Starting with Khan and INA markets, FSSAI wants to make you aware of food contamination

Medibulletin Desk
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Starting with Khan and INA markets, FSSAI wants to make you aware of food contamination

“Food Safety on Wheel” mobile lab, equipped with rapid testing kits capable of detecting 50 pesticide residues across various food matrices pressed into service

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Know your food: FSSAI has launched an awareness drive

The Food Safety and Standards Authority of India (FSSAI) has launched an extensive awareness and sensitization program targeting major markets in the national capital, in collaboration with the Food Safety Department, Delhi.

Kicking off from the popular Khan Market and INA Market of Delhi on 8th April, 2024, the awareness campaign will focus particularly on the detection and mitigation of pesticide residue and contaminants in food products.

Market associations and traders were actively engaged and educated on the harmful effects of pesticide residue, mainly in fruits and vegetables and the importance of their testing. Additionally, attendees were introduced to FSSAI’s pioneering initiative, the “Food Safety on Wheel” mobile lab, equipped with various rapid testing kits capable of detecting approximately 50 pesticide residues across various food matrices, namely, fruits and vegetables, milk and cereals. Results from these tests are available within a few hours, facilitating swift action to ensure food safety.

Traders were encouraged to capitalize on this resource for expedited testing and to ensure the safety and quality of products sold in the market. Furthermore, they were also sensitized about a wide array of topics concerning food safety like the necessity of obtaining FSSAI licenses or registration and strict adherence to food safety standards. Traders were encouraged to source raw materials exclusively from FSSAI licensed/registered vendors to ensure traceability and compliance.

Further, the significance of raw material testing to guarantee the safety and quality of food products was emphasized during the programme. Awareness regarding artificial ripening and wax coating of fruits and vegetables using unapproved chemicals and role of organic farming was created among the attendees. Attendees were informed about the availability of testing laboratories for food products in Delhi and nearby areas.

The event emphasized the collective responsibility in ensuring food safety, with the mantra, “Food Safety is Everyone’s Responsibility” and also the importance of vital role of every stakeholder across the food supply chain in fostering a healthier India. FSSAI, as the apex food regulator in the country, remains committed to safeguarding public health through the implementation of robust food safety protocols nationwide.

G7 Hiroshima Communique commits to global health investment, Pandemic Fund

MediBulletin Bureau
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G7 Hiroshima Communique commits to global health investment, Pandemic Fund

Leaders of G7 nations who met in Hiroshima between May 19-21 for their annual summit, outlined global health as one of the priority areas where they will work together. Vow to strengthen global health architecture with WHO at its core

 

New Delhi: Leaders of G7 nations, following their annual summit in Hiroshima, committed to global health investments to ensure equitable vaccine access, a Pandemic Fund and strengthening of the global health architecture with the World Health Organisation at its centre.

The summit was attended by prime minister Narendra Modi along with his counterparts from G7 nations. India is not a part of the G7 grouping but was invited as a guest nation as it has been in the past too.

The G7 Hiroshima Leaders’ Communique said that the nations are determined to work together alongside others to “invest in global health through vaccine manufacturing capacity worldwide, the Pandemic Fund, the future international agreement for pandemic prevention, preparedness and response, and efforts to achieve universal health coverage (UHC)”. The summit was attended by leaders of Australia, Brazil, Comoros, Cook Islands, India, Indonesia, Republic of Korea, and Vietnam.

The Communique also highlighted the need to stay prepared for future pandemics and highlighted that as the rationale behind the need to strengthen the global health architecture. “We renew our strong commitment to developing and strengthening the global health architecture (GHA) with the World Health Organization (WHO) at its core for future public health emergencies to break the cycle of panic and neglect, recognizing that the COVID-19 pandemic has made an unprecedented impact on the international community. To this end, we commit to further enhancing political momentum toward more coordinated and sustained leader-level governance for health emergency prevention…” reads the communique.

The leaders also committed to reverse the first global decline in life expectancy in more than seven decades emphasizing the importance of achieving universal health coverage by 2030 and accelerating progress toward ensuring healthy lives for all and promote well being for all ages. The last is one of the sustainable development goals. The decline has been a result of the COVID19 pandemic and the large numbers of premature deaths that have been recorded in varying degrees in almost all countries.

Among the other priorities for health highlighted in the high level inter governmental meeting were supporting primary healthcare on the road to UHC, developing and restoring essential health services and focussed efforts towards a global understanding of the post COVID19 scenario.

 

 

 

Liver care package need of the hour to track the missing millions

Dr. Rajesh Dey
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Liver care package need of the hour to track the missing millions

There is an estimated 40 million people infected with the Hepatitis B virus in India

 

World hepatitis day- the real ‘missing millions’ are those who perish because of unaffordable liver care

Mr Ray of Santa Cruz Bombay was left aghast when he found out that his nephew perished from cirrhosis ( permanent liver damage) of liver. The young man (49yrs) had been advised a liver transplant because his liver was damaged from long standing diabetes, however a transplant was not an affordable option for him.

And that is the case with millions of Indians who suffer from liver disease. Hepatitis B and C virus induced liver damage remains rampant in India, and there is an estimated 40 million people infected with Hepatitis B virus in India.

Hepatitis B mainly spreads through unsafe sex, contaminated blood transfusion, pregnant mothers to their children. Hepatitis C affects an estimated 18 million people, and is transmitted though contaminated blood transfusion, contaminated needles and injections.

The real danger is NAFLD (non alcoholic fatty liver disease) or fatty liver. With the epidemic of obesity currently spreading across India and India being the diabetes capital of the world, fatty liver disease affects a huge population of Indians. In majority of cases the liver damage remains subtle and progresses undetected till significant destruction has been done.

At that point the person will have water in his tummy, yellow eyes( jaundice), or confusion and the only viable treatment option at this stage remains a liver transplant. A conservative estimate of cost analysis of a person with liver damage proceeding to transplant and follow up care runs into a comfortable Rs 50-60 lakh over 5 to 7 years, provided that he doesn’t run into any added complications.

Out of every 100 patients needing a liver transplant in India, for 30 it is unaffordable, for 50 patients there is also no willing donor

This group of people constitute the real ‘missing millions’ in India. A brief survey carried out in a liver center in South India shows that out of every 100 patients needing a liver transplant in India, for 30 it is unaffordable, for 50 patients it’s unaffordable plus there is
no one to donate a part of liver to the patient.

India has emerged as a global leader in living donor liver transplantation, with around 2000 liver transplants being performed annually, it still this falls short of the 25000 transplants that are estimated to be required in the country. Transplant centers in India
serve a huge number of International patients as well making liver transplantation a truly ‘make in India’ story.

Sadly, many Indian patients have to make significant out of pocket investments for affording quality liver care, pushing their families towards the poverty line. Medical insurance is negligible and does not cover full expenses of a liver transplant and if there is any indication of the word ‘alcohol’ anywhere, insurance companies are prompt in refusing such claims.

The need of the hour is a comprehensive liver care package with combined efforts of the government, medical insurance and health care officials so that none with liver disease is denied treatment for want of funds.

Over 2.4 lakh more recovered COVID19 patients than active ones

MediBulletin Bureau
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Over 2.4 lakh more recovered COVID19 patients than active ones

As COVID19 numbers inch close to 8.5 lakh government of India flaunts recoveries; even as daily case rise touches new high of 28637

There are many more recovered COVID patients in the country right now than active ones, the Union ministry of health said on Sunday in a statement. This even as 28637 cases were reported in the last 24 hours along with 551 deaths. The total cases in the country currently stands at 849553.

“Focussed and coordinated steps taken in tandem by the Centre along with the States/UTs through a ‘Whole of Government’ approach, bolstered by effective clinical management of COVID-19 after early detection and timely diagnosis has led to a consistent increase in the recovered cases. In the last 24 hours, a total of 19,235 were cured of COVID-19. This has resulted in the cumulative total number of recovered cases among COVID-19 patients rising to 5,34,620 today. The recovery rate has presently improved to 62.93%,” says the statement

As more people are recovering due to all-round efforts, the recovered cases exceed active cases by 2,42,362. Medical attention is being provided to all the 2,92,258 active cases.

During the last 24 hours 2,80,151 samples have been tested. The cumulative number of samples tested, as of now is 1,15,87,153. As a result of these efforts, the testing per million for India is presently 8396.4

 

The present health infrastructure dedicated to providing medical attention to the COVID affected includes 1370 Dedicated COVID Hospitals (DCH), 3062 Dedicated COVID Health Centres (DCHC), and 10334 COVID Care Centres (CCC).

For the successful operation of these facilities, the Centre has so far provided 122.36 lakhs PPE Kits, 223.33 lakhs N95 masks, and 21,685 ventilators have been delivered to various States / UTs / Central Institutions.

Enabling factors like removing all impediments for COVID-19 testing and facilitation of widespread testing by States/UTs continues to result in a steady rise in the samples tested every day; during the last 24 hours 2,80,151 samples have been tested. The cumulative number of samples tested, as of now is 1,15,87,153. As a result of these efforts, the testing per million for India is presently 8396.4.

A crucial supporting factor in progressive rise in testing numbers is continuous expansion of the country-wide diagnostic lab network, which as on date comprises of 850 labs in the government sector and 344 private labs (total of 1194 labs). These include:

• Real-Time RT PCR based testing labs: 624 (Govt: 388 + Private: 236)

• TrueNat based testing labs: 472 (Govt: 427 + Private: 45)

• CBNAAT based testing labs: 98 (Govt: 35 + Private: 63)

49 districts of over 733 account for 80% COVID cases

MediBulletin Bureau
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49 districts of over 733 account for 80% COVID cases

The 18th meeting of the Group of Ministers on COVID19 was briefed about the situation in the country

Eight states (Maharashtra, Tamil Nadu, Delhi, Karnataka, Telangana, Andhra Pradesh, Uttar Pradesh and Gujarat) contribute to around 90% of the active COVID19 caseload. 49 districts account for 80% of active caseload, as of today. Six states (Maharashtra, Delhi, Gujarat, Tamil Nadu, Uttar Pradesh and West Bengal) account for 86% of total deaths, and 32 districts account for 80% deaths.

These data were shared on Thursday during a meeting of the high-level Group of Ministers (GoM) on COVID-19 was held under the chairpersonship of health minister Dr. Harsh Vardhan. The meeting, the 18th of the group was held via video-conference, here today. He was joined by Dr. S. Jaishankar, Union Foreign Minister, Hardeep S. Puri, Union Minister of Civil Aviation, Ashwini Kumar Choubey, Minister of State, Health & Family Welfare, and Mansukh Mandaviya, Minister of State, Chemical and Fertilizers, & Shipping. Dr. Vinod Paul, Member (Health), Niti Aayog joined the meeting through video conference link.

At the outset, the GoM was briefed on the current status of COVID-19 in India.

The global comparison between the five most affected countries clearly depicted that India has one of the lowest cases per million (538) and deaths per million (15) compared the global average of 1453 and 68.7, respectively.

There are total 3914 facilities in the country with 3,77,737 Isolation beds (without ICU support), 39,820 ICU beds and 1,42,415 oxygen supported beds along with 20,047 ventilators

As on today, there are total 3914 facilities in the country with 3,77,737 Isolation beds (without ICU support), 39,820 ICU beds and 1,42,415 oxygen supported beds along with 20,047 ventilators. In terms of healthcare logistics, cumulatively 213.55 lakh N95 masks, 120.94 lakh PPEs and 612.57 lakh HCQ tablets have been distributed.

Dr Harsh Vardhan said:  “as we move forward, our focus shall be on the management of
COVID-19 through strict containment measures and surveillance; utilizing full testing capacity; focus on monitoring of co-morbid and elderly population; predicting emerging hotspots leveraging digital tools such as Aarogya Setu; ensuring seamless patient admission processes; focus on infrastructure preparedness (critical care beds, oxygen, ventilators and logistics).”

Dr. Sujeet K Singh, Director (National Centre for Disease Control) presented a detailed report on surveillance efforts undertaken in India during the pandemic. The focus was on strict containment strategy and surveillance through SARI/ILI cases, serological survey and increase in lab network to widen countrywide testing. The major concern areas in the country were highlighted and the measures to be taken were listed including timely clinical management along with testing and surveillance in the high risk population with co-morbidities to reduce the Case Fatality Ratio.

In a detailed presentation by Amit Khare, Chairman of Empowered Group-8 (on
Information, Communication and Public Awareness), the GoM was briefed on the key steps
taken in Communication of Information and in raising public awareness. The group received
6,755 alerts of fake news out of which 5,890 were replied to directly and rebuttals were
published to 17 foreign media stories. The group also coordinated the issue of 98 daily COVID- 19 bulletins, 92 media briefings and 2,482 press releases.

Daily positivity at 13.4%, Govt of India claims reduction in rate

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Daily positivity at 13.4%, Govt of India claims reduction in rate

While the positivity rate of samples tested in last 24 hours is at an all-time high, the Union health ministry has started calculating cumulative positivity

On a day when the sample positivity rate for COVID 19 touched an all-time high of 13.4%, the government of India, in a statement claimed a reduction in positivity rate.

“As part of the coordinated efforts, the Union government has emphasized on increasing testing, prompt contact tracing and timely clinical management of the cases. It has also helped the States to significantly ramp up testing capacities. This has resulted in reduced positivity in the country. Currently the national Positivity Rate stands at 6.73%,” says the statement.

The statement conveniently calculates positivity as a percentage of the total number of cases in the country and the total tests done. The total number of tests so far  in the country is 9969662 and the total cases is 697413. On the other hand, the total number of tests done in the country in the last 24 hours is 180596 and the total positives is 24248 which means 13.4% of all samples tested in the country in the last 24 hours, were positive.

The total number of tests done in the country in the last 24 hours is 180596 and the total positives is 24248 which means 13.4% of all samples tested in the country in the last 24 hours, were positive

As on 5th July 2020, the States with their Positivity Rate lesser than the national average and tests per million higher than the national average are:

Serial No. State Positivity rate (in %) Tests per million
1 India (National) 6.73 6,859
2 Puducherry 5.55 12,592
3 Chandigarh 4.36 9,090
4 Assam 2.84 9,987
5 Tripura 2.72 10,941
6 Karnataka 2.64 9,803
7 Rajasthan 2.51 10,445
8 Goa 2.5 44,129
9 Punjab 1.92 10,257

 

The statement went on to talk about Delhi. “In Delhi, the efforts being made by the UT were significantly bolstered by the Central Government to ensure increase in testing. Tests were ramped up through increased RT-PCR testing along with the new Rapid Antigen Point-of-Care (POC) tests which gives results in only about 30 min As a result of concerted and focused efforts by Government of India to augment efforts, the average number of samples being tested per day which was only 5481 (1st-5th June 2020) has witnessed a huge increase to reach an average of 18,766 samples per day between 1st to 5th July 2020. In spite of significantly increased testing in Delhi, the positivity rate has seen a substantial decrease from about 30% to 10% in the last three weeks,” it said.

 

“Test, track, treat” Centre urges states as COVID19 cases near 6 lakh

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“Test, track, treat” Centre urges states as COVID19 cases near 6 lakh

Health secretary Preeti Sudan and DG ICMR write to states to step up  COVID19 testing of all symptomatic patients

 

With the aim to remove all impediments in testing, Preeti Sudan, Health Secretary and Dr Balram Bhargava, DG (ICMR) today urged the States/UTs to take immediate steps to facilitate and ramp up testing. They have reiterated that ‘test-track-treat’ is the key strategy for early detection and containment of the pandemic.

Pointing out that in some States/ UTs, the capacity utilization of the testing labs, particularly the ones in private sector, is grossly sub-optimal, States/UTs have been strongly advised to take all possible steps to ensure full capacity utilization of all COVID-19 testing laboratories in the State/ UT.

States/UTs have been advised to facilitate testing at the earliest by enabling all qualified medical practitioners, including private practitioners, to prescribe COVID test to any individual fulfilling the criteria for testing as per ICMR guidelines.

In order to facilitate testing, States/UTs have also been advised to  make efforts in ‘campaign mode’ by setting up camps/ using mobiles vans in high incidence areas to collect samples of all symptomatic individuals

ICMR has strongly recommended that laboratories should be free to test any individual in accordance to the ICMR Guidelines and State authorities must not restrict an individual from getting tested, as early testing will help in containing the virus and saving lives. While RT-PCR is the gold standard for diagnosis of COVlD-19, ICMR has recently approved the use of a point-of-care Rapid Antigen Test for early detection of COVID-19. The test is quick, simple, safe and can be used as a point-of-care test in containment zones as well as hospitals, as per criteria specified by ICMR for testing. More such kits are being validated by ICMR to increase the available options to the citizens. ICMR has so far approved a total of 1,056 laboratories for COVID-19 testing. Of this, 764 labs are in public sector and 292 are in the private sector.

In order to facilitate testing, States/UTs have also been advised to  make efforts in ‘campaign mode’ by setting up camps/ using mobiles vans in high incidence areas to collect samples of all symptomatic individuals as well as their contacts, and get those samples tested by using rapid antigen tests. The positive individuals should be treated according to the treatment protocol and the negative ones should be tested for RT-PCR. Also, the rate for RT-PCR test by private labs should be finalized by the States/UTs. They have been further advised to make it mandatory for all labs to upload the testing data on the ICMR database as well as report to State/ District/ City authorities for surveillance and contact tracing.

In addition to ramping up and facilitating testing, States/UTs have also been urged to pay attention to ‘contact tracing’ as it holds the key to containing the virus. States have also been asked to maintain strict vigil and continue to make all possible efforts for effective management of COVID-19.

Antibody tests for COVID-19 most accurate two weeks after symptoms

Dr O P Choudhury
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Antibody tests for COVID-19 most accurate two weeks after symptoms

Timing is the key to accuracy of antibody tests for detecting COVID-19, finds a global review

A review of studies looking at the accuracy of COVID-19 antibody tests was carried out by experts at the University of Birmingham and from universities around the globe to examine the accuracy of antibody tests for the novel COVID-19 infection.

The findings have been published in the Cochrane Database of Systematic Reviews – the gold standard for comparing evidence.

The review shows that antibody tests could have a useful role in detecting if someone has had COVID-19, but that timing is important. The review reports 30% of people were picked up by antibody tests in the first week against 90% in the third week. Researchers are however not sure, if this is true for people who have milder disease or no symptoms, because the studies in the review were mainly done in people who were in hospital. 

The immune system of people who have COVID-19 responds by developing proteins in the blood called antibodies that attack the virus. Antibody tests detect these antibodies in people’s blood and indicate whether they currently have COVID-19 or have had it previously. Detection of current infection is usually done using swab tests, also called RT PCR test.

15 and 35 days after symptoms first began, antibody tests accurately detected over 90% of people with COVID-19

Cochrane researchers analyzed data from 54 relevant studies reporting test results for nearly 16,000 samples. The majority of studies were from China and were carried out in people who had been admitted to hospital and likely to have had severe disease.

The researchers found that the sensitivity (the proportion of the people who have had COVID-19 that the test can detect) of antibody testing is very closely related to when the test is performed. Tests of the IgG and IgM antibodies at 8 to 14 days after onset of symptoms correctly identified only 70% of people who had COVID-19. However, when the researchers looked at data reported at between 15 and 35 days after symptoms first began, antibody tests accurately detected over 90% of people with COVID-19. There are insufficient studies to estimate the sensitivity of antibody tests beyond 35 days after the beginning of symptoms. The tests only wrongly diagnosed COVID-19 in 1% to 2% of people without COVID-19.

Results showed that antibody tests may have a role in diagnosing COVID-19 in patients who have had COVID-19 symptoms for two or more weeks but who have not had a swab (PCR) test or tested negative despite COVID-19-like symptoms.

Professor Jon Deeks, Professor of Biostatistics and head of the Test Evaluation Research Group at the University of Birmingham, explained: “We’ve analyzed all available data from around the globe – discovering clear patterns telling us that timing is vital in using these tests. Use them at the wrong time and they don’t work. While these first COVID-19 antibody tests show potential, particularly when used two or three weeks after the onset of symptoms, the data are nearly all from hospitalized patients, so we don’t really know how accurately they identify COVID-19 in people with mild or no symptoms, or tested more than five weeks after symptoms started.”

The researchers also had several concerns about the quality of the studies they found. Dr Jac Dinnes, who worked on the review with the University of Birmingham team commented, “The design, execution and reporting of studies of the accuracy of COVID-19 tests requires considerable improvement and we plan to update this review regularly as more studies are published.”

 

Ultraviolet light can safely kill 99.9% airborne coronaviruses

Shreya Sharma
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Ultraviolet light can safely kill 99.9% airborne coronaviruses

Ultraviolet light of particular wavelength can safely disinfect 99.9% airborne coronaviruses in indoor environments

More than 99.9% of seasonal coronaviruses present in airborne droplets were killed when exposed to a particular wavelength of ultraviolet light that is safe to use around humans, a new study has found. The research was published in Scientific Reports.

Conventional germicidal UVC light (254 nm wavelength) can be used to disinfect unoccupied spaces such as empty hospital rooms or empty subway cars, but direct exposure to these conventional UV lamps is not possible in occupied public spaces, as this could be a health hazard.

To safely disinfect occupied indoor areas, researchers investigated far-UVC light (222 nm wavelength). Far-UVC light cannot penetrate the tear layer of the eye or the outer dead-cell layer of skin so it cannot reach or damage living cells in the body.

The same team had previously shown that far-UVC light can safely kill airborne influenza viruses.

far-UVC light could be used in combination with other measures, like wearing face masks and washing hands, to limit the transmission of SARS-CoV-2 and other viruses

In the study, the researchers used a misting device to aerosolize two common coronaviruses. The aerosols containing coronavirus were then flowed through the air in front of a far-UVC lamp. After exposure to far-UVC light, the researchers tested to see how many of the viruses were still alive.

Results showed that continuous exposure to far-UVC light at the current regulatory limit would kill 90% of airborne viruses in about 8 minutes, 95% in about 11 minutes, 99% in about 16 minutes, and 99.9% in about 25 minutes.

“Since SARS-CoV-2 is largely spread via droplets and aerosols that are coughed and sneezed into the air it’s important to have a tool that can safely inactivate the virus while it’s in the air, particularly while people are around,” said lead author of the study, David Brenner, PhD, Higgins Professor of Radiation Biophysics at Columbia University Vagelos College of Physicians and Surgeons and director of the Center for Radiological Research at Columbia University Irving Medical Center.

Brenner also added, “Because it’s safe to use in occupied spaces like hospitals, buses, planes, trains, train stations, schools, restaurants, offices, theaters, gyms, and anywhere that people gather indoors, far-UVC light could be used in combination with other measures, like wearing face masks and washing hands, to limit the transmission of SARS-CoV-2 and other viruses.”

Mayo team finds plasma therapy safe for patients with COVID-19

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Mayo team finds plasma therapy safe for patients with COVID-19

Mayo clinic researchers found convalescent plasma therapy safe for a diverse group of patients with COVID-19

Mayo Clinic researchers and collaborators have found convalescent plasma to be safe following transfusion in a diverse group of 20,000 patients with COVID-19.

The study is part of the U.S. Food and Drug Administration’s Expanded Access Program for COVID-19. The findings are reported in Mayo Clinic Proceedings. 

The safety report assessed the seven days following transfusion for hospitalized patients between April 3 and June 11 who were deemed at risk of progressing to a severe or life-threatening condition. Nearly 40% of the patients were women; 20% African Americans; nearly 35% Hispanic and 5% Asian. Seven-day mortality rates declined to 8.6 % compared to 12% in a previous safety study of the first 5,000 transfused patients. Serious adverse events continued to be less than one percent.

Seven-day mortality rates declined to 8.6 % compared to 12% in a previous safety study of the first 5,000 transfused patients

“Our efforts to understand convalescent plasma continue,” said Michael Joyner, M.D., principal investigator of the EAP at Mayo Clinic and lead author of the article. “We’re optimistic but must remain objective as we assess increasing amounts of data.”

This expanded safety report reveals a decline in mortality which appears identical with the recent published studies, but the authors caution that this alone does not provide any evidence on effectiveness of convalescent plasma for treating COVID-19. Researchers are now expanding their focus to determine indicators of efficacy of convalescent plasma because of the rapidly increasing use of this therapy.  At this time, convalescent plasma therapy is the only antibody-based therapy for COVID-19.

The researchers commented that while the mortality rate has decreased, the patients in the latter part of this study were less critically ill. They also said the decrease may be in part due to improved medical care based on increased knowledge during the pandemic and that more of the patients received the plasma earlier in their hospital treatment. 

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