Dear Friends
Sharing this article published 21 March 2020
# Beating corona as a doctor
Singapore has not had a single health care related transmission of corona virus. No, they did NOT use universal N95 masks or full body protective gear for every patient contact. They did NOT use hydroxychloroquine either. Similar success story has been achieved in Honk Kong.
What can we learn from this ?
# Social distancing within hospitals and clinics
Waiting room chairs 6 feet apart.
Doctor and patient 6 feet apart.
Doctors should wear surgical masks.
No role for cloth masks.
# Who needs N95 masks?
The use of N95 masks, face-protectors, goggles, and gowns are reserved for procedures where respiratory secretions can be aerosolized (for example, intubating a patient for anesthesia) and for known or suspected cases of COVID-19.
# If your coworker becomes unexpectedly positive, the worker and his “close” contacts will be quarantined. Who is a “close”contact?
In Hong Kong, “close contact” means fifteen minutes at a distance of less than six feet and without the use of a surgical mask; in Singapore, thirty minutes. If the exposure is shorter than the prescribed limit but within six feet for more than two minutes, workers can stay on the job if they wear a surgical mask and have twice-daily temperature checks.
What this means is it is possible to cut down transmission to nearly zero even without unproven prophylaxis even if you are a healthcare worker at high risk.
(Source: Adapted from Atul Gawande in NYT on Mar 21)
