This is Dr. Pravin K. Goel, Professor and Head of Cardiology at Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow. You are listening to me on The RightDoctors.Com, which is India’s one of the leading medical knowledge platform. We are just talking about the corona pandemic. We all know that we are going through tough times with the corona pandemic as of now and this is a new disease, so whatever it is, lots of information is there on the net on different information platforms, but what is right, what is wrong sometimes is very difficult to clarify because the knowledge base of the people is also limited because the virus is new that has just come.

How is it affecting, like maybe, the cardiology, if I would like to talk a little about cardiology and this disease? So as we see, as times are passing, the one important thing that we have seen during this corona times, I do not know, I may be wrong or I may not be sure, but I am observing that the number of patients who used to come with acute cardiac events is less now. Is it that the people are not able to come or is it that the number of events that are happening is less? Is it the pollution that is less, so the events are less? Has the lifestyle reduced tensions? The diseases like diabetes, hypertension, heart disease, stress, usual life stresses do play a role in precipitation events.

So that these numbers are certainly less, is it truly less, or is it that we are delaying these numbers? In the sense, they are all piling up and they will come and they will show up the moment this lockdown period is released well and this is a million-dollar question which only time will tell us. But, whatever it is big numbers are less and of course, there are deaths because of corona disease but they are increasing every day as we see. But, one thing which one needs to understand is that this disease, that’s my thought, this disease, will take its time cycle. If you see what happened in China, the other countries that got the disease the earliest also are now reducing their numbers at the earliest, which suggests that there is a time cycle on which it will raise and then come down. Probably, this time cycle is around three months. It rises till about 3 months. That has what happened in China, that’s what happened in South Korea and now the disease has actually caught India and we have almost caught it together. But, there is one big observation now.

The US at the same time rose to a number which is nearly 50 times higher than India. For every one case in India, we have 50 cases in the US. Why is it so? This has a medical angle also when certain lockdowns are important and lockdowns in India could make a difference but in any scientific study, as we know, you have to have one group with a particular treatment, another group without treatment. Then only you can say this treatment worked. So, theoretically, it is not possible to do a study like this because it would be unethical not to have the lockdown as we believe in the lockdown, but certainly, there is something which could be there other than the lockdown in the patient itself. I wonder maybe the Indian patients, because of their exposure to so many other infections and viruses over his life, we get BCG vaccination, we are exposed to a lot of infections while the western population at large like the US or Italy, for example, could be less exposed to these infections in general. So they are kind of less experienced and their body defenses are less strong.

I wonder if that is also playing a role, but only time will tell us and that is the reason that we are increasing the numbers in the same way but the absolute numbers are much-much less in the same time zone as are happening in the US or happened in Italy or happened in China. So that is one aspect. The next aspect is how do you manage patients during this pandemic when the other diseases theoretically cannot disappear? So the COVID patients have to be managed by COVID doctors who are in front-line but other super specialties have to still run. If it were a short period, we could have considered that we will delay it till complete lockdown or complete the disease or complete this blackout period, but as we see today, as we understand, this disease, I can tell you, will certainly rise at least till May in India, 15th May, 30th May, it will not come down before that and things would be down to zero, I don’t know, finally, the low-level infection will continue.

You will have to learn to live with this and it is the herd immunity of ours which will only protect us from this disease. So we will have to now deal with only emergency cases, trying to delay the semi-emergencies. There are a lot of procedures in medicine, at least in cardiology. For example, if the procedure is not an emergency but it is definitive like you have to do it, you cannot postpone it endlessly. So if we were to postpone it endlessly, now it seems that you will have to postpone it endlessly. So it is not possible. So we will probably have to work out strategies, by which we can have the patient treated for these non-coronary events also plus protect the healthcare workers and others from infection.

So that strategies need to be made at the hospital level, at institutional levels. We will need areas where people have to be triaged, everyone has to be screened and then he comes in and then maybe testing has to be done, testing has to be more prevalent because this is another group. So groups visiting hospitals, whether he is a suspect for COVID or non-suspect will certainly need more scrutiny because he is one person who can immediately infect the whole group of healthcare workers. So I think strategies where any patient visiting the hospital or certainly one who is getting admitted has to be having a complete test before anything else could be done and we need reports at a faster pace, we need tests which can be done faster and with this, finally, I would say that this disease is not going to go so easily. It is going to peak according to its time, maybe in India, it may peak mid-may, end-may, but you cannot keep everything stopped for so long.

So we will have to work out strategy by which we can try to do things which will prevent disease progression plus continue some way to live, and this prediction has to be thought before we think of closing down everything because if we continue to have things closed endlessly then people would die of something else rather than the corona. So all these issues do come up and I think some experts would look into these matters and I am sure we will be able to come out of it and India in particular, I am reasonably confident, I am not sure, but possibly the patients could be having some immunity protection and that could be an additional reason that our numbers are high, but they are not as high as they are in other countries.