My First Note in Spike

 My First Note in Spike

I was ambiguous of my first note, simply because I have lost interest in many fields including medical matters.

1. I lost interest in politics after 50 years of its observation globally.
2. Then I lost interest in religion, that dated back to my childhood but hiding behind the masses who follow one or other form of it. Then after my retirement from active work, this resurfaced in vigour, questioning their contribution to humanity.
3. Then I lost interest in helping (not empathy) the beggars. My idea of creating (including political, I prefer a different word sounding similar but would be nice here) a beggar in any form is counterproductive.
4. Then, to keep me occupied I stared feeding all the dogs, where ever I meet then.
5. Finally, I developed a keen interest in birds after noting disappearance of sparrows, that made me to visit Bird’s Park in Singapore. Then I developed the idea of making bird friendly environment.The cats (snakes,too) are their biggest enemies but the biggest impact is from unregulated agricultural poisons dished out that get deposited in the ovaries and eggs.
6. Finally Coronavirus came in and it made me to wake up from slumber, as it was.
7. By the way, this piece is medical.
8. We were taught to be very careful when dispensing steroids due to many (some exaggerated) of its side effects. After the loss of two children who were under my care (due to D.J.V.P insurrection in 1989) who could not reach me (cell phones were not available then) physically, I totally revised my policy globally, in Ceylon and abroad dishing out steroids, (especially Dexamethasone) liberally. A reserve course (dose depending on the individual) of steroids was given to each deserving family, with an instruction to take the first dose and see any available (Typed Note was dispensed, no computers then) medical person (do not go on looking for me). The reason is, their is delay in action of steroids for 8 hours or more. This saved many an agony to many of my patients. Now for Coronavirus, there is no treatment.
9. At least to avoid respiratory complications that result from various kinds of interleukins, a fast and furious (this new terminology of mine, furious to mean large and aggressive dose of steroids) dose of dexamethasone should be given, (not chloroquine) with the onset of respiratory symptoms, and if any need arises a course of antibiotics.
10. This will SAVE lot of lives.

Incubation Period

Incubation Period of Viral Diseases I call it, ICP for short. It is very important to estimate the incubation period of diseases, not only for epidemiological reasons and isolation but also for recognition of the virus. Icubation period is the time in between the time of exposure to the time of onset of symptoms and signs of the disease. Good old days for hepatitis we had only two hepatitis viruses, A and B but extensive studies fifty years ago revealed much more up to 20 or more and we lost interest and would focus only on B and D. This is true for Coronavirus, especially because it is coming out of animal kingdom of Chinese wet markets. I think Chinese wanted to hide facts for its own economic reasons and survival in the global market place. I give credit to President Trump at least even lately for quedtioning, the Chinese secrecy, if not their wisdom. All the others kept numb and did not question them. The WHO was an adversary on this regard. The Chinese are known for their wisdom but not the current bunch of Communist carders. The incubation periods are specific for viruses like small pox, chicken pox and measles, unlike bacterial infections of short duration. Even typhoid has 10 -14 day incubation petiod. Hepatitis B has up to 6 months incubation period and can spread by both inoculation and by faeco-oral route. We do not know the exact ICP of the 10 to 20 or more types of Coronaviruses. Each type has its own roughly exact ICP. Known the type by ICP may help the epidemiologists to plan ahead before catastrophe strikes. Immune antigen typinng takes a lot of painstaking studies and inevitable delay. I am against the 2 weeks blanket time period of isolation. With schools reopening and if there is a quick and rapid spread of the virus, if we are to gain headway, we need to isolate putative exposed contacts to, at least for a period of ICP plus a few more days of STRICT isolation. My bone of contention here is, if the incubation period is more than six weeks, this is most likely an enterovirus with more surreptitious spread spreading over years and not one summer or one winter (of discontent) of the current expectation of the doctors and politicians. There is anothet caveat here patients with various other diseases have to suffer patiently until WHO gets its act together before more blame will fall on them for inaction as opposed to timely action. For Ceylon the political euphoria will disappear into thin air, if they get their protocol incorrect. Judicious caution against the unintended paranoia that is required by those who are on the top management posts. Could we trust them since the election is over and done with it? What is happening in Australia and New Zealand is an eye opener. If it is a long incubation period enterovirus the streams will be contaminated with this virus including gardia lamblia, dinoflagellates and protista. Be vigilant. This virus has surprises in its fold.