Category: Hospitals

Categories : Hospitals Medical Research & TechnologyTags :

Research Shows Surgical Simulation Training Improves Performance

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Photo by Tim Cooper on Unsplash

Success with independent surgical simulation training has made it the new normal for students at the Pan Am Clinic.

Traditionally, surgical resident training has been master–apprentice-type relationship, with gradually increasing responsibilities until the trainees can do procedures on their own. Given recent pressures in the health care system, including reduced operating room time, increased difficulty of procedures and working hour restrictions, there is less time for residents to learn using the traditional method.

Surgical simulation, a surprisingly old system, dates back nearly 2500 years, when they were first used to plan innovative procedures while maintaining patient safety. One of the first recorded instances of surgical simulation was the use of leaf and clay models in India around 600 BC to conceptualise nasal reconstruction with a forehead flap

In a recent study, researchers from the University of Manitoba and the Pan Am Clinic recently examined the effectiveness of a mixed reality simulator for the training of arthroscopy novices.

Study author Dr Samuel Larrivée said: “Sports surgeons at our institution noted anecdotally that junior residents had difficulty reaching competency in arthroscopic skills by the end of their three-month rotation, and were not as prepared when starting their senior rotation. There was a need to increase training opportunities outside of the operating room in order to prepare our residents for independent practice.”

Prior to obtaining the ArthroS™ simulator, the University of Manitoba Orthopedic Surgery program occasionally made use of options such as benchtop dry simulators, cadavers and an older generation simulator with active haptics. These largely complemented academic teaching sessions in small groups with some success, and were available for use by residents as needed. But, due to the low fidelity and difficult setup, few residents took advantage of it.

However, medical students readily took to the ArthroS simulator. Alisha Beaudoin, a co-author and medical student, attested to her experience using the ArthroS simulator in her early training. “I found this training to be very helpful during my surgery rotation. Many of my preceptors were impressed by my superior arthroscopic and laparoscopic skills. This training may allow students with an interest in surgery to be more prepared.

“Recently, many Canadian universities have moved to competency-based curriculums where residents must demonstrate competency prior to moving to the next defined practice level. The study noted that this is similar to the training available on VirtaMed ArthroS and that “a user enrolled in the mentoring program is progressed through various levels of training by meeting training targets, essentially providing a proficiency-based progression.”

This paper is the first in what the authors hope is a larger body of work on validating arthroscopy simulators for resident training. There are currently plans to repeat similar studies with the other modules (hip, shoulder, and ankle), with larger sample sizes, and at different levels of training.

Participants were split into three groups: simulator training only, mentor-based training, and a control. After  four weeks, surgical performance improved among both traditional and simulator-based training groups. The study concluded that “simulator training may provide enhanced skills to improve patient safety overall, as residents may become more skilled earlier in their training, leaving more time for the mentor to teach more advanced skills.” Dr Beaudoin further explains: “I believe that simulation training should be introduced into the standardised curriculum because I believe it offers a safe space to hone your skills and improve in a stress-free environment.”

On the strength of the results, the residency programme has made it a requirement in the curriculum that residents in their sports rotation complete the self-learning modules. Dr Larrivée believes this will help residents develop their triangulation skills and memorise the steps ahead of their first surgery, and to consolidate their knowledge.

Source: VirtaMed

Categories : COVID HospitalsTags : 1 Comment

Upgrade to FFP3 Face Mask Dramatically Cuts Infections

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Photo by Artem Podrez from Pexels

Upgrading face masks to filtering face piece (FFP3) respirators for healthcare workers on COVID wards produced a dramatic reduction in hospital acquired SARS-CoV-2 infections, according to a preliminary study published in the BMJ.

For most of 2020, Cambridge University Hospitals NHS Foundation Trust followed national guidance that healthcare workers should use fluid resistant surgical masks as respiratory protective equipment unless aerosol generating procedures (AGPs) were being carried out when FFP3 respirators were advised.

From the pandemic’s outset, the trust has been regularly screening its healthcare workers for SARS-CoV-2 even when asymptomatic. They found that healthcare workers on “red” COVID wards had a greater infection risk than staff on “green” wards, even with protective equipment. So in December 2020 the trust implemented a change in policy so that staff on red wards wore FFP3 masks instead of fluid resistant surgical masks. The FFP3 standard requires that masks filter 99% of all particles measuring up to 0.6 μm.

The study was carried out at Addenbrooke’s Hospital in Cambridge. Before the change in policy, cases among staff were higher on COVID versus non-COVID wards in seven out of eight weeks analysed. Following the change in protective equipment the incidence of infection on the two types of ward was similar. Of 609 positive results over the eight week study period, 169 were included in the study. Healthcare workers who were not ward based or worked between different wards were excluded, as were, non-clinical staff, and staff working in critical care areas.

The researchers developed a simple mathematical model to quantify the risk of infection for healthcare workers. This found that the risk of direct infection from working on a red ward prior to the policy change was 47 times greater than the corresponding risk from working on a green ward. While almost all cases on green wards were likely caused by community-acquired infection, cases on red wards at the beginning the study period were attributed mainly to direct, ward-based exposure.

The model also suggested that the introduction of FFP3 respirators provided 100% protection (confidence interval 31.3%, 100%) protection against direct, ward based covid infection.

Study author Chris Illingworth, from the MRC Biostatistics Unit at the University of Cambridge, said: “Before the face masks were upgraded, the majority of infections among healthcare workers on the COVID wards were likely because of direct exposure to patients with COVID. Once FFP3 respirators were introduced, the number of cases attributed to exposure on COVID wards dropped dramatically—in fact, our model suggests that FFP3 respirators may have cut ward based infection to zero.”

Michael Weekes from the department of medicine at the University of Cambridge added: “Our data suggest there’s an urgent need to look at the PPE offered to healthcare workers on the frontline. Upgrading the equipment so that FFP3 masks are offered to all healthcare workers caring for patients with COVID could reduce the number of infections, keep more hospital staff safe, and remove some of the burden on already stretched healthcare services caused by absence of key staff because of illness.”

Source: The BMJ

Journal information: BMJ 2021;373:n1663

Categories : Hospitals Obstetrics & GynaecologyTags :

Breakthrough AI Development for Premature Baby Care

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Researchers believe they have made a breakthrough in the science of keeping premature babies alive.

As part of her PhD work, James Cook University engineering lecturer Stephanie Baker led a pilot study that used a hybrid neural network to accurately predict how much risk individual premature babies face. This study was published in the journal Computers in Biology and Medicine.

Complications resulting from premature birth are the leading cause of death in children under five and over 50% of neonatal deaths occur in preterm infants, she said. In 2005, 12.9 million births, or 9.6% of all births worldwide, were preterm.

“Preterm birth rates are increasing almost everywhere. In neonatal intensive care units, assessment of mortality risk assists in making difficult decisions regarding which treatments should be used and if and when treatments are working effectively,” said Ms Baker.

To better guide their care, preterm babies are often given a score that indicates the risk they face.

“But there are several limitations of this system. Generating the score requires complex manual measurements, extensive laboratory results, and the listing of maternal characteristics and existing conditions,” noted Ms Baker.

She said the alternative was to measure variables that do not change (eg, birthweight) that prevents recalculation of the infant’s risk on an ongoing basis and does not show their response to treatment.

“An ideal scheme would be one that uses fundamental demographics and routinely measured vital signs to provide continuous assessment. This would allow for assessment of changing risk without placing unreasonable additional burden on healthcare staff,” said Ms Baker.

She said the JCU team’s research had culminated in the Neonatal Artificial Intelligence Mortality Score (NAIMS), a hybrid neural network that relies on simple demographics and trends in heart and respiratory rate to determine mortality risk.

“Using data generated over a 12 hour period, NAIMS showed strong performance in predicting an infant’s risk of mortality within 3, 7, or 14 days.

“This is the first work we’re aware of that uses only easy-to-record demographics and respiratory rate and heart rate data to produce an accurate prediction of immediate mortality risk,” said Ms Baker.

According to Ms Baker, the technique was fast with no invasive procedures or knowledge of medical histories needed.

“Due to the simplicity and high performance of our proposed scheme, NAIMS could easily be continuously and automatically recalculated, enabling analysis of a baby’s responsiveness to treatment and other health trends,” said Ms Baker.

She said NAIMS had proved accurate when tested against hospital mortality records of preterm babies and had the added advantage over existing schemes of being able to perform a risk assessment based on any 12 hour period of data gathered during the patient’s stay.

Ms Baker said the next step in the process was partnering with local hospitals to gather more data and undertake further testing.

“Additionally, we aim to conduct research into the prediction of other outcomes in neo-natal intensive care, such as the onset of sepsis and patient length of stay,” said Ms Baker.

Source: James Cook University

Journal information: Baker, S., et al. (2021) Hybridized neural networks for non-invasive and continuous mortality risk assessment in neonates. Computers in Biology and Medicine. doi.org/10.1016/j.compbiomed.2021.104521.

Categories : Gastrointestinal HospitalsTags :

High Risk for Upper GI Bleeding Developed During Hospital Stay

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Photo by Anna Shvets from Pexels

Patients who developed upper gastrointestinal (GI) bleeding during a hospital stay experienced worse adverse outcomes than those admitted for upper GI bleeding alone, according to a new study from France.

Currently hospitalised patients (inpatients) with upper GI bleeding showed a significantly higher mortality rate at 6 weeks than patients hospitalised for GI bleeding alone (outpatients), at 21.7% versus 8.8%, respectively, as well as increased frequency of rebleeding .

Upper GI bleeding is a common problem that occurs in 80 to 150 out of 100 000 people annually, with mortality rates between 2 and 15%. The condition is described as blood loss from a gastrointestinal source above the ligament of Treitz. 

Though upper GI bleeding in patients has fallen over the past decades, rates of rebleeding and mortality remained stable or risen slightly. The authors said that modifiable risk factors need to be identified to help reduce this.

Researchers investigated the outcomes among inpatients and outpatients with upper GI bleeding, collecting data on 2498 patients with upper GI bleeding from 46 hospitals. Inpatients were defined as patients who developed variceal or non-variceal bleeding at least 24 hours after hospitalisation, and outpatients (75% of participants) were defined as presenting with bleeding upon admission.

Primary outcomes included mortality and rebleeding rates, assessed at 6 weeks from onset. Hospital stay duration, and the requirement for radiological or surgical intervention were secondary outcomes.

Outpatients were younger (average age 67), more likely to be smokers and consumed more alcohol than inpatients. Inpatients had a significantly higher rate of comorbidities (39% vs 27%, respectively), and more inpatients had a Charlson score above 3 than outpatients (38.9% vs 26.6%). There was no difference in sex or body weight.

Outpatients had a shorter hospital stay of 9 days compared to 16 for inpatients. The  authors noted that the groups did not differ in needing radiological or surgical intervention.

More inpatients were taking aspirin, steroids, and heparin, while more outpatients were taking oral anticoagulants and NSAIDs. At bleeding onset, more inpatients were on proton pump inhibitors (PPIs) than outpatients (41.6% vs 27.5%). However, more outpatients received intravenous PPIs than inpatients (87% vs 79%).

“Despite the more prevalent use of PPI among inpatients, their [upper gastrointestinal bleeding] was mainly related to peptic ulcer disease (PUD) and [esophagitis],” the authors explained. “This may be explained by the higher intake of aspirin and steroids, known to increase PUD-related haemorrhage risks especially in the elderly and hospitalized patients.”

For all patients, risk factors associated with 6-week mortality were rebleeding, Charlson score > 3, haemodynamic instability, pre-Rockall score > 5 and being an inpatient.

Independent  mortality risk factors for inpatients were prothrombin < 50% and rebleeding, though bleeding-related mortality was lower among inpatients compared to outpatients (10.8% vs 20.6%).

“We found that mortality in outpatients was more likely to be directly related to [upper gastrointestinal bleeding] as opposed to inpatients where death resulted more commonly from other causes,” the authors stated.

When looking at patient groups separately, cirrhosis and antiplatelets were independent outcome predictors among outpatients, in addition to rebleeding, comorbidities, haemodynamic instability and severity of bleeding.

Difficulty in comparability of results to previous studies is a limitation to this study due to the 6-week mortality timeline versus the 28-day one for previous studies. The reason for inpatient hospitalisation also was not recorded, which could impact the results.

Source: MedPage Today

Journal information: El Hajj W, et al “Prognosis of variceal and non-variceal upper gastrointestinal bleeding in already hospitalised patients: Results from a French prospective cohort” United European Gastroenterol J 2021; DOI: 10.1002/ueg2.12096.

Categories : HospitalsTags :

Gift of The Givers Rescues Hospital by Drilling for Water

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Photo by Anandan Anandan on Unsplash

Three weeks into Johannesburg’s water crisis, which has put tremendous strain on hospitals amid the pandemic, Gift of the Givers have said they will drill for water at Rahima Moosa Mother and Child Hospital.

“Having delivered bottled water on 28 and 31 May, Gift of the Givers drilling teams will be arriving at the hospital shortly, having been granted permission by the management and infrastructure team to drill for water,” said Imtiaz Sooliman, founder of the non-governmental disaster response organisation, the largest African one on the continent.

According to the Daily Maverick, Johannesburg Water’s infrastructure woes are the consequence of years of chronic under-funding. In its business plan for the year, the entity has “has an infrastructure renewal backlog of approximately R19.9-billion as a result of underfunding, which has also led to having 25% of the asset base (reservoirs, towers, pipes, etc) that has a remaining useful life of less than 10 years.”

Amidst concerns about knock-on effects on facilities such as Helen Joseph and Rahima Moosa hospitals, Gauteng health department spokesperson Kwara Kekana said that since last week, the hospitals’ management were trying to ease the pressure on the two worst affected facilities by transferring some patients to other hospitals and performing some theatre operations at sister hospitals.

Hospital staff and management had approached Gift of the Givers, requesting bottled water, portable toilets and any means to augment the water tankers arriving daily.

Rahima Moosa is one of the feeder hospitals for the temporarily closed Charlotte Maxeke Hospital and healthcare workers trying to work through a backlog of non-COVID patients between the second and third waves. It couldn’t have come at a worse time, said Sooliman,

“Add to that a desperate community thronging to the hospital in search of drinking water, clearly worsening COVID risk,” he said.

Sooliman said a drilling site had been identified.

“Existing, defunct boreholes will be assessed with a view to resuscitating them while drilling for new boreholes then pumping water directly into the hospital infrastructure using booster pumps and setting up taps outside the hospital for community use once the water has been tested and approved for human consumption,” said Sooliman.

Bottled water from companies will be welcomed while they waited for the work to be completed, he added.

Source: Times Live

Categories : Hospitals Mental HealthTags :

Social Support Boosts Patient Survival by 29%

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New research from Brigham Young University found that providing medical patients with social support increases odds of survival and prolongs life. It comes as healthcare is searching for new ways to improve medical treatment and outcomes.

“The premise of the research is that everyone is strongly influenced by their social context,” said BYU counseling psychology professor Timothy B. Smith, lead author of the study. “Relationships influence our behavior and our physical health. We now know that it is possible to prolong life by fostering coping and reducing distress.”

Co-author Julianne Holt-Lunstad, BYU psychology professor, said there is now ample evidence that social needs should be addressed within medical settings.

“From pediatrics to geriatrics, physicians may encounter patients who are struggling. These data suggest that social interventions integrated within clinical treatments that help patients cope and reduce distress also improve their survival,” she said.

Analysing data from 106 randomised controlled trials with over 40 000 patients, the researchers examined the effects of psychosocial support. Group meetings or family sessions that promoted healthy behaviours by encouraging exercise, the completion of medical treatments, or offering group support for diet adherence increased survival by 29%.

“Providing medical patients with social support can be just as helpful as providing cardiac rehabilitation for someone recovering from heart disease,” said Smith. “It can be just as helpful as a diet or lifestyle program for obese patients or treatment for alcoholism among patients with alcoholism.”

The findings  could be used to implement support programs in hospitals and clinics for patients, especially those at risk of not completing treatments. It could also inform programmes for family members or caregivers.

“We already had robust evidence that social connection and other social factors significantly influence health outcomes including risk for premature mortality, but it was unclear what can be done about it to reduce risk,” said Holt-Lunstad. “Is it the role of healthcare, or should this be addressed outside the healthcare system? This research combined with the other consensus reports suggests that it is a role of the healthcare system.”

“Ultimately, these data should be used to foster collaboration between medical professionals and mental health professionals,” said Smith. “About half of all patient medical visits are about conditions that entail psychological considerations. Large hospitals now routinely hire psychologists to consult with physicians and to evaluate or work with patients, but more integration is needed in smaller hospitals and clinics.”

The findings also hold important implications for medical patients. People respond differently to medical conditions. While some will immediately take action in rehabilitation or preventative measures, others might delay or even avoid engaging in prescribed healthy behaviors. On top of that, depression and anxiety rates can be high among patients, which can limit responsiveness to treatments, making social support efforts even more critical.

“We know that when hospitals implement a social support group, people simply live longer,” said Connor Workman, a BYU student who assisted with the research during his undergraduate years. “The data show that relationships have a tangible effect on a person’s mortality and health. This will give decision-makers at hospitals the information they need to start pushing out programs and implementing the right social connections for patients.”

Source:  Brigham Young University

Categories : HospitalsTags :

SA Medical Insurance Schemes in the Crosshairs

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The Health Professions Council (HPCSA) said that South Africa’s new National Health Insurance (NHI) should be the sole funding mechanism for health in South Africa.

Addressing parliament on Tuesday, the president of HPCSA, Professor Simon Nemutandani, said that while the organisation accepts that the existence of private medical aid schemes in South Africa can continue, they should funded separately — over and above tax paid for the NHI.

The NHI itself should be funded through taxes paid by all employed South Africans, he said.

“For the NHI to succeed, health must be an exclusive national competence – and any sections of the Constitution that militate against this view must be amended,” the HPCSA stated.

“The Medical Schemes Act must also be amended to ensure alignment with the NHI. NHI should be about funding and contracting, while service provision is left to other entities — public and private.”

Prof Nemutandani said that the NHI Bill should repeal the Medical Schemes Act in its entirety, as the nationalised, centralised health funding system would have no place for it.

For those seeking additional insurance for health cover, they could apply for it under the Insurance Act. Medical schemes should also offer only complementary coverage for services that would not be covered by the NHI, he said.

Additionally, the current reserves of medical schemes — some R90 billion — and all other assets under their control should be transferred to the NHI, said Prof Nemutandani.

“It should be clear that the (NHI) replaces all funding mechanisms for health,” Prof Nemutandani said. “It must also be clear that the NHI is taking over from the medical schemes, and that all assets under the control of the medical schemes must be taken by over the NHI.”

Problematic aspects

The Board of Health Care Funders (BHF) said in its submission that current medical cover providers should be allowed to continue as insurance products. They also pointed out that a number of the Bill’s aspects are problematic, including a provision in the Bill transferring powers and duties of provinces to national government.

The BHF also expected there would be challenges from healthcare service providers and from members of the public over restrictions of their choices. Duplication of services and waste was another concern.

The NHI Bill was presented to and approved by cabinet in July 2019, and has been presented to parliament’s health portfolio committee.

Since then, it has been through an extensive public consultation process through committee roadshows and is scheduled for further parliamentary debates before being presented to the president for promulgation.

However, the Council for Medical Schemes has acknowledged that South Africa’s current financial situation and the impact of the COVID lockdown will make the rollout of the new NHI more difficult.

Source: BusinessTech

More information: Summary of all submissions (PDF)

Categories : Hospitals Substance UseTags :

Only Total Alcohol Bans Relieve Pressure on SA Hospitals

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A new study found that alcohol bans could be a sensible policy to help South Africa through new health crises, according to a study published on Monday.

Based on local hospital admission data, the authors said that their work demonstrates that “alcohol prohibition correlates with a decrease in health seeking behaviour for injury”.

Several organisations in the liquor industry have started pre-emptive lobbying in the face of possible new alcohol bans as COVID infections are rising in a third wave. At the same time, The Southern African Alcohol Policy Alliance is pressuring the government to institute tougher alcohol controls to pre-empt the new wave of infections. 

The study was published in the journal Drug and Alcohol Review.

The authors, all associated with Stellenbosch University or the South African Medical Research Council, which helped fund their work, compared data from Worcester Regional Hospital for 2020 with the same from 2019, across trauma admissions, trauma operations, and stab wound admissions, “as a proxy for intentional injury”.

A pattern of decreased hospital use was observed in 2020 when there were bans and partial bans, and a resurgence following even the partial lifting of bans.

“Each time a complete ban was instituted, there was a significant drop in trauma volume which was lost by allowing alcohol (even partial sales),” the researchers wrote.

Specifically, there was a 59–69% decrease in trauma volume between pre-Covid-19 and the first complete ban period. When alcohol sales were partially rein-stated, trauma volume significantly increased by 83–90% then dropped again by 39–46% with the second alcohol ban.”

The study “demonstrates a clear trend of decreased trauma admissions and operations during complete alcohol prohibition compared to when alcohol sales were allowed or only partially restricted,” the authors wrote.

They concluded that an alcohol ban is an effective way to reduce strain on healthcare infrastructure.

“These findings suggest that temporary, complete bans on alcohol sales can be used to decrease health facility traffic during national emergencies.”

The authors considered the possibility other measures such as the curfew could have affected the result, but argued that it was unlikely.

Source: Business Insider

Categories : HospitalsTags :

Cyber Attack Cripples Ireland’s Health Services

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A “significant ransomware attack” caused widespread disruption to Ireland’s health service, forcing cancellations and blocking services.

Paul Reid, Ireland’s Health Service Executive chief executive, told RTÉ there had been a “human-operated” attempt to access data for a likely ransom. “There has been no ransom demand at this stage. The key thing is to contain the issue. We are in the containment phase.”

Reid said the HSE was working with police, the defence forces and third-party cybersecurity experts to respond to the cyber attack. He apologised to patients and the public for the disruption.

The attack has affected national and local systems that provide core services. However COVID vaccinations and ambulance services were unaffected.

Several hospitals cancelled outpatient visits or asked patients with appointments to not attend. The Rotunda, a Dublin maternity hospital, said it was experiencing a “critical emergency”, cancelling all outpatients visits save for women over 35 weeks pregnant.

At Cork university hospital, the oncology department was reportedly brought to a halt. The child and family agency Tusla said its IT systems, including the portal through which child protection referrals are made, were offline.

In the US earlier this week, the Colonial petrochemical pipeline was crippled in a major cyberattack by a cybercriminal group called Darkside, resulting in fuel shortages and states of emergency being declared. The pipeline company reportedly paid a ransom fee of $5 million to get control back of their systems.

Master of the Rotunda Hospital Professor Fergal Malone told Morning Ireland that accessing patient records and data was the reason for the cancellations.

There was a backup plan to use an “old-fashioned” paper-based system, he said, but added that “throughput would be much slower” this way.

Malone said the hospital discovered unusual activity in its IT systems at about 2am and later detected what appeared to be a ransomware virus. “We use a common system throughout the HSE in terms of registering patients and it seems that must have been the entry point or source,” he told RTÉ. “It means we have had to shut down all our computer systems.”

However, all patients were safe. “We have systems in place to revert back to old-fashioned record-keeping.” Lifesaving equipment was not affected. “Patients will come in in labour over the weekend and we will be well able to look after them.”

Source: The Guardian

Categories : COVID HospitalsTags :

Indian Medical Trainee Exams Postponed to Boost Personnel

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Indian flag. Photo by Naveed Ahmed on Unsplash

India postponed exams for trainee doctors and nurses on Monday, freeing them up to fight the world’s biggest surge in COVID infections, as the health system buckles under the weight of new cases, and a lack of beds and oxygen.

The total number of infections so far rose to just short of 20 million, propelled by a 12th straight day of more than 300 000 new cases.

Actual numbers in India could be five to 10 times higher than those reported, according to medical exports.

Hospitals have been overloaded, oxygen has run short, and morgues and crematoriums have struggled with the number of corpses. 
“Every time we have to struggle to get our quota of our oxygen cylinders,” said BH Narayan Rao, a district official in the southern town of Chamarajanagar, where 24 COVID patients died, some suspected from lack of oxygen.

“It’s a day-to-day fight,” added Rao, describing the struggle for supplies.

In many cases, volunteer groups have come to the rescue. Outside a temple in India’s capital, New Delhi, Sikh volunteers provided oxygen to patients lying on benches inside makeshift tents, hooked up to a giant cylinder. A new patient would come in every 20 minutes.

“No one should die because of a lack of oxygen. It’s a small thing otherwise, but nowadays, it is the one thing every one needs,” Gurpreet Singh Rummy, who runs the service, told Reuters.

Offering a glimmer of hope, the country’s health ministry said that positive cases relative to the number of tests fell on Monday for the first time since at least April 15, and modelling shows that the virus could peak on Wednesday.

While 11 states and regions have put movement curbs in place to stem transmissions, Prime Minister Narendra Modi’s government, widely criticised for allowing the crisis to spin out of control, is reluctant to announce a national lockdown, concerned about the economic impact.

“In my opinion, only a national stay at home order and declaring medical emergency will help to address the current healthcare needs,” Bhramar Mukherjee, an epidemiologist with the University of Michigan, said on Twitter.

As medical facilities near collapse, the government postponed an exam for doctors and nurses to free up some to join in the COVID fight, it said in a statement.

Prime Minister Modi has provoked criticism for not acting earlier to limit the spread and for allowing millions of people, mostly without masks, to attend religious festivals and political rallies during March and April.

In early March, a forum of government scientific advisers warned officials of a new and more contagious variant of the coronavirus taking hold, five of its members told Reuters.

Four of the scientists said in spite of the warning, the federal government did not try and impose strict curbs.

Meanwhile, in response to India’s crisis, aid has poured in. On Sunday, the UK government said it will send another 1000 ventilators to India. 

Several nations have shut their borders to Indian arrival as the Indian COVID variant has now reached at least 17 countries including the UK, Iran and Switzerland.

Source: Reuters