Amid a surge in viral cases, how to differentiate between H3N2, Covid-19, H1N1, common cold, and flu?

The Indian Express | 1 week ago | 16-03-2023 | 11:45 am

Amid a surge in viral cases, how to differentiate between H3N2, Covid-19, H1N1, common cold, and flu?

India is seeing a surge in viral infections due to H3N2, Covid-19, and swine flu or H1N1. While most of the cases are reportedly due to H3N2, data shows that swine flu and covid cases are also rising in the country. Covid cases as per the Ministry of Health’s latest data stand at 4,623 with an active caseload of 0.01% per cent. It also noted that till February 28, 2023, a total of 955 H1N1 cases have been reported, the majority from Tamil Nadu (545), Maharashtra (170), Gujarat (74), Kerala (42) and Punjab (28). Meanwhile, 451 cases of H3N2 variant cases have been reported from January 2 to March 5, 2023, according to the union ministry with 2 dead, each in Karnataka and Haryana. The latest case of H3N2 has been detected in Assam.Given that all of them are viral respiratory conditions, how do we distinguish between them and seek treatment?Notably, H1N1, previously called swine flu, is a virus similar to the influenza viruses that cause illness in pigs. On the other hand, flu, or the common cold, is quite frequent during seasonal changes and is, often, harmless. “There are more than 200-300 viruses that may cause the common cold. In each virus type, there can be subtypes and variants. The majority of the common colds are caused by rhinoviruses, respiratory syncytial viruses, influenza type A and type B viruses, etc,” Dr Anantha Padmanabha, consultant, internal medicine, Fortis Hospital, Nagarbhavi told indianexpress.com in an earlier interaction. Covid-19, on the other hand, is caused by the SARS-CoV-2 virus and is considered highly infectious.“Current spread and intensity of flue especially its variant H3N2 are very concerning. Medically, it is a double whammy as Covid-19 cases have started surfacing once again,” said Dr Manisha Arora, senior consultant, Internal Medicine at Sri Balaji Action Medical Institute.While some may experience mild to moderate respiratory illness and recover without requiring special treatment, others may become seriously ill and require medical attention, especially older people and people with low immunity, or have co-morbidities.Dr Ravi Shekhar Jha, director and head, Pulmonology, Fortis Hospitals, Faridabad told indianexpress.com that all viral respiratory illnesses have similar symptoms. “Clinically, it is difficult to differentiate if it is Covid or flu. However, there are some features, which can help in differentiating,” said Dr Jha.*H3N2 can cause hoarseness of voice, while in Covid-19, symptoms start with fever or stuffy nose.*In flu, body ache or myalgia is too much*Flu causes severe dry cough which lasts for a longer period than usual (up to 3 weeks)DiagnosisBoth Covid-19 and swine flu are diagnosed with the help of a nasopharyngeal swab, an oropharyngeal swab and a nasopharyngeal wash. Rapid tests are also available for both Covid-19 and the flu.What to doExperts recommend medications to help relieve the symptoms of the flu, such as fever, cough, and congestion. These include painkillers, nebulizers, cough suppressants, and other decongestants.Adequate rest and recovery are advised at home with simple home-cooked, fresh food, and proper hydration.Dr Jha recommended:*Follow covid-appropriate behaviour which will also protect you from the flu.*Annual influenza vaccination again helps in reducing flu-related complications.*Drink plenty of water and avoid unnecessary antibiotics, Dr Jha said. Concurring, Dr Arora said that due to a lack of awareness, people take antibiotics that are not effective against the flu, as it is a viral illness, not a bacterial infection. “Moreover, taking antibiotics unnecessarily can lead to antibiotic resistance and other harmful side effects. Superadded secondary infections which are diagnosed by well-trained physicians only need antibiotics,” Dr Arora noted.World Health Organization, too, recommends that the most effective way to prevent infection with any virus is to get vaccinated and follow prevention measures: “Maintaining at least a 1-metre distance from others, wearing a well-fitted mask when keeping your distance is not possible, avoiding crowded and poorly ventilated places and settings, opening windows and doors to keep rooms well ventilated and cleaning your hands frequently.”It also advises that people should follow the advice “of your local authorities on getting influenza and Covid-19 vaccines“.Noting that influenza viruses, including H3N2, can mutate and evolve rapidly which makes it difficult to develop a vaccine that provides complete protection against all strains, Dr Arora said that nevertheless, vaccinations are a critical tool in the fight against infectious diseases. “It can help particularly those who are at higher risk of severe illness, such as young children, older adults, and people with weakened immune systems,” said Dr Arora.📣 For more lifestyle news, follow us on Instagram | Twitter | Facebook and don’t miss out on the latest updates!

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Chinese visa for Indian citizens resumes today after a 3-year gap
The Indian Express | 1 week ago | 15-03-2023 | 11:45 am
The Indian Express
1 week ago | 15-03-2023 | 11:45 am

After a three-year hiatus, China has announced the resumption of all types of visas for Indian travellers, including those for tourism purposes. “The Chinese Embassy and Consulates General in India will resume issuing various types of Chinese visas, starting March 15,” it announced Tuesday.With this, China has resumed all types of visas for foreigners, including tourism visas, port visas, and multiple visa-exemption policies, as a move to reopen its borders for the first time after the coronavirus pandemic struck in early 2020. However, inbound travellers have been advised to consult with their local China embassies or consulates for more detailed requirements and procedures.Under its zero-Covid policy, China had imposed strict travel restrictions on international arrivals starting March 28, 2020, to stop the spread of coronavirus disease cases from abroad. In addition to the reduced frequency of international passenger flights, the restrictions included limited visa availability – including a suspension of tourist visas – and strict Covid-19 testing and quarantine requirements before and after arrival in China.However, late last year, the country had shifted from a “zero-Covid” policy to “living with Covid”, with the removal of centralised quarantine for inbound travellers. Gradually, they reopened visa applications for most types of visas, even as visa applications for tourism and medical treatment were still on hold.Now, “with the latest policy adjustment” announced by the embassies across the world – including in Canada, France, Kuwait, Malta, New Zealand, Thailand, the US, and the UAE – these restrictions will finally be removed.In August 2022, the Chinese embassy had resumed services for 10 types of ordinary visas for Indian citizens, including long-term study, business, work, family visits, personal visits, and talent introduction, among others. However, applications for visas to China for travel, medical treatment and other reasons remain suspended.Even as the number of Indian citizens entering China with visas for business visits, family visits are also expected to rise significantly after this move, experts in the travel industry say this may not mean much till direct flights to China are resumed. Currently, China and India are said to be negotiating details for the resumption of direct flights, which were curtailed during the pandemic.

Chinese visa for Indian citizens resumes today after a 3-year gap
As ‘great migration’ kicks off under Covid shadow, China expects over 2 billion people to travel over next 40 days
The Indian Express | 2 months ago | 07-01-2023 | 05:40 pm
The Indian Express
2 months ago | 07-01-2023 | 05:40 pm

China on Saturday marked the first day of “chun yun”, the 40-day period of Lunar New Year travel known pre-pandemic as the world’s largest annual migration of people, bracing for a huge increase in travelers and the spread of Covid-19 infections.This Lunar New Year public holiday, which officially runs from Jan. 21, will be the first since 2020 without domestic travel restrictions. Over the last month China has seen the dramatic dismantling of its “zero-Covid” regime following historic protests against a policy that included frequent testing, restricted movement, mass lockdowns and heavy damage to the world’s No.2 economy. Investors are hoping that the reopening will eventually reinvigorate a $17-trillion economy suffering its lowest growth in nearly half a century.But the abrupt changes have exposed many of China’s 1.4 billion population to the virus for the first time, triggering a wave of infections that is overwhelming some hospitals, emptying pharmacy shelves of medicines and causing long lines to form at crematoriums. The Ministry of Transport said on Friday that it expects more than 2 billion passengers to take trips over the next 40 days, an increase of 99.5% year-on-year and reaching 70.3% of trip numbers in 2019.There was mixed reaction online to that news, with some comments hailing the freedom to return to hometowns and celebrate the Lunar New Year with family for the first time in years. Many others, however, said they would not travel this year, with worry of infecting elderly relatives a common theme.“I dare not go back to my hometown, for fear of bringing the poison back,” said one such comment on the Twitter-like Weibo.Also Read |BF.7 and BA.5.2: The Omicron sub-variants driving the China surgeThere are widespread concerns that the great migration of workers in cities to their hometowns will cause a surge in infections in smaller towns and rural areas that are less well-equipped with ICU beds and ventilators to deal with them. Authorities say they are boosting grassroots medical services, opening more rural fever clinics and instituting a “green channel” for high risk patients, especially elderly people with underlying health conditions, to be transferred from villages directly to higher level hospitals.“China’s rural areas are wide, the population is large, and the per capita medical resources are relatively insufficient,” National Health Commission spokesman Mi Feng said on Saturday.“It’s necessary to provide convenient services, accelerate vaccination for the elderly in rural areas and the construction of grassroots lines of defense.”INFECTION PEAK REACHEDSome analysts are now saying the current wave of infections may have already peaked.  Ernan Cui, an analyst at Gavekal Dragonomics in Beijing, cited several online surveys as indicating that rural areas were already more widely exposed to Covid infections than initially thought, with an infection peak already reached in most regions, noting there was “not much difference between urban and rural areas.”On Sunday China will reopen its border with Hong Kong and will also end a requirement for travelers coming from abroad to quarantine. That effectively opens the door for many Chinese to travel abroad for the first time since borders slammed shut nearly three years ago, without fear of having to quarantine on their return.More than a dozen countries are now demanding Covid tests from travellers from China. The World Health Organization said on Wednesday that China’s Covid data underrepresents the number of hospitalizations and deaths from the disease. Chinese officials and state media have defended the handling of the outbreak, playing down the severity of the surge and denouncing foreign travel requirements for its residents.On Saturday in Hong Kong, people who had made appointments had to queue for about 90 minutes at a Centre for PCR tests needed for travel to countries including mainland China.Also Read |What is BF.7, the Omicron sub-variant driving the new surge in China?TREATMENT TO THE FOREFor much of the pandemic, China poured resources into a vast PCR testing program to track and trace Covid-19 cases, but the focus is now shifting to vaccines and treatment. In Shanghai, for example, the city government on Friday announced an end to free PCR tests for residents from Jan. 8.A circular published by four government ministries Saturday signaled a reallocation of financial resources to treatment, outlining a plan for public finances to subsidies 60% of treatment costs until March 31.  Meanwhile, sources told Reuters that China is in talks with Pfizer Inc to secure a license that will allow domestic drugmakers to manufacture and distribute a generic version of the U.S. firm’s Covid antiviral drug Paxlovid in China.Many Chinese have been attempting to buy the drug abroad and have it shipped to China. On the vaccine front, China’s CanSino Biologics Inc announced it has begun trial production for its Covid mRNA booster vaccine, known as CS-2034.  China has relied on nine domestically-developed vaccines approved for use, including inactivated vaccines, but none have been adapted to target the highly-transmissible Omicron variant and its offshoots currently in circulation.The overall vaccination rate in the country is above 90%, but the rate for adults who have had booster shots drops to 57.9%, and to 42.3% for people aged 80 and older, according to government data released last month. China reported three new Covid  deaths in the mainland for Friday, bringing its official virus death toll since the pandemic began to 5,267, one of the lowest in the world.  International health experts believe Beijing’s narrow definition of Covid  deaths does not reflect a true toll, and some predict more than a million deaths this year.

As ‘great migration’ kicks off under Covid shadow, China expects over 2 billion people to travel over next 40 days
Canada, Australia impose Covid rules on travellers from China
The Indian Express | 2 months ago | 02-01-2023 | 11:40 am
The Indian Express
2 months ago | 02-01-2023 | 11:40 am

Australia and Canada have joined a growing list of countries requiring travellers from China to take a COVID-19 test prior to boarding their flight, as China battles a nationwide outbreak of the coronavirus after abruptly easing restrictions that were in place for much of the pandemic.Australian health authorities said Sunday that from January 5 all air travellers from mainland China, Hong Kong or Macao will need to show a negative COVID-19 test taken within two days of their departure.Canadian authorities announced similar measures that will also come into effect January 5 in a statement dated Saturday — a move experts say isn’t very effective.Kerry Bowman, assistant professor at the University of Toronto’s Temerty Faculty of Medicine, said the requirement is “not based on science at this point.” “This isn’t the early days of the pandemic,” he said. “It’s pretty clear that point-of-entry screening is not very effective at all.Often people can test positive days and weeks later.” Dr. Isaac Bogoch, associate professor at University of Toronto’s Temerty Faculty of Medicine, said it’s not entirely clear what the policy’s goals are, but such measures have not helped.“We know from the past that very focused and targeted travel measures such as this don’t do much to prevent the spread of COVID, either by importing COVID to Canada, or by the threat of variants of concern in Canada,” he said.Australia and Canada join other countries including the US, UK, India, Japan and several European nations in imposing tougher COVID-19 measures on Chinese travellers amid concerns over a lack of data on infections in China and fears of the possibility that new variants may spread.Research has shown how the virus spreads through human mobility, which means that the next variant of the virus may not even emerge from China, and even if it did, it could land in Canada from other indirect routes, Bowman said, adding that a more effective measure would be testing wastewater from airplanes and airports to check for the viral load and mutations.Vancouver International Airport said Saturday it would expand its wastewater testing pilot programme.China, which for most of the pandemic adopted a “zero-COVID” strategy that imposed harsh restrictions aimed at stamping out the virus, abruptly eased those measures in December. Chinese authorities previously said that from January 8, overseas travellers would no longer need to quarantine upon arriving in China, paving the way for Chinese residents to travel.Hong Kong is also preparing for quarantine-free travel to China, with plans to resume operations of more border checkpoints as early as January 8, according to a Facebook post by Hong Kong Chief Secretary Eric Chan.However, a quota will remain in place limiting the number of travellers between the two places.“Depending on the first phase of the situation, we will gradually expand the scale for a complete reopening of the border,” Chan said.In China, eased restrictions meant that residents could celebrate New Year’s in large-scale gatherings that were prohibited for much of the pandemic, even though the country is experiencing a massive outbreak of cases.“There are still some worries, more or less,” said Wu Yanxia, a 51-year-old Beijing resident who works at a logistic company. “I hope that next year everything will be normal, such as domestic travel.” Others hope that 2023 will bring better things after a difficult past year.“We have experienced a very uneven year, particularly unforgettable, with many things out of our imagination,” said Li Feng, a teacher in Beijing, adding that 2022 was a difficult year for both the people and the government.“But I think we have come through and everything will be fine,” Li said. “All of us will be better, and better in both work and life.”

Canada, Australia impose Covid rules on travellers from China
Back on China campuses, Indian students put behind surge worries: We are looking ahead
The Indian Express | 2 months ago | 01-01-2023 | 05:40 am
The Indian Express
2 months ago | 01-01-2023 | 05:40 am

After almost three years of campus life lost to the pandemic, when Ashutosh Kumar finally made it to his medical school in Baise, in southern China, on November 27, there was another looming threat: despite a stringent zero-Covid policy, the country was grappling with a steady rise in cases.Since then, however, much has changed. The uptick in cases is now a full-blown outbreak that followed China’s decision last month to relax much of the pandemic curbs. Yet, says Ashutosh, he is glad to be back.“I took a risk and decided to come back when the Chinese government began issuing visas in August. We couldn’t have wasted any more time back home. After all, you can’t do MBBS through online classes,” says Ashutosh, a final-year student of Youjiang Medical University in Guangxi.In January 2020, as the pandemic shut down campuses, sealed borders and grounded flights, around 1,000 Indians in China, mostly students of medicine, were evacuated back home. Over the next three years, the students attended online classes while waiting for China to ease visa restrictions and allow them back into the country. Earlier this year, in August, when China finally said international students could apply for visas, many of the students packed their bags to head back to their campuses.Ashutosh says that despite anxious calls from his family over the rising Covid cases in China, the situation is not as dire as it seems.“The Zero-Covid policy has been removed and the third round of vaccinations are being given to people. Also, I haven’t heard of too many deaths or cases of severe illnesses around me. In my medical college, too, there are not many patients. Had the situation been severe, China wouldn’t have thought of opening its borders,” says Ashutosh, who came to China on November 27 via Hong Kong.“I had to stay in quarantine for five days in Hong Kong and later for three more days once I reached the university. Now even the quarantine period has been removed; only those with symptoms need to be isolated,” says Ashutosh.From January 8, China is expected to further ease some of its restrictions, including the mandatory quarantine for incoming travellers.Reeba Khan, 23, reached China on October 25. “The situation then was very different – RTPCR tests were being conducted every 48 hours. But now, the quarantine policy has changed and hospitals are taking in only those with severe and co-morbid conditions,” says Reeba, a fifth-year MBBS student at Hubei University of Medicine in Shiyan City.Reeba says she is most excited about how the city has come alive after long. “There are no lockdowns or restrictions. The shops and malls are open and people are out shopping. The only rule that’s in place is of masks,” she says.Anayat Ali, a PhD student at Tongji University in Shanghai, too, says he can’t have enough of the “celebratory Christmas mood”.“We went to a German market recently. It was packed, mostly with local residents. It’s such a relief that people are finally shopping and travelling. In October, when one case was reported in our university, the entire campus shut down; that’s no longer the case,” he says.Andrews Mathew, President of the Foreign Medical Graduates Parents Association, says parents of those studying in China have been watching China’s Covid graph closely and fervently hoping that the situation doesn’t slip.“China has opened its border after three years due to which there is a mild spike in the disease but reports of deaths and hospitalisations are exaggerated,” says Andrews, who lives in Kozhikode in Kerala. His 24-year-old son Jonad Andrews is pursuing his MBBS from Jilin University.“I have waited for very long to complete my MBBS. I was very restless and worried while at home. But now that I am finally back on campus, I am at ease. The situation is a lot different now… Restaurants are open, we can freely go to public places now,” he says.Kanupriya, 24, who is pursuing her Master’s in Business Administration at Beijing Foreign Studies University, is undergoing a mandatory seven-day quarantine. “Everything is now open… Some of my friends even attended a Christmas party. I can’t wait to get out of quarantine. I am graduating in July and I want to make the most of my time on campus,” says the 24-year-old.

Back on China campuses, Indian students put behind surge worries: We are looking ahead
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