Covid-19 outbreak turned focus the world over to telemedicine

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The world is moving towards the post-Covid-19 era after the disease has caused severe damage to global healthcare services, scientific leaders said during the online seminar “Evolving Healthcare Priorities in Asia Pacific – Learnings from Covid-19” on Thursday.

Covid-19 outbreak turned focus the world over to telemedicine

Prof Ivan Hung, chief of the Division of Infectious Disease at the University of Hong Kong’s Li Ka Shing Faculty of Medicine, said Covid-19 cases in Asia Pacific have risen periodically from 1.68 million in 2020 to 53.9 million in 2021 and 164 million in 2022.

“However, Asia-Pacific has basically one of the highest rates of vaccination, such as in Singapore, China and South Korea,” he said.

He also pointed out that the Covid-19 pandemic has disrupted routine treatment for non-communicable diseases, such as cancer, diphtheria, measles and polio.

“The return to routine care is imperative to prevent non-Covid-19-related deaths,” he said.

He added that criteria allowing the world to move from Covid-19 pandemic to endemic are:

  • Widespread infection and mild disease with Omicron
  • Good, natural immunity achieved by infection and high vaccination rate
  • Effective antiviral treatment
  • Second generation Omicron matched vaccine

He expected trial data on second generation Omicron matched vaccine will be available soon.

Dr Anna Lisa T Ong Lim, chief of University of The Philiipines’s Division of Infectious and Tropical Disease in Paediatrics, said Covid-19 restrictions, such as lockdowns, have been primary intervention to contain disease transmission:

  • Stringency index, containment and health index show variation across countries
  • Higher stringency did not necessarily equate to less transmission
  • The World Health Organisation (WHO) estimates of excess mortality show that best performing countries record the highest income and institutional quality.

She pointed out that many essential health services were also disrupted amid the Covid-19 crisis, especially in the Eastern Mediterranean, followed by Southeast Asia, Africa, Western Pacific and Europe.

“Restrictions have led to limited access to in-person healthcare services,” she said.

She advised that providers and patients need to recognise this important paradigm shift in healthcare delivery as it has evolved.

“In the pandemic, telemedicine has become the norm because it is the only way for healthcare to be delivered in some conditions,” she said, “Telemedicine has also opened the way for wider adoption of platforms.”

Covid-19 outbreak turned focus the world over to telemedicine

Dr Jeremy Lim, Assoc Professor and director of Global Health Programs at National University of Singapore, said the Covid-19 pandemic had caused healthcare issues to become existential among public.

“We were grateful that media could help to challenge us to engage and spread our narratives among the wider public,” he said.

He also advised administrative organisations to listen to the public to meet their expectations, apply professional transformation on their working and maintain platforms for engagement with society to overcome the Covid-19 pandemic’s impact on public.

“We have to recognise that when we open up [the country], the cases will spike. So the public need to understand, while the politicians need to be able to manage this,” he added.

Dr Jung Ki-Suck, Professor of Pulmonary, Allergy and Critical Care Medicine at Halym University Medical Centre, South Korea, said partnerships, networks and information exchange have emerged amid Covid-19 pandemic, such as regional offices of WHO, Centres for Disease Control and Emergency Operations Centres.

He said the next generation of Covid-19 vaccines will be broader rather than specifically targeted, minimising severity and case fatality, and have long-term durability.

Apart from the next generation of vaccines, he added that alternative treatment for Covid-19 will also be available, such as antivirals nucleoside analogues, antiproteases, anti-inflammatory agents, Extracorporeal Membrane Oxygenation and lung transplantation.

“With a variety of treatment options, we will overcome the Covid-19 pandemic era,” he said.

Published : July 01, 2022

By : THE NATION

Respiratory specialist doesn’t want Covid to be declared endemic just yet

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The Public Health Ministry should wait for a while before declaring Covid-19 an endemic disease, Vichaiyut Hospital respiratory specialist Dr Manoon Leechawengwongs advised on Thursday.

Respiratory specialist doesn’t want Covid to be declared endemic just yet

The Public Health Ministry is pushing to meet its target of declaring Covid-19 endemic in Thailand on July 1.

Manoon reasoned that many hospitals in Bangkok were dealing with a rising number of Covid-19 patients. For instance, Vichaiyut Hospital in Phaya Thai district had reopened a ward for Covid-19 patients, he added.

However, he confirmed that most patients developed mild symptoms as they had already received Covid-19 vaccine jabs.

Manoon advised people to take precautions, such as wearing a face mask, avoiding crowded or poorly ventilated areas, maintaining social distancing, washing one’s hands regularly and getting another booster shot in time.

The doctor said he had received four Covid-19 jabs – two Sinovac, one AstraZeneca and one Moderna. He added that he would receive the fifth – a Moderna jab – before waiting for a new generation of vaccines.

Manoon expected new Covid-19 vaccines to be rolled out at the end of the year or the beginning of 2023.

“Everyone must know that they could be infected with Covid-19 despite receiving five vaccine jabs,” he said.

However, vaccines can reduce the risk of developing severe symptoms or death, he added.

Published : June 30, 2022

By : THE NATION

Omicron BA.5 infections will increase before declining in August: Yong

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The Omicron BA.5 subvariant is Thailand’s dominant strain for June, causing the disease to spread further, expert virologist Dr Yong Poovorawan said on Thursday.

Omicron BA.5 infections will increase before declining in August: Yong

He said infections would increase before declining in August and advised people to receive at least three Covid-19 vaccine jabs as well as booster shots periodically.

The number of Covid-19 patients has risen sharply in the past two weeks, especially children, he noted.

Citing Chulalongkorn University’s Centre of Excellence in Clinical Virology that he heads, Yong said each Covid-19 strain became the dominant one for only a short period.

He predicted Omicron BA.5 instead of BA.2 would be the country’s dominant strain this month.

“Once a new strain becomes dominant, the virus will spread further,” he said.

Omicron BA.5 infections will increase before declining in August: Yong

He said BA.5 can escape immunity provided by vaccines, so it is not surprising that vaccinated people can get infected with the virus again. However, he stressed that most patients developed mild symptoms.

Yong expected more than 10,000 people to be infected with Covid-19, more than ten times the figure in a Public Health Ministry report.

Thailand recorded 2,695 Covid-19 cases and 14 deaths on Thursday in the past 24 hours.

He said the death rate among Covid-19 patients is now lower than 0.1 per cent. Vulnerable people, the elderly aged 60 years or above, pregnant women, people with underlying diseases and the unvaccinated accounted for most deaths.

“Vaccines can reduce the severity of Covid-19, enabling many patients to receive treatment at home despite rising infections,” the doctor pointed out.

Vulnerable people should receive Covid-19 antiviral drugs as soon as possible, Yong advised, recommending three drugs approved by the World Health Organisation – Remdesivir, Molnupiravir and Paxlovid.

“Vulnerable people should be given antiviral drugs within five days after developing symptoms,” he added.

Published : June 30, 2022

By : THE NATION

Five teens, 3-yr-old girl suffer from cannabis side effects: doctor

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Five teenagers and a child suffered from cannabis side effects between June 21 and 26, Dr Opass Putcharoen, head of Chulalongkorn University’s Emerging Infectious Diseases Clinical Centre, revealed on Wednesday.

Five teens, 3-yr-old girl suffer from cannabis side effects: doctor

Many people have bought food, beverages and products with cannabis as an additive after the plant was legalised for medical and commercial use on June 9, causing dozens to suffer from the decriminalised herb’s side effects.

“The legalisation of cannabis has caused medical staff to work harder, especially psychiatrists and neurosurgeons, as many children and teenagers have begun to suffer from side effects,” Opass said.

Citing the Royal College of Paediatricians of Thailand, the six cases are:

• A 14-year-old male psychiatric patient in Bangkok suffered from “confusion and change in behaviour” after smoking cannabis contained in tobacco without notice.

• A 17-year-old male in Phichit suffered from “confusion and auditory hallucination and became aggressive” after smoking the plant.

• Another 17-year-old male, in Nakhon Si Thammarat, suffered from “weight loss, drowsiness and dizziness” after smoking cannabis.

• A 16-year-old male in Bangkok suffered from “confusion and tried to use a knife to harm himself” after smoking the plant.

• A 3-year-old girl in Bangkok suffered from “dizziness” after consuming cannabis contained in cookies without notice.

• A 15-year-old male psychiatric patient in Bangkok suffered from “nausea, auditory hallucination and depression” after consuming cannabis contained in chocolate.

More than 100 people in Khon Kaen were reportedly hospitalised on June 17 with suspected cannabis allergies or overdose.

On June 15, Bangkok officials reported that four people had been admitted to hospital in the capital with suspected cannabis overdose. One died later of heart failure.

Published : June 29, 2022

By : THE NATION

Thailand’s real Covid numbers far higher than reported: top virologist

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The actual number of Covid-19 infections must be 10 times higher than reported by the Public Health Ministry as most patients develop mild symptoms, top virologist Dr Yong Poovorawan said on Sunday.

Thailand’s real Covid numbers far higher than reported: top virologist

Thailand recorded 2,378 Covid-19 cases and 17 deaths on Sunday, according to the ministry.

Dr Yong also pointed out that the number of children infected by Covid-19 has surged now that schools have reopened, triggering a spread among families.

With children, he said, it was difficult to tell if they have the common flu or Covid-19.

“We expect Covid-19 to spread quickly from this month and the number of infections to reach their peak between July and September,” he said.

He reckoned that Covid-19 infections will start dropping between October and December, before rising again in January, when respiratory diseases usually peak.

Thailand’s real Covid numbers far higher than reported: top virologist

Dr Yong, who leads the Chulalongkorn University’s Centre of Excellence in Clinical Virology, said half of the children who participated in the centre’s study had been infected with Covid-19 but were asymptomatic.

“To achieve a real number, a sentinel surveillance must be conducted in each venue, because the current Covid-19 infections report is based on patients who are hospitalised or tested positive via the RT-PCR method,” he said.

He added that patients with mild symptoms were less infectious than those with severe symptoms. Also, those with mild symptoms recover quickly, he added.

Published : June 26, 2022

By : THE NATION

Covid-19 infections far less severe after mRNA shots: lung specialist

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Recipients of mRNA jabs (Pfizer or Moderna) have reported far less severe Covid-19 symptoms compared to those who have taken other vaccines against the virus, a respiratory specialist said.

Covid-19 infections far less severe after mRNA shots: lung specialist

However, Dr Manoon Leechawengwongs from Vichaiyut Hospital warned that people can be hit with a Covid-19 infection despite receiving a third or fourth jab.

He said people who have received three mRNA jabs or two AstraZeneca jabs and an mRNA booster may not require a fourth jab if they have been infected by the Omicron variant, because their immunity will be very high.

However, he said, those who have received two Sinovac jabs and an AstraZeneca booster or have been infected by Omicron after getting two AstraZeneca jabs should receive one mRNA booster, he said.

An mRNA vaccine’s side effects include pain at the injection site, swollen arm, fatigue, body ache, headache and fever for a couple of days.

He said myocarditis and pericarditis after two mRNA jabs were mostly found in men aged below 39. Most of them developed mild symptoms and recovered on their own, Dr Manoon added, pointing out that the possibility of developing myocarditis after getting an mRNA jab is very low. He also said that myocarditis was rarely found in people who had received a third or fourth mRNA booster.

Published : June 24, 2022

By : THE NATION

Get an mRNA booster jab, respiratory specialist advises

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Everyone should go in for an mRNA booster jab as Covid-19 will mutate over time, Vichaiyut Hospital respiratory specialist Dr Manoon Leechawengwongs warned on Thursday.

Get an mRNA booster jab, respiratory specialist advises

He said the dominant Covid-19 strain is currently Omicron BA.2, which can overcome immunity provided by vaccines.

Dr Manoon also expects the Omicron BA.4 and BA.5 subvariants to become dominant strains in the future.

He advised all healthy Thais to receive at least three Covid-19 jabs, while those with chronic diseases, the pregnant and the elderly must have four.

Manoon said an mRNA vaccine (Pfizer or Moderna) must be included in the jabs to ensure increased immunity and safety.

He said people who have been given three Sinovac or Sinopharm jabs, or two Sinovac jabs and an AstraZeneca booster, must receive at least one mRNA booster.

Two AstraZeneca jabs and a Pfizer or Moderna booster provide 90 per cent immunity against developing severe symptoms and death, and the efficiency will increase up to 99 per cent after receiving the fourth mRNA jab, he pointed out.

The doctor advised people with chronic diseases, pregnant women and the elderly to go in for a fourth jab – Pfizer or Moderna – three months after receiving the third.

He said others should get their fourth jab – an mRNA – four months after receiving the third.

It is up to each person whether to follow the recommendation to get a booster jab every four months or wait for a new generation of Covid-19 vaccines, Manoon said.

“In the future, we will have a new Moderna vaccine which can protect people from Omicron and the virus’s original strains,” he said, adding that people would have to receive this vaccine annually, similar to influenza.

Published : June 23, 2022

By : THE NATION

Cannabis can bring blood pressure down too low, warns doctor

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People should control their consumption of cannabis as tetrahydrocannabinol (THC) can bring down their blood pressure and pulse to dangerous levels, a medical expert said on Thursday.

Cannabis can bring blood pressure down too low, warns doctor

Dr Thiravat Hemachudha, head of Chulalongkorn University’s Information Centre for Emerging Infectious Diseases, warned that people with heart diseases should be particularly aware as they can develop serious symptoms.

He added that using high amounts of cannabis does not mean it will give good results. Instead, he said, it can bring the blood pressure down far too much, and cause nausea, vomiting, disturbed vision, balance problems and depression.

Published : June 17, 2022

By : THE NATION

It’s up to you whether you want a 5th Covid jab: Yong

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It is up to each person to decide whether he or she would like to get a fifth Covid-19 jab as they have received vaccine doses for more than a year, top virologist Dr Yong Poovorawan said on Thursday.

It's up to you whether you want a 5th Covid jab: Yong

Citing a study on a volunteer who had five Covid-19 jabs, he said the volunteer’s immunity against the virus rose sharply two weeks after receiving the booster before declining.

However, vaccinated people develop mild symptoms and recover from Covid-19 quickly as their “body memory” helps boost immunity once they are infected, Yong made clear.

It's up to you whether you want a 5th Covid jab: Yong

He said everyone should receive at least three jabs, while at least four should be administered to those with chronic diseases and frontline medical staff so they can deal with virus mutations, especially Omicron.

Yong also advised people to get their next Covid jab four to six months after the third or fourth shots as immunity against the virus drops sharply during that time.

He expected people, especially the vulnerable, would need annual Covid-19 doses, just as in the case of influenza.

Published : June 16, 2022

By : THE NATION

Cannabis can affect nervous system, liver, mental health, doctor warns

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Cannabis can impact the nervous system and liver, apart from affecting mental health, an expert at Siriraj Hospital’s Faculty of Medicine said on Wednesday.

Cannabis can affect nervous system, liver, mental health, doctor warns

The faculty’s dean for informatics, Clinical Prof Dr Adune Ratanawichitrasin, explained that the decriminalised herb’s effect on the nervous system includes widening of the blood vessels, a slow or fast heart rate, and irritable bowel syndrome.

He also pointed out that people who eat or smoke cannabis could suffer from its effect on the nervous system.

Adune said people could also be at risk of drug overdose due to the herb’s effect on liver functions, especially enzymes which help mitigate effects of the drug.

He went on to say people who use anticoagulants, diabetes drugs, lipid-lowering agents and sleeping pills after consuming cannabis are at risk of drug overdose.

Adune warned that using cannabis as a food additive without informing consumers would trigger risks especially for those with chronic diseases who consume various drugs.

Restaurants or food stalls which add cannabis to food can’t blame consumers who suffer from the effects of the herb, he added.

Published : June 16, 2022

By : THE NATION