Editor in Chief Dr KK Aggarwal, Padma Shri Awardee                                                                               Dated:14 March,2020

Coronavirus: China stalls supplies, India faces anti-retroviral shortage

Antiretrovirals - used for treating coronavirus - are manufactured by around five major pharma companies in India.

NEW DELHI: Local drug makers are facing supply disruptions from China for some active pharmaceutical ingredients (APIs) that are used in manufacturing medicines for treating coronavirus, industry executives said.

These medicines - antiretrovirals - are manufactured by around five major pharma companies in India and are supplied to various other countries apart from local use. While in the wake of global coronavirus outbreak, the demand for such drugs have surged, China is holding back supplies to meet its own demand. ....read more?

First death in India: The case calls for implementation of IPC 270 and Epidemic Disease Act

Severe violation of epidemic guidelines in the first death
In an epidemic, one needs to follow one protocol, police should be informed for ‘left against medical advice’, suspected COVID-19 cases cannot be shifted to other state hospital. Suspected cases should be treated as positive cases unless tested negative. One such case with pneumonia (LRTI has high viral load) can make all the difference in the country and spread the disease like a wild fire. ....read more

It's official IPL 2020 postponed to April 15

We wrote to the PM and BCCI, also asked to be postponed. The 13th edition of the Indian Premier League (IPL) will not begin on March 29 as per the existing schedule. The tournament is being postponed to April 15th.
The postponement will allow them to see if the threat of the virus ceases any time soon, remains in control, or gets worse. Depending on these scenarios and what the central and state governments say, a further call can be taken....read more


127 countries, deaths to cross 6000, > 1000 deaths in Italy, 1 death in India
India,States: 13,Total cases 74, MOH Website (78 Media Reports),Serious: Zero,Death: 1,Community spread: zero,Super spreader: Zero,Men more than women,Age group (3-45 years) ,Delhi age group: 45, 25,52,25
ICMR: Testing across 52 labs (ICMR-National Institute of Virology, Pune is the apex laboratory for reconfirmation of any positive samples); additionally, 57 other labs to help sample collection ....read more

Positive Attitudes

All those out there who feel you are at your wits end wondering how things don’t ever work out for you, can now relax and dwell on all those failures that life has taken you through and turn failure into success.

Failure doesn’t mean you are a failure. But it does mean you haven’t succeeded yet.

Failure doesn’t mean you have accomplished nothing. It does mean you have learned something....read more

How Corona Aware Are You

Health Sutras By Dr K K Aggarwal

Malaria, dengue, chikungunya, filaria, Zika, Japanese encephalitis, West Nile fever are spread by the bite of an infected female mosquito.



Healthcare News Monitor

Covid-19 outbreak unlikely to impact credit rating of pharma companies
The Hindu

About 70 per cent of India’s total activated pharmaceutical ingredients requirement is met by imports from China The Covid-19 outbreak is unlikely to impact the credit profiles of India Ratings and Research (Ind-Ra) rated pharmaceutical companies in the near term, despite the industry’s heavy reliance on Chinese activated pharmaceutical ingredients (API) and intermediates, the rating agency said in a statement on Friday. However, in the event of supply disruption continuing over the next three-to-nine months, the pressures on credit buffers could intensify and rating transitions would be imminent, especially in case of the entities rated ‘IND A’ and below. Furthermore, if the disruption spills beyond the next nine-to-12 months, some of the higher-rated corporates could face downward pressure, Ind-Ra said. The agency in the statement added that China is the world’s largest exporter of APIs and intermediates. Approximately 70 per cent of India’s total API requirement is met by imports from China. IND-Ra’s portfolio consists of 19 pharma-formulation, manufacturing issuers that are rated ‘IND A-’ and above. Among these entities, only nine have their own API manufacturing facilities, and only one entity manufactures intermediates. The degree of backward integration is lower for players rated ‘IND A’ or below, thereby making them more vulnerable to supply disruptions compared to higher rated players.

CCI warns drugmakers not to indulge in unfair business practices
Business Standard- PTI

Fair trade regulator CCI has asked Bengal Chemists and Druggists Association (BCDA), its two district committees, Alkem Laboratories and Macleods Pharmaceuticals to refrain from indulging in anti-competitive business practices. The district committees are Murshidabad District Committee and Burdwan District Committee. In a press release, CCI said it has passed an order against the entities for violating provisions of the Competition Act by involving in anti-competitive business practices. The Competition Commission of India (CCI) found that pharmaceutical companies -- Alkem Laboratories and Macleods Pharmaceuticals-- had an anticompetitive agreement with BCDA. CCI noted that BCDA used to mandate pharmaceutical companies in some districts of West Bengal to ask their new stockists to obtain a stock availability information (SAI) / no objection certificate from BCDA before supply of drugs can be commended to them and used to collect monetary considerations for issuance of SAI through its district committees. Also, the promotion cum distributor agents of pharma companies had to obtain product availability information from BCDA after paying money to the association in the form of donations to start marketing drugs of their respective pharma companies in West Bengal.

Family of Karnataka coronavirus patient who died ignored hospital advice. Not once, twice
India Today- Ashish Pandey

The family of a 76-year-old Karnataka man who died due to the novel coronavirus, or COVID-19, this week apparently went against medical advice and forcibly got him discharged from hospitals not once but twice in the days before his death. This according to statements released by Union Ministry of Health and a private hospital in Hyderabad. According to the statements, the family ignored medical advice at a hospital in Karnataka's Kalaburagi, or Gulburga and another one in Hyderabad. The man died on March 10 while he was being moved from Hyderabad to Gulburga. According to a statement by the Union Ministry of Health, the man had visited Saudi Arabia last month. He returned to India on February 29. Initially he did not have any symptoms, but he developed fever and cough in the first week of March. On March 9, the man visited a private hospital in Kalaburagi where, the statement says, he was "provisionally diagnosed as 'mid zone viral pneumonia' and 'suspected COVID-19'." Doctors then collected his samples and sent them for testing. However, his family got him discharged "against medical advice" and took him to a private hospital in Hyderabad in neighbouring Telangana, around a four-hour drive from Kalaburagi.

Suspected of COVID-19? You can get yourself tested at 65 government labs

With cases of COVID-19 swelling to 84 in India along with two casualties due to the virus on Friday, the Indian Council of Medical Research (ICMR) expanded its network of Virus Research and Diagnostic Laboratories (VRDLs) equipped to test COVID-19 from 51 to 65. ICMR is also the testing agency for the virus. The secondary test for reconfirmation of the virus which was earlier conducted only in National Institute of Virology (NIV) has also been expanded to 31 laboratories, the ICMR said on Friday. In New Delhi, there are currently three laboratories testing for COVID-19 which are based at the National Centre for Disease Control (NCDC) (not under VRDL network), All India Institute of Medical Sciences (AIIMS), New Delhi and Lady Hardinge Medical College and hospital . The testing laboratories have recently also been approved in Srinagar, Chandigarh, Jodhpur, Patna, Agartala, Dibrugarh, Bhopal, Jabalpur, Pondicherry, Jamnagar, Varanasi, Amritsar and Agartala. “We have a total network of over 106 laboratories across the country. As the requirement is increasing with the evolving situation of COVID-19, we are identifying more laboratories from this network. In case of any signs or symptoms like fever, dry cough, difficulty in breathing etc. one should visit a doctor or call the Ministry of health and family welfare’s 24X7 Helpline - 011-23978046. They should always remember to wear a mask before stepping out to see the doctor," said senior official at the ICMR. “If the person is very sick, the doctors and paramedical staff can also come to his/her home as well and collect the sample. They can also go to a designated government hospital for giving sample," the official said. Till date ICMR has tested more than 6500 samples of 5900 individuals, out of which 78 cases have been tested positive for the virus. Routine confirmation of suspected cases is based on detection of unique sequences of virus RNA with nucleic acid amplification tests (NAAT), such as real time reverse transcription-Polymerase Chain Reaction (rRT-PCR). If a negative result is obtained from a patient with a high index of suspicion for COVID-19 virus infection, another sample is taken from his lower respiratory tract. Health officials usually take swab from the upper-respiratory tract or sputum for the test. Though respiratory samples have the greatest yield, the virus can also be detected in other specimens, including stool and blood.