FPA Beats

Editor: Dr Pragnesh Shah

Clinical Cardiologist.

Issue: May 2020

Family Physicians’ Association, Vadodara

Dr Pragnesh Shah, MBBS, PGDCC (Dip. Cardiology)

Editor,

FPA Beats,

Family Physicians’ Association, Vadodara

Dear Friends,

Let’s drop all fears and perform our duty as doctors and win the war against

COVID-19.

Let’s fight like soldiers in this war against CORONA. We all know that the

world is suffering from a Pandemic: COVID 19. We doctors are the frontline

soldiers supported with nursing staff, paramedical staff, cleaning staff (Safai

kaamdar) and Police as an important internal army.

जातस्य हि धु्रवो मृतु्यधुु्रवं जन्म मृतस्य च।

तस्मादपरििारे्यऽरे्थ न तं्व शोहचतुमिुहि॥

(Death is certain for the born, and re-birth is certain for the dead; therefore

you should not feel grief for what is inevitable.)

Ultimately we should make ourselves so strong that no problem could affect

our life and we should also set an example for others.

The solution for getting energy for facing negative situation is to believe that

God is with you always and he will surely take you out from all the adverse

situations , this will give u mental power to face all the troubles of this world.

CORONA to COVID – 19 to lockdown to market crash to fear of death to

what not? We don’t have an answer! This 2020 year, CORONA, Bollywood

loses Irfankhan & Rushikapoor, sad demise of Kundanika Kapadia, writer of

“સાત પગલા આકાશમાાં”, Vishakhapatanam gas leak, 2020 is still not finished.

India is an emerging nation in this CORONA era. We are providing medicines

to almost all countries of the world. This CORONA gives us a clear message

to be self sufficient i.e. let’s promote “SWADESHI PRODUCTS”. Our

beloved PM Shree Narendra Modi’s dedicated untiring efforts really make all

of us feel proud about our PM and his vision for India.

But at the same time we appeal our beloved respected PM Narendra Modiji to

provide us N95 masks, PPE, sanitizer, infrared temperature etc to medical

fraternity at reasonable rate. Please stop black marketing of weapons in war

against CORONA and support medicos. This is kind request from medical

fraternity to most beloved PM of India.

Jay hind, Jay bharat.

Though of the month: न हिमहप शाश्वतं। (Nothing is permanent.)

Yours,

Dr Pragnesh Shah, MBBS, PGDCC (Dip. Cardiology)

Clinical cardiologist,

Vadodara, Gujarat.

Email : pragnesh8399@gmail.com

Contact : +91 9426336422

Special thanks

In response to our movement to join hands to serve society and our

members in this pandemic COVID 19, Dr Ranjit Patel, Neurophysician

at USA and Mr Kiran Dave donated 51,000 and 50,000 respectively.

We also thank our all members who have donated generously.

*Reprinted with permission

Position Paper

A Statement of Solidarity on COVID-19 Pandemic

2020 by the South Asian Family Physicians

Raman Kumar1 , Shehla Naseem2 , Jayantha Jayatissa3 , Chhabi Lal Adhikari4

, Tariq Aziz5 , Riaz Qureshi6 , Pratap Narayan Prasad7 , Sankha

Randenikumara8 , Pratyush Kumar9 , Md Zakiur Rahman10, Pramendra

Prasad Gupta11, Md Kabir Ahmed Khan12, Marian Antoinette Perera13,

Vandana Boobna14, Resmi S Kaimal15, Mohan Kubendra16, Sanjeeb Tiwari17,

Hina Jawaid18, Shyamalee Samaranayaka19, Marie Andrades20, Kishore

Purshottam Madhwani21, Pragnesh R Shah22

1 National President, Academy of Family Physicians of India, New Delhi, India, President

WONCA - World Organization of Family Doctors, South Asia Region, 2 Secretary General,

College of Family Medicine, Pakistan, 3 President, College of General Practitioners, Sri Lanka,

4 Professor of General Practice and Course Coordinator, Khesar Gyalpo University of Medical

Sciences of Bhutan (KGUMSB), Thimphu, Bhutan, 5 President, Pakistan Academy of Family

Physicians, Lahore, Pakistan, 6 Professor, Department of Family Medicine Department, Aga

Khan University, Karachi, Pakistan, 7 Institute of Medicine, Department of General Practice

and Emergency Medicine, TUTH, Maharajgunj Kathmandu, Nepal, 8 Chair, The Spice Route:

WONCA Young Doctor’s Movement of South Asia, Sri Lanka, 9 Chair, WONCA Rural South Asia,

Senior Resident, Department of Geriatrics, Patna Medical College Hospital, Patna, Bihar,

10President, Primary Care & Rural Health Bangladesh, Dhaka, Bangladesh, 11 Associate

Professor Department of General Practice, B.P.Koirala Institute of Health Sciences, Dharan,

Nepal, 12 PRAAVA Health, Family Doctors & Diagnostics, Bangladesh, 13 Emeritus prof of

Family Medicine University of Sri Jayawardenepura, Sri Lanka, 14 Department of Preventive

Care , Medicine Max Super Specialty Hospital, Delhi, India, 15 Consultant Family Medicine

Department of Family Medicine, Lourdes Hospital, Kochi, Kerala, India, 16 CEO, Spandana

Health Care, Bangalore, India, 17 Assistant Professor, TUTH, Maharajgunj, Kathmandu, Nepal,

18 Department of Family Medicine, University of Health Sciences Lahore, Punjab, Pakistan, 19

Head, Department of Family Medicine, Faculty of Medical Sciences, University of Sri

Jayewardenepura, Sri Lanka, 20 Head, Institute of Family Medicine Jinnah Sindh Medical

University, Karachi, Pakistan, 21 CEO, Center for Excellence in Family Medicine and

Occupational Health, Mumbai, India, 22 Member, Federation of Family Physicians Association

of India (FFPAI), SMO ESIS General Hospital, Vadodara, Gujarat, India

Abstract

The World Organization of Family Doctors (WONCA) is a not-for-profit

organization and was founded in 1972 by member organizations in 18 countries.

WONCA now has 118 Member Organizations in 131 countries and territories with

a membership of about 500,000 family doctors and more than 90 percent of the

world's population. WONCA has seven regions, each of which has its own regional

Council and run their own regional activities including conferences. WONCA

South Asia Region is constituted by the national academies and colleges and

academic member organizations of this region namely India, Pakistan, Bangladesh,

Nepal, Sri Lanka, Bhutan, and the Maldives. In the background of the ongoing

COVID 19 pandemic, the office bearers, academic leaders, practitioners, and

researchers of primary care from the South Asia Region have issued a solidarity

statement articulating the role of primary care physicians.

Keywords: COVID 19, COVID in South Asia, COVID in India, Lockdown, Primary Care, World Organization of Family Doctors, WONCA

Background: COVID-19 Pandemic 2020 in South Asia

The COVID-19 pandemic presents one of the most unprecedented challenges to the

health and wellness of the people of South Asia. After having a devastating impact on

the population health of many countries, the threat is now looming over the countries

of the most populous region of the world. The impact is likely to be short term as well

as long term; both on health as well as the economy. South Asian countries share

many healthcare problems that are unique, including maternal and child health issues;

the double burden of infectious diseases as well as noncommunicable diseases. Also,

there is a need to reach of the weaker section of the society, the one who is

marginalized, vulnerable and underserved, during the pandemic. Having a population

predominantly of rural habitation, special provisions are required to protect the rural

population from the adverse outcomes of the pandemic in South Asia. Healthcare

professionals as precious resources not only for South Asian countries but for the

whole world. When the health systems of the most developed countries are struggling,

we recognize that all sections of society and the healthcare professionals, within our

respective countries, need to come together to be able to pool resources and ensure

optimal care during the most testing circumstances.

Health System Response and the Role of Primary Care Physicians

Primary healthcare and teams including family doctors, medical officers, nurses, and

other healthcare providers are essential foundations of any emergency community

response and risk management. Family doctors as primary care physicians are the

front line health workers who provide services to persons from all age groups, organ

systems, and genders. They also provide the most cost-effective medical care within

the community. Within the government systems, medical officers play the role of

primary care physicians. Family physicians often see undifferentiated symptoms such

as fever and flu and are more likely to encounter COVID-19 cases as well. They are

proficient in managing infectious diseases in the community in the south Asian

context. Therefore the family physician's role is pivotal along with other healthcare

professionals towards addressing the community aspect of the pandemic. However,

considering the novelty of COVID-19, we emphasize that it is necessary that all

family physicians and the primary care providers have access to unhindered updated

academic resources, equipped with appropriate personal protection equipment (PPE),

upgraded with digital technologies, and be given a safe working environment. We also

recognize that the health systems should be receptive to the needs of healthcare

providers and protect them adequately while they can perform their duties in front

lines of the pandemic situations. In this regard, the need for personal protection

equipment (PPEs) for the primary care providers is equally important to anyone else

working in a similar situation irrespective of the setting of care provision. Family

physicians should be provided with PPE through the government schemes in the South

Asian countries or be made available at discounted rates.

Primary Care Physicians: Specific Roles and Responsibilities

In a pandemic situation, the roles and responsibilities of family physicians as

primary care physicians are manifold. The specific roles in mitigating the

pandemic include triage, fever screening, handling the helplines, providing

telemedicine consultations, training the paramedics, educating the community,

facilitating community participation, guiding the local community leader and

assisting the public health authorities Their contribution is also important in the

context of the provision of care for non-COVID-19 morbidity. Family physician's

unique training and experience enable them to take care of ninety percent of the

community-based morbidity. They can also provide primary care for mental health

issues. Thus as front line primary care providers, they can help in mitigating the

pandemic and prevent unnecessary burden presenting at the hospitals.

We Stand Together in Solidarity!

In the moment of a great public health crisis, something which impacts all human

beings on the earth, we the family physicians of South Asia are together in solidarity

with all our professional colleagues and people. We salute all healthcare workers who

have stood to this call of duty. There is no greater service than the service of

humanity. May we all triumph together for ourselves, our families, our people, our

countries and our world.

Consensus Statement By: WONCA SAR - World Organization of Family Doctors South Asia Region The Spice Route - WONCA Young Doctors Movement of South Asia WONCA Rural South Asia Region (WoRSA) South Asia Primary Care Research Network (SAPCRN) Academy of Family Physicians of India (AFPI) Bangladesh Academy of Family Physicians (BAFP) Bangladesh College of General Practitioners (BCGP) College of Family Medicine Pakistan (CFMP) College of General Practitioners of Sri Lanka (CGPSL) Federation of Family Physicians Associations of India (FFPAI) General Practitioners Associations of Nepal (GPAN) General Practitioners in Bhutan General Practitioners in the Maldives Indian Medical Association College of General Practitioners (IMACGP) Pakistan Society for Family Physicians (PSFP) MRCGP (INT) South Asia Board Primary Care and Rural Health Bangladesh

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Presidential and Secretary Address

Dear friends,

All of you know that Corona Virus pandemic has changed all the equations

in the world.

Now we understand that we have to live with corona and we have to

change our lifestyle. Vaccines and herd immunity is the only hope for the

upcoming months.

Due to increase in local cases and looking at the high infectivity of corona

virus government approached our team members and discussed the new

concept of "Corona Positive Home Based Care." Friends we have decided

to support government because we need to protect our health care system

to handle the load and we don't want to lag behind this time when other

associations are also supporting the government at their best we have

taken all the due precautions during meeting for the legal protection and

safety of our members which is the supreme priority in our minds.

I really thank all who have registered their name when they were asked for.

When we have to do only telephonic consultation and no physical contact

with patient I think most of our members will be able to render their

services.

All of you know that social distancing and staying at home all these

measures were not to cure COVID 19. These were measures to slow it

down so as to not overwhelm our healthcare system, for the most part we

have done that but it does not change the course of COVID infection, It

was intended to delay it. If you are driving from Jaipur to Delhi at 50 mph

or 100 mph, the distance doesn't change. So be prepared for the worst as

when lockdown is over the virus will spread again and the people

with weakened immune system will steal succumb to eat. This is a harsh

fact.

Friends we are always with our members and are really concerned for the

safety of our members. We will try our best to help our members in this

COVID era. Thanks to all our COVID consultant friends. United we will

definitely defeat the corona, lastly I cannot forget the effort put in by our

efficient IMA Team Members

Thanks All

Dr Ketan Shah Dr Rikul Shah

President, Hon. Secretary,

FPA Vadodara FPA Vadodara

જ ાંગ તો લડી જ લઈશ ાં કોરોનાથી,

બધા સાથે હશ ેતો મજા આવશે.

જીતીશ ાં - જીવીશ ાં જ કોરોના પછી,

સાથે લડીશ ાં બધા તો મજા આવશે.

અનેક રોગો હાર્ાા, હવે કોરીનાની વારી,

તબીબ બની જીવીશ તો મજા આવશે.

ડર, ક ટ ાંબ પે્રમ અડચણ છે કોરોના સામે,

અર્ ાન બનશે તબીબ, તો મજા આવશે.

હ ેમાધવ, બની જા સારથથ કોરોના સામે,

કમાથી ન થવચલલત થવ ાં હ ાં, તો મજા આવશે.

ડૉ પ્રજ્ઞેશ શાહ,

કલીથનકલ કાર્ડિર્ોલોજજસ્ટ,

વડોદરા.

Humour out of CORONA – COVID 19

(From social media)

Corona virus won’t last long because it was made in China.

Love knows no borders, neither do people with corona virus.

It’s been almost a week me and wife are working from home due to

corona virus situation. I think we will kill each other before the virus

does!

This is your pilot speaking. I’m working from home today.

Earlier in history man had to fight wars to save his country. Now we

have to stay home to save the country.

I am not Kareena, I am Corona.

Meanwhile in Lahore, a terrorist blows up his own house, after

Pakistan government issued a work from home advisory for its

citizens.

Boyfriend to girlfriend: can’t spell quarantine without you.

U.. R.. A..QT ..... How is this?

Teacher: What is the opposite of Valentine? Boy: Quarantine

CORONA gives us following messages

Close nose & mouth by mask

Obey government notification

Rest adequately

Observe social distances

Nourish your body and mind properly

Aware society and accept challenges

For during and after CORONA era

Tips for “COVID 19 Pandemic” for

Community as well as for Medical Professionals

Dr. Jitendra D. Lakhani,

Prof of Medicine and Academic

Director, SBKSMIRC & Dhiraj Hospital,

Sumandeep Vidya peeth Deemed University, Piparia.

Preamble: During “COVID 19 Pandemic”, preserving our own health is

priority and our own responsibility. Government, Experts and Administrators

may suggest guidelines and enforce law to protect community by large but

individual and or own family’s health should be given priority. Following

priorities has to be set in our day to day living;

1. Holistic approach to be given more priority than “COVID centric”

approach.

2. Mental health to be given equal importance to Physical health.

3. Wisdom coupled with evidence based knowledge is more important than

unnecessary information and Statistics.

4. Balanced and Nutritious Diet should be more important than getting a

particular vegetable or fruit.

5. Money is important; no doubt, but your own health is much more important

than anything else.

6. General hygiene principle is more important than only COVID related

issues. No amount of sanitizers is going to help if cleanliness of our own

surrounding is not maintained. William Osler’s statement of “Cleanliness,

Soap and water and Commonsense” is very important for prevention of

infective disorders.

7. Virus does not have language, religion, boundaries or emotions. It can

effect anybody who comes in their vicinity .Elderly suffer more because of co-

morbidities, senescent body tissues and apoptotic cells. Children do not

develop adult type of symptoms, but they can develop COVID in typical or

atypical way.

8. Masks are important however very colourful, dirty, improperly worn (not

covering nose), having fashionable accessories, made from clothing which

absorb secretions, wearing a mask and putting it in cupboard or on table and

wearing it again, holding mask from centre while discarding are some

dangerous practices.‘

10. STAY SAFE; STAY HEALTHY, PRIMUM NON NOCERE: “first, do no

harm.”

Home quarantine and isolation under medical supervision with best practices

in mildly symptomatic cases can be recommended. Quarantine is a strict

isolation imposed to prevent the spread of disease. Voluntary quarantine/ self-

quarantine in COVID positive health professional can be done however

medical supervision and progress check should be done.

** ** ** ** ** ** ** ** ** **