IndiaMedToday May 2021

MAY 2021, VOLUME 5 ISSUE 5 `200 INDIA MED TODAY

Anatomy of Oxygen Crisis in India APPROACH Lending a Helping Hand FEATURE Distressed Diagnostic Labs IMPACT Diagnostics Vs COVID-19: The David versus Goliath Story MAY 2021

PULSE COVID-19 Second Wave in India

EDIT NOTE www.indiamedtoday.com

Vast Human Tragedy

MAY 2021 EDITORIAL Editor Neelam Kachhap Sub-Editor Abishek Raj editorial@ indiamedtoday.com ART & PRODUCTION ScreeTract Shylesh

BOARD OF ADVISORS Dr Alexander Thomas Dr Girdhar Gyani Dr Prem Kumar Nair Dr Bhabatosh Biswas

An acute health crisis emerged in the second half of April 2021 in India, claiming countless lives. The suffering and pain were

Dr Alok Roy

brought on by the deadly second wave of COVID-19. And this

Ramesh Kannan

time the death toll was huge. Almost every day more than four

CONSULTING EDITOR Dr Libert Anil Gomes Dr Salil Choudhary

lakh new case of COVID-19 were being reported and more than 3000 were dying since the second wave hit.

We lost friends and family at an alarming rate, the pain more than what we could cope with. The industry struggled with the

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sudden onset of critically ill patients requiring ICU beds. Soon our hospitals were overwhelmed with a shortage of resources.

Doctors both seniors and juniors took to social media to ask for help.

Unprecedented, scenes of people gasping for breath among acute lack of oxygen began circulating through our phones. Desperate plea for bed, medicines and oxygen kept ringing through the day and night.

Our cover story this issue focuses on the glaring oxygen supply crunch and its effects. The story brings together experts in healthcare engineering and consultants who deliberate on the way out of the bottleneck.

Our special feature looks at the diagnostic labs that have to bear the brunt of testing with a fast-turn-around time and keeping their staff safe and secure. Experts lay out the challenges and learnings during the COVID-19 pandemic.

We also have a line-up of interesting stories related to the COVID-19 pandemic. These are aimed to help our readers to identify with and cope during these difficult times.

Do write-to us and let us know your views.

Send in your letters to editorial@indiamedtoday.com

Lingrajpuram, Bangalore 560084 www.indiamedtoday.com IndiaMedToday expressly disclaims liability for errors and omissions in this publication. While we try to keep the information timely and accurate, we make no guarantees. The views and opinions expressed in the magazine do not necessarily reflect the official policy or position of IndiaMedToday or the publication. Information on IndiaMedToday should not be used as a substitute for professional healthcare advice. Readers are advised to always seek specialist advice before acting on information contained in this publication.

Never disregard professional medicaladvice or delay in seeking it

Editor M Neelam Kachhap

because of something you have read on IndiaMedToday. No part of this publication or any part of the contents thereof may be reproduced, stored in a retrieval system or transmitted in any form without the permission of the publishers in writing.

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MAY 2021

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CONTENTS

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18

15

34

APPROACH

IMPACT

FEATURE

Lending a Helping Hand

Diagnostics Vs COVID-19: The David versus Goliath Story

Distressed Diagnostic Labs

UPFRONT

20 COVER STORY

Anatomy of Oxygen Crisis in India

03 Editorial 06 News Roundup 32 Pulse 34 Report 36 Study Report 38 Detail News www.indiamedtoday.com

CHECKIT OUT ONLINE

LETTERS World Health day

T

he World Health Day 2021, and its goal of building a fairer and healthier world, allows us to reflect on our learnings from the COVID-19 pandemic. The pandemic has taught us that a country's healthcare system is just as much a part of its critical infrastructure as the ability to supply energy, water, or food. We have learned that independent national

healthcare initiatives do not work in a worldwide crisis; we need more international cooperation. The pandemic has also shown us that healthcare will become a community task. It will require a combination of both government and private responsibility.

One of the irreversible outcomes of the pandemic is accelerated digitalization across all industries, including healthcare. The focus on collecting and harnessing the massive amount of healthcare data will make medicine more precise, ensuring the right treatment to the individual patient at the right time. Digital is emerging as the new normal in healthcare.

Dileep Mangsuli, Head, Development Center, Siemens Healthineers

If the year 2020 was appalling because of the pandemic, then

has underlined the need for a resilient health system – not as an

beginning April 2021 the skewed graph of rising number of

option, but a necessity – to provide comprehensive, accountable,

patients in the second wave is a ruthless reminder that it is far

inclusive, and affordable quality health care to all.

from being over yet. In the last one year, the perception about healthcare workers and need for augmented focus towards

Poonam Muttreja, Executive Director of Population Foundation

investment in healthcare has underlined the need for affordable

of India

and accessible care. We must all consider that health is not a privilege it is a basic right! It is up to us, how we can make a difference in the lives of the needy. The theme for World Health Day 2021 is dedicated to ‘Building a Fairer, Healthier World for

Digital technology has transformed countless sectors in the last couple of decades. It has embarked a key role in the growth and advancement of the healthcare sector as well. Technological

Everyone’ the World Health Organization (WHO) calls for urgent

innovations

action to eliminate health inequities and mobilize action to attain

equalised the relationship between healthcare providers and

better health for all and leave no one behind.

patients. It continues to foster accessible, faster, cheaper and

Dr Alok Roy – Chair FICCI Health Services Committee & Chairman Medica Group of Hospitals The focus on public health today, brought on by the COVID-19 pandemic, must be leveraged to improve access to quality health care, an essential service for all. Universal health coverage is critical and must reach the most vulnerable. This pandemic

have

brought

sustainable

healthcare

systems,

effective solutions for diseases. Hospitals are gearing up to leverage data visualisation to maximise their medical efficiencies and also to present accurate health-related findings. Visualising health data is an effective way to share crucial health information quickly.

Varun Babbar, MD, Qlik India

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NEWS ROUNDUP Apollo Hospitals releases COVID-19 Red Book The Apollo Hospitals Group has developed a ready reckoner of Best Practice Guidelines for Hospitals, Nursing Homes and Healthcare Workers during this challenging period of the COVID pandemic.

The COVID-19 Red Book summarises evidence-based best practice guidelines to support big and small healthcare institutions in making quick and timely decisions for diagnosis, treatment and management of COVID and non-COVID cases during the pandemic. The book also includes guidelines for non-clinical processes, policies, and protocols to improve efficiency and ensure a sound working environment. The guidelines will empower the healthcare institutions and the medical fraternity to react agilely to the evolving situation brought about by the second wave of the COVID pandemic.

Hospitals becomes India’s second-largest multi-speciality hospital chain. Today, the integrated organisation with the strong clinical expertise and breadth of services of Manipal Hospitals, complemented by the strengths of Columbia Asia in clinical and service quality, is uniquely placed to enhance access and address the growing demand for high quality tertiary and quaternary healthcare in the country.

Manipal Hospitals announced the successful completion of acquiring 100 per cent stake in Columbia Asia Hospitals (Columbia Asia). The transfer of ownership has taken place post the completion of all regulatory approvals. With this acquisition, Manipal

6

May 2021

data to ensure optimal use and better access to healthcare resources.

Syngene International extends research collaboration with Bristol Myers Squibb Syngene International has extended its

The acquisition helps Manipal Hospitals with a remarkable geographical and cultural fit that Columbia Asia offers to reach a larger national footprint.

ongoing

Cipla enters into a licensing agreement with MSD

discovery research conducted, including

Cipla has signed a non-exclusive licensing agreement with MSD a tradename of Merck & Co, Inc Kenilworth, NJ, USA for the manufacturing and distribution of Molnupiravir, the investigational oral antiviral drug currently being studied in a Phase 3 trial for the treatment of nonhospitalized patients with confirmed COVID-19. MSD is developing Molnupiravir in collaboration with Ridgeback Biotherapeutics. This agreement is a part of Cipla’s efforts to enhance global access to treatments for patients affected by the pandemic. As part of the agreement, Cipla will be permitted to manufacture, market and distribute Molnupiravir in India and more than 100 low and middle-income countries. Cipla’s extensive geographical and commercial footprint will help make this therapy accessible to more patients and markets.

Verraton Health’s HIMS bags NDHM approval Manipal Hospitals acquires 100 per cent stake in Columbia Asia Hospitals

digital repository of all citizen’s healthcare

National Digital Health Mission (NDHM), Ministry of Health, Government of India has approved Verraton Health to implement its proprietary Hospital Information Management System (HIMS).

The Maharashtra-based start-up is dedicated to creating an IT-based solution for the healthcare sector. Verraton Health is the fourth company among the other three from the government sector. The developed solution builds upon the government’s mission to create a massive

research

collaboration

with

Bristol Myers Squibb. The collaboration has been extended through the end of 2030 and will expand the breadth of drug chemistry, biology, drug metabolism and pharmacokinetics, as well as translational medicine research and pharmaceutical development, including chemical process development and analytical sciences, in the coming years. The extension envisions a 40 per cent increase in the number of scientists and the addition of a new 50,000 sq ft dedicated laboratory space.

Kiran Mazumdar-Shaw joins Board of Trustees of Memorial Sloan Kettering Cancer Center, US Biocon

announced

that

its

Executive

Chairperson Kiran Mazumdar-Shaw has been appointed to the Board of Trustees of Memorial Sloan Kettering Cancer Center (MSK), a world leader in cancer treatment and research, based in New York, US. She is among the 52 members on the board and will serve for a term of three years w.e.f. April 14, 2021.

Mazumdar-Shaw is the first woman of Indian nationality to be appointed for this prestigious role. Memorial Sloan Kettering is ranked as one of the top two hospitals for cancer care in the US for more than 30 years and among the nation’s top paediatric

hospitals

for

cancer

care,

according to US News & World Report.

Memorial Sloan Kettering maintains one of the world’s most dynamic programmes of cancer research, with more than 120 research laboratories that are focussed on better understanding every type of disease.

(mAbs) manufacturing facilities in India in terms of built area for a single building/ site. The first phase of the facility has been built at an investment of ~$120 million.

MSD ties up with five pharma majors in India for molnupiravir

Thermo Fisher Scientific’s Amplitude Solution

Thermo Fisher Scientific’s Amplitude Solution receives FDA nod for COVID-19 testing

COVID-19. The kit’s multi-gene target design and updated interpretive software may help labs detect SARS-CoV-2 variants.

in serving science, received emergency

Biocon Biologics facility wins ISPE’s 2021 FOYA Award

use authorization (EUA) from the US Food

Biocon Biologics has received the 2021

and Drug Administration (FDA) for Thermo

Facility of the Year Award (FOYA) from the

Fisher Scientific Amplitude Solution with

International Society for Pharmaceutical

the TaqPath COVID-19 High-Throughput

Engineering

Combo Kit. The modular solution processes

received an Honorable Mention award

samples in a four-step process requiring

for

minimum hands-on time, laboratory space

substances manufacturing facility located

and staffing resources. It was introduced

at Biocon Park, Bengaluru, a ~100-acre

as an automated real-time PCR test that

integrated complex with all infrastructure

can analyse up to 8,000 COVID-19 samples

and utilities. This is the first time that

in a single day. It empowers clinical and

a

public healthcare laboratories to scale

India has been awarded an ISPE FOYA

gold standard PCR testing with minimal

Honorable Mention. Every year, ISPE’s

staffing needs and a secured supply of

FOYA

kits, reagents and consumables to meet

the-art projects utilising new, innovative

the rising testing demands. The Amplitude

technologies to improve the quality of

Solution uses Thermo Fisher’s Applied

products, reduce the cost of producing

Biosystems

high-quality medicines and demonstrate

Thermo Fisher Scientific, the world leader

TaqPath

COVID-19

Combo

its

(ISPE).

monoclonal

biopharmaceutical

programme

The

company

antibodies

company

recognises

drugs

from

state-of-

Kit, a quick, highly sensitive multiplex

advances

diagnostic test that contains the assays

Biologics’ new 340,000-square feet B3

and controls needed for the qualitative

facility is being built in a modular manner

detection of nucleic acid from SARS-

to allow for expansion into Phase 2. This is

CoV-2, the virus responsible for causing

one of the largest monoclonal antibodies

in

project

delivery.

Biocon

Merck, known as MSD outside the US and Canada, has entered into non-exclusive voluntary licensing agreements for molnupiravir with five established Indian generics manufacturers. Molnupiravir is an investigational oral antiviral agent currently being studied in a Phase 3 trial for the treatment of non-hospitalised patients with confirmed COVID-19. Merck is developing molnupiravir in collaboration with Ridgeback Biotherapeutics. Merck has entered into these agreements to accelerate the availability of molnupiravir in India and other low- and middle-income countries (LMICs) following approvals or emergency authorization by local regulatory agencies.

Digital therapeutics startup Fitterfly nets $3.1 million Indian digital therapeutics startup Fitterfly has raised $3.1 million in a preseries A round led by Fireside Ventures.

Venture Catalysts and its accelerator fund 9Unicorns also participated in the round alongside a group of angel investors from India, the US, and Singapore, according to a statement. Fitterfly is a health-tech startup that offers therapy services and connects patients with health coaches and healthcare providers through voice and digital touchpoints. Its current suite of products includes programmes that address diabetes, PCOS, obesity, pregnancy, and child wellness.

Oxford scientists develop promising malaria shot A potential new malaria vaccine has proved highly effective in a trial in babies in Africa, pointing to it one day possibly helping reduce the death toll from the mosquito-borne disease that kills up to half a million young children a year. The candidate vaccine, developed by scientists

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7

NEWS ROUNDUP at Britain’s University of Oxford and called R21/Matrix-M, showed up to 77 per cent efficacy in the year-long trial of 450 children in Burkina Faso, researchers leading the trial said in a statement.

wave

The scientists, led by Adrian Hill, director of Oxford’s Jenner Institute and also one of the lead researchers behind the OxfordAstraZeneca COVID-19 vaccine said they now plan to conduct final stage trials in some 4,800 children aged between 5months and 3 years in four African Countries.

Facemasks have (or must) become a default

IIT Mandi researchers develop anti-bacterial, self-cleaning material for face masks, PPE equipment

the case of reusable masks, which are a

Indian Institute of Technology Mandi researchers have developed a virusfiltering, self-cleaning and antibacterial material that can be used to make face masks and other PPE equipment. This path-breaking development of Dr Amit Jaiswal, Assistant Professor, School of Basic Sciences, IIT Mandi, along with his research scholars, Praveen Kumar, Shounak Roy and Ankita Sarkar comes at a time in which it has become imperative to develop techniques to stop the second

of

the

COVID-19

pandemic

in

the country. Results of this work have recently been published in the journal of the American Chemical Society – Applied Materials & Interfaces.

piece of apparel to be worn in public in these pandemic times. They are largely designed to act as a physical barrier between the wearer and the external environment, but in reality, must also act as anti-microbial agents to inhibit or kill pathogens. This is especially important in necessary alternative to single-use masks that add to littering and pollution issues, and secondary infections.

IIT Kharagpur commercialises COVIRAP IIT

Kharagpur

commercialised

its

has flagship

successfully healthcare

product – COVIRAP – the novel diagnostic technology to zero in on infectious diseases including COVID-19, the institute said. The product, developed by lead researchers Professor Suman Chakraborty, Dr Arindam Mondal and their research group, has been licensed for commercialisation to the Rapid Diagnostic Group of Companies, India and Bramerton Holdings LLC, USA.

Zydus Cadila’s Virafin gets DCGI’s nod for COVID-19 treatment Zydus Cadila has received restricted emergency use approval from the Drug Controller General of India (DCGI) to use the antiviral drug Virafin for the treatment of moderate COVID-19 infections. A single dose subcutaneous regimen of the antiviral drug will make treatment of COVID-19 disease more convenient. In its regulatory filing, the company said, “When administered early on during COVID, Virafin will help patients recover faster and avoid much of the complications. Virafin will be available on the prescription of medical specialist for use in hospital/institutional setup.”

Meitra Hospital collaborates with MGM Healthcare Meitra Hospital has collaborated with Chennai-based MGM Healthcare to set up comprehensive heart and lung as well as liver transplant programmes. Faizal E Kottikollon, Chairman, Meitra Hospital and Dr KR Balakrishnan, Director at Institute of Heart & Lung Transplant & Mechanical Circulatory Support at MGM Healthcare and Dr Thiagarajan Srinivasan, Director,

Dr Amit Jaiswal, Assistant Professor, School of Basic Sciences, IIT Mandi, Praveen Kumar, Shounak Roy and Ankita Sarkar

8

May 2021

Team of medical experts Institute of Liver Diseases, Transplant & HPB Surgery, MGM Healthcare signed the Memorandum of Understanding (MoU).

Dr Ali Faizal, Director, Meitra Hospital and Harish Manian, CEO, MGM Healthcare were present at the MoU signing ceremonies.

Through the heart and lung transplant programme, Meitra Hospital aims to advance its reputed Centre of Excellence for Heart and vascular care by offering heart and lung transplants, mechanical circulatory support devices for failing hearts and single lung retrieval and transplant. The transplant programme will be led by an expert team that does the highest number of heart and lung transplants in Asia.

Barco India partners with Sigma – Jones AV Barco, a market leader in visualisation and collaboration technology, announced its partnership with Sigma – Jones AV to deliver best-in-class digital experiences in healthcare for its next-gen operating room video integration solution Nexxis.

Barco leverages Nexxis, its video-overIP platform for digital integration in the operating room to deliver precise imagery, efficient workflow, and maximise flexibility across the increasingly complex Operating Room (OR) procedures globally.

Jones AV is one of the most successful Barco Nexxis partners to have developed a tried and tested Nexxis platform.

Featuring one of the largest install bases and some of the most complex and innovative solutions for fully integrated state-of-the-art operating theatres across Europe, Sigma AVIT is one of India’s leading premium Corporate AV System integrators and has a pan Indian network of offices and engineers. The synergies in Sigma – Jones AV add value to hospitals by bringing the longstanding experience in operating theatre integration from Europe with an unparalleled service network and local experience.

mental-health digital platform MANAS

SpiceXpress signs agreement with B Medical Systems

national digital wellbeing platform and

SpiceXpress, the cargo arm of SpiceJet airline, signed an agreement with Luxembourg-based B Medical Systems for safe, reliable and temperature-controlled transportation of COVID-19 vaccine across India. With an aim to expand the basket of COVID-19 vaccines and enhance the pace of inoculation in India, the central government had announced fast-track emergency approval for foreign-produced jabs that have been granted similar clearances in other countries.

The government’s move is significant as it may make available several vaccines, including those made by Pfizer, Moderna and Johnson & Johnson, in India with certain conditions.

Govt launches community

The Principal Scientific Adviser to the Government of India Prof K Vijay Raghavan virtually launched the MANAS App to promote wellbeing across age groups.

MANAS which stands for Mental Health and Normalcy Augmentation System was endorsed as a national programme by the Prime Minister’s Science, Technology, and Innovation Advisory Council (PM-STIAC).

MANAS is a comprehensive, scalable, and an app developed to augment the mental well-being of

Indian citizens. MANAS

App integrates the health and wellness efforts of various government ministries, scientifically validated indigenous tools with

gamified

interfaces

developed/

researched by various national bodies and research institutions.

MANAS was initiated by the Office of the Principal Scientific Adviser to the Government

of

India.

It

was

jointly

executed by NIMHANS Bengaluru, AFMC Pune and C-DAC Bengaluru.

CSIR-CMERI develops oxygen enrichment technology CSIR-CMERI

has

developed

‘Oxygen

Enrichment’ technology which has been transferred virtually to Apollo Computing Laboratories,

Kushaiguda,

Hyderabad.

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9

NEWS ROUNDUP

(Right) Prof (Dr) Harish Hirani, Director, CSIR-CMERI On this occasion, Prof (Dr) Harish Hirani,

state-of-the-art cancer care centre and a

Director,

the

palliative care centre in Bhubaneswar. The

unit requires easily available oil-free

first MoU was signed for Bagchi-Sri Shankar

reciprocating compressor, oxygen grade

Cancer Centre and Research Institute by

zeolite sieves and pneumatic components.

the state government, Susmita Bagchi and

It is capable of delivering medical air in the

Shri Shankar Cancer Foundation. The MoUs

range of up to 15 LPM with oxygen purity

were signed in presence of Chief Minister

of more than 90 per cent. If required, this

Naveen Patnaik. The centre will provide a

unit can even deliver up to 70 LPM at a

global standard cancer treatment facility

purity of around 30 per cent and can safely

to people in Odisha and from the eastern

be placed in the isolation ward of the

region of the country.

CSIR-CMERI

said

that

hospital for patients who are in dire need of oxygen. This will help the accessibility of oxygen in the remotest places and widest points of need. The outreach factor of oxygen will be multiplied through the adoption of this in-situ and decentralised generation of oxygen.

The second MoU was inked for BagchiKarunashraya Palliative Care Centre by the state government, Susmita Bagchi and Karunashraya Hospice Trust. The centre will provide high-quality palliative care, peace and dignity to patients in their last few days.

He also added that further research is

inhalation only. This mode is supposed to

West expands partnership with Venus Remedies

reduce the oxygen demand by around 50

West Pharmaceutical Services (West), a

per cent when compared with the current

global leader in innovative solutions for

version of continuous mode.

injectable drug administration, recently

Odisha signs MoUs for cancer hospital and palliative care centre

announced its partnership with domestic

going on to develop a pulse dose mode that is capable of sensing the breathing pattern of a patient and then deliver during the

The

signed

brand

Cloti-Xa

has

made

its

introduction in the growing low molecular weight heparin market and has adopted the NovaGuard SA Pro safety system,

Memorandums of Understanding for a

a single-use accessory for prefilled ISO

May 2021

government

whose

two

10

Odisha

Indian pharma company Venus Remedies

standard 1mL long staked-needle syringes.

The NovaGuard SA Pro safety system is a product with innovative safety features that help protect healthcare workers and patients from accidental needlestick injuries.

Several biopharmaceutical manufacturers have commented that this product delivers a compelling total cost of ownership in that it prevents preactivation, offers a lower syringe snap-in force and a lower activation force for enduser comfort, and mitigates the practice of recapping which helps to provide tamper evidence to customers.

Renowned radiologist Dr Kakarla Subba Rao passes away Renowned radiologist and former Director of Nizam’s Institute of Medical Sciences in Hyderabad Dr Kakarla Subba Rao passed away while undergoing treatment at Krishna Institute of Medical Sciences (KIMS), Secunderabad recently. Dr Rao, 96, was admitted to KIMS a month ago with age-related health complications.

Known for his efforts to transform NIMS into a super-speciality hospital, Dr Rao was its first director between 1985 and 1990 and later between 1997 and 2004, before retiring.

Born on January 25, 1925, in a middle-

current and future programmes and foster innovation and entrepreneurship across healthcare and agri sectors.

Lumos selects startups in early cancer detection and advanced cancer prognostics Lumos,

a

healthcare

programme,

speed

announced

the

scaling addition

of Onward Assist and ErlySign to its speed scaling programme. The startups were selected after a careful evaluation Dr Kakarla Subba Rao

of

their

technological

strengths

and

business capabilities. Lumos will provide

class agricultural family at Pedamuttevi, a small village in Krishna district, Dr Rao completed his MBBS from Andhra Medical College in 1950 and did his Residency in the US. He was a Professor of Radiology at Albert Einstein College of Medicine, New York, before returning to India in 1985-86.

clinical, technical and business advisory

Juniper Biologics appoints Raman Singh as CEO

advisory services. They have partnered

Singapore-headquartered Juniper Biologics, a science-led healthcare company focusing on researching, developing and commercialising novel therapies, has announced the appointment of celebrated pharmaceutical executive Raman Singh to the role of Chief Executive. Juniper Biologics will be focused on researching, developing and commercialising innovative medications in the areas of oncology, Rare/Orphan Diseases and gene therapy. The company is headquartered in Singapore.

enable startups to hit impressive growth

to help the startups scale and will offer infrastructure

credits

to

help

defray

certain operating expenses. Lumos is a speed scaling ecosystem that helps earlystage healthcare startups grow through timely and powerful business and technical with

premier

healthcare

organisations

to provide valuable mentoring, advisory and business development services to trajectories. The existing repertoire of companies under Lumos are Kronikare, AyuRythm, Alixir, and Raybaby continue to grow with the numerous speed scaling capabilities offered by Lumos.

SIRO Clinpharm partners with ACROSS Global Alliance SIRO Clinpharm has partnered with ACROSS Global Alliance (ACROSS) and will help represent India in working towards the common goals and objectives of ACROSS in bridging a gap in the pharmaceutical service provider market. ACROSS is a global alliance of clinical research organizations (CRO’s) also known as Partners along with special service providers known as Qualified Vendors. The partners form the core of the ACROSS organization. SIRO Clinpharm will have the opportunity to provide its core services and expertise in India’s geography.

National Autism Helpline launched in India The National Autism Helpline number has been launched in India. Parents, family members of autistic children can dial India’s National Autism Helpline 9100 181 181 to get free professional guidance, assistance on autism. They can receive free professional advice from expert doctors or therapists regarding their children’s physical growth, behavioural and developmental changes, healthwellness issues and find useful solutions to manage them. This would help the lives of autistic kids better with further inclusion in schools and society at large.

Atal Innovation Mission collaborates with Bayer Government think-tank Niti Aayog’s Atal Innovation Mission (AIM) and German drug and agrochemicals major Bayer partnered to work towards fostering innovation and entrepreneurship across agriculture and healthcare sectors, a statement said.

A Statement of Intent (SOI) of strategic partnership between AIM and Bayer was signed. Under the SOI, Bayer will collaborate with AIM to support their

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11

NEWS ROUNDUP APACMed announces new Executive Committee in India The

Asia

Pacific

Medical

Technology

Association (APACMed) has announced its new Executive Committee (ExCo) in India. The India ExCo appointments are Pavan Mocherla, MD, Becton Dickinson India, South Asia, as the Chairperson, Meenakshi Nevatia, MD, Stryker India as Vice-Chairperson and Narendra Varde, MD, Roche India & Neighbouring Markets as Vice-Chairperson.

Commenting on the new appointments of

the

India

ExCo,

Harjit

Gill,

CEO,

APACMed said, “We are in a period of transformational

change

within

the

healthcare ecosystem, and are delighted to have MedTech industry leaders step forward to contribute and steer India’s healthcare infrastructure and delivery of care through innovative collaborations and engagements with key stakeholders in the system.”

Mocherla is the Managing Director of BD where he is closely involved in giving a strategic direction to the organisation’s South Asia operations. Nevatia brings over 20 years of healthcare experience. In her current role as the Managing Director of Stryker, India, Meenakshi is responsible for building Stryker’s business strategy.

Varde is the Managing Director for Roche Diagnostics India and Neighboring Markets.

Hester signs agreement with ICAR – IVRI Hester has signed two agreements with ICAR-IVRI (Indian Council of Agricultural Research – Indian Veterinary Research Institute), for acquiring technologies for the production and commercialisation of the following vaccines: Classical Swine Fever Vaccine and Sheep Pox Vaccine.

May 2021

Practo has introduced vernacular language options for its teleconsultation service.

This initiative will allow online consultation users to choose a doctor who can speak in their preferred language. Currently, this service covers 15 languages – including

These vaccines are the first that have been developed within the country by using locally isolated strains, a step towards making India self-sufficient, Atmanirbhar, for the country’s requirement of Classical Swine Fever Vaccine and Sheep Pox Vaccine.

Hindi, Marathi, Tamil, Kannada and Bengali

The agreements followed with a virtual ceremony that took place on April 7, 2021. The technologies were developed

by ICAR-IVRI and the commercialization of the technologies was facilitated by Agrinnovate India, a company owned by the Department of Agricultural, Research & Education (DARE), Ministry of Agriculture, Government of India.

was launched as a pilot project earlier this

Both the vaccines have been extensively tested by IVRI for safety and potency and have been found to provide 100 per cent protection.

Classical Swine Fever Vaccine has been found to induce protective immunity up to 24 months. Sheep Pox Vaccine has been found to induce protective immunity up to 48 months. The vaccines hope to prevent economic losses in swine and sheep farming in India.

Meenakshi Nevatia, Pavan Mocherla & Narendra Varde

12

Practo launches online consultations in 15 vernacular languages

– with more to be added soon. With this, Practo is one step closer to breaking down access barriers for 200 million unique users in the future.

After receiving lakhs of user requests for language-specific features on Practo, this year, with Hindi as the alternate option for users to choose from.

During this time, 25 per cent of all online consultations on Practo were conducted in vernacular languages, with Hindi, Tamil, Marathi, and Kannada (in that order) emerging as their preferred language(s) for consultation. Around 67 per cent of all vernacular consultations were from users living in non-metro cities. Remarkably, 65 per cent of all vernacular consults were from users aged 60 and above.

Medtronic Engineering and Innovation Centre opens in Hyderabad Medtronic announced the inauguration of its newly expanded state-of-the-art

The inauguration ceremony Medtronic Engineering and Innovation Center (MEIC) in Hyderabad. The research and development facility was inaugurated

by KT Rama Rao, Minister for Municipal Administration and Urban Development, Industries & Commerce, and Information Technology and his team of officials from the Government of Telangana.

The 150,000 square feet centre employs engineers currently in the areas of software development and testing, test automation, mechanical design, analysis and hardware.

With this expansion, MEIC aims to leverage the sizeable pool of diverse and skilled talent in India to continue its pioneering work in the medical technology space and add further to Medtronic’s 150+ patents and 400+ IP disclosures globally that MEIC has been a part of.

J Mitra launches COVID-19 neutralising antibody test kit J Mitra & Company has launched India’s first COVID-19 Neutralizing Antibody Microlisa Elisa Test. The test kit has cleared all government parameters and received all necessary approvals, including Drug Controller General of India

(DCGI) and successful product validation.

Virus neutralisation remains the gold standard for determining antibody efficacy. COVID-19 Neutralizing Antibody Microlisa Elisa Test is the first commercial laboratory test to detect neutralising antibodies against SARS-CoV-2, the virus that causes COVID-19. The test kit will help to highlight the efficacy of the vaccines on the human body and the development of the antibodies to fight the virus and help identify potential plasma donors. The test kit has high sensitivity (> 95 per cent) and Specificity (100 per cent).

The test identifies individuals who have had recent or prior infection with SARSCoV-2. Detection of neutralising antibodies helps us identify its significance for patients as we continue the fight against COVID-19.

Dr Harsh Vardhan launches IHIP The Union Minister of Health & Family Welfare, Dr Harsh Vardhan virtually launched the Integrated Health Information Platform (IHIP) in New Delhi, in the presence of Ashwini Kumar Choubey, Minister of State for Health and

Family Welfare. Chief Minister Shri Tirath Singh Rawat (Uttarkhand) was also present digitally. The IHIP is the next generation highly refined version of the presently used Integrated Disease Surveillance Programme (IDSP). The virtual event was attended by health ministers of various states including Balbir Singh Sidhu (Punjab), Alexander Laloo Hek (Meghalaya), Dr K Sudhakar (Karnataka), Dr Prabhuram Choudhary (Madhya Pradesh), Jai Pratap Singh (Uttar Pradesh), Etela Rajendra (Telangana), TS Singh Deo (Chhattisgarh), Dr R Lalthangliana (Mizoram) and S Pangnyu Phom (Nagaland).

Piramal acquires Hemmo Pharma for Rs775 crore Piramal Pharma’s Contract Development and Manufacturing Organization (CDMO), Piramal Pharma Solutions (PPS), has agreed to acquire a 100 per cent stake in Hemmo Pharmaceuticals for an upfront consideration of Rs 775 crores and earn-outs linked to the achievement of milestones.

Hemmo is one of India’s largest manufacturers of synthetic peptides with a legacy of more than 38 years in

www.indiamedtoday.com

13

NEWS ROUNDUP business supplying peptide products and custom peptide synthesis. Hemmo has R&D capabilities and a world-class GMP manufacturing facility that has been inspected and deemed compliant by the US, the EU and Asian regulatory agencies.

The company has strong expertise in both solution-phase and solid-phase synthesis of peptides, the announcement said.

Siemens Healthineers announces upcoming ‘Innovation Hub’ in Bengaluru Siemens Healthineers announced the winner of their architecture competition for the upcoming ‘Innovation Hub’ in Bengaluru. The company invited six architecture firms to participate in a contest to design a campus that combines the existing research and development centre and a state-of-the-

art manufacturing facility for entry-level medical imaging products. The campus will also house the Indian sales headquarters and is to be set up over the next five years with an investment of Rs 1,300 crores.

Fortis Healthcare appoints Joerg Ayrle as additional director Fortis Healthcare said its board has approved the appointment of Joerg Ayrle as an additional director (non-executive) of the company, with immediate effect. He was appointed as the group chief financial officer (CFO) of IHH Healthcare Berhad on February 1, 2021, Fortis Healthcare said in a filing to the BSE. With a wealth of international experience from the US, Germany, Singapore, China and Thailand, he will be responsible for providing financial leadership and strategic guidance for IHH and its operations and

‘Innovation Hub’ Siemens Healthineers, Bangalore

14

May 2021

Joerg Ayrle the business plan development, it added.

Before joining IHH, Ayrle was the group CFO of Thai Union Group and steered the company’s financial transformation journey, the filing said.

APPROACH

Lending a Helping Hand How Corporates to NGOs and even small startups are assisting in the fight against COVID-19

about people dying on roads gasping for oxygen while their relatives made a frantic effort to locate oxygen cylinders.

Though the government tried its best it was too little and too late and the entire country was reeling under a catastrophe. Though foreign countries chipped in with BiPAP machines, oxygen concentrators

(OC),

the

distribution

mechanism was a major hurdle for the administration of various states.

This is where NGOs, individuals and organisations joined hands with the ministry to help the needy with COVID relief materials. Even special mention can be made of several crowd funding initiatives by startups and NGOs who have come forward to fight the deadly pandemic.

Initiatives by organisations • Recently India did manage to overcome the

the

Indian

start-up

community joined hands to set up

first wave of COVID-19 pandemic with

ACT Grants to help the country face

stringent measures in place. However,

the crisis. Amazon India tied up with

the

everyone

ACT Grants, Temasek Foundation, Pune

unaware and it dealt a death blow

Platform for COVID-19 Response (PPCR)

to the people with the healthcare

and other partners to airlift over 8,000

infrastructure totally overburdened and

oxygen concentrators and 500 BiPAP

collapsed. The country already grappling

machines from Singapore.

for better infrastructure saw a surge in

• Food

second

wave

caught

oxygen demand besides shortage of medicines and vaccines.

delivery

and

restaurant

aggregator Zomato has rolled out a new feature on Apple and Android devices

The second wave has seen a sudden

to enable users to mark food orders as

demand of oxygen as the mutant

‘COVID-19 emergency’. It has partnered

virus turned out to be more fatal than

with logistics firm Delhivery to address

previous occasions. There were news

the acute medical oxygen shortage.

www.indiamedtoday.com

15

APPROACH •

Paytm under the #OxygenForIndia

providing

cash

Concentrators (OCs) and for the same

COVID-19 crisis. GiveIndia has ramped

the company has already raised Rs 5

its effort to help people suffering from

crore from citizens for the initiative and

the

has matched rupee for rupee making

fund has been re-initiated to provide

it Rs 10 crore. The Paytm Foundation

life-saving equipment such as oxygen

is

start-ups,

concentrators and cylinder, help with

organisations and enterprises to source

supplies of N95 Masks, PPE Kits, 3ply

OCs from the international market.

masks, bedsheets, hand sanitisers and

also

app,

21,000

supporting

has

campaign

other

App,

the

telemedicine

started

a

crowdfunding

across

several

platforms

pandemic.

The

covid

response

other resources for critical patients and healthcare workers at hospitals and Covid care centres.

to help hospitals across the country

•

get

oxygen

to donate food to families struggling

concentrators. Swasth along with ACT

with hunger in COVID-19's second wave

Grants have launched a website called

and help women in need to have a

liferesources.in.

hygienic menstrual cycle by providing

immediate

• Similarly, Hemkunt

access

to

Gurgaon-based

Foundation

is

NGO

distributing

oxygen cylinders to COVID-19 patients through its network of volunteers. The NGO has supplied more than 1,000 oxygen cylinders to needy patients. It

May 2021

is

assistance to families hit hardest by

airlifted

• Swasth

16

• GiveIndia

Oxygen

initiative

The funds raised will be allocated

them with reusable sanitary napkins.

GiveIndia's COVID funds will also be used to increase the vaccination and testing capacity across the country, in addition to providing cash relief for the families of the deceased.

has also started a 'drive thru' scheme

• Additionally,

for patients to come to their office and

brands like Google, Flipkart, Amazon

corporations

and

inhale oxygen from the cylinders free-

have also partnered with GiveIndia to

of-cost.

provide cash assistance to families hit

hardest by the crisis to help with their everyday expenses.

•

• NGO Milaap is running food support programmes to covid patients across Delhi where 1000 food packets are being provided to the homeless people daily. Democracy People Foundation’s self-funded mission called 'Mission Oxygen' help hospitals across the country get immediate access to oxygen concentrators. As the demand grew, the NGO has now launched a crowdfunding initiative on Ketto to raise Rs 5 crore for the cause.

and Medium sized Enterprises) have

• KVN Foundation has launched Mission Million Air and is working to supply free oxygen concentrators to the needy until they find a hospital bed, get access to doctors, or recover completely. Starting in Bengaluru and Mumbai, the initiative plans to add more cities as they work to procure oxygen concentrators in bulk.

by individually entering different PIN

• Homegrown mapping platform MapMyIndia is working to make it easier to track vehicles carrying oxygen, vaccines and other medical infrastructure transport. Free GPS tracking systems will be installed in such vehicles in the country.

and critical medical equipment, provide

• Jeeva Rakshak Foundation, a nonprofit organisation, has joined hands with VMEDO, specialists in emergency healthcare services primarily ambulance services.

cylinders and concentrators.

FICCI, and its partner association

BVMW (German Association of Small extended their support by successfully procuring 1500 oxygen concentrators for

private

entities

in

the

Indian

Healthcare industry, to combat the current crisis.

•

Adding to it, Paytm announced the

launch of COVID-19 Vaccine Finder on its Mini App store. The platform helps citizens to check the availability of vaccination slots for a specific date codes or district details along with age group (18+ or 45+).

•

Recently, Wells Fargo & Company

has committed more than $3 million (Rs 25 crores) through non-governmental organisations

to

increase

hospital

capacity, supply oxygen concentrators emergency transportation, and support healthcare workers.

• HealthCube under the initiative called OxygenForIndia will now enable the distribution of medical oxygen

Contribution

from

organisations

in

large numbers will help India fight the pandemic in a new way.

www.indiamedtoday.com

17

IMPACT

Diagnostics Vs COVID-19: The David versus Goliath Story Insight into the contribution made by the Indian diagnostics industry amidst the COVID-19 pandemic

The year 2020 has been tumultuous for the healthcare industry across the world on account of the corona pandemic. And if that wasn’t enough, the second wave of COVID-19 has had a devastating effect on the healthcare industry in general, and the diagnostics industry in particular.

The First Wave Story

Jatin Mahajan, Managing Director, J Mitra & Company

18

May 2021

When corona hit us in December 2019-January2020, the world had no idea about the disease. But the Indian diagnostics industry was quick to rise to the occasion and develop tests based on different technologies – Antibody tests, antigen tests, RT-PCR tests, amongst others. This was remarkable, especially in the backdrop of a scenario where foreign-made tests were drawing a lot of flak on account of their accuracy and sensitivity. India’s strategy to combat COVID-19 was — Test-Track-Treat. These locally developed test kits did a real yeoman service when there was a real scarcity of test kits in the market, and India was finding it difficult to attain the testing momentum that was required to counter the threat of COVID-19. The Indian test kit manufacturers, driven by their extensive R&D, were quick to

• The masses became extremely complacent, especially after the launch of the two vaccines in India. People assumed that the worst is over, and disregarded all caution and standard operating procedures related to masks, social distancing and avoiding crowded areas and possible infections. People adopted a lifestyle like what they had been practising in October-November 2019 before the pandemic • The central and state governments ruefully misjudged their preparedness and the impact of the mutated virus.

The restrictions were imposed too less, and too late, and this led to the massive spread of the virus and more and more people getting affected.

come up with extremely potent test solutions in all the above-mentioned technologies. It was this quick and effective action of the Indian diagnostics manufacturers that arrested the spread of the coronavirus in the country.

And most of these test solutions were much better on various parameters as compared to their foreign counterparts.

Most Indian COVID-19 test kit manufacturers were dependent on foreign suppliers for their raw materials, and thus production was severely impacted. But the Indian manufacturers quickly figured out alternate sources for the raw material to mitigate the loss of production.

India’s delivery of the diagnostics story is also a remarkable one and an example of leadership and planning at various levels of the diagnostics and policy ecosystem. Both the government and the private sector came together to effectively tackle the pandemic.

The government ensured that all tests were Aadhaar-linked, and thus properly traceable – thus ensuring proper management of COVID-19 positive patients. The hospitals and diagnostic chains came forward very effectively

to ensure that all precautions were taken to mitigate risks and at the same time provide an environment for quick, convenient, effective and in many cases door-step collection of sample and online reportage – enabling more and more people to come forward and get tested as and when they demonstrated covid-like symptoms. While everything may have seemed very normal to the end-users, the effective mechanism of collection, timely submission to the laboratories (especially in the case of central lab systems), testing and reportage was perfected to an art.

The second Wave and its Aftermath

But the diagnostics industry has risen to the challenge, and all diagnostics teams are working overtime and multiple shifts to cater to the increased testing demands. There are currently no numbers available to provide a clear indication of the increased percentage, but I probably would not be wrong if I say that they have increased 10 times what it was in February. There are lines outside testing laboratories, and there is a wait time of three to four days just to get yourself tested. In many cases, the test results are being delayed for a couple of days because there are not enough machines and technically qualified staff to cater for this unimaginable demand. But this failing is not of the diagnostics industry because these are unprecedented and unimaginable demands, and the faults lie elsewhere.

The 2nd wave of the corona pandemic in India paints a very sordid story of the overall scenario in India. We were completely caught unaware and unprepared to handle the situation as a country. We failed on three major counts

COVID-19 testing is being accorded priority over all other diagnostics to ensure that test results are provided at the earliest, both to dispel anxiety in case of a negative report and to mitigate chances of further spreading in the case of positive reports.

• We were completely unaware and unprepared for the second wave. As a country, we did not see the mutated virus spreading until it was too late and massive damage and loss of lives had already taken place

The Indian diagnostics segment has truly demonstrated sheer leadership in tackling the corona pandemic and bringing diagnostics to the very forefront of the fight against the pandemic.

www.indiamedtoday.com

19

COVERSTORY

Anatomy of Oxygen Crisis in India

Exploring the extent and cause of oxygen crisis that led to avoidabledeath toll during the second COVID-19 wave in India M Neelam Kachhap 20

May 2021

O

n April 21, 2021, India woke up to an unprecedented scene. A 67-year-old doyen of medical institute in Delhi had lost 25 critically ill patients due to oxygen shortage. Shortly after, other hospitals in Delhi also sent out SOS for oxygen as they did not have enough supply to help their patients. In the following days, reports of

patients dying due to a shortage of oxygen emerged from different parts of India.

Many PILs were filed at different high courts asking the government to expedite the supply of oxygen to hospitals.

Long queues of empty cylinders and people waiting outside hospitals flash across TV screens every day, bringing to light, the lack of facilities and the glaring gaps in governments preparedness to tackle the pandemic.

The second wave of COVID-19 has crippled the existing healthcare infrastructure and indented the hospitals and healthcare workers in India. The avoidable death due to the shortage of Liquid Medical Oxygen (LMO) has been one of the most discerning pictures during this second wave of the pandemic.

Second Set-back India has been hit hard with the second wave of COVID-19 pandemic- a covid storm. The WHO said that the situation in India is beyond heartbreaking. “Globally, the COVID-19 pandemic continues to intensify. To put it in perspective, there were almost as many cases globally last week as in the first five months of the

www.indiamedtoday.com

21

COVERSTORY

pandemic. Many countries are still

Dr Balakrishna GK, HOD & Senior

experiencing

transmission,

Consultant - Internal Medicine, BGS

and the situation in India is beyond

Gleneagles Global Hospital said, “The

heart-breaking,” Dr Tedros Adhanom

current

Ghebreyesus,

is highly virulent, which is rapidly

intense

Director-General,

WHO

said during a press briefing.

“The LMO cylinders are cheaper and provide good quality oxygen, with a steady supply,” Sameer Mehta, Director – Projects, Hosmac India

What is more discerning is the number

highest single-day cases of COVID-19.

The data sourced from covid19india. org, an independent aggregator of daily figures from state health departments showed more than four lakh cases and 3,464 new deaths on the day.

of patients requiring oxygen support. to

the

National

Clinical

COVID-19 Registry 54.5 per cent or more than one out of two people admitted in hospitals, need oxygen support during the second COVID-19 wave as compared to 41.5 per cent in

22

May 2021

with

mutant

strains

spreading to a larger population, at

On April 30, 2021, India recorded the

According

wave

once. In addition, 1-2 per cent of these patients develop SARS (Severe Acute Respiratory Syndrome COV 2).

An unexpected sudden increase in the number of cases with limited availability of infrastructure is the main reason for increased demand for oxygen.”

He said that the current wave with mutant strains has severely affected a large number of the younger population.

“In the first wave, timely preventive measures helped, to a certain extent, in reducing the burden of oxygen support,” he adds.

the first wave. Oxygen continues to be

Procuring oxygen

a critical factor in the management of

There are two ways in which oxygen

COVID-19 during the second wave.

is supplied to the patients. One is an

onsite-oxygen concentrator at hospitals

“Currently, we are not facing an oxygen

that filters atmospheric oxygen and

shortage at any of our Aster Hospitals.

collects it in tanks for the hospital to

We are working closely with the district

use later. Second, is the more popular

and state administration and monitoring

and prevalent practice of hiring high-

the situation in real-time, and all help is

pressure LMO cylinders. “The LMO

being provided by the state authorities,”

cylinders are cheaper and provide good

an Aster DM Healthcare spokesperson

quality oxygen, with a steady supply,”

said.

says Sameer Mehta, Director – Projects, Hosmac India. Mehta, an expert in

“Generally, you will find a very tall

“The situation in India is beyond heartbreaking,”

medical

and

white tank connected to pipes at the

engineering has worked on more than

bottom and surrounded by a fence

500 hospital projects across India.

around the back of the hospital. This

“If the hospital is in a remote area,

Dr Tedros Adhanom Ghebreyesus, Director-General, WHO

Ideally, a hospital is required to have a

where LMO supply is not available then

minimum of one day’s supply on hand

we recommend oxygen concentrators,”

and one normal day’s back up supply

Mehta adds. He further explains that

in case the main system fails to sustain

there has never been a challenge with

their patients giving them time to fix

LMO before as hospitals map their

or replace the primary oxygen supply,”

consumption requirements and vendors

explains Ayanabh Debgupta, Co-founder

refill or replace cylinders conveniently.

& Group President, Medica Hospitals.

planning,

architecture

tank contains tonnes of liquid oxygen.

Aster

Hospitals,

a

group

of

large

corporate hospitals in South India has

e

said that it has managed the situation

specialised equipment and checks that

further

explains

that

there

so far.

need to be in place for the consumption

www.indiamedtoday.com

are

23

COVERSTORY of LMO at hospitals. “Liquid oxygen

pronounced

boils at normal temperatures, that’s why

compared to last year consumption of

it is always transported in cryogenic

oxygen is higher at hospitals. We have

tanks and cylinders. Oxygen is highly

never seen a situation like this before

inflammable so transporting the gas is

where hospitals had to send out SOS for

very challenging,” says Debgupta.

oxygen. This is unprecedented,” Mehta

When oxygen is at room temperature the

gaseous

phase

is

piped

at

a

regulated pressure into the hospital building where it is measured and the pressure regulated before being piped throughout the building. At the entry point, there must be a shut-off valve and a pressure sensing alarm, he says.

this

time

around.

As

laments.

Short-sighted Management Five days before the oxygen crisis became

catastrophic

in

late

April

2021, the Empowered Group 2 (EG2, a group formed by the PMO comprising

also

officials from different ministries and

specialised. “Oxygen follows through

experts), met to review the availability

a special kind of copper pipe that has

of essential medical equipment and

to be brazed together in a nitrogen

oxygen. According to a release from

atmosphere. These oxygen pipes in the

the Health Ministry, they discussed the

walls and ceilings of the hospital deliver

rising demand for oxygen and were

The

pipeline

for

oxygen

is

pure hydrated oxygen to the outlets on the wall near each bed. Before the oxygen gets to those outlets it is valved, gauged and alarmed one or two more times,” Debgupta explains.

Use of LMO Talking about the use of LMO at hospitals Mehta says, “Commonly, use of oxygen is minimal at hospitals, around 5-6 litres per min per bed, but not all beds use oxygen at the same time. If 10 per cent of non-critical care beds in a 100-bed hospital are using oxygen then one can estimate about 50-60l per min per bed.”

The use of oxygen at hospitals has surged

due

to

the

unprecedented

number of patients admitting with the disease that requires management with oxygen. “In mid-march, we had five Covid-19 patients. However, in April 2021 almost all our beds, 250 of them were full and we had patients waiting outside for beds,” Debgupta explains.

“Criticality of the disease is more

24

May 2021

“In mid-march, we had five Covid-19 patients; by April 2021 almost all our beds, 250 of them were full and we had patients waiting outside for beds” Ayanabh Debgupta, Co-founder & Group President, Medica Hospitals

“An unexpected sudden increase in the number of cases with limited availability of infrastructure is the main reason for increased demand for oxygen.”

Dr Balakrishna GK, HOD & Senior Consultant - Internal Medicine, BGS Gleneagles Global Hospital

aware of the increasing demand for

capacity. “Along with the ramped up

medical oxygen, especially from the

production of the oxygen manufacturing

12 states with a high burden of active

units and the surplus stocks available

COVID cases– Maharashtra, Madhya

(50,000 MTs), the present availability of

Pradesh, Gujarat, Uttar Pradesh, Delhi,

oxygen is sufficient,” said a ministry of

Chhattisgarh, Karnataka, Kerala, Tamil

the health press release. However, they

Nadu, Punjab, Haryana and Rajasthan.

were proved to be wrong.

While the demand in Maharashtra was not expected to go beyond the available production capacity of the state, states like Madhya Pradesh did not have any production capacity to meet their demand for medical oxygen, the group noted.

According to official figures, India has a daily production capacity of 7127 MT of oxygen per day. On 12, April 2021, the medical oxygen consumption in the country was 3842 MTs, which was only 54 per cent of the daily production

The Hindu reported that six people died at a private hospital, Neelkanth at Amritsar, Punjab when they did not receive proper oxygen. In another incident, at least 24 COVID-19 patients in Nashik city died when the hospital’s oxygen supply ran out because a tanker refilling it suffered a leak and had to be shut for maintenance. 25 patients at Delhi’s Jaipur Golden hospital died late night April 23, allegedly due to the shortage of oxygen, according to a

hospital

statement.

Delhi’s

Batra

hospital said in a statement that eight of its patients, including a doctor, passed away on Saturday 29 April due to lack of oxygen.

Similar stories were reported from Gujarat, Uttar Pradesh and Karnataka.

According

to

the

Johns

Hopkins

University Center for Systems Science and

Engineering

(JHU

CSSE)

data,

an average of 3187 people died of COVID-19 in a week in India between April 14-May 1, 2021. However, there is no official figure yet listing deaths due to oxygen shortage in India.

Portable Oxygen Concentrators Among a large number of COVID-19 patients who are at home and in need of oxygen therapy has thrown the spotlight on smaller devices. An oxygen concentrator is a device that filters the air around us to supply only oxygen to the patients through a cannula, oxygen masks or nasal tubes.

www.indiamedtoday.com

25

COVERSTORY However, its use is limited to patients

bridge this surging demand and supply

with moderate symptoms.

gap.

“Oxygen concentrators can be used only

Oxygen manufacturers like Inox Air

in moderate cases of COVID-19 when

Products, Linde India, Goyal M G Gases,

the patient experiences drop in oxygen

National Oxygen and Taiyo Nippon

levels, where the oxygen requirement

Sanso Corporation have said that they

is a maximum of 5 litres per minute,”

have

explained

Prof

Sanyogita

Naik,

Professor and Head of Department Anaesthesia, BJ Medical College, Pune.

Speaking at a webinar on COVID-19 organised by PIB the professor added that oxygen concentrators are also very useful for patients experiencing postCOVID complications which necessitate oxygen

therapy.

Depending

upon

the capacity, O2 Concentrators cost upwards of Rs 30,000.

increased

production

capacity

but the transport of oxygen is still a challenge.

However, most experts we spoke to said that the production capacity of oxygen is not the problem, but its distribution and transport were the bottlenecks.

“India can produce LMO for its domestic consumption, however, its distribution and transport are the major bottlenecks that need to be streamlined,” said Mehta.

The Indian Railways’ Oxygen Express is

Way Out

trying to ease this problem. Trains have

As the news of medical oxygen shortage

via Nagpur to Nashik and Lucknow to

spread, the government along with

Bokaro and back with a total of 10

the corporate sector came into action.

containers having nearly 150 tonnes of

In addition, the government of other

liquid oxygen have been carried so far

countries mobilised instruments to help

the ministry said on April 24.

26

May 2021

run between Mumbai to Visakhapatnam

“Oxygen concentrators can be used only in moderate cases of COVID-19” Prof Sanyogita Naik, Professor and Head of Department Anaesthesia, BJ Medical College

In addition, PM CARES Fund has given in-principle approval for the allocation of funds for the installation of 551 dedicated Pressure Swing Adsorption

Oxygen Requirement for

50 patients

(PSA) Medical Oxygen Generation Plants inside public health facilities in the country.

Steel plants in both the public and

1 patient requires

10Lpm

private sector are striving hard to supply liquid oxygen to different states.

2894 tonnes of oxygen was dispatched to different states on 24 April by steel plants in the public and private sector

10Lpm X 50 X 1440 minutes =

720000 litres in a day

as against 1500-1700 metric tonnes per day a week earlier. Steel plants are also filling oxygen cylinders and supplying them to the public and private hospitals in Orissa and Jharkhand.

Further, the government has imported 20 cryogenic tankers of 10 MT and 20 MT capacities and allocated them to states, addressing the shortage of

One D type cylinder has about

7000 litres 102

So cylinders per day

oxygen tankers in the country.

All these efforts are welcome but these will dwarf in comparison to the rising Covid-19 infections. If India can reduce the daily Covid-19 cases then

With back-up

120 cylinders per day would be required

the oxygen crisis will dissipate but with the current measures this looks like a distant dream; blaring alarm for even bigger oxygen crisis in coming days.

Source: Senior Engineer, Multispeciality Hospital

www.indiamedtoday.com

27

FEATURE

Distressed Diagnostic Labs A look into the burdened COVID-19 testing labs and how they work against time to fulfil mounting demand

Diagnostic laboratories are facing unprecedented challenges to help fight the COVID pandemic on one hand and the other sustaining themselves financially due to the price cap by the government. Big players have however somehow succeeded with many adopting technology as a means to survive.

Before travelling to my native place from Mumbai in April 2021, I came to know from certain government websites, airline portals and certain apps that one has to undergo compulsory RT-PCR test with a handy negative report to travel.

I was caught unaware of how bad the situation was on the ground when my family reached the door of a private laboratory to undergo the RT PCR test.

I was shocked to see a huge number of people in the queue having COVID like symptoms on one hand and others trying to leave the city as the lockdown deadline was nearing. The situation was so bad that upon enquiring I was told that many people were standing in the queue since morning only to have their samples taken by late afternoon. With a raging second wave of COVID, the staff seemed helpless, overburdened and in chaos.

Pandemic Impact After the first wave of the pandemic, many were caught unaware of the second wave which resulted in a catastrophic situation. Overburdened diagnostics labs, staff shortage,

28

May 2021

Dr Abhik Banerjee Chief of Quality, Senior Consultant- Pathology, Nodal Officer, COVID 19 Cell, Suraksha Diagnostics lockdown protocols all lead to delay in handing over the reports which resulted in late medication for COVID positive patients and ultimately deaths for many. (As on May 1, 2021, India reported 3,92,603 new COVID-19 cases and 3,673 deaths till 11.15 p.m ) To mitigate the crisis, laboratories across India undertook certain measures.

Maintaining the safety of staff, running the labs during the pandemic were all looked upon by the management so that people were less inconvenienced.

Kolkata-based

Suraksha

diagnostics,

Dinesh Chauhan, CEO, CORE Diagnostics like many other labs, faced fewer walkin patients on one hand during the pandemic and subsequent lockdown while on the other the labs were overburdened with the challenge of testing the samples in huge numbers.

Dr Abhik Banerjee, Chief of Quality, Senior Consultant- Pathology, Nodal Officer, COVID 19 Cell, Suraksha Diagnostics says, “Several areas of diagnostic healthcare have been impacted due to this pandemic. One has to maintain the usual lab and centre

operation, the emergency services as far as possible despite the threat to the safety of customers and its staff.

Secondly, the financial impact was huge given the drastic reduction in revenue generated from routine test segments and thirdly has been a shift in the overall environment of the laboratories due to the increased demand for COVID-19 testing.”

Challenges Galore Sharing similar challenges, Dr Harish Pillai, CEO – Aster India, Aster DM Healthcare, says that there was a challenge to collect samples and provide reports on time along with ensuring service standards were maintained.

Dr Pillai adds, “The unavailability of manpower due to quarantine measures, burn out of home collection services, surge in the prices of PPE material, increased lead time for delivery of diagnostic equipment from two to three weeks in normalcy changed to seven to eight week time, the unavailability of consumables like sodium citrate tubes, delays in imported kits due to global lockdown, etc. were some of the other challenges faced.”

Dr Harish Pillai, CEO – Aster India, Aster DM Healthcare

However, according to him, processes were altered to tackle the unprecedented load and besides a fully equipped pathology reference laboratory, a

team of highly trained lab technicians followed all requisite processes to not only manage the load but ensured the quality of services provided.

Dr Kamlesh Kumar Patel, Director of Rajasthan-based Livepath Diagnostic Laboratory shared similar views of the overburdened system which arose due to the unprecedented situation. Dr Patel opines, “Keeping the price of the test affordable while maintaining quality standards was extremely challenging.”

The private diagnostics sector played a crucial role in expanding and strengthening the testing capacity to meet the recurring surge. Cost pressure is another major challenge being faced by the diagnostics labs.

Dinesh Chauhan, CEO, CORE Diagnostics opines that there is still an existing challenge for certified labs to conduct tests at the set price given the rise in the cost of consumables and supply chain shortages. Furthermore, with prepayments becoming a norm for suppliers and deferred payments from hospitals (both private and government), there is indeed a cost pressure for diagnostic companies.

So what has become the new norm for the diagnostic labs to overcome the above-mentioned challenges? It may be noted that smaller labs ceased to

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29

FEATURE exist in many places and bigger labs could afford to tweak their strategies to somehow manage to sustain themselves.

information management system has been the norm since the company's incubation stage.”

The New Norm

The Tech Push

Many pathologists are working remotely through digital pathology solutions to avoid challenges related to physically being in the labs/hospitals.

The world has witnessed phenomenal technological innovation in the healthcare space and diagnostics labs have been able to utilise the right opportunity to evolve in this space.

Automation in healthcare has helped diagnostics labs mitigate the crisis to a certain extent.

According to Chauhan from Core Diagnostics, “To access the best pathologists globally, we have been scanning and getting slides reviewed wherever needed. Another significant change we saw was the adoption of home collection. The surging panic and need for stabilisation helped the industry to re-focus on the importance of the home collection. Furthermore, early detection and accurate diagnostics are important for labs as screening becomes the new normal.”

Suraksha Diagnostics has been able to reestablish the importance of laboratory medicine specialists. According to Dr Banerjee, the footprint is surely going to stay forever. The development of new molecular biology setups and scaling up of existing infrastructure, have been noticed at a pace that was never imagined before. The customer

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May 2021

Dr Kamlesh Patel, Director Livepath Diagnostic Laboratory relationship management team has observed a dramatic increase in phone calls requesting for home collection and inquiring about the availability of tests like CRP, D-DIMER, IL6 etc.

In addition, 24/7 operations have become the new norm adopted by Mapmygenome. Says Anu Acharya, CEO, Mapmygenome, “Mapping the workflows into our secure laboratory

Aster DM Healthcare adopted highend technological options by the molecular department, with lesser TAT like the Abbot Id & Genexpert. Mobile applications for quick bookings of the service by the patients were introduced which also enabled them to track the report status. Even automation in admin workflow helped Aster DM Healthcare overcome the challenge somewhat.

While the diagnostic industry was already on the verge of technological advancements, the crisis accelerated the pace. Right from booking tests, sample collection, to reporting- everything is now fully automated.

CORE

Diagnostics

not

only

started

working remotely but many of the pathologists were examining the dayto-day slides while physically being in the lab. Chauhan says, “Data has always been of utmost importance to us ever since we started, and we have state-ofart security for storing samples after analysing them. Shortly, we intend to set up an R&D facility that will solely focus on bringing low-cost, reliable, and easy-to-use in-house testing kits.”

MapmyGenome’s Viral Transport Medium ensured that there is no lab contamination – and any virus in COVID samples is killed in CoviSafe kits, while its genetic structure remains intact for testing purposes. The entire workflow is mapped into secure LIMS.

several blood tests to help understand antibodies and other COVID-related parameters. It has also been involved in seroprevalence studies with RT PCR, antibodies, T cell markers etc.

The future The year 2020 was a hectic year for diagnostic labs with staff and management on the tenterhooks as with rising cases a large number of samples were required to be analysed within a short period. With COVID-19 showing no signs of abatement and subsequent waves coming back, diagnostic labs

R&D in Full Force

Acharya opines, “The pandemic has increased people's awareness towards preventive healthcare.

Predictive testing is rapidly seeing more takers.

For healthcare providers and their customers, now is the best time to shift to a personalised, predictive, preventive, and participatory model.”

Patel foresees a lot of growth in the online healthcare space. During the pandemic, Livepath Laboratory has identified the need and growth potential of online healthcare facilities and launched an online medical aggregator platform.

Dr Banerjee is optimistic about the future of diagnostic labs and predicts a definite increase in predictive health check-up in the coming days. “No doubt, the laboratory industry is better prepared now to handle challenges and days are going to be brighter than ever before,” he opines.

Many labs have taken up new and innovative test methods. With the pandemic raging across the country, Mapmygenome’s R&D team turned its focus on developing two tests — an RTPCR based diagnostic test for COVID-19 and a predictive genomics solution Genomepatri Immunity. The combined teamwork of Mapmygenome employees helped to develop the COVID testing workflow and to gain NABL and ICMR approvals.

In September, Mapmygenome built a second ICMR approved lab at GMR Hyderabad International Airport to help screen both departing and arriving passengers.

The company added

have been able to gauge the right sentiments.

Anu Acharya CEO Mapmygenome India

As predicted that COVID-19 is here to stay forever with waves coming in at different times, diagnostics labs will be under tremendous pressure till new strategies are adopted. For big laboratories implementing the right strategies will work in favour of them but for smaller labs, it will be a tough road ahead to sustain. Only time will say what the future beholds.

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31

PULSE

COVID-19 Second Wave in India After early success, India's daily COVID infections have surpassed the US and Brazil. Why?

Rajib Dasgupta, Chairperson, Centre of Social Medicine and Community Health, Jawaharlal Nehru University

India is in the grip of a massive second wave of COVID-19 infections, surpassing even the US and Brazil in terms of new daily infections. The current spike came after a brief lull: daily new cases had fallen from 97,000 new cases per day in September 2020 to around 10,000 per day in January 2021. However, from the end of February, daily new cases began to rise sharply again, passing 100,000 a day, and now crossing the 200,000 mark.

Night curfews and weekend lockdowns have been reinstated in some states, such as Maharasthra (including the financial capital Mumbai). Health services and crematoriums are being overwhelmed, COVID test kits are in short supply, and wait times for results are increasing.

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May 2021

How has the pandemic been spreading?

Residents in slum areas and those without their household toilet have been worst affected, implying poor sanitation and close living have contributed to the spread.

One word that has dominated discussions about why cases have increased again is laaparavaahee (in Hindi), or negligence. The negligence is made out to be the fault of individuals not wearing masks and social distancing, but that is only part of the story.

Negligence can be seen in the nearcomplete lack of regulation and its implementation wherever regulations did exist across workplaces and other public spaces. Religious, social and

political congregations contributed directly through super-spreader events, but this still doesn’t explain the huge rise in cases.

The second wave in India also coincides with the spread of the UK variant. A recent report found 81 per cent of the latest 401 samples sent by the state of Punjab for genome sequencing were found to be the UK variant.

Studies have found this variant might be more capable of evading our immune systems, meaning there’s a greater chance previously infected people could be reinfected and immunised people could be infected.

A new double mutation is also circulating in India, and this too could be contributing to the rise in cases.

Low fatality rate?

In the first phase of the pandemic, India was lauded for its low COVID death rate (case fatality rate) of about 1.5 per cent.

However, The Lancet cautioned about the “dangers of false optimism” in its September 26 editorial on the Indian situation.

In a pandemic situation, the public health approach is usually to attribute a death with complex causes as being caused by the disease in question. In April 2020, the World Health Organization clarified how COVID deaths should be counted: Death due to COVID-19 is defined for surveillance purposes as a death resulting from a clinically compatible illness, in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma).

It is unclear the extent to which the health authorities across the states of India were complying with this.

Many states have set up expert committees to re-examine and verify COVID-19 deaths after coming under criticism that reported death rates were not accurate. Many states made corrections in mortality figures, and the full extent of undercounting is being actively researched.

District-level mortality data, both in the first wave as well as in the current wave, confirm that the global case fatality rate of 3.4 per cent was breached in several districts such as Maharashtra, Punjab and Gujarat. Case fatality rates in some of the worst-affected districts were above 5 per cent, similar to the 5 per cent mortality level in the US.

What are the challenges this time?

A majority of the cases and deaths (81 per cent) are being reported from ten (of 28) states, including Punjab and Maharashtra. Five states (Maharashtra, Chhattisgarh, Karnataka, Uttar Pradesh and Kerala) account for more than 70 per cent of active cases. But the infection seems to have moved out of bigger cities to smaller towns and suburbs with less health infrastructure.

Last year, the government’s pandemic control strategy included government staff from all departments (including non-health departments) contributing to COVID control activities, but these workers have now been moved back to their departments. This is likely to have an effect on testing, tracing and treating COVID cases. And healthcare workers now have a vaccine rollout to contend with, as well as caring for the sick.

What now?

In early March the government declared we were in the endgame of the pandemic in India. But their optimism was premature.

Despite an impressive 100 million-plus immunisations, barely 1 per cent of the country’s population is currently protected with two doses of the vaccine.

The India Task Force is worried that monthly vaccine supplies at the current capacity of 70 million to 80 million doses per month would “fall short by half” for the target of 150 million doses per month.

Strict, widespread lockdowns we have seen elsewhere in the world are not appropriate for all parts of India given their effect on the working poor. Until wider vaccination coverage is achieved, local containment measures will have to be strengthened. This includes strict perimeter control to ensure there is no movement of people in or out of zones with local outbreaks, intensive house-to-house surveillance to ensure compliance with stay-at-home orders where they are in place, contact tracing, and widespread testing.

It should go without saying large congregations such as political rallies and religious festivals should not be taking place, and yet they have been.

Strong leadership and decentralised strategies with a focus on local restrictions is what we need until we can get more vaccines into people’s arms.

This article is republished from The Conversation under a Creative Commons license.

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33

REPORT

Double-lung transplant after COVID-19 First case in Canada on a patient whose lungs were irreparably damaged by COVID-19

University Health Network has performed what is believed to be the first lung transplant in Canada on a patient whose lungs were irreparably damaged by COVID-19.

Timothy Edwards Sauvé, 61, contracted the disease in December and was referred to UHN for a transplant assessment about two months later.

After a careful assessment by a multidisciplinary team in the Toronto Lung Transplant Program at UHN's Ajmera Transplant Centre, Sauvé was listed and received the life-saving organ in February.

"It's been quite a journey, and I'm very thankful to my medical team and my donor," says Sauvé who had no prior comorbidities that would put him at higher risk for infection or complications from the disease.

"I was in great physical shape so I never thought I would get so sick from COVID. It still doesn't seem real to me, and I hope my story will show people how dangerous this disease can be."

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May 2021

machine (ventilator) - which ultimately was also not enough to keep him alive.

Once transferred to Toronto General Hospital, at UHN, he eventually needed the advanced lung support therapy called extracorporeal membrane oxygenation (ECMO) - which is essentially a machine that pumps and oxygenates the blood outside of the body providing healing time and relief to damaged lungs.

"A few weeks after he cleared the virus, it was very clear from his scans that Sauvé's lungs were severely and permanently damaged, and would not recover. His only chance of survival would be by receiving a transplant," says Dr Marcelo Cypel, Surgical Director at the Ajmera Transplant Centre and the surgeon who led the team performing the transplant.

Dr Cypel says transplant is certainly a life-saving treatment for a very small subgroup of COVID patients. However, with variants of concern increasingly infecting younger healthier patients during this third wave of the pandemic, the number of transplant referrals may grow. The programme is currently evaluating three additional COVID patients for transplantation candidacy.

Sauvé developed cold-like symptoms and screened positive for COVID-19 back in December. In a matter of days, the disease progressed, and he was hospitalized.

When to consider lung transplantation for COVID-19

As oxygen levels went down, he needed support from a mechanical breathing

There have been few cases of lung transplant after COVID reported around

Dr Marcelo Cypel, (L), seen here performing an unrelated surgery, says scans showed Timothy Edwards Sauvé’s lungs were so badly damaged by COVID-19 that “his only chance of survival would be by receiving a transplant.” the world, as it is only a recommended therapy in exceptional circumstances.

explored considerations for transplant assessment.

The majority of patients who develop severe COVID infection are usually not candidates for transplant, since other risk factors and complications from the disease would significantly compromise the chances of success for such a major surgery.

Sauvé was an ideal candidate for transplantation as he had no other comorbidities, and no other organs were significantly impacted by the COVID infection. Despite being on ECMO, he was awake and able to understand the implications and risks of transplantation.

"Transplant is not a cure for COVID," says Dr. Shaf Keshavjee, Director, Toronto Lung Transplant Program.

"In this case, with ECMO support and intense rehabilitation, we were happy to see it provided a second chance of life for Sauvé. Given the nature of COVID infections, transplant is only recommended in exceptional conditions - where the lungs are truly destroyed from the disease without the hope of recovery, and the patient is strong enough to go through a lung transplant."

Drs Cypel and Keshavjee have authored a scientific paper published in The Lancet Respiratory Medicine that

"We had one-on-one lengthy conversations so he understood the long road ahead of him, of the recovery journey after surgery, and the immunosuppression that comes with any transplant," says Dr Stephen Juvet, a transplant respirologist at UHN who was part of the team looking after Sauvé.

Recovery journey While no longer critically ill, patients that have spent prolonged time in hospital often require a period of inpatient rehabilitation to regain their strength before transitioning home.

Breathing with new lungs is one thing, but it can take time to work up the stamina and energy to use those lungs and re-train one's muscles to complete everyday tasks.

After his transplant, Timothy Sauvé is recovering well. His lung function is excellent and he no longer requires any oxygen support.

He has been transferred to UHN's Toronto Rehab Bickle Centre, where an active multidisciplinary team is helping him improve his mobility, lung function and quality of life.

"Our primary goal is to improve a patient's independence and function.

We learn about their home environment, interests, support system and hobbies to work with them to get back to the activities they enjoy," explains physiatrist Dr Alexandra Rendely.

"We want to add life to the years that the transplant has afforded them."

Source: University Health Network

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35

STUDY REPORT

Happy Nurses Critical to Better Outcome Nurses' physical, mental health connected to preventable medical errors

A study led by The Ohio State

well-being were twice as likely to have

University College of Nursing finds that

better physical health.’

critical care nurses in poor physical and mental health reported significantly more medical errors than nurses in better health.

The study, which was conducted before the COVID-19 pandemic, also found that ‘nurses who perceived that their worksite was very supportive of their

Study findings were published in the

American Journal of Critical Care.

"It's

critically

important

that

we

understand some of the root causes that lead to those errors and do everything we can to prevent them," lead author Bernadette Melnyk said. She serves as vice president for health promotion, chief wellness officer and dean of the College of Nursing at Ohio State.

The authors quoted research on the prevalence of stress, anxiety, depression and burnout symptoms among critical care nurses as a basis for examining the potential correlation between wellbeing and medical errors. The study surveyed nearly 800 members of the American Association of Critical-Care Nurses.

"It's clear that critical care nurses, like so many other clinicians, cannot continue to pour from an empty cup," Melnyk said. "System problems that contribute to burnout and poor health need to be fixed. Nurses need support and

investment

programming

in

and

evidence-based resources

that

enhance their well-being and equip them with resiliency so they can take optimal care of patients."

Study findings included: Bernadette Melnyk, chief wellness officer and Dean of the College of Nursing at The Ohio State University

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May 2021

•

Of those surveyed, 61 per cent

reported suboptimal physical health,

The Buckeye Paws programme helps healthcare workers at The Ohio State University Wexner Medical Center cope with stressful situations. It’s one of several resources offered to staff to preserve their mental and physical health and prevent burnout. while 51 per cent reported suboptimal

health resources and services such

counselling and mindfulness, I was

mental health.

as counseling, mindfulness coaching

finally able to see that I didn’t need to

and its Stress, Trauma and Resilience

push my feelings down, and that there

(STAR) Program that offers the Buckeye

were healthy ways to feel and express

Paws pet therapy program to promote

the grief that comes with being a critical

building coping and resiliency skills.

care nurse.”

“I think the pandemic has brought

The authors mention that levels of

• Approximately

40

per

screened

for

depressive

positive

cent

symptoms and more than 50 per cent screened positive for anxiety.

•

Those who reported worse health

and well-being had between a 31 per cent to 62 per cent higher likelihood of making medical errors.

•

magnification to the issues of burnout, depression, even suicide amongst our nurses, physicians, and other clinicians,” Melnyk said. “A hospital’s investment

Nurses who reported working in

in

the

well-being

of

their

health

stress, anxiety and depression are likely even higher in the current environment than before the pandemic, when the study was conducted.

places that provided greater support for

care professionals will lead to better

"The major implication of this study's

wellness were more than twice as likely

quality and safety of care and fewer

findings for hospital leaders and policy

to have better personal health and

preventable medical errors.”

makers is that critical care nurses

professional quality of life compared with those whose workplace provided little or no support.

The

Ohio

State

Center has several

“The feeling of being the person holding someone’s hand as they pass away is hard to describe, but it’s something I

Wexner

Medical to

impacted every aspect of my life,” said

promote clinician well-being, including

Jessica Curtisi, a critical care registered

its

Program

nurse in the Ohio State Wexner Medical

mental

Center intensive care unit. “Through

Employee

which

offers

programmes

definitely took home with me, and that

Assistance confidential

whose well-being is supported by their organizations are more likely to be fully engaged in patient care and make fewer medical errors, resulting in better patient outcomes and more lives saved," the researchers wrote.

Source: The Ohio State University College of Nursing

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37

DETAIL NEWS

Battling Public Health Misinformation Online “Dear Pandemic has demonstrated that consistently content

publishing

outside

a

high-quality peer-reviewed

venue can result in incredible impact— personal behavior change, informed nodes of trust to further disseminate factual

information,

and

resources

for community providers navigating constantly evolving knowledge,” says Penn Nursing’s Ashley Z Ritter, PhD, CRNP, the article’s lead author.

Dear

Pandemic

necessary

is

an

example

low-barrier

of

information

exchange with the public and a tool for community providers like nurses to stay informed of breaking news. Increased engagement of nurses in endeavors like

Dear

Pandemic

amplifies

the

impact of collective interdisciplinary Social media and web-based news

delivers

channels

and

became

a

communication

curated,

timely

comprehensive,

information

about

the

efforts to educate the public, contain misinformation, and motivate individual and systemic action, the article explains.

superhighway for correct and incorrect

COVID-19 pandemic in a question-and-

public health information during the

answer format. Complex topics such

“Now is the time for nurses to flex their

COVID-19 pandemic. The study of this

as COVID-19 aerosol transmission, risk

communication and trust muscles in

reduction strategies to avoid infection,

both traditional and innovative ways

and excess mortality are explained in

to advance the health of the public

common language and shared widely.

through trusted, actionable messaging

vast amount of information, known as infodemiology, is critical to building public health interventions to combat misinformation and help individuals,

in addition to exceptional patient care,”

groups, and communities navigate and

Now with more than 100,000 followers

distill crucial public health messages.

and accounts on Facebook, Twitter,

PhD, CRNP, a Fellow of the National

and Instagram, the campaign has an

Clinician Scholars Program.

In a novel effort to combat COVID-19 misinformation, a group of women

international and multilingual impact

researchers, including nurse scientists

offering important public health insight

from the University of Pennsylvania

via social media. An article in the journal

School

Nursing),

Public Health Nursing describes how the

launched the Dear Pandemic social

campaign is combating misinformation

media campaign in March 2020. It

about COVID-19.

38

of

May 2021

Nursing

(Penn

says co-author Shoshana Aronowitz,

The article “Dear Pandemic: Nurses as Key Partners in Fighting the COVID-19 Infodemic” is available online.

Source: University of Pennsylvania School of Nursing

The Evolving Cybersecurity Landscape Remote working has increased cyberthreats.

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Customized MVISION Device-to-Cloud Suites MVISION Advanced

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https://www.mcafee.com/enterprise/en-us/assets/reports/restricted/rp-carr-wfh.pdf https://www.mcafee.com/enterprise/en-us/assets/reports/restricted/rp-carr-wfh.pd Source: https://www.darkreading.com/cloud/as-cloud-adoption-grows-dlp-remains-key-challenge/d/d-id/1335000 https://newsroom.ibm.com/2020-07-29-IBM-Report-Compromised-Employee-Accounts-Led-to-Most-Expensive-Data-Breaches-Over-Past-Year https://www.gartner.com/smarterwithgartner/is-the-cloud-secure/ https://media.nominet.uk/wp-content/uploads/2019/02/12130924/Nominet-Cyber_CISO-report_FINAL-130219.pdf

8 https://www.mcafee.com/enterprise/en-us/assets/reports/rp-cloud-adoption-and-risk-report-work-from-home-edition.pdf McAfee and the McAfee logo are trademarks or registered trademarks of McAfee, LLC or its subsidiaries in the US and other countries. Other marks and brands may be claimed as the property of others. Copyright © 2020 McAfee, LLC. 4619_0920 SEPTEMBER 2020

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May 2021