public and healthcare providers against COVID-19 at the beginning of the nationwide lockdown in India.

Who is dying from COVID-19 and when? An Analysis of fatalities in Tamil Nadu, India.

BACKGROUND: As the number of COVID-19 cases continues to rise, public health efforts must focus on preventing avoidable fatalities. Understanding the demographic and clinical characteristics of deceased COVID-19 patients; and estimation of time-interval between symptom onset, hospital admission and death could inform public health interventions focusing on preventing mortality due to COVID-19. METHODS: We obtained COVID-19 death summaries from the official dashboard of the Government of Tamil Nadu, between 10th May and July 10, 2020. Of the 1783 deaths, we included 1761 cases for analysis. RESULTS: The mean age of the deceased was 62.5 years (SD: 13.7). The crude death rate was 2.44 per 100,000 population; the age-specific death rate was 22.72 among above 75 years and 0.02 among less than 14 years, and it was higher among men (3.5 vs 1.4 per 100,000 population). Around 85% reported having any one or more comorbidities; Diabetes (62%), hypertension (49.2%) and CAD (17.5%) were the commonly reported comorbidities. The median time interval between symptom onset and hospital admission was 4 days (IQR: 2, 7); admission and death was 4 days (IQR: 2, 7) with a significant difference between the type of admitting hospital. One-fourth of (24.2%) deaths occurred within a day of hospital admission. CONCLUSION: Elderly, male, people living in densely populated areas and people with underlying comorbidities die disproportionately due to COVID-19. While shorter time-interval between symptom onset and admission is essential, the relatively short time interval between admission and death is a concern and the possible reasons must be evaluated and addressed to reduce avoidable mortality.

Ensuring continuity of care by small family practices and clinics in the primary care setting during COVID 19 pandemic 2020 - A position paper by the Academy of Family Physicians of India.

The world is passing through a global pandemic of COVID 19. The number of positive cases has crossed over twenty thousand as of April 2020. Like everyone else, it is indeed a very challenging situation for family physicians and primary care providers as most of the guidelines presently have focused on screening, quarantine, isolation, and hospital-based management. Limited information or clarity is available on running small private clinics during pandemic times. The key concern is professional obligation versus risks of community transmission. Family physicians see routine flu-like illnesses throughout the year with seasonal variation within their practices. This document is intended to develop consensus and standard practices for the family physicians and other primary care providers during the pandemic, ensuring optimal continuity of care. This document was reviewed by the national executive of the Academy of Family Physicians of India and approved for dissemination among members. However, due to the dynamic status of the pandemic, all practitioners are advised to closely follow the instructions, guidelines, and advisories of national, state and local health authorities as well.

Stochastic approach to study control strategies of Covid-19 pandemic in India.

India is one of the severely affected countries by the Covid-19 pandemic at present. Within the stochastic framework of the SEQIR model, we studied publicly available data of the Covid-19 patients in India and analysed possible impacts of quarantine and social distancing as controlling strategies for the pandemic. Our stochastic simulation results clearly show that proper quarantine and social distancing should be maintained right from the start of the pandemic and continued until its end for effective control. This calls for a more disciplined social lifestyle in the future. However, only social distancing and quarantine of the exposed population are found not sufficient enough to end the pandemic in India. Therefore, implementation of other stringent policies like complete lockdown as well as increased testing of susceptible populations is necessary. The demographic stochasticity, which is quite visible in the system dynamics, has a critical role in regulating and controlling the pandemic.