Characterization of the Second Wave of the COVID-19 Pandemic in India: A Google Trends Analysis

BackgroundThe second wave of the COVID-19 pandemic has led to considerable morbidity and mortality in India, in part due to lack of healthcare access, low health literacy, and poor disease surveillance. In this retrospective, descriptive ecological study, we utilized Google Trends (GT) to characterize the second COVID-19 wave and its association with official case counts based on search terms related to symptoms, testing, disease complications, medications, preventive behaviors, and healthcare utilization. MethodsGT is a publicly available, online tracking system of Google searches. Searches are presented as relative search volumes (RSV) from 0 (least) to 100 (most number of searches). We performed pre-defined Web searches in India from 2/12/2021 to 5/09/2021. We characterized the peak RSV, RSV doubling rates, and Spearman rank correlation of selected search terms with official case counts. We also used date-adjusted linear regression to estimate the association between highly correlated search terms and official case counts. We then qualitatively classified public search queries into thematic groups to better understand public awareness and needs related to COVID-19. ResultsWe observed that searches for symptoms (most searched terms in order: fever, cough, headache, fatigue, chest pain), disease states (infection, pneumonia), COVID-19-related medications (remdesivir, ivermectin, azithromycin, Fabiflu, dexamethasone), testing modalities (PCR, CT Scan, D-dimer, C-reactive protein, oxygen saturation), healthcare utilization (oxygen cylinders, hospital, physician), and preventive behaviors (lockdown, mask, pulse oximetry, hand sanitizer, quarantine) all demonstrated increases, in line with increases in official case counts. Symptoms, PCR testing, outpatient medications, and preventive behaviors peaked around April 24th, approximately two weeks prior to the peak RSV in official case counts. Contrarily, healthcare utilization factors, including searches for hospital, physicians, beds, disease states, and inpatient medications did not peak until the first week of May. There were highly significant correlations between Coronavirus Disease 2019 (r=0.959), fever (r=0.935), pulse oximetry (r=0.952), oxygen saturation (r=0.944), C-reactive protein (r=0.955), D-Dimer (r=0.945), & Fabiflu (r=0.943) and official case counts. ConclusionGT search terms related to symptoms, testing, and medications are highly correlated with official case counts in India, suggesting need for further studies examining GTs potential use as a disease surveillance and public informant tool for public health officials.

Re-enchanting the body: overcoming the melancholy of anatomy.

I argue here that Weberian disenchantment is manifest in the triumph of instrumental reason and the expansion of analytic enquiry, which now dominates not simply those sciences upon which medicine depends, but medical practice itself. I suggest ways that analytic enquiry, also referred to here as anatomical reasoning, are part of a particular ideology-a way of seeing, speaking about, and inhabiting the world-that often fails to serve the health of patients because it is incapable of "seeing" them in the moral sense described by Iris Murdoch and others. I use the work of James Elkins and Wendell Berry to call for the recovery of a way of seeing the human body as both other and more than an object of scientific enquiry and social control.

Testicular sarcoidosis masquerading as testicular carcinoma.

We present a case of a 27-year-old man with a history of weight loss. A chest x-ray demonstrated hilar lymphadenopathy and he was treated with anti tuberculosis treatment. He noticed a painless left scrotal swelling and a scrotal ultrasound scan raised the possibility of testicular cancer. He underwent an orchidectomy and histology confirmed a testicular sarcoidosis. He was commenced on steroid treatment.

Clinical results of linezolid in arthroplasty and trauma MRSA related infections.

AIM: To analyse the management of patients treated with linezolid for orthopaedic infections. METHODS: Twenty-two patients with orthopaedic related infections receiving a course of linezolid were reviewed retrospectively. Patients were classified into either post trauma, post arthroplasty and non trauma related infections. A diagnosis of infection was based on clinical findings, positive microbiological specimens, and positive signs of infection on radiological imaging and raised inflammatory markers. Pathogens isolated, inflammatory markers both at presentation and at final follow up, length of linezolid treatment, adverse drug reactions, concomitant anti-microbial therapy, length of hospital stay and any surgical interventions were recorded. RESULTS: Infections were classified as post arthroplasty (n = 10), post trauma surgery (n = 8) or non-trauma related infections (n = 4). Twenty patients (91%) underwent surgical intervention as part of their treatment. The number of required surgical procedures ranged from 1 to 6 (mean = 2.56). Mean total length of stay per admission was 28.5 d (range 1-160 d). Furthermore, the mean duration of treatment with linezolid of patients who had resolution of symptoms was 31 d (range 10-84 d). All patients within this group were discharged on oral linezolid. Pathogens isolated included methicillin resistant Staphylococcus aureus, coagulase negative staphylococci, coliforms, enterococcus, Staphylococcus epidermidis, streptococcus viridans, Escherichia coli, group B streptococcus and pseudomonas. An overall 77% of patients demonstrated resolution of infections at follow-up, with mean C-reactive protein reducing from 123 mg/L to 13.2 mg/L. CONCLUSION: This study demonstrates that the use of linezolid offers excellent efficacy in orthopaedic related infections when used alongside appropriate surgical management.