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Guidelines for YOGA Practitioners for COVID-19

by Public Health Update
written by Public Health Update

Guidelines for YOGA Practitioners for COVID-19

Yoga may play significant role in the psycho-social care and rehabilitation of COVID-19 patients in quarantine and isolation. They are particularly useful in allaying their fears and anxiety.

Overview

Guidelines for YOGA Practitioners for COVID-19  provides guidelines for yoga professionals (Certified Yoga teachers/ instructors and therapists etc.) to teach a safe set of Yoga practices based on available scientific evidences, to novices in all walks of society as a service to humanity during this pandemic of COVID -19.

Department of Ayurveda and Alternative Medicine (DoAA)

Objectives

This is complimentary to all measures that have been adopted. Yoga based life style modules which can be used for different sections of the society in the present scenario are presented with the following objectives.

  • To improve general immunity among the population.
  • Prehabilitation of vulnerable populations (children, elderly and those with comorbid conditions such as diabetes and hypertension) and to those patients in isolation/quarantine with or without mild symptoms.
  • To add-on Yoga based interventions and Meditation practices in covid-19 cases in isolation and hospitalization for psychosocial care.

To reduce disease susceptibility in high risk population This guideline recommends evidence based safe and simple yoga practices as mentioned above that promote health of the respiratory, cardiovascular and the immune systems.

Contents

This guideline consists of;

  • Yoga based lifestyle modules for health promotion in healthy population; Yoga Based life style module to improve immune resilience in healthy population of all age groups.
  • Common Yoga Protocol
  • Yogic Diet
  • Abstinence from substance abuse including tobacco,alcohol and other addictive drugs
  • Yoga based life style to hospitalized cases without acute respiratory distress.
  • Yoga Practices for prevention, rehabilitation and to increase immunity. (Do’s/ Dont’s/Benefits)
  • Common Yoga Protocol- 10 minutes
  • Common Yoga Protocol- 20 minutes
  • Common Yoga Protocol- 45 minutes

DOWNLOAD YOGA GUIDE

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Comparative Evaluation of Commercially available Rapid Diagnostic Test Kits for the use of Screening of Suspected Cases of Novel Coronavirus infection in Nepal

by Public Health Update
written by Public Health Update

Comparative Evaluation of Commercially available Rapid Diagnostic Test Kits for the use of Screening of Suspected Cases of Novel Coronavirus infection in Nepal

Comparative evaluation study was conducted by Nepal Health Research Council (NHRC), in collaboration with Ministry of Health and Population (MoHP), Epidemiology and Disease Control Division (EDCD), and National Public Health Laboratory (NPHL) in Sudurpashchim Province to evaluate commercially available RDTs for SARS CoV2 (COVID 19) against the most sensitive and WHO/CDC standardized rRT-PCR and to establish the laboratory based confirmation of the COVID19 cases among the clinically suspected referred cases.

Recommended: Preparedness and Readiness of Government of Nepal Designated COVID Hospitals

A hospital based quantitative cross sectional study was conducted during ongoing outbreak of 2020 month of April. A total of 200 cases were enrolled in the study using consecutive sampling. Probable and suspected cases for COVID-19 admitted in hospitals (isolation/ quarantine for covid-19) were recruited for the study.

Sensitivity and Specificity

The result of study shows that the sensitivities of the Wondfo Kits were 50%, and the specificities were 99.5% (Compared to the reference standard (RT-PCR)). Similarly, positive and negative predictive values of the test kit were 66.7% and 99% respectively. Similarly, accuracy was 98.5%. 

  • Sensitivity: TP/ (TP + FN) × 100, 2/4× 100 = 50%
  • Specificity: TN/ (TN+FP) × 100,195/196 × 100=99.5%
  • Positive Predictive Value (PPV): TP/ (TP + FP) × 100, 2/3 × 100 = 66.7%
  • Negative Predictive Value (NPV): TN/ (TN + FN) × 100, 196/197 × 100 = 99%
  • Accuracy: TP+TN/TP+TN+FP+FN× 100, 197/200× 100 = 98.5% 

For more result please download final report (NHRC)

Comparative evaluation of RDTs and RT-PCR

RDTs (Test)

RT-PCR (confirmatory)
Positive Negative Total

Positive

 2 (TP) 1 (FP) 3

Negative

 2 (FN) 195 (TN) 197

Total

 4 196 200

Conclusion of study

Comparative evaluation of RDTs against confirmatory diagnosis of COVID-19 (RT-PCR) showed moderate sensitivity, but high specificity and desirable accuracy. The accurate diagnosis of people infected with the SARS-CoV-2 is essential to control the global spread of COVID-1. The existing clinical accuracy of rapid tests still needs to be stringently evaluated before they are authorized for the mass screening of COVID-19. Hence, RDTS could be used as complementary to the existing RT-PCR assays, which could lead to much better diagnosis of COVID-19 and provide additional information about the immune status of the cases and community as well as for rapid surveillance where there is no amenities of laboratory facilities for RT-PCR test.

For more results please download final report (NHRC)

For additional information, please contact: Nepal Health Research Council (NHRC) Ramshah Path, Kathmandu Phone no: +977-1-4254220 / +977-1-4254220 Email: nhrc@nhrc.gov.np

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Preparedness and Readiness of Government of Nepal Designated COVID Hospitals

by Public Health Update
written by Public Health Update

Assessment of Health-related Country Preparedness and Readiness of Nepal for Responding to COVID-19 Pandemic.

Preparedness and Readiness of Government of Nepal Designated COVID Hospitals

A nation-wide study was conducted to assess the preparedness and readiness of Government of Nepal (GoN) designated COVID hospitals to respond to COVID-19 pandemic. A cross-sectional study was conducted among 30 COVID hospitals via face to face and telephonic interviews with focal persons. Among them, telephonic interviews were carried out with focal persons of few unreachable hospitals.

A total of 30 COVID hospitals were included in the study, among which Level 1, Level 2 and Level 3 hospitals were 15 (50%), 12 (40%) and 3 (10%) respectively. The data was collected during the time period of one month (26 April 2020 to 27 May 2020). All the designated COVID hospitals were included in the study and the response rate was 100%.

Recommended: Preparedness and Readiness of Government of Nepal Designated Hospital running COVID Clinics

This fact sheet summarizes the main indicators of designated hospitals related to COVID-19 preparedness and readiness. It will support the GoN/Ministry of Health and Population (MoHP) to assess the current status of the hospitals, find the gaps and align the practices and resources for better preparedness and readiness to respond against COVID-19.

This study gathered data on general information of the hospitals including 12 domains as described below;

1. Health care facility preparedness and planning

  • 25 (83.3%) of 30 designated hospitals were existing functional hospitals and among them 4 (16%) had shifted the non-COVID patients to alternate hospitals.
  • All the hospitals coordinated with the government and had COVID management core team (96.7%); and COVID-19 Preparedness response plan (93.3%), while only 19 (60.3%) had an Infection Prevention Committee (IPC).
  • All designated hospitals had the provision of hand washing (soap water/ alcohol-based hand rub) at the hospital entrance.
  • The provision of Infra-red thermometer was available at the entrance of 93.3% of the hospitals.

2. Infrastructure

  • All the hospitals had adequate space between the beds (at least 1 meter).
  • Provision of 24 hours electricity and water supply were available in all the hospitals.
  • There were a total of 1,926 number of beds allocated for COVID patients.
  • 23 (92%), 22 (88%) and 19 (76%) COVID clinics of the respective hospitals had waiting/holding areas, separate examination areas and triage systems respectively.

3. Clinical services

  • Only 7 (23.3%) hospitals had designated emergency services for COVID patients.
  • 20 hospitals (66.7%) had Intensive Care Unit (ICU) facilities with a total of 235 ICU beds. Among them, very few, 4 (13.3%) hospitals had provision of negative pressure ICU. 7 (23.3%) hospitals had High Dependency Unit (HDU)/ Step down with a total number of 95 functional beds.

Critical equipment in ICU

  • Slightly more than half 17 (56.7%) of the hospitals had functional ICU ventilators, and 18 BiPAP machines were available in 10 (33.3%) hospitals. There were a total of 98 functional ICU ventilators. 19 (63%) of the hospitals had a defibrillator and only 8 (26.7 %) hospitals had the ABG machine.
  • None of the hospitals had availability of Extra-Corporeal Membrane Oxygenator (ECMO).
  • A total of 10 Neonatal Intensive Care Unit (NICU) beds and 21 Pediatric Intensive Care Unit (PICU) beds were available in 3 (10%) and 1 (3.3%) hospitals respectively.
  • 11 (36.7%) hospitals had operation theatres (OT) among which there were 30 OT rooms with 29 functional OT ventilators. Only 10 (33.3%) hospitals had Ante-room attached to the OT facility for PPE donning and doffing.

Laboratory services

  • Out of 29 hospitals who had facilities of special blood test, only 10% conducted D-dimer test, whereas Lactate Dehydrogenase level was conducted by 63.3%, Quantitative C-reactive protein by 53.3%, Troponin by (76.7% and Ferritin by 33.3% respectively.
  • Most of the hospitals conducted tropical disease profile tests like Scrub Typhus (50%), Dengue (66.7%), Leptospirosis (23.3%), Malaria (76.7%), Kala-azar (66.7%), Brucellosis (16.7%), Typhoid (90%), and Tuberculosis (76.7%).

COVID Investigation provision and services

  • More than a quarter (30%) of the COVID hospitals did not have the provision of investigation in the same hospital and 13.3% did not have separate designated areas for sample collection.
  • 17 (56.7%) hospitals had the provision of RDT services whereas, only 10 (33.3%) hospitals had the provision of RT-PCR services.
  • There were 70 trained human resources to conduct RT-PCR in 19 (63.3%) hospitals.

Isolation Facilities

  • 25 (83.3%) hospitals had the provision of isolation facilities with total beds of 729 for the suspected cases until the test results were available. Among them, 88% had ante-room attached for PPE donning and doffing.
  • 25 (83.3%) hospitals had a provision of admitting confirmed cases with a total number of 836 beds. Among them, 70% had an ante-room attached for PPE donning and doffing.

Personal Protective Equipment (PPE)

  • Only 12 (40%) of the designated hospitals had categorized PPE sets according to MoHP and Nepal Medical Council (NMC) guidelines.
  • There were altogether 9,280 N95 masks; 3,796 Goggles or Visor and 3,805 Water resistant OR standard disposable gowns.

4. Support services

  • More than a half (53.3%) of the COVID hospitals had provision of Central Pipeline Oxygen Supply (CPOS). Similarly, in the COVID clinic, less than half (46.7%) were facilitated with CPOS. Altogether, 503 beds were covered with CPOS in hospitals.
  • 73.3% of the hospitals had mechanized laundry facilities.
  • 36.7% of the hospitals had blood banks or storage units.
  • Ambulance services were available in 23 (76.7%) hospitals with a total number of 41 ambulances.

Diagnostic services

  • 76.7% and 73.3% of the hospitals had portable X-ray and portable Ultrasonography (USG) respectively.
  • Very few hospitals 11(36.7%) had provision of CT scan facilities.

5. Human resources

  • 83.3%, 76.7%, 30%, 16.75% and 20% of the hospitals had General Practitioner/Emergency Medicine, Anesthesiologists, Pulmonologists/ Respiratory physicians, Infectious disease specialists and critical care specialists respectively.
  • Almost half (46.7%) and 63.3% of the hospitals had trained Nursing staff for isolation wards and intensive care respectively. Capacity building (Training/ Orientation)
  • Majority 24 (80%) of the COVID hospitals had provided training on COVID-19 testing and sample handling; and use of PPE.
  • Only 13 (43.3%) hospitals had given orientation about handling the dead body to their health care workers.

6. Infection, Prevention and Control (IPC)

  • Almost all the hospitals 28 (93.3%) segregated and transported waste as per Health care waste management guidelines 2014 published by MoHP.
  • Majority of the hospitals used Hypochlorite solution 28 (93.3%) as disinfection modality for PPE followed by autoclave 25 (83.3%) and UV sterilization 3 (10%).

7. Medicine and Consumables

  • Majority 29 (96.7%) of the hospitals had Essential emergency medicines and 28 (93.3%) had recommended drugs for COVID19.
  • Hydroxychloroquine, Chloroquine and Azithromycin were available in almost all the hospitals. However, none of the hospitals had Ramdesivir, Tocilizumab (IL-6 blocker) or provision of convalescent plasma.

8. Referral

  • More than two third (70%) of the facilities had provision of referral to higher level COVID hospitals.

9. Discharge and Follow up

  • Most of the COVID hospitals (90%) had the provision of ambulance service for the patients at the time of discharge.
  • 93.3% hospitals had the provision of contact and follow up of the discharged patients along with counseling provision for home isolation. 10. Safety provisions for staffs
  • 80% and 93.3% of the hospitals had the provision of COVID-19 testing and quarantine provision for their staff respectively.

11. Handling of dead body

  • Very few (20%) COVID hospitals had body bags for dead bodies available in their hospitals.
  • The total number of body bags were 109. 12. Presence of printed copies of Guidelines and Directives published or endorsed by Ministry of Health and Populations
  • All the guidelines and directives published/endorsed by MoHP during the study period had been archived by more than 50% of the hospitals.

DOWNLOAD: FACT-SHEET

For additional information, please contact: Nepal Health Research Council (NHRC) Ramshah Path, Kathmandu Phone no: +977-1-4254220 / +977-1-4254220 Email: nhrc@nhrc.gov.np

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Fact SheetHealth in DataNational Plan, Policy & GuidelinesOutbreak NewsPublic HealthPublic Health UpdateReportsResearch & Publication

Preparedness and Readiness of Government of Nepal Designated Hospital running COVID Clinics

by Public Health Update
written by Public Health Update

Assessment of Health-related Country Preparedness and Readiness of Nepal for Responding to COVID-19 Pandemic

Preparedness and Readiness of Government of Nepal Designated Hospital-running-COVID Clinics

A nation-wide study was conducted to assess the preparedness and readiness of the Government of Nepal (GoN) designated Hospital running-COVID Clinics to respond to COVID-19 pandemic. A cross-sectional study was conducted among 95 COVID Clinics via face to face and telephonic interviews with focal persons. Among them, telephonic interviews were carried out in few unreachable COVID Clinics due to national lockdown. A total of 95 COVID Clinics were included in the study, among which two of the hospitals were found not to be running COVID Clinics. Hence, a total of 93 hospitals served as COVID Clinics. The data was collected during the time period of one month (26 April 2020 to 27 May 2020).

All the designated COVID Clinics were included in the study and the response rate was 100%. This fact sheet summarizes the main indicators of designated COVID Clinics related to COVID-19 preparedness and readiness. It will support the GoN/ Ministry of Health and Population (MoHP) to assess the current status of the Clinics, find the gaps and align the practices and resources for better preparedness and readiness to respond against COVID-19.

This study gathered data on general information of the Hospitals-running-COVID Clinics including 11 domains as described below;

1. Health care facility preparedness and planning

  • Majority of the COVID Clinics (99%) coordinated with the government and had COVID-19 task force committee (80%), management core team (96.7%), and COVID-19 Preparedness response plan (93.3%) respectively, while only 60.3% had an Infection Prevention Committee (IPC).
  • 95.8% of the COVID Clinics had provision of hand washing, (soap water/ alcohol-based hand rub).
  • The provision of Infra-red thermometer was available at 92.6% of the hospital entrance.

2. Infrastructure
For COVID Clinic

  • 80 (86%) and 83 (89.2%) COVID Clinics had provision of waiting area/holding area and examination area respectively while only half of the Clinics 46 (49.5%) had provision of triage system.
  • Only 52 (55.9%) COVID Clinics provided 24 hours service. 

Recommended: Preparedness and Readiness of Government of Nepal Designated COVID Hospitals

For Whole-Hospital

  • Designated Emergency for non COVID patients were available in all the hospitals.
  • There were a total of 13,724 beds in 93 hospitals.
  • 35 hospitals (37.6%) had Intensive Care Unit (ICU) facilities with a total of 809 ICU beds and 314 functional ICU ventilators. Among them, very few, 10 (28.6%) hospitals had provision for negative pressure ICU. 23 (23.3%) hospitals had High Dependency Unit (HDU)/ Step down with a total number of 279 functional beds.
  • Very few (3.2%) hospitals had availability of Extra- Corporeal Membrane Oxygenator (ECMO)
  • More than a third of the hospitals (29%) had provision for Neonatal ICU (NICU) while only 22.6% of the hospitals had Pediatric ICU (PICU) provision.
  • 93.5% of the hospital had Operation Theatres (OT) with a total of 273 OT rooms and 170 OT ventilators.

3. Clinical services

  • About 7 in 10 COVID Clinics (71%) had provision of investigations (RDT and/or RT-PCR) in the same hospital.
  • 61 (65.6%) Clinics had provision of providing RDT services whereas only 3.2% had RT-PCR facilities.
  • Trained human resources to conduct RT-PCR were available in only one-third (33.3%) of the hospitals.

Laboratory services

  • None of the COVID Clinics had dedicated Laboratory services (Routine Blood tests, Special blood tests, Culture and Tropical Disease Profile Test). However, all of them shared such laboratory facilities with their respective hospital services.
  • Almost 9 in 10 hospitals had the facilities for testing Malaria, Typhoid and Tuberculosis, while about three-fourth (75.3%) of the hospital had the capacity for testing Dengue.

Isolation Facilities

  • About 96% of the COVID Clinics had provision of Isolation for COVID suspected cases till the result was available, among which 68.5% had ante-room attached for PPE donning and doffing.
  • There were a total of 1, 185 beds in isolation for suspected cases.
  • Provision of admitting confirmed COVID patients were only present in 15 (16.1%) COVID Clinics and among them 11 (73.3%) hospitals had ante-room attached for PPE donning and doffing.
  • There were in total 243 beds for the confirmed cases.

Personal Protective Equipment (PPE)

  • Among 93 (33.3%) COVID Clinics, only 42 (45.2%) of them had categorized PPE sets according to MoHP and NMC guidelines.
  • There were altogether 10,761 N95 masks; 5,454 Goggles or Visor; 213,033 Gloves (loose/ Surgical gloves); 5,310 Water resistant or standard disposable gowns; 107,173 Caps, 1,97,360 surgical masks; 1,81,029 non-surgical gloves; 5,331 Gowns, and 2,643 Eye protection.

4. Support services

  • Only 3.2 % of the COVID Clinics had dedicated diagnostics services, while almost 95% reported to share such services with respective hospitals if needed.
  • None of the Clinics had CT scan service. Very few Clinics (3.2%) had designated Portable X-ray and Ultrasonography (USG) facilities.
  • Only few Clinics (19.4%) had facilities of Central Pipeline Oxygen Supply (CPOS).
  • Designated ambulance services were available in 40 (43%) hospitals with a total number of 53 ambulances.

5. Human resources

  • Only 14 % of COVID Clinics had dedicated medical officers whereas, 86% of the Clinics had medical officers pooled from respective hospitals.
  • On an average 3 Health Care Workers (doctors and/or nurses) worked in one shift in the COVID Clinics. They worked for 9 hours on an average in a single shift.

Capacity building (Training/ Orientation)

  • Only 60.2% of the Clinics had orientated their health Care workers on running COVID Clinics.
  • 67 (72%) of the Clinics had provided training on COVID-19 testing and sample handling whereas training on use of PPE was provided by 76.3% of Clinics.
  • Only 25 (26.9%) Clinics had given orientation about handling the dead body to their health care workers.

6. Infection, Prevention and Control (IPC)

  • The practice of segregation and transportation of waste as per Health care waste management guidelines 2014 was present in 80 (86%) of COVID Clinics.
  • There was provision of disinfecting modality for PPE by Hypochlorite solution in 89.2%, UV sterilization in 10.8%, and autoclave in 83.9% Clinics respectively.

7. Medicine and Consumables

  • Majority 90 (96.8%) of the COVID Clinic had essential Emergency medicines and 74 (79.6%) had recommended drugs for COVID-19.
  • Hydroxychloroquine, Chloroquine and Azithromycin were available in almost all COVID Clinics. However, none of the Clinics had Ramdesivir, Tocilizumab (IL-6 blocker) or provision of convalescent plasma.

8. Discharge and Follow up

  • Most of the COVID Clinics (68%) had the provision of ambulance service for the patients at the time of discharge.
  • 78% of Clinics had the provision of contact and follow up of discharged patients and 73% of Clinics had counseling provision for home isolation.

9. Safety provisions for staffs

  • 54.8% and 49.5% of the hospitals had the provision of COVID-19 testing and quarantine facilities for their staffs respectively.

10. Handling of dead body

  • Very few (6.5%) COVID Clinics had availability of body bags.
  • The total number of body bags were 214.

11. Presence of printed copies of Guidelines and Directives published or endorsed by Ministry of Health and Population

  • Except one, all the guidelines and directives published/endorsed by MoHP during the study period had been archived by more than 50% of the hospitals.

DOWNLOAD FACT SHEET FOR MORE INFORMATION: NHRC

For additional information, please contact: Nepal Health Research Council (NHRC) Ramshah Path, Kathmandu Phone no: +977-1-4254220 / +977-1-4254220 Email: nhrc@nhrc.gov.np

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WHO welcomes preliminary results about dexamethasone use in treating critically ill COVID-19 patients

by Public Health Update
written by Public Health Update
The World Health Organization (WHO) welcomes the initial clinical trial results from the United Kingdom (UK) that show dexamethasone, a corticosteroid, can be lifesaving for patients who are critically ill with COVID-19. For patients on ventilators, the treatment was shown to reduce mortality by about one third, and for patients requiring only oxygen, mortality was cut by about one fifth, according to preliminary findings shared with WHO.
The benefit was only seen in patients seriously ill with COVID-19, and was not observed in patients with milder disease. 

Dexamethasone reduces death in hospitalised patients with severe respiratory complications of COVID-19

“This is the first treatment to be shown to reduce mortality in patients with COVID-19 requiring oxygen or ventilator support,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This is great news and I congratulate the Government of the UK, the University of Oxford, and the many hospitals and patients in the UK who have contributed to this lifesaving scientific breakthrough.”

Dexamethasone is a steroid that has been used since the 1960s to reduce inflammation in a range of conditions, including inflammatory disorders and certain cancers. It has been listed on the WHO Model List of Essential Medicines since 1977 in multiple formulations, and is currently off-patent and affordably available in most countries.

The researchers shared initial insights about the results of the trial with WHO, and we are looking forward to the full data analysis in the coming days. WHO will coordinate a meta-analysis to increase our overall understanding of this intervention. WHO clinical guidance will be updated to reflect how and when the drug should be used in COVID-19.

Today’s news builds off the WHO Research & Development Blueprint meeting, which took place in Geneva in mid-February to accelerate health technologies for COVID-19, where further research into the use of steroids was highlighted as a priority. The findings reinforce the importance of large randomized control trials that produce actionable evidence. WHO will continue to work together with all partners to further develop lifesaving therapeutics and vaccines to tackle COVID-19 including under the umbrella of the Access to COVID-19 Tools Accelerator. 

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Dexamethasone reduces death in hospitalised patients with severe respiratory complications of COVID-19

by Public Health Update
written by Public Health Update

Dexamethasone reduces death in hospitalised patients with severe respiratory complications of COVID-19

In March 2020, the RECOVERY (Randomised Evaluation of COVid-19 thERapY) trial was established as a randomised clinical trial to test a range of potential treatments for COVID-19, including low-dose dexamethasone (a steroid treatment). Over 11,500 patients have been enrolled from over 175 NHS hospitals in the UK.

WHO welcomes preliminary results about dexamethasone use in treating critically ill COVID-19 patients

On 8 June, recruitment to the dexamethasone arm was halted since, in the view of the trial Steering Committee, sufficient patients had been enrolled to establish whether or not the drug had a meaningful benefit.

A total of 2,104 patients were randomised to receive dexamethasone 6 mg once per day (either by mouth or by intravenous injection) for ten days and were compared with 4,321 patients randomised to usual care alone. Among the patients who received usual care alone, 28-day mortality was highest in those who required ventilation (41%), intermediate in those patients who required oxygen only (25%), and lowest among those who did not require any respiratory intervention (13%).

Dexamethasone reduced deaths by one-third in ventilated patients (rate ratio 0.65 [95% confidence interval 0.48 to 0.88]; p=0.0003) and by one fifth in other patients receiving oxygen only (0.80 [0.67 to 0.96]; p=0.0021). There was no benefit among those patients who did not require respiratory support (1.22 [0.86 to 1.75; p=0.14).

Based on these results, 1 death would be prevented by treatment of around 8 ventilated patients or around 25 patients requiring oxygen alone.

Given the public health importance of these results, the researchers are now working to publish the full details as soon as possible.

Peter Horby, Professor of Emerging Infectious Diseases in the Nuffield Department of Medicine, University of Oxford, and one of the Chief Investigators for the trial, said, ‘Dexamethasone is the first drug to be shown to improve survival in COVID-19. This is an extremely welcome result. The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment, so dexamethasone should now become standard of care in these patients. Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives worldwide.’

Martin Landray, Professor of Medicine and Epidemiology at the Nuffield Department of Population Health, University of Oxford, one of the Chief Investigators, said, ‘Since the appearance of COVID-19 six months ago, the search has been on for treatments that can improve survival, particularly in the sickest patients. These preliminary results from the RECOVERY trial are very clear – dexamethasone reduces the risk of death among patients with severe respiratory complications. COVID-19 is a global disease – it is fantastic that the first treatment demonstrated to reduce mortality is one that is instantly available and affordable worldwide.’

Dexamethasone reduces death in hospitalised patients with severe respiratory complications of COVID-19

Dexamethasone reduces death in hospitalised patients with severe respiratory complications of COVID-19

The UK Government’s Chief Scientific Adviser, Sir Patrick Vallance, said, ‘This is tremendous news today from the Recovery trial showing that dexamethasone is the first drug to reduce mortality from COVID-19. It is particularly exciting as this is an inexpensive widely available medicine. This is a ground-breaking development in our fight against the disease, and the speed at which researchers have progressed finding an effective treatment is truly remarkable. It shows the importance of doing high quality clinical trials and basing decisions on the results of those trials.’

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Dexamethasone reduces death in hospitalised patients with severe respiratory complications of COVID-19

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National Plan, Policy & GuidelinesResearch & Publication

Quick Need Assessment and Recovery Strategy Framework for Local Government

by Public Health Update
written by Public Health Update

Quick Need Assessment and Recovery Strategy Framework for Local Government

DOWNLOAD PDF FILE 

DOWNLOAD PDF FILE 

COVID-19 AND IT’S PSYCHOLOGICAL IMPACT ON CHILDREN’S AND ADOLESCENT

COVID19 Resources: Guidelines and Documents- Ministry of Health and Population 

COVID-19 Handbook for Health Workers |NHTC (Updated)

Coronavirus (COVID-19) Action plan – Ministry of Federal Affairs & General Administration

National Testing Guidelines for COVID-19

Call for Applications! COVID-19 Surveillance Associates (Roster)- WHO Nepal

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COVID-19 AND IT’S PSYCHOLOGICAL IMPACT ON CHILDREN’S AND ADOLESCENT

by Public Health Update
written by Public Health Update

COVID-19 AND IT’S PSYCHOLOGICAL IMPACT ON CHILDREN’S AND ADOLESCENT

Sanchita Subedi

A Novel Coronavirus (Covid-19) was identified as the cause of an outbreak of Viral Pneumonia in Wuhan, China in December 2019. According to WHO (World Health Organization) Corona Virus is a newly discovered virus which causes Coronavirus disease (Covid-19). This virus affects both humans and animals. Most people infected from the virus experience mild to moderate respiratory illness. The viruses like Severe Acute Respiratory Syndrome (SARS) which was reported in the year 2002 and Middle East Respiratory Syndrome (MERS) which were reported in the year 2012 related to the same family.  According to the information from MOHP (Ministry of Health & Population) there are 5062 confirmed cases and 877 recovered and the reported death cases are 16 till the date of today. During this pandemic Lockdown (mass quarantine) is still done by the Government of Nepal to control the spread of the communicable disease. It is very good action to control the spread of the disease as its vaccine and medicines are still not available.

Today the entire population of the world has been suffering from the pandemic of the Covid-19. Along with the increasing cases everyday but still we don’t know how the mental health of adolescents and children’s are being affected. Since, the last time the children’s and the adolescents in the Nepal are experiencing a prolonged   state of physical isolation from their friends, school, as well as community networks.

All the academic exams are cancelled and schools and colleges are closed in order to control the spread of the virus.

Overall the Social Isolation and Loneliness has increased the risks of Depression and Anxiety among the children and adolescents because of the lack of Social-Interaction. This also suggests that the current social-distancing measures enforced in children and adolescents during Covid-19 pandemic could even lead to the increase mental health problems including post-traumatic stress. Lack of social-interaction with the people’s can also lead to the social anxiety because; the social anxiety is triggered with the lack of the interaction with the community world and loneliness.

There are certain precautions which can be well established that can promote child and adolescent mental health during the Covid-19 pandemic.

  • Listening to the news can provide you the information and knowledge about the conditions but; these days there are many news that are spreading wrong information, myths, in social sites. In general, listening and watching the news for similar time per day would be good.
  • Spending more time with them in indoor activities and providing them supportive environment at home will help them to express and communicate about their feelings and emotional experiences.
  • Schools and colleges are one of the important part in the life of children’s and adolescents lives and changes, and regularly checking update of student life and how they are coping up with the current situation would play a great role.
  • Education related programs on Televisions and Social sites related to hygiene and safety can also play a great role for proper knowledge enhancement.

Sanchita Subedi, Public Health Professional, Email: sanchitasubedi19@gmail.com

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World Blood Donor Day
Health Literacy, Health Education & PromotionPH Important DayPublic Health

Who can give blood? Safe blood saves lives!

by Public Health Update
written by Public Health Update

Who can give blood? Safe blood saves lives!

Most people can give blood if they are in good health. There are some basic requirements one  need to fulfill in order to become a blood donor.  Below are some basic eligibility guidelines:

World Blood Donor Day: Safe blood saves lives! Give blood and make the world a healthier place

Age

You are aged between 18 and 65.

  • In some countries national legislation permits 16–17 year-olds to donate provided that they fulfil the physical and hematological criteria required and that appropriate consent is obtained.
  • In some countries, regular donors over the age of 65 may be accepted at the discretion of the responsible physician. The upper age limit in some countries are 60. 

 

Weight

You weigh at least 50 kg.    

  • In some countries, donors of whole blood donations should weigh at least 45 kg to donate 350 ml ± 10%.

 

Health     

You must be in good health at the time you donate.

You cannot donate if you have a cold, flu, sore throat, cold sore, stomach bug or any other infection.

If you have recently had a tattoo or body piercing you cannot donate for 6 months from the date of the procedure.  If the body piercing was performed by a registered health professional and any inflammation has settled completely, you can donate blood after 12 hours.

If you have visited the dentist for a minor procedure you must wait 24 hours before donating; for major work wait a month.

You must not donate blood If you do not meet the minimum haemoglobin level for blood donation:

  • A test will be administered at the donation site. In many countries, a haemoglobin level of not less than 12.0 g/dl for females and not less than 13.0 g/dl for males as the threshold.
Travel

Travel to areas where mosquito-borne infections are endemic, e.g. malaria, dengue and Zika virus infections, may result in a temporary deferral.

Many countries also implemented the policy to defer blood donors with a history of travel or residence for defined cumulative exposure periods in specified countries or areas, as a measure to reduce the risk of transmitting variant Creutzfeldt-Jakob Disease (vCJD) by blood transfusion.

Behaviours

You must not give blood:

  • If you engaged in “at risk” sexual activity in the past 12 months
  • Individuals with behaviours below will be deferred permanently: 
  • Have ever had a positive test for HIV (AIDS virus)
  • Have ever injected recreational drugs.

In the national blood donor selection guidelines, there are more behavior eligibility criteria. Criteria could be different in different countries.

National Blood Transfusion Policy-2071

Pregnancy and breastfeeding

Following pregnancy, the deferral period should last as many months as the duration of the pregnancy. It is not advisable to donate blood while breastfeeding. Following childbirth, the deferral period is at least 9 months (as for pregnancy) and until 3 months after your baby is significantly weaned (i.e. getting most of his/her nutrition from solids or bottle feeding).

SOURCE OF INFO: WORLD HEALTH ORGANIZATION

World Blood Donor Day: Safe blood saves lives! Give blood and make the world a healthier place

World Blood Donor Day 2019: Safe Blood for all!

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PH Important DayPublic Health

World Blood Donor Day: Safe blood saves lives! Give blood and make the world a healthier place

by Public Health Update
written by Public Health Update

World Blood Donor Day: Safe blood saves lives! Give blood and make the world a healthier place

World Blood Donor Day is an annual event celebrated on 14th June. The first World Blood Donor Day was celebrated in 2004. World Blood Donor Day serves to thank voluntary, unpaid blood donors for their life-saving gifts of blood and also to raise awareness of the need for regular blood donations to ensure that all individuals and communities have access to affordable and timely supplies of safe and quality-assured blood and blood products. 

World Blood Donor Day 2020

The campaign theme for World Blood Donor Day 2020 is “Safe blood saves lives” with the slogan “Give blood and make the world a healthier place”. The idea is to focus on the contribution an individual giver can make to improve health for others in the community. Blood donations are needed all over the world to ensure individuals and communities have access to safe and quality-assured blood and blood products in both normal and emergency situations. Through the campaign, we call on more people all over the world to become life-savers by volunteering to donate blood regularly.

The objectives campaign

  • to celebrate and thank individuals who donate blood and to encourage those who have not yet donated blood to start donating;
  • to highlight the need for committed, year-round blood donation, to maintain adequate supplies and achieve universal and timely access to safe blood transfusion;
  • to focus attention on the contribution donors make to the entire community as a critical factor in improving health;
  • to demonstrate the need for universal access to safe blood transfusion and provide advocacy on its role in the provision of effective health care and in achieving the goal of universal health coverage;
  • to mobilize support at national, regional and global levels among governments and development partners to invest in, strengthen and sustain national blood programmes.

What you can do

Everyone

  • Become a blood donor today and help make the world a healthier place.
  • Commit to being a regular donor and give blood throughout the year.
  • Encourage your friends and family to become regular blood donors.
  • Volunteer with the blood service to reach out to members of your community, provide care to donors, and help manage blood donation sessions/drives.
  • Find out your blood type and register as a blood donor.
  • Participate in World Blood Donor Day with your social networks.

Who can give blood? Safe blood saves lives!

Ministries of Health

  • Organize and participate in virtual activities to celebrate World Blood Donor Day, promoting voluntary unpaid blood donation to the public, across government and to other sectors.
  • Acknowledge the important role of blood donors in achieving the goal of “safe blood saves lives”.
  • Provide resources and infrastructure to facilitate voluntary blood donation.
  • Support the development of nationally coordinated blood transfusion services that provide equitable access to safe and quality assured blood transfusions for the whole population.
  • Put quality assurance systems in place for blood and blood products.
  • Download and distribute WHO’s World Blood Donor Day materials to health centres.
  • Speak to media about the importance of blood donation and the successes and challenges of your country in meeting national needs for blood.

 National blood transfusion services

  • Disseminate information about the importance of giving blood.
  • Distribute campaign materials that you can download from the World Blood Donor Day campaign website.
  • Organize a virtual World Blood Donor Day celebration. This could include:
    • Inviting prominent politicians, celebrities and sporting heroes to make videos or communicate on the importance of giving blood;
    • Producing and disseminating promotional materials through your web site and social channels;
    • setting up virtual visits of blood centres and inviting the public to learn about blood donation and transfusion; and
    • promoting blood donation success stories and heroic blood donors to your media.
  • Improve the infrastructure for blood donation and blood donor care.
  • Focus attention on donor health and care and provide quality service to blood donors.
Key messages
  • The world needs enough safe blood for everyone in need.
  • Every few seconds, someone, somewhere, needs blood.
  • Transfusions of blood and blood products save millions of lives every year.
  • Health is a human right; everyone in the world should have access to safe blood transfusions, when and where they need them.
  • Regular blood donations are needed all over the world to ensure individuals and communities have access to safe and quality-assured blood and blood products.
  • Everyone who can donate blood should consider making regular voluntary, unpaid donations, so that all countries have adequate blood supplies.
  • Ensuring the safety and well-being of blood donors is critical; it helps build commitment to regular donations.
  • Access to safe blood and blood product is essential for universal health coverage and a key component of effective health systems.
  • Blood and blood products are essential to care for:
    • women with pregnancy and childbirth associated bleeding;
    • children with severe anaemia due to malaria and malnutrition;
    • patients with blood and bone marrow disorders, inherited disorders of haemoglobin and immune deficiency conditions;
    • people with traumatic injuries in emergencies, disasters and accidents; and
    • patients undergoing advanced medical and surgical procedures.

     

  • The need for blood and blood products is universal, but access to safe blood and blood products varies greatly across and within countries.
  • In many countries, it is challenging for blood services to make sufficient blood and blood products available, while also ensuring its quality and safety.
  • Governments, national health authorities and national blood services must work together to:
    • ensure systems and infrastructure are in place to increase collection of blood from voluntary, regular unpaid donors;
    • establish and strengthen quality assurance systems for blood and blood products to ensure safe blood and blood products;
    • provide quality donor care;
    • promote and implement appropriate clinical use of blood; and
    • oversee the whole chain of blood transfusion.

Source of info: WHO

World Blood Donor Day 2019: Safe Blood for all!

Blood Connects us All – World Blood Donor Day

What can you do? Give blood. Give now. Give often – World Blood Donor Day, 14 June 2017

National Blood Transfusion Policy-2071

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