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Let's Talk Covid-19 with Dr. Dilip Malkan

Hey all, I have tried my best to make notes during this talk, please accept my sincere apologies for any mistakes below, thus I request that you watch the full video and refer to the Q&As later. The video also highlights what you as a student can do should you or your housemate contract COVID-19.

Was Ireland’s reaction to Covid-19 emergency appropriately timed and do we have enough ICU beds?

Lucky that all the preparations which were done by our Taoiseach are very good by closing the schools and colleges, in quite early time as compared to other countries. And in Ireland, we've got about 51 hospitals of various sizes. Total bed capacity is around 4200. And total ICU beds are 275. But like intensive care means this Intensive Care Unit, coronary care unit and high dependency unit. So, these all are converted into Intensive Care Unit beds. And according to the surge plan, we can go up to 800 ICU beds. So, nothing to worry about that like there are rumours that we don't have enough ICU beds and all, that is not there, and the surging thing has worked very well. And at present also we have got about 100 to 120 ICU beds still vacant, where patients can be treated.

Why is there a variation in transmission and death rates from country to country? And is airborne transmission a possibility.

Different countries have imposed different regulations, some of them are late in imposing restrictions. So, they got the results here the numbers are increased the death rate is increased while we did it earlier, so, it is better that's why it varies between country to country.

Airborne initially it was said that is only droplet transmission but airborne as well. If you are in within a radius and if someone is coughing or sneezing and if you are within two meters away from him, of course, it will be airborne, and you will get that. So, you can say it can be airborne as well.

Are members of the public allowed to get tested for Coronavirus through private healthcare? And if so, would they be able to receive an immunity certificate as this has been proposed in the UK.

Now, the thing is all the private hospitals have been closed. They have been taken over by HSE. So, there is nothing like private now. All we be treated as public now and you to contact your GP

If you don't have your GP, you can contact any GP, you can go onto the internet and see the nearest GP in your place. You can ring them, and they can arrange for you. It's not that you must be registered with him or it can be but if you're registered with a GP, of course, you will contact him or her to do that.

Their view on malaria drug. Will that be helpful for healthcare staff as tried in India?

Regarding malaria drug to use it as a prophylactic it is not recommended yet to be used as a prophylactic only those who are positive and hospitalised, they get this treatment of hydroxychloroquine. So, I don't recommend to be taken by everyone as profile access like we take it for malaria.

Which treatments are currently being used in hospitals in Ireland for COVID patients?

We follow the WHO guidelines, whatever treatment we give, and one of the treatments will be hydroxychloroquine and an antibiotic called erythromycin, plus of course, oxygen and other treatment as required with the symptoms and science.

Is there a shortage of testing kits of COVID in Ireland?

We have enough kits and a further 100,000 testing kits were recently ordered/arrived from China and tests are no longer sent to Germany. And the good news is that before the transmission was 1 to 4, now it is 1 to 1.

The cases turning out positive even after they are announced, are they recovering and how well prepared it the government with ICU beds and testing kits?

Results are getting better.

I'll tell you about the few statistics like Saturday midnight total cases were around 10,600, of this 25 % were healthcare workers. That was really unfortunate, but it happens because you are constantly exposed to these patients.

And there are about 1,849 patients in the hospital. That is 17% and 83% had mild symptoms.

In ICU there were about 232 patients that is 2% of 10,600. And that's around 365 that is 3.4% of 10,600. And of this 50% were in the nursing homes, unfortunately.

As of 13th of April, this is just two days back. There were 148 COVID patients in ICU. And after that also they were 135 ICU beds still available and around the hospitals are about 2250 bed, extra available for the wards.

As of yesterday, there were about 269 patients who were treated in ICU since the crisis began, so it's right from the beginning. And 65 were discharged that is 24%. 37% died, which is 14%, rest were being still treated in ICU. And 90% of those who died were about the age of 65 years. And the mean age was 69. And 80% had an underlying illness.

How safe are people who have already been infected and can they get it again?

Now, this is a very new virus, so we don't know how much immunity you may get once you get infected, but a similar virus which was SARS a few years back, they showed that you get immunity of that the peak is about four months and your immunity may last for two to three years. But regarding this Coronavirus, we still don't know what may be there is too early to say that. In addition to this, anyone with immunity comprised must cocoon themselves irrespective of age as they could get very critical.

Though WHO is waiting for evidence about BCG vaccine being used as a generic one, if proven, will BCG vaccine be administered to people in Ireland to protect from COVID (as prevention is better than cure)?

They are not recommending, WHO is not recommending to have BCG vaccine for everyone. But it is said that BCG vaccine definitely restricts this infection of Coronavirus but it's not yet proved. Once proves, of course, we follow whatever WHO says, every day new things are coming up. So we go according to that.

We hear about plasma transfusion as one of the means to save patients affected by Covid19. Is that true and if yes then have we tried them in our hospitals here?

Plasma transfer is you extract plasma from the blood of a person who is recovered from the infection. So, it has got antibodies in his plasma, and this plasma is being injected into critically ill patients. So, the antibodies which are injected with had to fight

This trial is still going on in various countries, mainly China, France, Germany, the United States. So, once it is approved, then probably the treatment may start in a critically ill patient, not in every patient.

But we are yet to start this in Ireland.

Are there are special facilities arranged in children's hospital for Covid19 affected ones and any precautions parents of children with underlying respiratory conditions need to take?

throughout the world, there are very few cases in children. Even if they get the virus, the symptoms are very mild. And they may recover very soon. But the problem is, they are the main candidate for transfer of virus to other homes in the whole house or maybe if they're playing outside their trance, transfer to their friends, and when they go home, they were transferred to your elders, grannies or parents so that you have to be careful. But we are well prepared for that. We have got two big hospitals Temple Street and we are prepared for that if someone is infected.

Please stay home, maintain a 2m distance, wash your hands and exercise within 2km. It is working and together we shall overcome! Stay safe & stay connected!



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