Do COVID vaccines cause heart inflammation?

Yes

COVID Vaccines have caused heart inflammation in a small minority of people.

But that does NOT mean Vaccines have to be avoided.

The benefits of vaccines are far higher than risk of side effects for vast majority of adult population.

People have not stopped traveling by car because of risk of road accidents. This is because benefits considerably outweigh the risks !

References

BBC news. Heart inflammation link to Pfizer and Moderna jabs
By James Gallagher
Health and science correspondent

BMJ. News Analysis.
Covid-19: Should we be worried about reports of myocarditis and pericarditis after mRNA vaccines?
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1635 (Published 24 June 2021)
Cite this as: BMJ 2021;373:n1635

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s personal views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is NOT previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice.

A new blood test for cancer

Cancer cells can float in a person’s blood. But finding them, in the past, used to be like “looking for a needle in a haystack”.

But new smart technology promises to detect these cancer cells easily and much early before a person develops symptoms. Detection of cancer cells at an early stage may be helpful for some patients.

A recently published study in the journal “Annals of Oncology” reports exciting results.

A Californian company called Grail has developed a blood test which seems to have a high degree of accuracy for detection of multiple cancers.

Times newspaper reports that “The NHS will begin a pilot scheme of the test with 140,000 people this year. If that is successful it will be used for millions of patients by 2025”

A word of caution though.

Just because something could be diagnosed early does not always mean that it is a good thing.

The most important thing is whether the early diagnosis can lead to better cure rates and a better quality of life.

If a test detects a cancer early but has no meaningful effect on quantity or quality of life, then it is not a good thing.

For example. Up to 80% of men have prostate cancer which can now be detected by a simple blood test called PSA. There is a good reason why we are NOT using the simple PSA test in every 80 year old.

Most 80 year old men die WITH prostate cancer rather than DUE to prostate cancer.

So why diagnose a cancer that is not causing symptoms if it is not going to make person live longer !

REFERENCES

Times. New blood test, created by Californian company Grail, detects cancers among over-50s. Kat Lay, Health Editor. Friday June 25 2021, 12.01am, The Times.

Clinical validation of a targeted methylation-based multi-cancer early detection test using an independent validation set. E A Klein et al. Ann Oncol. 2021.

Guardian. Blood test that finds 50 types of cancer is accurate enough to be rolled out.
Diagnostic tool being piloted by NHS England shows ‘impressive results’ in spotting tumours in early stages
Blood tests’ development could help the NHS further.
Nadeem Badshah and agency
Fri 25 Jun 2021 06.00 BST

Daily Mail. NHS trials ‘holy grail’ blood test that can spot 50 kinds of cancer: Ground-breaking check that can accurately detect two thirds of deadly cancers early in healthy people could save thousands of lives a year. By Victoria Allen Science Correspondent For The Daily Mail
00:00, 25 Jun 2021 , updated 10:04, 25 Jun 2021

NHS. Should I have a PSA test?

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

Would COVID Vaccination become mandatory for all adults ?

It is unlikely to become mandatory in most western countries. It almost certainly would not become mandatory in USA, where Vaccination seems to become tangled with highly divisive politics.

But it is not an impossible scenario in European countries.

It is possible that more countries would follow the example of Turkmenistan, which has a policy of “no jab, no job”

Also, it does not have to a direct government policy.

If the governments change the law to allow businesses to demand vaccination proof, then indirectly vaccination becomes mandatory for most people.

Private Businesses and Travel industry may decide to make vaccination mandatory for their employees and customers so as to avoid further disruption to their business.

In countries, such as Israel and U.K., where there is already high uptake of vaccination, a change in Law may not be needed at present.

But if the present surge in infections continue, and variants emerge, Governments may change their approach.

References

BMJ. Covid-19: Turkmenistan becomes first country to make vaccination mandatory for all adults
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1766 (Published 12 July 2021)
Cite this as: BMJ 2021;374:n1766

Daily Mail. Get ready for Covid jab passports at busy pubs that don’t do enough to tackle infections, warns Boris Johnson. By Daniel Martin Policy Editor For The Daily Mail
23:54, 12 Jul 2021 , updated 01:47, 13 Jul 2021

Daily Mail. Pingdemic pandemonium! Chaos at airports and on the railways as key workers are ordered to go into self-isolation by controversial app. By David Churchill, Transport Correspondent For The Daily Mail
23:51, 12 Jul 2021 , updated 23:59, 12 Jul 2021

Daily Mail. It IS full steam ahead on freedom day: Boris Johnson puts faith in the public’s common sense on July 19 – even though some doctors and scientists want to delay it. By Glen Owen and Anna Mikhailova For The Mail On Sunday
22:00, 10 Jul 2021 , updated 01:52, 11 Jul 2021

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s personal views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is NOT previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice.

Do poor sleepers die early ?

Yes !

If someone feels they are not having regular refreshing sleep, then it is bad news.

In a very large U.K. study, involving 487,728 people, the following question was asked: Do you have trouble falling asleep at night or do you wake up in the middle of the night?

About a quarter of people in study answered “never/rarely”; just under half answered “sometimes” and less than one-third reported “usually”.

The people in study were followed up for many years (mean follow-up time = 8.9 years)

The people who reported frequent sleep disturbances (“usually” category) were found to be at risk of dying early.

The risk was highest in those with both diabetes and frequent sleep disturbances.

It needs to be seen whether the sleep disturbance by itself led to early death or whether people who are going to die early have medical problems that cause them to have disturbed sleep !

Sleep well. Don’t compromise sleep time !

References

Associations between sleep disturbances, diabetes and mortality in the UK Biobank cohort: A prospective population-based study
Malcolm von Schantz, Jason C. Ong, Kristen L. Knutson
First published: 08 June 2021
https://doi.org/10.1111/jsr.13392

( UK Biobank study participants experiencing sleep disturbances: 24.2% “never/rarely” ; 47.8% “sometimes” and 28.0% “usually”)

BMJ Minerva. Cognitive decline . . . and other stories. BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1545 (Published 24 June 2021)
Cite this as: BMJ 2021;373:n1545

People who have trouble sleeping are at a higher risk of dying early – especially diabetics

NHS. Why lack of sleep is bad for your health

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

Would we be having a third dose of COVID-19 Vaccine as a Booster ?

Yes, it is a possibility that a third booster dose of COVID vaccine would be offered later this year.

Vaccination has been tremendously successful so far. But it is too early to declare victory against the virus.

Data from Israel indicates that the current Pfizer vaccine, although still highly active, offers less protection against delta variant.

In June, the vaccine was found to be just 64 percent effective in preventing coronavirus infection whereas during May, when the delta strain was less prevalent, the vaccine was 94.3% effective.

So if more variants emerge, then vaccine boosters may be particularly needed for the vulnerable people.

References

Ministry data said to show Pfizer shot blocks majority of serious Delta cases. Figures reportedly indicate vaccine less effective against contagion from variant, but hospitalizations remain low; officials said weighing use of Moderna for 2nd dose for over 18s. By AMY SPIRO
Today, 10:23 am

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

Should you elect to wear masks when restrictions are lifted ?

U.K. is on course to lift almost all COVID restrictions in mid July 2021.

A U.K. minister has said that “wearing masks” would become a personal choice.

Just because there is a choice, it does not mean it is always good for you.

Government decisions are often made not only with scientific facts but also with economic and political considerations. Compulsory masks may not be liked by a section of society and Government has to take that into account in a democratic society.

Personally electing to wear masks in crowded public places could be sensible for the following reasons.

– There is some debate about the extent of protection a person gets wearing masks following the Danish mask study. But no robust scientific study has shown significant harm from wearing masks. So it is better to be safe and wear masks even if the extent of protection is debatable.

Infections are rising now and luckily, vaccines seem to have protected most people from getting severe COVID. But Vaccines are not 100% effective. Moreover, when infection rates go up further and society opens up more, there is a risk of variants emerging that may be partially vaccine resistant. So wearing masks may provide some protection.

– Not all people get poorly when they get COVID. But these people with COVID can still pass infection to other vulnerable family members and people who don’t have the protection from vaccines. So wearing a mask can stop people with mild COVID from spreading the infection to others.

– Some people do not want to wear masks because they think they are not at risk of death or hospitalisation. Remember, COVID related problems affect different people in different ways. Lot of people do recover from COVID without major problems. But some people do develop long-term symptoms from COVID. So it is better to wear masks for COVID protection.

References

1. BBC news. Covid-19: Masks will become personal choice, says Robert Jenrick
By Emma Harrison & Kathryn Snowdon
BBC News

2. Bloomberg. Face Masks in England to Become ‘Matter of Personal Choice’
By Andrew Atkinson
4 July 2021, 09:47 BST
Updated on 4 July 2021, 11:14 BST

3. Daily Mail. SAJID JAVID: The economic arguments for opening up Britain are well known. But, for me, the health case is equally compelling. By Sajid Javid For The Mail On Sunday 22:02, 03 Jul 2021 , updated 23:13, 03 Jul 2021

4. BBC news. Covid-19 in the UK: How many coronavirus cases are there in my area?
By The Visual and Data Journalism Team
BBC News

5. Daily Mail. Face masks do NOT protect the wearer from coronavirus, but will stop them from infecting other people, Danish study finds. By Mary Kekatos Senior Health Reporter For Dailymail.com and Reuters
15:26, 18 Nov 2020 , updated 18:02, 20 Nov 2020

6. BMJ. Danish mask study: masks, media, fact checkers, and the interpretation of scientific evidence. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4919 (Published 23 December 2020)
Cite this as: BMJ 2020;371:m4919

7. NICE. COVID-19 rapid guideline: managing the long-term effects of COVID-19
NICE guideline [NG188] Published: 18 December 2020

8. Coronavirus: When can we stop wearing face masks or coverings?
By Michelle Roberts
Health editor, BBC News online

9. Science. Implications of defective immune responses in SARS-CoV-2 vaccinated organ transplant recipients. Peter S. Heeger, Christian P. Larsen, Dorry L. Segev

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

Is Aspirin useful for COVID-19 ?

No

Many drugs, which are commonly used for other diseases, have been tried in COVID

Aspirin was also tested and it was NOT helpful

Covid-19: Aspirin does not improve survival for patients admitted to hospital, trial reports
BMJ 2021; 373
doi: https://doi.org/10.1136/bmj.n1475 (Published 08 June 2021)
Cite this as: BMJ 2021;373:n1475

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

Do face masks prevent COVID illness ?

Yes, good masks may help to reduce infections that are spread by airborne particles.

But not all masks are the same.

Cloth masks were promoted during 2020 when the proper surgical masks were in short supply . The effectiveness of cloth masks are not well studied and they are of varying quality depending who made them and how well they were made.

Properly manufactured surgical masks are better than home made cloth masks. But how much protection they can offer is a matter of scientific debate. Surgical masks have been found to give some protection against other respiratory viruses in past. But a recent Danish study found no significant benefit against COVID among the general public.

The high quality FFP3 masks which filter most of the inhaled air is superior to normal surgical masks. A recent study from Cambridge found that Heath care workers who used FFP3 masks had better protection from COVID compared to normal surgical masks in the Hospital.

Overall, clean, well manufactured masks are likely to of some benefit to the public rather than wearing no masks at all. In the hospital setting, FFP3 masks seem to provide superior protection to Health care staff working with COVID patients.

And most importantly people have to understand that masks are not to be used alone. Masks got to be used along with protective measures such as social distancing and Hand-washing.

References

CLOTH MASKS

BMJ. Covid-19: What is the evidence for cloth masks? BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1422 (Published 07 April 2020)
Cite this as: BMJ 2020;369:m1422

DANISH STUDY- SURGICAL MASKS

Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers : A Randomized Controlled Trial
Henning Bundgaard et al. Ann Intern Med. 2021 Mar.

BMJ. Danish mask study: masks, media, fact checkers, and the interpretation of scientific evidence. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4919 (Published 23 December 2020)
Cite this as: BMJ 2020;371:m4919

BMJ. The curious case of the Danish mask study
BMJ 2020; 371
doi: https://doi.org/10.1136/bmj.m4586 (Published 26 November 2020)
Cite this as: BMJ 2020;371:m4586

Daily Mail. Face masks do NOT protect the wearer from coronavirus, but will stop them from infecting other people, Danish study finds. By Mary Kekatos Senior Health Reporter For Dailymail.com and Reuters
15:26, 18 Nov 2020 , updated 18:02, 20 Nov 2020

Spectator (magazine) https://www.spectator.co.uk/article/do-masks-stop-the-spread-of-covid-19-

Full fact.org. Danish study on mask efficacy only tells us half the story. 24 NOVEMBER 2020

Forbes. Lead Researcher Behind Controversial Danish Study Says You Should Still Wear A Mask
Leah Rosenbaum. Forbes Staff 18 Nov 2020. Critics of mask-wearing policies used a Danishstudy on mask-wearing to bolster their claims such policies are ineffective, but scientists, including those involved with the study, disagree.

JAMA Insights
February 10, 2021
Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2
John T. Brooks, MD1; Jay C. Butler, MD1
Author Affiliations
JAMA. 2021;325(10):998-999. doi:10.1001/jama.2021.1505

CAMBRIDGE REPORT ON HIGH QUALITY MASKS

BMJ. Covid-19: Upgrading to FFP3 respirators cuts infection risk, research finds
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1663 (Published 29 June 2021)
Cite this as: BMJ 2021;373:n1663. https://www.bmj.com/content/373/bmj.n1663

BBC news. Covid: Masks upgrade cuts infection risk, research finds
By David Shukman
Science editor

Guardian. Cambridge hospital’s mask upgrade appears to eliminate Covid risk to staff
Hospital infection study shows use of FFP3 respirators at Addenbrooke’s ‘may have cut ward-based infection to zero’
Nicola Davis and Denis Campbell
Tue 29 Jun 2021 10.49 BST

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

Should we continue to wear masks and be cautious in public places after July 19th ?

Yes, we should be cautious after the freedom day on July 19th and this is for the following reasons.

1. Vaccines are highly effective but they are NOT 100% effective.

2. Two doses are needed for full protection. Even though, more than two third of adults have had atleast one vaccine, only about half the U.K. population had double vaccination so far.

3. Vaccine Protection against New COVID variants may NOT be as good as it is now. For instance , vaccines are slightly less effective against the delta variant particularly after first dose.

4. Vaccine protection may decrease over time and Vaccines may not give the same level of protection as months pass by.

4. Being cautious now, may helps us to avoid lockdowns during Autumn and would help to save Christmas !

Of course, some people may feel strongly against any compulsory restrictions and hence it should not be made compulsory.

People, who are comfortable at being cautious, can try to wear masks and practice as much social distancing as possible in public places.

References

BBC News. Covid-19: End of England’s Covid rules still set for 19 July
By Hazel Shearing
BBC News

Daily Mail. Freedom Day ‘will see virtually ALL Covid curbs axed’: Ministers prepare full unlocking on July 19 with masks, social distancing and work from home advice dropped to save shattered businesses – but date will NOT be brought forward. By James Tapsfield, Political Editor For Mailonline
08:29, 23 Jun 2021 , updated 14:52, 23 Jun 2021

Daily Mail. Now Jacob Rees-Mogg joins the calls to DITCH masks as soon as restrictions are lifted: Three Cabinet members break ranks to urge PM to ditch face coverings amid calls for clarity. By Jack Maidment, Deputy Political Editor For Mailonline and James Tapsfield Political Editor For Mailonline
17:40, 24 Jun 2021 , updated 19:56, 24 Jun 2021

Guardian. Vaccines are not magic bullets – we’ll still have to take precautions
Zania Stamataki
To make the most of England’s vaccination rollout we may need to keep wearing masks even after restrictions are lifted
Dr Zania Sta. Tue 22 Jun 2021 06.00 BST

Public Health England. Press release
Vaccines highly effective against hospitalisation from Delta variant
New analysis by PHE shows for the first time that 2 doses of COVID-19 vaccines are highly effective against hospitalisation from the Delta (B.1.617.2) variant. Published 14 June 2021

Public Health England (page 39).
Investigation of SARS-CoV-2 variants of concern: technical briefings
Technical briefing documents on novel SARS-CoV-2 variants.
Last updated
25 June 2021

European Centre for Disease Prevention and Control. Immune responses and immunity to SARS-CoV-2.
(last update 18 May 2021)

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

Can someone who had both COVID vaccines still die from COVID-19?

Yes, even after having both the vaccines, there is still a small risk of dying from COVID-19

Why?

This is because the vaccines are not 100% effective.

People who had both the vaccines can still get COVID-19 infection. A unlucky few of those who get an infection can still die from COVID-19.

Recent reports indicate that about half of deaths in U.K. are in people who had at least one dose of COVID vaccine.

The good thing is that the overall number of deaths is VERY LOW compared to the high number of deaths at the peak of pandemic when vaccines were not available.

Vast majority of infections do still occur in the unvaccinated individuals. ( PHE document- page 13 & 14)

The Guardian newspaper has got a good article on this topic.

One has to hope that vaccines do NOT lose their effectiveness over time.

We have to hope that more new variants do NOT emerge as there is a possibility that Vaccines may be less effective against new variants emerging in future.

References

Guardian.
Why most people who now die with Covid in England have been vaccinated
David Spiegelhalter and Anthony Masters
Sun 27 Jun 2021 08.00 BST

Daily Mail. Are these the numbers scaring Boris? Study shows 29% of the 42 people who have died after catching the new strain had BOTH vaccinations as cases soar another 40%. By James Robinson for MailOnline
14:08, 13 Jun 2021 , updated 12:22, 14 Jun 2021

Public Health England. Research and analysis
Investigation of SARS-CoV-2 variants of concern: technical briefings.
Technical briefing documents on novel SARS-CoV-2 variants.

Last updated 25 June 2021. (page 13 and 14)

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

Was the Kent variant more dangerous than the original Wuhan variant ?

Yes, the Kent variant who got a foothold in December was far more dangerous.

A recent study in BMJ reports that “the risk of hospital admission is higher” for people infected with the Kent variant compared with the original wild-type Wuhan variant of Coronavirus.

This higher severity seems to be specific to adults older than 30 years.

The current variant spreading in U.K. (delta a.k.a Indian variant) may not cause widespread havoc, like the Kent variant, due to the lock down and wide spread vaccination.

One has to hope that we do not get any variants that breaks the protective shield of COVID vaccines.

BMJ Risk of hospital admission for patients with SARS-CoV-2 variant B.1.1.7: cohort analysis
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1412 (Published 15 June 2021)
Cite this as: BMJ 2021;373:n1412

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

Is drinking alcohol within guideline amount safe ?

No !

It would be a shock for many to hear that “No amount of alcohol is absolutely safe”.

A team at Imperial College London analysed MRI scans of heart, brain and liver of people who drink alcohol. They found that higher alcohol consumption was related to smaller brain, weaker heart and fatty liver.

They reported that “there is no ‘safe threshold’ below which there were no toxic effects of alcohol.

Previously other studies have also reported that there is no safe limit for alcohol!

In 2018, a Lancet study reported that the risk of death and risk of cancers increased substantially with increasing levels of alcohol consumption; and there was no safe limit below which there was no risk.

The message is “Avoid alcohol”

If you can’t, then atleast drink as little as possible.

References:

Alcohol consumption in the general population is associated with structural changes in multiple organ systems. Evangelos Evangelou, Hideaki Suzuki, Wenjia Bai, Raha Pazoki, He Gao, Paul M Matthews MD, PhD, Paul Elliott. https://doi.org/10.7554/eLife.65325

Does Drinking Within Low-Risk Guidelines Prevent Harm? Implications for High-Income Countries Using the International Model of Alcohol Harms and Policies
Adam Sherk et al. J Stud Alcohol Drugs. 2020 May

Lancet. GBD 2016 Alcohol Collaborators
Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016.
Lancet. 2018; (published online Aug 23.)
http://dx.doi.org/10.1016/S0140-6736(18)31310-2

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

Do people in U.K. trust the COVID vaccines?

Yes, a very high percentage of U.K. people trust the COVID-19 vaccines.

A recent report in BBC says that U.K. is the most trusting nation with regards to COVID-19 vaccines.

The survey found that 87% of survey respondents in U.K. had faith in the COVID jab.

This survey involved more than 68,000 people and hence the results are highly reliable.

This high level of faith is certainly helping the U.K. Government as it rolls out vaccines for most of adult population.

The U.K. Government, in particular, the “Public Health England” deserves credit for keeping the U.K. people well informed.

References :

BBC News. UK ‘most trusting’ country on Covid vaccines

BBC News. Covid-19: More than half of UK adults have had second jab. By Dulcie Lee

NATURE Journal. News.
Trust in COVID vaccines is growing. 10 February 2021

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

Are many NHS staff reluctant to have COVID-19 vaccines?

No !

Vast majority of health care workers already had the COVID vaccine. Only a small minority have vaccine hestitancy.

A recent study found that about 90% of staff had at least one dose of the vaccine within 2 months of vaccine roll out. That is very impressive.

This study ( published in Lancet Journal) found that vaccines are very effective in reducing infections.

But the study also showed what we know already. Vaccination does not give 100% protection.

Everyone, in particular, health care staff need to continue with other COVID precautions such as masks, distancing and regular washing as advised by Government.

Reference: COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study. Published:April 23, 2021 DOI: https://doi.org/10.1016/S0140-6736(21)00790-X

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

Have People died after COVID-19 vaccines ?

Yes, people have died after having COVID-19 vaccines.

Recently, a BBC Radio Newcastle presenter, Lisa Shaw was reported to have died after the Astra Zeneca COVID vaccine. Her family is blaming the COVID vaccine for causing clots and ultimately her death.

In India, a Popular Tamil actor and comedian died within 48 hours of receiving a COVID vaccine. His vaccination was broadcast live on TV to encourage public uptake of vaccination but his unfortunate death after vaccination probably ended up causing vaccine hesitancy in some people.

A news article in BMJ reports that the “Pfizer-covid-19 vaccine is “likely” to have been responsible for at least 10 deaths of frail elderly people in nursing homes in Norway”.

But, the most important thing to remember is that deaths are rare after COVID-19 vaccines.

Yes, there are true distressing accounts of vaccine side effects. But what you do not hear is the benefit most people have from vaccines.

Millions of people received vaccines so far with vast majority having no major side effects.

Consider this for context. Think about plane accidents. Millions of people travel by plane without any problems. If People fly safely and reach their destination, it is not headline news. People do not go around saying that they have traveled safely by plane and that they are alive !

But a aeroplane accident which happens rarely is front page news. It would be all over the 24 hour TV news channels across the world. Plane accidents are utterly and unimaginably devastating for those individuals and families involved. But the rare plane accidents do not make most other people avoid flying. The accidents do not mean that no one should travel by plane. The travel by planes has far more benefits than risks for majority of population.

Same with COVID vaccines. Serous Side effects are headline news even if they are very uncommon and rare. The available data indicate benefits are much greater than risks.

So think carefully before you refuse a vaccine.

References

Guardian. Lisa Shaw death: BBC presenter had blood clots after AstraZeneca jab, family says
(Radio Newcastle broadcaster had severe headaches a week after vaccine and fell seriously ill days later, relatives say).
Lisa Shaw
Lucy Campbell
Thu 27 May 2021 18.36 BST

BMJ. News. Covid-19: Pfizer-BioNTech vaccine is “likely” responsible for deaths of some elderly patients, Norwegian review finds
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1372 (Published 27 May 2021)
Cite this as: BMJ 2021;373:n1372

BMJ. Research. Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1088 (Published 13 May 2021)
Cite this as: BMJ 2021;373:n1088

BMJ. News. Covid-19: Risk of cerebral blood clots from disease is 10 times that from vaccination, study finds
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1005 (Published 16 April 2021)
Cite this as: BMJ 2021;373:n1005

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

Vaccine Hesitancy

Worries about vaccines are nothing new. Anti_vaccination groups were formed in 1860s when small pox vaccination was made compulsory. Even when small pox was causing untold devastation, some people were opposed to it.

The Vaccine hesitancy of 19th century is somewhat excusable. Some of the worries were real, and not much was known about the safety of small pox vaccine at that time. Lot of people were ill-informed and did not have access to good sources of information. They didn’t know the immense potential of the vaccination to eliminate distressing diseases.

Vaccines have now successfully eradicated small pox. Many other devastating infectious diseases such as polio have been controlled in many countries across the globe due to the vaccines.

Some of the vaccine hesitancy in west is because western people are not fully aware of the devastating power of infectious diseases (at least until COVID-19 came to the world in 2020).

Vaccine hesitancy is also sustained by “confirmation bias” . Confirmation bias is the tendency of human beings to seek information that confirms what they believe in. If you distrust vaccines, you go looking for information that confirms you beliefs and you disregard information that proves vaccines are hugely beneficial.

Some people wish for a 100% safe vaccine. But there is no such thing as completely risk free vaccine. It is true Vaccines can cause serious side effects. It is true that Vaccines can cause long term side effects. It is true that Vaccines can rarely cause life threatening side effects and even deaths.

It is normal to worry about side effects of vaccines. But the potential for side effects should not be the reason to decline vaccination.

One has to look at benefits as well as risks. Some people focus on everything bad that can happen as a result of vaccines.

COVID-19 vaccines had an unusually short development period. This is because of the pandemic. The available evidence indicate that the benefits of the vaccines are far greater than risks. It is true that there is no long term safety data. But in the middle of a pandemic, which has caused untold misery to millions, waiting for perfect long term data is not an option.

If you are sceptical about vaccines, please do focus on benefits as well as risks. Do not focus on risks only.

References

BMJ. Practice Pointer. Covid-19 vaccination hesitancy. BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1138 (Published 20 May 2021)
Cite this as: BMJ 2021;373:n1138

BMJ. News. Covid-19: Pfizer-BioNTech vaccine is “likely” responsible for deaths of some elderly patients, Norwegian review finds.
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1372 (Published 27 May 2021)
Cite this as: BMJ 2021;373:n1372

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

Is PTSD over diagnosed?

Some Soldiers from world war one, suffered from what is then known as “shell shock

“Shell Shock” should have been very devastating when there was less recognition of that condition.

Fast forward a few decades, a committee of wise men and women, relabelled the condition as “Post Traumatic stress disorder” (PTSD)

The criteria for diagnosis of PTSD is much wider and all encompassing, with inclusion of trauma from road accidents and crime as well as indirect exposure to trauma through professional attendance at a crime scene or site of an accident.

There is concern whether PTSD is now over-diagnosed. There is a debate at the BMJ journal. Please do read my views and submit your views through the rapid response section.

References:

BMJ Head To Head.
Is PTSD overdiagnosed?
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n787 (Published 05 May 2021)
Cite this as: BMJ 2021;373:n787

S Sundar. Rapid Response: Over diagnosis hurts those most in need.

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

U.K. approach to vaccination proven to be the right one. Is it Luck or Foresight?

UK government wanted as many people have “some” degree of protection against the COVID-19 rather a only few people having “full” protection against COVID-19.

A recent paper published in BMJ validates the U.K. approach even though it was initially criticised by WHO ( world health organisation)..

Is it Luck or Foresight that U.K. Govt got it right? Probably both but more foresight than luck. Perhaps a cappuccino cup of foresight sprinkled with chocolate of luck.

Guardian. No data to support UK delay of vaccines’ second dose, says WHO.
Sarah Boseley Health editor
Tue 5 Jan 2021 19.48 GMT

Daily Mail. UK should feel ‘vindicated’ over its ‘brave’ decision to delay second doses of Covid vaccines, World Health Organization official says. By Sam Blanchard Deputy Health Editor For Mailonline. 13:29, 08 Feb 2021 , updated 15:03, 08 Feb 2021

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.

Should chemotherapy be used before radiotherpy for bladder cancer?

Yes, chemotherapy given before surgery or radiotherapy for invasive bladder cancer improves cure rates and survival rates.

But there is also strong U.K. data to show that Chemotherapy given along with Radiotherapy is useful because it makes radiotherapy work better .

Should chemotherapy be given before radiotherapy and then followed by more chemotherapy along with radiotherapy ?

There is lot of scientific debate on this question and well known U.K. experts are favouring this “double chemo” approach in-spite of inconclusive new data published in the European Urology journal.

The NICE guidelines on bladder cancer also favours this approach of “double” chemotherapy ( before as well as along radiotherapy).

It is a question that ideally needs to addressed in clinical trials .

Read my views expressed in a letter published in the Journal European Urology

Reference: Re: Syed A. Hussain,
Nuria Porta, Emma Hall, et al. Outcomes in Patients with Muscle-invasive Bladder Cancer Treated with Neoadjuvant Chemotherapy
Followed by (Chemo)radiotherapy in the BC2001 Trial. Eur Urol 2021;79:307–15

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

How effective are the COVID vaccines against the new Indian variant?

Everyone in U.K. hoped that we have turned the corner with this pandemic after the recent spike in infection from the Kent Variant,

But now comes the Variant from India. (the scientific name is B1.617.2 variant of concern).

The Indian variant appears to be more transmissible but no evidence yet that the Indian variant is inherently more deadly than the Kent variant.

Naturally, we are in a better place now than last year because of the vaccination.

But there is some evidence that spontaneous changes (mutations) in the B.1.617.2 variant virus may make it partially resistant to antibodies produced by vaccines.

So how effective are the current vaccines against this Variant from India?

Lab testing shows that the current vaccines can be still effective against the Indian variant but may not be highly effective as it is against the Kent/U.K. variant.

PHE data shows that after two doses, Pfizer vaccine is 88% effective against Indian variant compared to 93% effectiveness against the Kent strain.

After two doses, AstraZeneca jab is 60% effective against Indian variant compared to 66% effectiveness against the Kent variant.

But after the first dose, both vaccines were only 33% effective against Indian variant compared to around 50% efficacy against the Kent strain.

The vaccine protection is better with two doses of vaccine and that’s why the Govt is speeding up second vaccine dose in affected areas.

Fingers crossed, hope this strategy works !

References

BMJ. Covid-19: Caution urged while lockdown eases in England because of vaccine success
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1203 (Published 11 May 2021)
Cite this as: BMJ 2021;373:n1203

BMJ News Covid-19: UK cases of variant from India rise by 160% in a week
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1315 (Published 21 May 2021)
Cite this as: BMJ 2021;373:n1315

U.K. Govt. Most vulnerable offered second dose of COVID-19 vaccine earlier to help protect against variants. From: Department of Health and Social Care. Published 14 May 2021

Telegraph: Two doses of AstraZeneca vaccine provide over 80 per cent protection against Indian variant, PHE study finds.

Guardian. India Covid variant: is it a threat to the UK’s reopening plans?
Ian Sample Science editor
@iansample
Fri 14 May 2021 11.19 BST

Daily Mail. UK is in a ‘very good position’ against Covid variants as Pfizer says there is NO proof current jab needs updating to fight mutant strains. By Luke Andrews Health Reporter For Mailonline
16:30, 10 May 2021 , updated 18:12, 10 May 2021

Daily Mail. How deadly is India’s Covid variant and is it REALLY behind explosion of cases? Scientists say ‘perfect storm’ fuelled nation’s crisis and mutant strain just had a ‘head-start’ – as study shows vaccines DO work against it. By Connor Boyd Assistant Health Editor For Mailonline
16:26, 27 Apr 2021 , updated 08:17, 28 Apr 2021

Collier, DA et al. SARS-CoV-2 B.1.1.7 sensitivity to mRNA vaccine-elicited antibodies. Nature; 11 March 2021; DOI: 10.1038/s41586-021-03412-7

BBC. What is the India Covid variant and will vaccines work?
Soutik Biswas
India correspondent

BBC. Covid: Increasing confidence jabs work against Indian variant
By Doug Faulkner
BBC News

ONS. Coronavirus (COVID-19) Infection Survey, UK: 21 May 2021 (“early signs of a potential increase in the week ending 15 May 2021”)

BBC. Covid: Pfizer and AstraZeneca jabs effective against Indian variant – study
By Dulcie Lee
BBC News

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

How effective is a single dose of Pfizer and AstraZeneca vaccine?

UK government wanted as many people have “some” degree of protection against the COVID-19 rather a only few people having “full” protection against COVID-19.

So the U.K. government delayed the second dose of Covid vaccine for 12 weeks.

Some people have now been offered two vaccines but still there are many people who were yet to have the second dose. They would be wondering how effective a single dose of the vaccine is. How much protection they have now.

A recent paper published in BMJ provides very encouraging news .

With Pfizer vaccine, vaccine effectiveness reached 61% after 4 to 5 weeks of the first dose.

With AstraZeneca vaccine, vaccine effectiveness reached 73% after 5 weeks of first dose.

This data is very reassuring

But the data also stresses the importance of having the second dose for further protection.

Please do make a note that (a) vaccines do take a few weeks to be become effective after the first dose (b) no vaccine is 100% effective and (c) we also do not know how long this protection from vaccine will last.

BMJ. Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1088 (Published 13 May 2021)
Cite this as: BMJ 2021;373:n1088

BMJ. Public health impact of delaying second dose of BNT162b2 or mRNA-1273 covid-19 vaccine: simulation agent based modeling study
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1087 (Published 12 May 2021)
Cite this as: BMJ 2021;373:n1087

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.

Can Mistletoe control cancer?

round white fruit

Photo by Pixabay on Pexels.com

No, there is no good clinical evidence to show that Mistletoe therapy improves life expectancy or quality of life of cancer patients.

Laboratory studies have indicated that Mistletoe might have some clinical activity. But activity seen in lab setting is not good enough for using it in actual patients.

The popularity of mistletoe extracts continues unabated despite their unproven efficacy in oncology.

The clinical evidence does not support use of Mistletoe as a standard therapy for cancer.

Mistletoe is best used as Christmas decoration only !

References:

1. Mistletoe and cancer: controversies and perspectives. Patrick J Mansky. Semin Oncol. 2002 Dec.

2. Is Mistletoe Treatment Beneficial in Invasive Breast Cancer? A New Approach to an Unresolved Problem. Peter Fritz et al. Anticancer Res. 2018 Mar.

3. Molecular mechanisms of mistletoe plant extract-induced apoptosis in acute lymphoblastic leukemia in vivo and in vitro. Georg Seifert et al. Cancer Lett. 2008.

4. From ill-defined extracts to the immunomodulatory lectin: will there be a reason for oncological application of mistletoe?H J Gabius et al. Planta Med. 1994 Feb.

 Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

New treatment for Cervical cancer

Advanced Cervical cancer which has come back after surgery or radiotherpy is usually treated with chemotherapy.

There is a new immunotherapy treatment option for all advanced cervical cancer patients now .

At the European Society of Medical Oncology (ESMO 2021) virtual conference, an international team of investigators, presented trial data regarding this new immunotherapy drug called cemiplimab.

One group of patients in the trial received the immunotherapy drug cemiplimab every 3 wks and another group of patients received intravenous chemo (pemetrexed, vinorelbine, gemcitabine, irinotecan or topotecan).

Cemiplimab significantly improved survival of patients and was better than chemotherapy.

This new immunotherapy drug cemiplimab is already being used for skin cancers and vulval skin cancers. Very soon, it would be used in cervical cancer patients.

Reference

ESMO 2022 Virtual Plenary Resources:
RANDOMISED PHASE III TRIAL DATA ON THE EFFICACY AND SAFETY OF CEMIPLIMAB AS OPPOSED TO CHEMOTHERAPY IN PATIENTS WITH PROGRESSIVE ADVANCED CERVICAL CANCER. Presenter: Krishnansu S. Tewari, USA; Discussant: Mansoor Mirza, Denmark;

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.

Delaying second vaccine dose leaves cancer patients vulnerable to coronavirus

How effective is a single dose of Pfizer Vaccine in cancer patients?

Single dose is not very effective in cancer patients.

An UK study has now been peer reviewed and published in the esteemed Lancet oncology journal. The study showed inadequate protection after first dose.

More than half of the cancer patients receiving a single dose of the Pfizer COVID-19 vaccine have been left with little protection against the virus.

Two doses are critical and the second booster ideally need to be given on time at 21days.

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.

Here we go again – another new variant that can derail the plans to return to normality in U.K.

The UK is coming out of lockdown and the infection rates, hospital admissions and deaths are reassuringly low.

The vaccination rates are rapidly going up and understandably many people are hoping for some sort of normality very soon.

But a new variant has been detected across the country. The scientists are worried about this new variant of coronavirus- called India variant. This variant can derail government plans in UK.

The current vaccines seem to offer somewhat less protection against this new variant . If this variant takes a strong foothold in UK , then we have to wait a bit longer for normality.

References:

Guardian: India Covid variant: is it a threat to the UK’s reopening plans?
Ian Sample Science editor
@iansample
Thu 13 May 2021 15.35 BST

BBC. Covid: Three cases of Indian variant found in Leicester
Published 28 April.

BBC. Covid: Targeted testing in Nottingham after Indian variant rise. 11 May.

BBC. Covid: Boris Johnson ‘anxious’ about Indian variant
By Hazel Shearing & Joseph Lee
BBC News. 13 May.

BBC. Covid vaccine: How many people in the UK have been vaccinated so far?
By The Visual and Data Journalism Team
BBC News

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.

Can unauthorised treatments cause harm?

Yes, there is a risk of serious harm from “unauthorised” COVID treatments that are not officially authorised by competent regulatory authorities such as MHRA in UK or FDA in USA.

If a treatment is not authorised, it should have at least have good clinical trial evidence.

India is going to a rough patch. People with COVID are desperate for treatment. There is shortage of oxygen which is a commonly used treatment.

Apart from oxygen for respiratory support, only Two treatments have been proven to be of significant help in COVID-19 pneumonia. (1) Steroids (2) An arthritis drug called Tocilizumab

Many antivirals drugs have not shown any meaningful benefit. Various other drugs are still in trials.

It is rapidly evolving area and the BMJ has a COVID guideline which is being frequently updated during this pandemic.

This is significant risk of harm from drugs which are NOT properly assessed in clinical trials.

Anecdotally there has been lot of sudden deaths in India. Lot of unproven treatments such as Azithromycin, ivermectin, antivirals agents, chloroquine, and other agents widely used in india.

Although there is no definitive proof, One cannot help wondering whether poor outcome in at least some Indian patients is related to combinations of unproven drugs that are used widely in unregulated private healthcare sector.

BMJ. Drug treatments for covid-19: living systematic review and network meta-analysis
BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2980 (Published 30 July 2020)
Cite this as: BMJ 2020;370:m2980

BMJ. A living WHO guideline on drugs for covid-19 BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3379 (Published 04 September 2020).

BMJ COVID-19 Treatment algorithm.

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.

What has ‘Public health’ ever done for us ?

An apple a day might not keep the doctor away. But a good public health team can keep the doctors away for many people!

Public health is about prevention and promotion of health in the society.

Public health is largely responsible for the significant improvements in life expectancy over the last 150 years.

Providing people with clean drinking water, removal of rubbish from houses and streets, good sewage system, and vaccination has saved many millions of lives over the years.

The recent smoking ban in work-places, public places and indoor venues is a modern example of public health activity.

The one area where public health has not been hugely successful is obesity. It may be because of the reliance on nudging the individual to change rather than dealing with underlying structural problems.

Read my letter in BMJ and make your views known at the BMJ rapid response section.

Sundar S. Public health needs to go back to basics, not rely on nudge theory.

Toll-free link:
http://bmj.com/cgi/content/full/bmj.n1153?ijkey=CUQNozGH9yJeK57&keytype=ref

References:

BMJ. Lifestyle and socioeconomic group on health
Public health needs to go back to basics, not rely on nudge theory
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1153 (Published 06 May 2021)
Cite this as: BMJ 2021;373:n1153

BMJ. Short term impact of smoke-free legislation in England: retrospective analysis of hospital admissions for myocardial infarction
BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c2161 (Published 08 June 2010)
Cite this as: BMJ 2010;340:c2161

BMJ. Associations of healthy lifestyle and socioeconomic status with mortality and incident cardiovascular disease: two prospective cohort studies
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n604 (Published 14 April 2021)
Cite this as: BMJ 2021;373:n604

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.

Would COVID-19 vaccination be made compulsory for people in some jobs !

New Zealand recently fired customs and border officials after they refused vaccines.

Compulsory COVID vaccination -for people in some jobs- is not official policy in UK or USA yet.

“Italy has become the first country in Europe to make COVID vaccination compulsory for healthcare workers”

It does look like that COVID-19 vaccination would be made compulsory for people in some jobs !

Any third wave, later year, in UK may push the government in making COVID vaccination mandatory for health workers and some other key workers.

References

Guardian. New Zealand fires nine border workers who refused Covid vaccine.
Tess McClure in Christchurch
@tessairini
Mon 3 May 2021 02.32 BST

BMJ. News Analysis. Covid-19: Is the UK heading towards mandatory vaccination of healthcare workers?
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1056 (Published 21 April 2021)
Cite this as: BMJ 2021;373:n1056

BMJ News. Covid-19: Italy makes vaccination mandatory for healthcare workers
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n905 (Published 06 April 2021)
Cite this as: BMJ 2021;373:n905

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.

Is it the beginning of the end ?

COVID-19 is still raging like wild fire in various parts of world particularly in India now.

But, in U.K, it does look like the “beginning of the end” for the COVID pandemic. Vaccines seem to have greatly aided this end.

On Tuesday, UK reported 1,946 new infections and only four deaths within 28 days of a positive test.

So unless there is a new variant which overcomes the protective shield of the Vaccines, there may be no more lockdowns and life may go back to some sort of normality.

References

BBC news. Another Covid lockdown unlikely, says scientist. By Hazel Shearing
BBC News

The official UK government website for data and insights on coronavirus (COVID-19).

BBC news. What is the India Covid variant and will vaccines work?
Soutik Biswas
India correspondent
Published22 April

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.

Outdoor face masks: is it helpful or an hindrance?

In the indoor settings, wearing masks can help to reduce the risk of getting COVID-19 infection.

But in the outdoor setting, masks may not be very helpful as the risk of getting COVID-19 infection from others, in outdoor settings, is considerably smaller.

Two teams discuss the pros and cons of outdoor mask wearing in a BMJ debate.

Apart from infection prevention, I can see some additional benefits for voluntarily wearing masks in the streets.

The streets of major cities have significant air-pollution. So facial masks can help to reduce inhalation of toxic chemicals.

More and more surveillance street-cameras are now deploying facial-recognition software to deter criminals. But the cameras may also track movements of ordinary law-abiding people for marketing and advertising reasons. So face-masks may also be helpful to those with privacy concerns.

Read the article and submit your views through BMJ rapid response section.

BMJ . Coronavirus Transmission
Should masks be worn outdoors?

BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1036 (Published 28 April 2021)
Cite this as: BMJ 2021;373:n1036

Sundar S. Voluntary outdoor mask-wearing can have incidental benefits in cities. BMJ rapid response. 2nd May 2021.

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.

Should hormone therapy be used before or after prostate radiotherpy?

Combination therapy with Hormone therapy and Radiotherapy is used with curative intent for treatment of prostate cancer.

There is some debate which treatment should be started first. At present, the hormone therapy is started first and radiotherpy is started second at a later date.

This is because many previous clinical trials, which found beneficial effects for the combination therapy, involved starting hormones first.

One advantage of starting hormone therapy immediately and delaying the start date of radiotherpy is that hormone therapy shrinks the size of prostate before radiotherpy . This greatly helps when image-guided Radiotherpy is planned later on.

A group of high Calibre researchers and authors from Canada and USA have published paper arguing in favour of radiotherpy starting first and starting hormones afterwards.

Some of the authors behind this paper in Journal of Clinical oncology have previously published seminal, practice changing, papers in field of prostate cancer.

My personal view, is that we have to wait for confirmatory evidence before changing the current practice.

I have to resort to the megaphone of a provocative headline grabbing title so that oncologists won’t uncritically accept the conclusion of the paper

Read the original paper and my published response .

Adjuvant Hormone Therapy After Prostate Radiation: Is This Data Torture?

, MD and , MD. Nottingham University Hospital NHS Trust, Nottingham, United Kingdom

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.

Medical Resuscitation: the unnecessary distress due to misconception

CPR or cardiopulmonary resuscitation is a medical procedure that is often misunderstood. It causes lot of anguish and distress to patients and family unnecessarily.

It is sometimes colloquially known as “kiss of life” as “mouth to mouth resuscitation” was previously used in pre-COVID era along with “chest compressions”.

CPR may involve “electric shocks to heart” when needed if machines are available. CPR in hospital may involve “tubes pushed down the throat” to enable air get into lungs. CPR almost always involves someone “pressing hard on the chest repeatedly with both hands” so as to help air get into lungs.

Overall, it can appear a bit brutal but it can be a life saver. That’s why the work places, train stations, airports and some public parks have the automatic defibrillators.

CPR is a wonderful medical first aid, which, delivered promptly, can save lives. It is highly successful in previously fit people with a sudden cardio respiratory arrest due to a “reversible or treatable” illness.

Television serials and Hollywood movies often portray CPR as a highly successful procedure.

But, unfortunately, in routine hospital practice, the success rates are low.

In particular, success rates are very low in “terminally ill” cancer patients and in frail patients with “multiple irreversible medical conditions”.

Because many people believe CPR is hugely successful in “everyone”, patients and families understandably get very upset when the medical team talk about “do not attempt resuscitation (DNAR)“.

When CPR is NOT used appropriately, it prevents peaceful death and stops terminally ill patients from gently fading away surrounded by their loved ones.

In cancer patients, when cancer treatments are not working, death occurs after the body has been overwhelmed by cancer. Trying to re-start the heart and lungs after the organs have stopped working due to cancer is often futile. More importantly, CPR can make death more traumatic for patients and family.

Other than educating people about benefits and limitations of CPR, there is no easy way to make this misconception about resuscitation go away.

Read my BMJ letter on this topic and contribute your views on the rapid response section of BMJ.

BMJ. Misconceptions about CPR distress patients at the end of life and bereaved people.

Toll-free link:
http://bmj.com/cgi/content/full/bmj.n1060?ijkey=YhH9UQOseeXaJzT&keytype=ref

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.

COVID-19 pandemic: India vs Israel

The contrast between India and Israel over this weekend is astonishing. (Gloom vs Cheer).

Israel reports “no new daily Covid-19 deaths for the first time in 10 months”.

India, on the other hand, reports, a record 2,624 deaths in the 24 hours and about one million infections in last three days alone.

The new wave in India seems to have been caused by emergence of new variants, as well as mass gatherings.

It maybe that the mass rapid vaccination drive in Israel helped.

Let’s hope that UK, Europe and USA are firmly on the path towards normality in the summer as the vaccination rates go up.

References

BBC news. Covid-19: Israel records no daily deaths for the first time in 10 months.

BBC news. India Covid surge: Hospitals send SOS as record deaths registered.

Guardian. CoronavirusWhat do we know about the Indian coronavirus variant?
Ian Sample Science editor
@iansample. Mon 19 Apr 2021 16.50 BST

BBC news. Covid vaccine: How many people in the UK have been vaccinated so far?
By The Visual and Data Journalism Team
BBC News

New York Times. Tracking Coronavirus Vaccinations Around the World.
By Josh HolderUpdated April 23, 2021.

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.

Can someone die due to COVID-19 infection even after having the full course of protective vaccination?

Yes, rarely it can happen.

COVID vaccines are very highly effective in preventing serious infections that would result in hospitalisation. Even a single dose of the vaccine has very good efficacy.

But vaccines are not 100% effective.

So until the pandemic is under full control, older adults, particularly those over 60 years, should be cautious even after full vaccination.

It also has to be said that the risk is dramatically small after full vaccination. Only a tiny minority of people get serious COVID-19 infection after full vaccination.

In USA, about 5800 “breakthrough” COVID-19 infections has been reported so far among the roughly 77 million people who had been fully vaccinated. That’s less than 0.008% cases.

A much more smaller minority among this minority group had serious infections. Among the 5800 cases, 396 patients were admitted to hospital and 74 patients died from COVID-19. That’s less than 0.0001% deaths.

So unless new viral mutations dramatically reduce vaccine efficacy, it looks very promising.

References:

1. BMJ News. Covid-19: Infections fell by 65% after first dose of AstraZeneca or Pfizer vaccine, data show BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1068 (Published 23 April 2021)
Cite this as: BMJ 2021;373:n1068

2. BMJ news. Covid-19: US reports low rate of new infections in people already vaccinated
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1000 (Published 16 April 2021)
Cite this as: BMJ 2021;373:n1000

3. Sun News. DOUBLE TROUBLE ‘Concerning’ Indian Covid variant now in UK has two ‘escape mutations’ that could dodge antibodies
Vanessa Chalmers, Digital Health Reporter
12:22, 16 Apr 2021Updated: 12:25, 16 Apr 2021

4. BBC news. Coronavirus: ‘Double mutant’ Covid variant found in India. Published 25 March

5. Daily Mail. Could the Indian ‘double mutant’ coronavirus derail Britain’s roadmap out of lockdown? Experts warn variant could ‘scupper our escape plan’ and urge Boris to put country on red list. By James Robinson for MailOnline
01:49, 17 Apr 2021 , updated 11:08, 17 Apr 2021

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.

Are COVID-19 vaccines necessary for someone who has recovered from a COVID-19 infection ?

Yes !

If someone has recovered from a COVID-19 infection, they would have some protection against getting another COVID-19 infection.

But, even if someone has recovered very well from a previous infection, vaccination is necessary because there is still a significant risk of getting COVID-19 infection again.

A recent study published in the medical journal Lancet reports that people who had a previous infection have about one-fifth risk of getting an infection again compared to those without a previous infection.

So while there is some protection against future infections, there is still a risk and hence it is prudent get the Vaccine when it is offered.

Reference:

Lancet. SARS-CoV-2 seropositivity and subsequent infection risk in healthy young adults: a prospective cohort study. DOI: https://doi.org/10.1016/S2213-2600(21)00158-2

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Should young adults avoid Astra Zeneca COVID-19 vaccine ?

Probably Yes, because of the reports of rare cases of brain clots following vaccination.

Like everything else in medicine, risks and benefits needs to be assessed in each individual case.

For instance, a doctor won’t give toxic treatments for a self limiting flu. But, on the other hand, a doctor will try toxic chemotherapy to control advanced lung cancer.

It’s always going to be a balance between risks from a disease versus risks and benefits of a particular treatment.

No vaccine or medicine is ever going to be 100% safe.

For that matter, Life is full of risks. Getting out of bed can be risky. Not getting out of bed everyday is also risky.

Older adults who are at high of COVID related death and COVID related complications should have the vaccine during this pandemic and not worry too much about rare serious side effects.

But young adults, who are a low risk, can avoid Astra Zeneca vaccine based on the available data, if alternatives are available.

References

Official UK data. MHRA. Research and analysis. Coronavirus vaccine – weekly summary of Yellow Card reporting. Updated 8 April 2021.

BBC news. Covid-19: Seven UK blood clot deaths after AstraZeneca vaccine. By James Gallagher.
Health and science correspondent.

BBC news. AstraZeneca vaccine: How do you weigh up the risks and benefits? By Robert Cuffe. Head of statistics

BBC news. Covid: Under-30s offered alternative to Oxford-AstraZeneca jab. By Nick Triggle. Health correspondent

BMJ news. AstraZeneca vaccine: Blood clots are “extremely rare” and benefits outweigh risks, regulators conclude. BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n931 (Published 08 April 2021). Cite this as: BMJ 2021;373:n931

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Can Vitamins and anti-oxidants increase the risk of breast cancer coming back?

Yes, Dietary supplements can be harmful.

Vitamins and Minerals are absolutely essential nutrients for a Healthy body and a Healthy mind. Anyone not eating a healthy balanced should look what nutrients they might be missing.

But on the other hand, taking too much of vitamins and minerals, when they are not needed, could be harmful to the body.

There is widespread use of dietary supplements during cancer treatment, in the hope they can reduce side effects but many do not think about the disadvantages.

An American study of Breast cancer patients undergoing Chemotherapy looked at the effect of taking dietary supplements such as anti-oxidants, iron, vitamin B12, and omega-3 fatty acids.

Breast cancer patients who took the dietary supplements during chemotherapy were found be harmed by them. They had a higher chance of cancer coming back compared to people who did not take these supplements. The supplements also increased risk of death in those the supplements.

Beware supplements when used improperly, can be harmful.

Dietary Supplement Use During Chemotherapy and Survival Outcomes of Patients With Breast Cancer Enrolled in a Cooperative Group Clinical Trial (SWOG S0221)

, PhD1; , PhD2; , PhD1; 1; , PhD, RD1; , PhD3; , MD1; , PhD, EdD1; , PhD4; , MD5; , PhD3; , MD6; , MD7; , MD8; , MD9; , MD10; , MD11; , MD12; , MD6; and , MD13

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Are COVID-19 vaccines safe in cancer patients having immunotherapy?

Yes, Pfizer vaccine is safe.

A recent study published in the esteemed Lancet Oncology Journal shows that the vaccine is well tolerated in patients having immunotherapy.

Unlike cancer chemotherapy, immunotherapy works differently. It works by releasing the in-built brakes holding down the immune system thereby boosting the body’s immune system against cancer.

There has been some theoretical concerns whether this might lead to COVID vaccine causing more side effects.

Reassuringly, the Vaccine side effects were NO different from those seen in people not having immunotherapy. The Vaccine also did NOT increase the immunotherapy side effects.

Immunotherapy is increasingly used widely in treatment of cancer are often better tolerated than chemotherapy.

So the study is good news for tens of thousands of patients on immunotherapy and any cancer patient who has hesitated before, should seriously consider having the vaccine now

COVID infection could be very nasty in cancer patients and all evidence points to the benefits of vaccine far outweighing any risks from the Vaccine.

References

Short-term safety of the BNT162b2 mRNA COVID-19 vaccine in patients with cancer treated with immune checkpoint inhibitors
The Lancet Oncology. Published: April 1, 2021
Barliz Waissengrin et al. DOI:https://doi.org/10.1016/S1470-2045(21)00155-8

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Are COVID-19 vaccines safe in Children ?

Yes, Israel has vaccinated vulnerable children and there have been NO reports of unusual or unexpected reactions.

Pfizer has just released positive results of a study which looked at safety and efficacy of the Vaccine in 12 to 15 year olds.

Pfizer-BioNTech covid-19 vaccine has shown 100% efficacy against SARS-CoV-2 in 12 to 15 year olds.

The Vaccine reassuringly was well tolerated, and the side effects were no different from those observed in the group aged 16 to 25.

What about much more younger children?

A vaccine trial in the children aged 6 months to 11 years has been started recently and results should be available later this year.

References

SKY news. Wednesday 31 March 2021 14:35, UK

The Guardian. Wed 31 Mar 2021 14.20 BST

BMJ News. Covid-19: Pfizer reports 100% vaccine efficacy in children aged 12 to 15
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n881 (Published 01 April 2021)
Cite this as: BMJ 2021;373:n881

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

How long do the COVID-19 vaccines offer protection?

Many millions of people have now been vaccinated against COVID-19.

The COVID-19 vaccines are highly effective but the next important question is how long would the vaccines continue to protect.

Some vaccines for other viral diseases offer life long protection but others like flu vaccines need annual boosters. COVID-19 Studies are still ongoing.

A recently released Pfizer vaccine study data indicates that protection with Pfizer vaccine lasts for many months as a minimum. To be precise, so far, Pfizer vaccine was found to have 91% efficacy for up to six months. Ongoing studies would clarify whether booster vaccines are needed in future.

Guardian. Pfizer vaccine has 91% efficacy for up to six months, trial shows. Ian Sample Science editor
@iansample
Thu 1 Apr 2021 17.27 BST

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

COVID-19 is risky even after a patient recovers from it initially

COVID-19 is not a self limiting illness particularly if you have been poorly enough to be hospitalised the first time around.

Even after recovering from a COVID-19 infection, many people remain at high risk of death.

A recent UK study published in the BMJ found that “ Nearly a third of people who have been in hospital before were readmitted after discharge for further treatment in the following four months”.

“And worryingly one in ten patients died during the follow up period after hospital discharge”.

The increase in risk was not confined to the elderly. So everyone still needs to be careful as the lockdown is being gradually eased.

References:

1. BMJ. Post-covid syndrome in individuals admitted to hospital with covid-19: retrospective cohort study. BMJ 2021; 372 doi: httpst://doi.org/10.1136/bmj.n693 (Published 31 March 2021)
Cite this as: BMJ 2021;372:n693

2. Guardian. Almost third of UK Covid hospital patients readmitted within four months. Ian Sample Science editor
@iansample
Thu 1 Apr 2021 06.00 BST

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Can Traffic pollution kill you ?

Yes, pollution from cars and lorries can kill.

A recent study published in BMJ shows increase in heart and lung related deaths due to traffic pollution.

Reference:

BMJ. Short term associations of ambient nitrogen dioxide with daily total, cardiovascular, and respiratory mortality: multilocation analysis in 398 cities. BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n534 (Published 24 March 2021)
Cite this as: BMJ 2021;372:n534

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Selenium can be harmful for Skin cancer patients

Nutritional supplements are often tried to prevent cancer. But well- designed rigorously conducted clinical trials have NOT shown any benefit in prevention of many cancers.

Selenium was suggested as a preventative supplement for skin cancer.

A clinical trial compared Selenium against placebo in United States. The results were disappointing.

Selenium supplementation was found to be ineffective at preventing Skin cancers.

To make matters worse, Selenium was found to Harmful and increased the the risk of getting some skin cancers such as squamous cell carcinoma.

Selenium Supplementation and Secondary Prevention of Nonmelanoma Skin Cancer in a Randomized Trial. Anna J. Duffield-Lillico, Elizabeth H. Slate, Mary E. Reid, Bruce W. Turnbull, Patricia A. Wilkins, Gerald F. Combs, Jr., H. Kim Park, Earl G. Gross, Gloria F. Graham, M. Suzanne Stratton… Show moreJNCI: Journal of the National Cancer Institute, Volume 95, Issue 19, 1 October 2003, Pages 1477–1481, https://doi.org/10.1093/jnci/djg061

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Which COVID vaccine is the best ?

All vaccines approved by the regulatory authorities are in fact good.

No need to be choosy as there is no head to head comparative data.

Pfizer is new exciting technology. (‘mRNA technology’).

Astra Zeneca is based on tried and tested, old reliable technology. (‘viral vector’ technology).

In fact, ‘anything is better than nothing’ principle applies; any of the approved Vaccines would be helpful during this dreadful pandemic .

Israel easing restrictions following vaccination proves vaccines are our way of this horrible pandemic.

References

BBC news. Coronavirus doctor’s diary: Don’t ask me which vaccine is best, please.

Daily Mail: So which Covid vaccines is Britain getting – and which one is the best? How two companies’ jabs are already being used, another is coming in March and two more could be approved within weeks. By Connor Boyd Assistant Health Editor For Mailonline
11:58, 29 Jan 2021 , updated 02:00, 30 Jan 2021

BBC news. Israel eases restrictions following vaccine success.

Blog. Where can I find official detailed information about the three COVID vaccines (Pfizer, Astra Zeneca and Moderna).

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

How long does it take for taste sensation to recover after Radiotherpy to Head and Neck region ?

Curative Radiotherpy to Tongue, Mouth , Throat and other parts of head and Neck can lead to dry mouth, sticky saliva, difficulty in swallowing solid foods, and loss of taste sensation.

Loss of taste sensation affects food intake and affects quality of life.

A group from Tel Aviv studied the effect of radiotherapy on taste sensation in head and neck cancer patients.

They found that “taste recovery started to occur 1 month after treatment completion

References:

The effect of radiotherapy on taste sensation in head and neck cancer patients – a prospective study. Michal Asif et al. Radiat Oncol. 2020. Radiat Oncol. 2020 Jun 5;15(1):144. doi: 10.1186/s13014-020-01578-4. Authors: Michal Asif, Assaf Moore, Noam Yarom, Aron Popovtzer.

Oral complications at 6 months after radiation therapy for head and neck cancer. R V Lalla et al. Oral Dis. 2017 Nov. Oral Dis. 2017 Nov;23(8):1134-1143. doi: 10.1111/odi.12710. Epub 2017 Aug 3.

Prospective assessment of taste impairment and nausea during radiotherapy for head and neck cancer. Stefania Martini et al. Med Oncol. 2019 Apr 9;36(5):44. doi: 10.1007/s12032-019-1269-x.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Does Hand Washing help to prevent COVID-19 ?

Yes,

But the extent to which Hand washing helps is uncertain.

Masks, Social distancing and Vaccination seem to be more highly important than Hand Washing.

Read the very good Guardian newspaper piece on the topic of hand washing.

References

Guardian: Q&A: Does handwashing stem the transmission of Covid-19?
James Tapper
Sun 14 Feb 2021 10.00 GMT

Daily Mail: So which Covid vaccines is Britain getting – and which one is the best? How two companies’ jabs are already being used, another is coming in March and two more could be approved within weeks. By Connor Boyd Assistant Health Editor For Mailonline
11:58, 29 Jan 2021 , updated 02:00, 30 Jan 2021

Daily Mail. Pfizer’s Covid vaccine COULD stop people spreading the virus as well as preventing serious illness, Israeli doctor claims after finding antibody levels surged after second dose. By Emily Webber and Sam Blanchard Deputy Health Editor For Mailonline
12:05, 19 Jan 2021 , updated 14:06, 19 Jan 2021

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Vitamin D reduces risk of advanced cancer in normal-weight individuals.

“An ounce of prevention better than a pound of cure” is certainly true when it comes to cancer prevention.

Vitamin D, the “sunshine” vitamin has been proven to reduce risk of advanced cancers an large American study.

The study presented at the ASCO ( American Society of Clinical Oncology) virtual scientific symposium in 2020,

“The VITamin D and OmegA-3 TriaL (VITAL) was a high quality study. The study randomly assigned patients to Vitamin D3 supplements and/or omega-3 fatty acid supplements and/or both or placebo in 25,871 men and women.

The study found that “vitamin D supplementation decreased risk of developing advanced cancers by 17% compared with placebo ”

“Omega-3 supplementation did not reduce the incidence of advanced cancer.”

Reference:

Vitamin D Reduces Incidence of Advanced Cancers in Normal-Weight Individuals. ASCO Annual Meeting 2020.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Two New Vaccines against COVID-19

More good news on the vaccine front in the fight against the coronavirus.

Two new vaccines have reported positive results.

The NOVAVAX vaccine is first Vaccine to report efficacy against the new variants. It is 95.6% effective against the original strain of coronavirus.

NOVAVAX is 86% effective at protecting against the new UK variant, which is very reassuring. But the Vaccine is only, 60% effective against South African variant of the virus. The efficacy against Brazilian variant is unknown.

The Janssen vaccine, produced by the US giant Johnson & Johnson, is a single-dose vaccine and has proved 66% effective against Covid-19. The vaccine was just 57% effective in the South African part of the trial.

The reduction in efficacy of both vaccines against new variants is a bit worrying and indicates that if further new variants emerge in future, existing vaccines could be less effective and vaccines would need to be updated.

The Janssen vaccine uses a common cold virus and uses a approach similar to the Oxford Astra Zeneca Vaccine.

Novavax vaccine differs from existing vaccines and it uses a artificially produced COVID-19 spike protein, which is then assembled into nanoparticles to make them look like coronavirus.

Bloomberg: Covid Mutations Undercut Optimism Even as More Vaccines Near
By Robert Langreth
30 January 2021, 00:04 GMT
Updated on 30 January 2021, 12:02 GMT

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Spit test for COVID

Anyone who had the COVID test would know that the swab up the nose and throat is unpleasant.

Life would be much more easier if you can just spit in a test tube and the saliva could be tested for COVID.

Early results are promising and tests so far has shown that saliva testing is as good as nose swab testing

References

BBC. Covid-19: No-swab saliva test finds symptomless cases.
By Michelle Roberts
Health editor, BBC News online.

JAMA January 15, 2021. Comparison of Saliva and Nasopharyngeal Swab Nucleic Acid Amplification Testing for Detection of SARS-CoV-2
A Systematic Review and Meta-analysis

Guillaume Butler-Laporte, MD1; Alexander Lawandi, MD, MSc2; Ian Schiller, MSc3; et al. JAMA Intern Med. Published online January 15, 2021. doi:10.1001/jamainternmed.2020.8876

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Is social media inadvertently responsible for the spread of vaccine misinformation?

Read the excellent article in BMJ and contribute your views through the rapid response section of BMJ

Reference

Too little, too late: social media companies’ failure to tackle vaccine misinformation poses a real threat
BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n26 (Published 21 January 2021)
Cite this as: BMJ 2021;372:n26

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.