Dr. Kishore Madhwani makes a case for Don’t-Worry-Stay-Calm even as the media reports about variants of the pandemic exacerbate stress and anxiety.

It has been established that the ‘variant of concern’ (VOC) was responsible for the monstrous second surge of the Coronavirus in India. We had many more patients, a significant number were RTPCR negative but still had features of COVID-19 detected in CT scans and blood investigations.

Today the Delta variant is prevalent in 85 countries globally. It has been optimistically stated that the news is the Covidshield vaccine has beneficial effects against the Delta infection: Taking one dose shows 30 per cent efficacy and 2 doses 60 per cent efficacy against symptomatic disease. Another advantage: one dose prevents hospitalization by 71 per cent and 2 doses by 92 per cent. (Source: Public Health England data). The Pfizer and Moderna vaccines have 79% efficacy against the Delta variant and 94% for Alpha variant of 2020 (as earlier reported).

It would be best to remain calm and be sure, amongst us, that we can fight the pandemic together. Hope surges. Indigo airlines have announced discounts. Emirates have announced flight services resumption from July. People are now relatively gaining confidence to travel by air. On most modern aircrafts, approximately 35 to 40 to air exchanges per hour take place - such air exchange signifies efficient ventilation, it has been determined.

Indeed if aerosol transmission of COVID-19 is to be controlled in workplaces and locations like restaurants and pubs, it would be important to restrict the number of visitors including limiting their timing, ensuring there is entry of fresh outside air entering the premises and at the same time effective exhaust ventilation is incorporated.

This ventilation monitoring (air quality maintenance) is essential in real time for carbon dioxide levels in parts per million. The Co2 levels of outside air are 400 ppm. If indoor air levels of carbon dioxide are maintained at 700 ppm, then the possibility of aerosol transmission of COVID-19 is near zero. Hence it will be prudent for all office workplaces to monitor Co2 levels in real time to control virus transmission.

Vaccines for Children

Serum Institute of India’s Covovax (Novavax in USA) will initiate vaccine trials in children in July 2021 for 2 months. Once results are declared and if favorable, let us hope that we will be able to vaccinate children in India by Diwali or latest before the year-end, in order to have fully vaccinated families.

Needless to emphasize that opening of schools by completing vaccination of children, teachers, staff, following strict COVID appropriate behavior by all students and ensuring hygiene as well as ventilation of school premises is the top priority today. Children are becoming anxious, restless, addicted to games and developing musculoskeletal disorders due to adoption of sustained awkward unergonomic postures while attending classes and subsequent homework. These are important issues that should be addressed.

Good News

As plasma therapy is now banned by WHO and by ICMR,  the good news is that in India a readymade Antibody Cocktail (casirivimab and imdevimab) is available. If given in the first three to four days of mild to moderate confirmed cases (above 12 years and above 40kg), who are at risk (comorbidities) of developing severe COVID-19 - can result in 70 percent reduction in hospitalisations. This will be extremely useful for obese, asthmatic, hypertensive, diabetic, kidney disease patients as they face greater risk of being hospitalised and also of requiring assisted ventilation. This is the same cocktail that was given to the former US President Donald Trump.   

A recent study has reported that the drug used to treat gout, available as colchicine, reduces the need for supplemental oxygen as well as speeds up recovery for patients hospitalised with COVID-19 by three days on an average.

As lockdown restrictions are being relaxed across India with local governments directing the guidelines, it is important to be extremely cautious, get vaccinated from genuine vendors and step out of home only if it is absolutely essential. Above all COVID-appropriate behavior is essential since this is our ultimate armor against the virus.

Incidentally, those individuals in New York city who received Pfizer mRNA vaccine from 5^th to 10^th June 2021 have been recalled to take the vaccine; as they had been given jabs that had expired. There is a group of evangelicals in us (reported by CNN) who refuse to take the mRNA vaccine. Clearly, there is no country in the world where vaccination challenges do not exist. 

Mindfulness Meditation

The current situation of COVID-19 across the globe arouses emotions of anxiety, feelings of uncertainty since new highly transmissible and increasingly virulent mutants have been announced. This allows negative thoughts to enter our minds, making us lose calm and in some of us becoming irritable and stressed to an extent that it affects our daily routine work and lifestyle. Due to this, we stop functioning at our optimum best personally and professionally.

Solution - consider summing up the entire pandemic situation as: The past is becoming history, the future is a mystery but we need to ‘live the present moment’ and make the most of our current lifestyle and daily routines including our professional careers by practising Mindfulness Meditation. It’s a beneficial practice - the more you do it, the more you’ll find it effective.

Mindfulness meditation is a mental training practice that teaches you to slow down racing thoughts, let go off negativity, reduce brain chatter, hone innate abilities to focus your mind, lower stress levels and calm both your mind and body. Techniques can vary, however the concept is: mindfulness meditation involves deep breathing and awareness of body and mind. The goal of mindfulness is to wake up to the inner workings of our mental, emotional, and physical processes.

Mindful movement can help you tap into that space beyond your busy mind where you become calm and you clear the clutter. You can practice anywhere for even short periods of 10 to 15 minutes (while sitting, too), though it is preferable to lie down in a cool and calm environment.

After lying down, keep all your thoughts and tensions away from your mind and focus on your breathing (in and out). Take deep breaths and synchronize your mind and body with breath and rhythm. Even after  a few minutes you begin to pause and start to focus on the present, forgetting your tensions and go into a trance, a relaxation phase. You may find the experience quite different than what you expected. There’s a good chance you’ll be pleasantly surprised, rejuvenated and able to better control stressful situations.

Improved Concentration and performance: Writer Hugh Delehanty calls it as tactical breathing, which can help foster what he calls “full presence and conviction in the moment.”  He advocates all athletes to use this practice for improved concentration and performance.

Boosts creativity: by incorporating it as a ritual in our routine lifestyles.

Strengthens neural connections: By training our brains in mindfulness, we can build new neural pathways and networks in the brain, boosting concentration, flexibility, and awareness thereby making well-being a skill.

I sincerely appeal to you to become a motivator and take up the responsibility for inspiring all individuals who interact with you and your families in our housing societies and workplaces to get vaccinated and also ensure that they implement COVID-appropriate behavior for the greater good. Becoming a motivator is what we owe to our existence on this planet; to make it safe and anxiety-free.