New Delhi: An everyday medical device, called a pulse oximeter, has recently started gaining attention for its potential in diagnosing and monitoring COVID-19 symptoms. A small equipment that clips onto a person’s finger, pulse oximeter measures pulse and the percentage of oxygen in the blood. It is mostly used for monitoring patients in hospital including those who have had some surgeries and at homes by people with respiratory problems. According to medical experts, the device helps the healthcare provider to decide whether the patient needs extra oxygen.
Dr. Arvind Kumar, Director, Institute of Robotic Surgery and the Chairman of Centre for Chest Surgery and Lung Transplantation at Sir Ganga Ram Hospital, New Delhi said that a pulse oximeter measures blood oxygen saturation and heart rate by shining a light through the skin and detecting both the colour and movement of your blood cells. Blood cells with a good amount of oxygens are bright red while other are dark red. The pulse oximeter compares the number of bright red cells to dark red cells to calculate oxygen saturation as a percentage, he said. So, if the reading says 95 per cent, it means that 5 per cent of the blood cells have been depleted of oxygen. He added,
Pulse oximeter helps in detecting hypoxia, a condition in which the body is deprived of adequate oxygen supply.
According to Dr. Kumar, the normal blood oxygen saturation level for someone who is healthy will be around 95–100 per cent. The oxygen level below 95 per cent indicates that there is a lung problem. A level below 92 per cent would suggest that the person is seriously ill and may need supplementary oxygen or to be monitored in the hospital.
A pulse oximeter runs on battery and provides real-time results on a small LED (light-emitting diode) display on the device itself.
Dr. Surya Kant, Professor and Head of Department of Respiratory Medicine, King George’s Medical University (KGMU) Lucknow explained that a pulse oximeter is part of a larger screening and testing process of COVID-19 patients and cannot detect the disease on its own. He said,
A pulse oximeter may indicate issues with blood oxygen levels which could be related to coronavirus because COVID-19 is not the only disease that causes low blood oxygen levels. Other diseases like Chronic obstructive pulmonary disease (COPD), asthma and other non-COVID-19 lung infection can also result in low oxygen count.
He added that pulse oximeter is recommended for the early detection of ‘COVID Pneumonia’, a potentially deadly condition seen among the most severe coronavirus cases.
In a video interaction with the Health Ministers and Health Secretaries of the States on April 24, Union Health Minister Dr. Harsh Vardhan said that the portable pulse oximeter can help in early diagnosis of the corona patients which can help to curb the mortality rate due to COVID-19.
According to Dr. Kumar, patients suffering hypoxia need to be identified and given oxygen supply. He said,
In many cases, the patients may feel comfortable and may not realise that they have developed hypoxia. This means that the lungs of the patients are tending to involve in the disease. Relying only on clinical tests or waiting for advanced symptoms like shortness of breath to occur may delay the treatment and the patient may become critical due to the loss of this precious time. Regular monitoring of oxygen level will help medical staff to take actions sooner instead of waiting for shortness of breath or pneumonia to occur. This will also help in curbing the sudden increase in distress.
Explaining further, Dr. Kumar gave an example of the 31-year-old police constable who died at Ram Manohar Lohia (RML) Hospital, Delhi on Tuesday (May 5). He said,
The young constable showed no COVID-19 symptoms until Monday evening. Within the next few hours, he had spiked a fever and developed breathing problems prompting his family to rush him to the hospital where he was declared brought dead. I think that he was in a hypoxic state which went undetected in time.
Dr. Surya Kant says that buying a pulse oximeter for using at home is not necessary at all. He said,
There is no need to panic and buy pulse oximeter for home use. If a COVID-19 positive patient feels uncomfortable, they can have their assessment done at the nearby hospital. All hospitals and most doctors have pulse oximeter.
The complex world of Covid-19 vaccine trials explained.
SOMEWHERE IN THE DEEP UNEXPLORED depths of Madagascar, an unknown herb is probably on its way to becoming a global panacea for the pandemic
This is Africa, a continent ripe with possibilities, where you cannot rule out that a cure for Covid-19 could perhaps come from nature itself. Just like Madagascar, currently touting Artemisia Afra (umhlonyane in Nguni languages and previously used as an ingredient for treating malaria) as a potential cure for Covid-19, bigger economies like South Africa are also looking to the botanical world for answers. Its national Department of Basic Education has reassigned R15 million ($960,982) of its budget on Covid-19 interventions such as Artemisia. Nigeria has also made a move towards a more homeopathic approach, as a ministerial committee has been put in place to further examine the potential natural compounds hold in combating the Covid-19 pandemic.
But the focus of this story is exploring humanity’s race to uncover a universal vaccine – or any cure – that can assuage a health crisis confronting the entire world.
Currently, there are over 60 possible vaccines the world over being put through the paces. Of these, only nine are in the third phase of trials. The road to finding a Covid-19 vaccine since the start of the pandemic this year has been long and arduous. For the layperson, desperate to see an effective vaccine come online soon, the deluge of news on vaccine trials can seem complex. This article will discern the facts around them.
In comparison to its European and American counterparts, Africa has seen a relatively lower rate of virus spread and a lower death rate. As of November 11, Africa accounted for 3.7% of the world’s total number of cases; and southern Africa the worst hit with over 800,000 cases.
Scientists are yet to definitively map out the effects of the Covid-19 virus and its ability to recur within individuals who have had it before. Fear of public spaces and physical interactions have become the norm. Face masks and sanitizing products have become staples in every handbag and car cubbyhole.
Put simply, a clinical trial is a series of phases within an experiment being conducted to test a new drug, type of therapy or new medical device. It also looks at the efficacy of pre-existing medical interventions in the treatment of numerous illnesses and different types of patients.
Clinical trials can be performed on both healthy and ill participants. There are a number of protocols and regulations that accompany a clinical trial to ensure that the wellbeing of the participant is maintained as far as possible. It ensures that the benefits of the medical intervention being tested outweigh the risks and each phase of a trial plays a part in testing this.
Clinical trials usually happen in four phases. Before these phases occur, a preclinical test is done. Each phase needs to produce a favorable result in order for the next phase to be conducted. In order for a medical intervention to get to the stage of manufacturing and distribution, all four phases need to have occurred successfully. The success of each phase is measured by the number of medically adverse events that have occurred as a result of the medical intervention being tested. These adverse events include mild to serious medical side-effects that have occurred to the participants of the trial.
Dr. Sinead Delany-Moretlwe, Director of Research at the Wits Reproductive Health and HIV Institute in Johannesburg, South Africa explains how innovations made with expediting the clinical trials for the Covid-19 vaccine could reshape how clinical trials are done across the board. She has also been the lead on HPTN 084, an injectable form of an antiretroviral (ARV) used to prevent HIV in women in sub-Saharan Africa.
The frantic search for a Covid-19 vaccine is being closely watched by every country on earth. At the time of going to press mid-November, there were currently 51 trials between Phases I and III of the clinical trials. When they will be available to all is a question on everyone’s mind.
South Africa’s Health Minister, talking to FORBES AFRICA about vaccine manufacturers, says: “Collaboration across global institutions has led to the transfer of technology and therefore new developments and new discoveries in combating the pandemic.”
In an interview with Aspen Pharmacare CEO and founder, Stephen Saad, he highlights to FORBES AFRICA the need for efficient manufacturing and distribution channels for the vaccine, once it becomes available. Aspen recently partnered with Johnson & Johnson for their vaccine Ad26.COV2-S(now known as JNJ-78436735). This partnership will see the manufacturing and distribution capacity of Johnson & Johnson increase significantly.
Saad explains that Aspen uses just 40% of their current manufacturing capacity for their own products and the other 60% was available for use. “Covid-19 is prevalent everywhere. We were very committed to trying to find a partner that would use our capabilities to be able to provide a vaccine,” says Saad.
At the heart of the partnership is the transfer of technology as Johnson & Johnson share their protocols and blueprint for creating the vaccine so they are able to manufacture it once it has passed Phase III trials.
“We are very pleased because Johnson & Johnson have made big commitments to distribute their vaccine universally, so they’ve made commitments through the Bill & Melinda Gates Foundation and to their own public statements about offering up 500 million doses to the developing world,” says Saad.
The manufacturing site in Port Elizabeth in South Africa’s Eastern Cape province will be utilized in this partnership where as many as 300 million doses can be produced and this is expected to begin the second quarter of next year should the Ad26.COV2-S proves successful.
“So much depends on the trials and the success of these trials,” says Saad. Aspen, having been linked to the success of the steroid Dexamethasone, and now as a vaccine frontrunner, have proven their reputation as a pharmaceutical powerhouse.
With an investment of R3 billion ($194 million) into their “sterile site”, Saad is confident. “There’s not a lot of companies that can manufacture on this scale,” he says.
Saad recognizes the urgency for a vaccine. “Our first and only priority right now is to get the product out to the world and our focus is on the job that we have to do very quickly over the next period.”
Currently, the only African country involved in the trial phases of these vaccines has been South Africa across different sites. Progress is being made by Oxford University as they await final clearance to begin trials in Kenya and the Uganda Virus Research Institute is aiming to collaborate with the Imperial College London and begin trials in Uganda in December.
Historically, only 2% of all vaccine trials have occurred on the African continent, according to a report in The Lancet.
Despite being no stranger to viral outbreaks, Africa as a whole is often excluded from the vaccine process and as such there is a severe lack of understanding of the African context when trialing a potential vaccine or medical intervention.
There are several factors that could possibly hinder the efficient and comprehensive administration of a Covid-19 vaccine when it eventually becomes available.
Accessibility to the vaccine is seen as a key issue, particularly within developing countries. While there are several initiatives such as the investments made by Coalition for Epidemic Preparedness Innovations as well as the Bill & Melinda Gates Foundation, African countries are still amongst the last buyers of any possible vaccine that emerges.
There is surely light at the end of the tunnel but it may be a while before a cure will finally see the light of day.
This article was originally published at:
Watch SA’s leading experts discuss the country’s #COVID19 vaccine strategy while answering pertinent questions from Morning Live viewers on SABC News this morning.
5 January 2021
Today we report a cumulative total of 1 127 759 COVID-19 cases identified, with 14 410 new cases since the last report, representing a 30% positivity rate.
|Province||Total cases for 05 January 2021||Percentage total|
A cumulative total of 6 828 147 tests have been conducted with 47 875 tests conducted since the last report.
Deaths, Recoveries and Active Cases
Regrettably, a further 513 deaths have been reported: Eastern Cape 124, Free State 14 , Gauteng 64, Kwa-Zulu Natal 92, Limpopo 3, Northern Cape 14 and Western Cape 202.
This brings the total deaths to 30 524.
We convey our condolences to the loved ones of the departed and thank the health care workers who treated the deceased.
Our recoveries now stand at 920 879 at a recovery rate of 81,6%
Dr Zwelini Mkhize
Minister of Health
Don’t be complacent about #Covid19, warns Dr Jacqui Brown, head of ICU at CH Baragwanath Hospital in Soweto.
Human Coronaviruses are common throughout the world. There are many different coronaviruses identified in animals but only a small number of these can cause disease in humans.
On 7 January 2020, ‘Severe Acute Respiratory Syndrome Coronavirus 2’ (SARS-CoV-2) was confirmed as the causative agent of ‘Coronavirus Disease 2019’ or COVID-19. The majority of the case-patients initially identified were dealers and vendors at a seafood, poultry and live wildlife market in China. Since then, the virus has spread to more than 100 countries, including South Africa.
Currently, travellers to areas where there is ongoing sustained transmission of COVID-19 including Mainland China (all provinces), Hong Kong, Japan, Republic of Korea, Singapore, Vietnam, Taiwan, Italy and the Islamic Republic of Iran are at greatest risk of infection.
Furthermore, the elderly, individuals with co-morbidities and healthcare workers have been found to be at a higher risk of death.
While the first cases probably involved exposure to an animal source, the virus now seems to be spreading from person-to-person.
The spread of the disease is thought to happen mainly via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza and other respiratory pathogens spread. Thus far, the majority of cases have occurred in people with close physical contact to cases and healthcare workers caring for patients with COVID-19.
Current symptoms reported for patients with COVID-19 have included mild to severe respiratory illness with cough, sore throat, shortness of breath or fever.
The complete clinical picture with regard to COVID-19 is still not fully clear. Reported illnesses have ranged from infected people with little to no symptoms to people being severely ill and dying.
Treatment is supportive (providing oxygen for patients with shortness of breath or treating a fever, for example). To date, there is no specific antiviral treatment available. Antibiotics do not treat viral infections. However, antibiotics may be required if a bacterial secondary infection develops.
The following can provide protection against infection from Coronaviruses and many other viruses that are more common in South Africa:
On 23 March 2020, President Cyril Ramaphosa announced a new measure to combat the spread of the Covid-19 coronavirus in South Africa – a three-week nationwide lockdown with severe restrictions on travel and movement, supported by the South African National Defence Force – from midnight on Thursday, 26 March, to midnight on Thursday, 16 April. The President said more needed to be done to avoid “an enormous catastrophe” among the population.
In essence, this meant people would only be allowed to leave their homes to buy food, seek medical help or under other extreme circumstances.
The lockdown follows government regulations that limited public gatherings, travel from high-risk countries and the sale of alcohol.
In addition, borders were closed to reduce the rate of infection from those travelling into South Africa from other countries. A quarantine was also enforced on inbound travellers and returning citizens.
On Wednesday, 1 April, Minister of Health, Dr Zweli Mkhize, launched 60 new mobile laboratories to boost the country’s capacity to test for COVID-19.
The sampling and testing units, procured by the National Health Laboratory Service (NHLS), will be deployed nationwide to all priority districts and metros.
10,000 community health care workers will be deployed across the country for door-to-door household screening. Each province has been requested to start working on this strategy by deploying provincial community healthcare workers, with appropriate Personal Protective Equipment, to undertake a house-to-house programme of “no-touch” screening for Covid-19 symptoms and to refer symptomatic people to clinics for testing.
In addition, PEPFAR-funded District Support Partners have been instructed to support provinces in this programme.
South Africa currently has the capacity to conduct 5,000 tests for COVID-19 daily. However, with the addition of mobile testing units, combined with 180 testing sites and 320 testing units across the country, this number will now increase six-fold.