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1. Presenter
Dr. Dharanidhar Singh
Junior Resident
Moderator
Prof. C.P. Mishra
MD, PhD, FIPHA, FIAPSM,FAMS
Prof & Head
Corona Virus Outbreak
from Introspect to
Prospect
Corona Virus Outbreak
Public Health
Emergency

2. The Outline
 The Timeline
 Magnitude
Global Scenario
Indian Scenario
 Effect of COVID-19
 The Virus : SARS CoV2
 Management
 Infection Prevention and Control
 Vaccine
 Infodemic & Stigma Minimization
 Silver Lining
 Future Challenges
2

3. The Timeline
cluster of cases of pneumonia of unknown cause in Wuhan, Hubei Province
WHO announces that the outbreak in Wuhan is caused by a previously unknown type of coronavirus :2019-nCoV
cross borders : Thailand and Japan announce their first cases, in individuals who travelled from Wuhan
China's NHC confirms human-to-human transmission of the virus has been observed
public health emergency of international concern : PHEIC
WHO named it COVID-19
India confirmed their first cases of the virus
WHO declared Pandemic
31 Dec2019
9 Jan 2020
13 Jan 2020
20 Jan 2020
23 Jan 2020
30Jan 2020
Wuhan Lockdown
30 Jan 2020
11 Feb 2020
11 Mar 2020
India Report 1st COVID19 death
12 Mar 2020
1st ever human trial of COVID 19 Vaccine( Moderna)
16 Mar 2020
Countrywide Lockdown India 1.0
23 Mar 2020 3

4. The Timeline
Lockdown India 2.0
Lockdown India 3.0
Vande Bharat Mission: India’s largest Repatriation mission begins
Unlock 1.0 : phased re-opening begins
Human Trial for COVAXIN started in India
14 Apr2020
1 May 2020
7 May 2020
8 June 2020
1 July 2020
14 July 2020
Unlock 2.0
India’s COVID19 tally crossed 1 Million
17 July 2020
1 Aug 2020 Unlock 3.0 :night curfew revoked
India’s COVID19 tally crossed 2 Million
7 Aug 2020
UK approved 1st ever vaccine (Pfizer)
8 Dec 2020
India Started vaccination drive
16 Jan 2021
At present
Reverse Migration of Laborers
May 2020
5
Total case:106 M, Vaccination152 M dose

5. Magnitude of Corona virus : Global Scenario
7

6. Burden of Corona virus : Indian Scenario
8

7. Current Scenario :Choropleth map
9

8. 10

9. Current Scenario
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10. Source: https://www.bbc.com/news/business-51706225
Unemployment
Automobile
Air Travel
Global Tourism
Drop in Shoppers
GDP Growth
Definite booming in One industry 12

11. Impact on India
GDP Growth
Job losses
Unemployment
Reverse Migration
Railway loss
13

12. SARS CoV 2
 Enveloped
 Positive sense SS RNA
 Incubation Period 2- 14 days
 Basic Reproductive No ( R0 ) = 2.2-2.8
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13. Transmission Dynamics
 Droplet
 Fomite
 Aerosol
Sign and Symptoms
 Asymptomatic
 Respiratory symptoms
 Non-respiratory Symptoms
Laboratory Testing
 Specimens to be collected
 Packaging and shipment of clinical specimens
 Routine confirmation
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14. Management
Flattening the
curve of COVID-19
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 Contact Tracing
 Isolation and Quarantine
 Home Management

15. Clinical Management in Hospitals
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COVID-19 Suspect/Confirmed( Stratification Based on Severity of Disease)
MILD MODERATE SEVERE
Fever
Uncomplicated URTI
Pneumonia
RR>24
SpO2<95%
Respiratory Distress
RR>30
SpO2<90%
Dedicated COVID Care Centre (DCCC)
makeshift facilities, both public and private
Dedicated COVID Health Centre
(DCHC)
Dedicated COVID Hospital
(DCH)
Triage
appropriate IPC measures
Early supportive therapy and monitoring
Collection of specimens for
Symptomatic TRT
Standard Precaution
Refer if complicated
O2 support
Investigational therapies
Anti Coagulant (LMWH)
Antiviral
Corticosteroids
Ventilator CPAP
ARDSnet Protocollink

16. Infection Prevention and Control
1. Ensuring triage & early
recognition.
2. Applying standard
precautions
3. Implementing empiric
additional precautions
4. Implementing administrative
controls
5. Using environmental
controls
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17. Vaccine
 Protein Subunit
 Novavax
 Viral Vector Technology
 Oxford AstraZeneca
 Gamaleya RI (Sputnik V)
 Janssen
 Cansino
 mRNA
 Pfizer BioNtech
 Moderna
 Whole virus
 COVAXIN Bharat Biotech
 Sinovac
 Sinopharm X2
 Medicago Inc
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18. Vaccine progress
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Source :https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/

19. Vaccine progress
21
Source :https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/

20. Vaccine Choropleth
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Source :https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/

21. Global Vaccine Campaign
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Source :https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/

22. Particulars Oxford AstraZeneca Pfizer BioNTech Moderna NIAID
Type VVT mRNA PEG-LNP mRNA
Place of Study UK Brazil USA USA
Sample 3,000 9,000 43,000 30,000
Dose 0.25mL f/b 0.5mL
IM, 4wk apart
0.5mL IM, 4wk
apart
0.3mL IM, 3wk apart 0.5mL IM, 4wk apart
Placebo Vaccine Placebo Vaccine
+ve 162 8 185 11
Severe case 9 1 30 0
Efficacy 68% 90% 94% & 87% 94% & 100%
Storage +2 to +8 -60 to -80
(with diluent NaCl +2to +5 for 6Hrs)
-4

23. Vaccine : Indian Scenario
Indicator COVISHIELD COVAXIN
Type VVT Whole Viron
Inactivated
Dose 2 dose 4wk apart
0.5mL IM
2 dose 4wk apart
0.5mL IM
Storage &
Transportation
+2t o +8 degree Celsius +2t o +8 degree Celsius
Shelf Life 6 months 6 months
Open Vial
Policy
NA NA
AEFI MINOR
*Demyelinating Disorder
(Causal Relationship not
established)
MINOR
Discard if Visible Particle observed Particulate matter
other coloration
Union health secretary Rajesh Bhushan on
Jan12 said the Covid-19 vaccine may cost in
the range of ₹200 to 295 in India.
25

24. Infodemic & Stigma Minimization
https://www.epi-win.com/
27

25. Silver Lining
 Level of Nitrogen Dioxide
 Level of PM2.5
 CO2 Emission Level
 Water Standards
 Opportunities for renewable energy
 Education Digitalized and affordable
 Importance to hygiene BCC
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26. People living in low- and
middle-income countries
disproportionately experience
premature deaths due to air
pollution.
Source: https://www.who.int/news-room/fact-sheets/detail/ambient-(outdoor)-air-quality-and-health
Nitrogen Dioxide
4.2 M
premature deaths
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27. Nitrogen Dioxide
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28. PM2.5
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29. Water Quality
SOURCE: https://timesofindia.indiatimes.com/india/how-lockdown-has-been-a-gift-for-river-ganga/articleshow/75569852.cms
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30. Carbon Dioxide Level
Source: https://www.carbonbrief.org/analysis-indias-co2-emissions-fall-for-first-time-in-four-decades-amid-coronavirus
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31. Carbon Dioxide Level
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32. Renewable Energy
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European Union (EU) electricity
market
Electric Vehicle (EV) Boom
India is also catching up slowly

33. Social/ Educational/ Others
Importance to hygiene:
Behavior Change
Occurred ?
Education Digitalized and
affordable
Remote working is reality
Quality Family time
36

34. Challenges
Future Possibilities: Strategies for mask,
Social distancing, hand hygiene ?
Vaccine continued till what period ?
Is this type of Economic Meltdown
necessary for Healthier Earth ?
How are our healthcare delivery system is
prepared for future outbreaks ?
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35. Thank You
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