"Omicron? / Variant of Corona
"Omicron? / Variant of Corona 19
OMICRON WATCH B.I.I.529
"Omicron may be less severe in young and old but not mild."
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| New Omicron Virus |
Introduction
"Omicron" as a variant of concern. Its WORRYING . Variant of Corona first detected in South Africa on November 12 2021 and Botswana. It is labelled as Virus of concern."V.O.C}. The new variant - also known as B. 1.1529 rent It is the first variant since delta to demonstrate the sort of worrying sign that signal a dangerous variant.
The global scientist trying to determine whether the new variant is more transmissible or more lethal than previous ones., but it does have the most mutations of any strain yet identified.. Variant has about 30 mutations "that seems relevant" - double the number seen in the highly transmissible Delta variant.This is the raised concern across the world
The variant has a spike protein that's different to the one in the original virus that vaccines are based on. This one is warning.
COVID-19 caused by omicron have caused mild symptoms, most of those people have been younger,
Is Astra Zeneca vaccine effective against the COVID-19 variant Omicron?
Why is the alarm
1 . The rapid jump in infection recorded in South Africa.
The country reported 2,500 cases on 25 November which is over 320 % of the average number of new infection seen just a week ago, when the number was 650. Of particular concern is the situation in Guateng province, where test positivity in one particular region (Tashwane) jumped from 1 % to over 30% in three weeks.Sequencing there showed almost all recent samples are of B.1.1527 but competing Delta in a way not seen before.
2 . Mutation profile of the virus.
There are a whopping 32 mutations in the spike protein, the part that latched into human cells.For the first time scientist have recorded two mutations at what is known as the furin cleavage site, the segment of the virus that is responsible for its entry into human cells.
3 . Many of these mutations have separately been seen in the three other V.O.Cs - Alpha, Beta, and Delta Which means ... The variant has demonstrated higher transmiblity and has a host of mutations that can cause a sizable antigenic shift -the scientist term for a pathogen to have changed significantly
.
Symptoms
Upper respiratory and musculoskeletal symptoms (Last for 3-5 days).
The big difference from Delta is that lungs are not affected ..
We are not seeing thrombo-embolic events either such as stroke ..
- Sore throat
- Congestion & Dry cough
- Chills & Fever (low grade fever
- Acute pain in leg and back
- Running nose
- Cough
- Body ache / Myalgia
- Headache
- Sneezing
- Weakness
- Fatigue / Tiredness
- Grappling with excruciating lower body pain
- Weakness
- Abdominal symptoms : Nausea,abdominal ache,vomiting,loss of appetite ,Diarrhoea
How long do Covid symptoms last?
What does it mean for a vaccine?
Early sign shows that the variant has major immune escape mutations in each of the three portions of the Sars-Cov-2 that are targeted by the antibodies both natural and those elicited by vaccines. But that still does not mean the variant will fully escape vaccine, or protection elicited antibodies
The government of Maharashtra has imposed Section 144 of Cr PC, which bars the assembly of five or more persons, from 9 pm to 6 am.
139 Countries affected
Australia
Austria
Argentina
Belgium
1 case
Botswana
Brazil
Canada
China
Czech Republic
Denmark
France
Germany
1
Hong Kong
2 confirmed cases
India
422 Cases
Italy
Israel
1 confirmed cases 2 suspected
Japan
Neither land
13 cases
Nigeria
Norway
Punjab
Portugal
Saudi Arabia
2
Singapore
Spain
South Africa
Sweden
UK
US
6,358 new cases of Covid-19
INDIA 653 CASES
omicron 2,100
DELHI
5 th Wave has set in
Updated on 13th Jan 2022
DELHI recorded
New Covid cases 27,561
Omicron 82 Total 464
Death 17 total 40
Positivity rate 26.22 %
Containment zone 24,000
Date 27 th Dec 2021 (First case on 2nd Dec 2021)
. “While we cannot stop the surge, we can certainly halt it, by Covid appropriate behavior. ..
Night curfew 11 PM -5 AM from 27th Dec 2021
According to Delhi Disaster Management Authority (DDMA)'s four-stage Graded Response Action Plan (GRAP), a 'yellow alert' will be sounded if the positivity rates remains over 0.5 percent for more than two days.
Omicron is 'dangerous ' for unvaccinated persons.
INDIA
Covid 194,720 lakh new cases of Covid-19
omicron 3000
INDIA 1,68,0632 CASES 1,79,723
Positivity 11.%
Death 442 in 24 hours.
omicron New 243 2,135
Other states affected in India
Andaman & Nicobar 2
Arunachal Pradesh 17
Assam 1167
Delhi 513 21,259
Chhtisgarh 37
Dadra, Nagar , Havel, Daman Diu
Gujrata 136
Goa 2,476 4 death 30.37% positivity
Haryana 61
Himachal Pradesh 1
Jammu &Kashmir 1
Jharkhand
Kerala 9,066 19 deaths
Karnataka 479 Positivity rate 10% Banguluru 15,167
Ladhak
Noida 721
Maharashtra 1,216 4033 Mumbai 16,420 2 deaths (cases drop for 4th consequent day}
Manipur 1
Madhya Pradesh 9
Meghalaya 64
Orissa 3679
Punjab 1
Pondicherry 2
Rajasthan 120
Sikkim
Tamil Nadu 45 Chennai 7,372
Uttar Pradesh 4228
Uttarakhand 1
West Bengal 2I,098 19 DEATHS calcutta 7,060
COVID 19
All persons aged 60 yrs & above with co-morbidity will not be required to produce / submit any certificate from the doctor, at the time of administration of precaution dose: Union Health Ministry
Recommended actions for people
The most effective steps individuals can take to reduce the spread of the COVID-19 virus is to keep a physical distance of at least 1 metre from others; wear a well-fitting mask; open windows to improve ventilation; avoid poorly ventilated or crowded spaces; keep hands clean; cough or sneeze into a bent elbow or tissue; and get vaccinated when it’s their turn.
5 Days quarantine for Asymptomatic contacts.
For symptomatic patients : Isolation for at least 7 days sincetesting positive and no fever for 2 days.
WHAT SYMPTOMS APPEAR IN WHAT CONDITION
Home Isolation and care for Covid 19
DO'S
- Stay home
- Sanitize hands
- Isolate and take rest
- All family members should wear mask.
- Cross ventilation in room
- Monitor body temperature
- Monitor oxygen saturation using pulse oximeter
DON'T
- Use Ramdesvir at home
- Use Budedonide Nebulizer
- Use an oxygen cylinder without a doctors advice.
For Positive Patients
HOME CARE
For Fever
- Paracetamol Tab 650 mg
- Consult a Physician if fever persist for 3 + days
- Can add non-steroidal anti-inflammatory drug Tab Naproxen 250 mg.
For Cold
- Tab Cetrizine 10 mg or Levicetrizine 5 mg
For Cough
- Drink fluids (water, juices, coconut water etc.)
- lie on chest and breath deeply to improve Oxygen saturation.
Instruction for Patient :
- Patient must isolate himself from other household members, say in the identified room and away from other people in home, especially elderly and those with co-morbid conditions like Hypertension, cardiovascular disease and renal disease etc.
- The patient should stay in a well ventilated room with cross ventilation and windows should be kept open to allow fresh air to come in.
- Patient should at all times use triple layer medical mask . They should discard mask after 8 hours of use or earlier if the mask becomes wet or visibly soiled in the event of caregiver entering the room, both caregiver and patient may preferably consider using N-95 Mask.
- Mask should be discarded after cutting them to pieces and putting them in a paper bag minimum of 72 hours.
- Patient must take rest and drink lot of fluids to maintain adequate hydration.
- Follow respiratory antiquates at all times.
- .Undertake frequent hand washing with soap and water for at least 40 seconds and clean with alcohol based sanitizer.
- The patient shall not share personal item including utensils with other people in the household.
- Need to ensure of cleaning of frequently touched surface in the room (tabletop, doorknob, handles,etc). with soap, detergent and water.The cleaning can be undertaken either by the patient or the caregiver duty following required precautions such as to use of mask and gloves.
- Self monitoring of oxygen saturation, with a pulse oximeter for the patient is advised.
- The patient shall self monitor his or her health with daily temperature monitoring and report promptly if any deterioration of symptoms is noticed. The status shall be shared with the treating medical officer as well as surveillance teams/ control room.
For Contacts
Testing : Not mandatory for asymptomatic contacts.
Asymptomatic family members exposed to Covid patients should monitor health.
For Suspect Cases : Following symptoms it means you are a suspect case
FEVER
COUGH
HEADACHE
SORE THROAT
BODY ACHE
LOSS OF TASTE / SMELL
BREATHLESSNESS : These people should get a self test / RAT / RT-P.C.R. Repeat test not required.
Updates
1. Don’t be surprised to find many patients or almost alternate patient suffering from upper respiratory tract infection and found to have Covid.
2. This all is Omicron. The R O can be as high as nine. Means every single patient can transmit infection two other nine patients.
3. The numbers of Covid patients are likely to be very very high than the official figures. Many patients refuse to get tested, now a days many doctors prefer not to test!
4. It is difficult to believe the high numbers so many doctors have doubt if some other virus is causing cross reactivity and false positive reports. Please remember that are RAT and RT PCR have high specificity of more than 90% or even more. It just means that a positive report is true positive and not false positive. Other viruses like RSV, flu etc cannot cross react and produce positive report for Covid. P.C.R detects targets which are specific to the virus so chance of cross reactivity it’s almost Zero.
5. Talking about sensitivity it is much low for RAT. Maybe around 50%. So it is very much likely that if you have symptoms and the RAT comes negative then it is likely to be false negative. RT P.C.R even though more sensitive then rapid test, can still be negative in almost 15% of cases. Sometimes 2 to 3 sequential tests may be required to confirm.
6. It is still advisable to continue testing and all preventive measures. Even though this strain is mild and predominantly upper respiratory, it can cause complications in the high-risk and elderly subset. Admission rate is gradually picking up. Last one week almost one patient referred daily for admission. Of course all were in the high-risk category. Good thing is that nobody below 60 years of age are showing any complications. Even recovery rate among those admitted seems good.
7. Coming back to Omicron.
B.1.1.529 is original strain and there are three lineages of original Omicron
- BA.1, BA.2 and BA.3
8. BA.1- supposed to be predominant in India responsible for 99% cases as per data. The S Gene deletion in RT P.C.R is classically present.
9. BA.2- Also called as stealth Omicron is now predominant in Bengal and North East. The S Gene deletion is absent and it is difficult to differentiate from Delta on routine RT P.C.R hence the name. Needs ALLELIC DISCRIMINATION RT P.C.R. Nobody is doing it in our region. The OMISURE kit has abilities to discriminate or detect Omicron accurately but presently not available. Genomic sequencing is Gold standard but practically impossible.
10. BA.3 - Not yet detected in India.
11. What is our present strain? I was very keen to differentiate between Delta and Omicron not just on clinical basis but also on micro biological basis. The S Gene target deletion Was used as a surrogate marker to single out Omicron and assume as Delta if no S Gene target deletion. It was true in the initial phase of this third wave, but not now a days. On tests performed on many patients it was found that most of them had NO S gene target failure AND all symptoms pointing towards OMICRON. So it is a very high possibility that our presents strain is BA.2 and not BA.1. Authorities need to confirm by appropriate genomic sequence testing from patients in our region. I have already requested them.
12. So the decision about monoclonal antibodies used for delta is now based on clinical criteria and some other surrogate markers of Omicron . The S GENE TARGET FAILURE doesn’t remain a criterion for Omicron (BA.2 )anymore .And believe me Monoclonal are now very very rarely required. Almost all are Omicron.Predominantly upper respiratory complaints especially throat related and a CT value of below 20 in RT P.C.R report points towards Omicron. Decision of Monoclonal is now entirely clinical and as per risk factors plus indicators of Delta.
13. Lower respiratory complaints like breathlessness and desaturation points towards delta. Multiple GGOs on CT chest seen on day 5-6 or beyond points towards delta.
14. Only symptomatic treatment for Omicron. No need of repeated investigations CRP, D-dimer. Usually stay normal. No need of routine CT chest . The thrombotic complications and long Covid also seems to be very low. Patients get to near normal within a week.
Thanks
SEEK MEDICAL CONSULT / HOSPITALIZATION IF
- Budesonide metered dose inhaler / dry powder inhaler - only if symptoms persist 5+ days.
- Antibiotics as advised by a doctor.
CRITERIA (whichever is earlier)
Level of Positivity Rate
Alert
(for 2 consecutive
days)
Level 1 More than 0.5% Or (Yellow)
Level 2 More than 1% Or (Amber)
Level 3
(Orange)
More than 2% Or
. ·,
Level '4,_ .:. More than 5%
Cumulative New
Positive Cases
(for a duration of 7
days)
1500 cases
3500 cases
9000 cases
16000 cases
Average
Oxygenated
Bed
Occupancy
(for a duration
of 7 days)
Or
500 beds
Or
700 beds
Or
1000 beds
Or
3000 beds
Note :
The positivity rate for 2 days at any level
Treatment
Molnupiravir to treat high-risk adult patients with COVID-19 across India
Govt issues revised guidelines for home isolation of mild or asymptomatic Covid-19 cases
The Union health ministry on Wednesday said Covid-19 patients under home isolation will stand discharged after at least seven days from testing positive and no fever for three successive days, in revised guidelines for home isolation of mild or asymptomatic cases. It also advised people not to rush for self-medication, blood investigation or radio logical imaging like chest X-ray or CT scan without consultation of treating medical officer.
Underlining that steroids are not indicated in mild disease and should not be self-administered, the ministry said overuse and inappropriate use of steroids may lead to additional complications. Treatment for every patient needs to be monitored individually as per the specific condition of the patient concerned and hence generic sharing of prescriptions should be avoided, the revised guidelines stated.
According to the guidelines, patients under home isolation will stand discharged and end isolation after at least seven days have passed from testing positive and no fever for three successive days, but they shall continue wearing masks. Earlier, the duration of home isolation ended after 10 days of onset of symptoms. There is no need for re-testing after the home isolation period is over. Asymptomatic contacts of infected individuals need not undergo Covid test and monitor health in home quarantine, the guidelines stated
Corona virus Omicron LIVE Updates | Latest guidelines for all international arrivals in India include a 7-day mandatory home quarantine
Vaccination Alert : Tab DOLO not recommended after Co-vaccine.
Key takeaways :
1. Omicron is he most infectious respiratory virus the world has ever seen. It is 3-5 times more infectious than Delta
2. We can safely say 90% of the current cases are Omicron virus
3. The milder symptoms seem mainly upper respiratory tract infection is whether because of low virility of the mutant Omicron strain or because of immunity induced by vaccine/past infection is still not known. Vaccine does not prevent Omicron infection but seems to protect severity/hospital admissions .
4. Omicron DOES NOT affect Lungs and hence 70% less chance of admissions and in only 10% oxygen was required and these all were elderly patients more than 70 years and were immuno-compromised / had comorbidity .
5. Booster vaccine recommended . if possible try to get a different vaccine than the primary one .
6.The available Antibody cocktail is USELESS in Omicron infection . It has become a fad amongst the rich . Please stop asking for it .
7 . Mixed opinions on Molnupiravir . If at all recommended , to be given on Day 4/5 if fever and cough not coming down or increasing and that too in elderly patients with co morbidity .
8 . No Antibiotics / Ivermectin / Favipiravir please
9 . PLEASE STOP USING ONLY SURGICAL AND CLOTH MASKS . USE ONLY N 95 MASK . infect if crowded or at risk places ..double masking recommended one N 95 mask and one surgical mask
10 . Ct values are not important and should not be considered evaluating the severity of the infection . Ct values differ morning/evening, lef t/ right nostril . Most labs abroad have been banned for publishing Ct values . Labs in India give because doctors/patients ask for it !
Paxlovid
Generic version of key Covid drug approved
Nirmatrelvir is an antiviral medication developed by Pfizer which acts as an orally active 3C-like protease inhibitor. It is part of a nirmatrelvir/ritonavir combination used to treat COVID-19 and sold under the brand name Paxlovid. It is taken orally
The drug has been shown to reduce the risk of hospitalization and death from COVID-19 by 88% if taken within five days of getting symptoms.
How it works?
Nirmatrelvir inhibits an enzyme that the coronavirus needs to make core viral particles. This causes the replicated virus within the body to become duds - no longer being able to enter uninfected cells.
The outer componant of the treatment is ritonavir, a drug that specially shuts down Nirmatrelvir metabolism in the liver which means it can stay on in the body and work longer.
How effective it is?
It is found an 89% reduction in the risk of hospitalization and death in unvaccinated people.
Throughout the year, Paxlovid was rolled out in many countries- including US where the government offers it for free.
When taken within 5 days of covid 19 diagnosis had a 51% lower hospitalization rate.
Side effects of Paxlovid include:
- changes in taste,
- diarrhea,
- high blood pressure (hypertension), and.
- muscle aches.
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