Eggs are rated as one of Nature’s most perfectly balanced foods, containing all the protein, minerals and vitamins (except vitamin C) essential for good health. And they are tasty too when cooked ! I am emphasizing on this as there is a fad some people , especially young, athletic types have, about consuming raw eggs and such like.

Egg white contains an anti nutritional factor (avidin) which binds with biotin and makes it unavailable, it also contains a protein (ovomucoid) which can inhibit trypsin activity. However cooking (or boiling) ensures that these anti nutritional factors are destroyed. Hence eat only cooked eggs, as there is no benefit achieved in eating them raw.

• Cook eggs until both the yolk and the white are firm. Scrambled eggs should not be runny.
• Casseroles and other dishes containing eggs should be cooked to 70° C. Use a food thermometer to be sure.
• Once cooked , hot items must be served straight away and cold items must be stored cold.

Kitchen Safety : Wash hands, utensils and equipment with hot, soapy water and wipe down kitchen surfaces with a regular kitchen compatible surface disinfectant, before and after they come in contact with raw eggs and raw egg-containing foods.

Do we put all our eggs in one basket? Read on for eggciting info. In these COVID19 pandemic times, everyone is washing everything! Including eggs! Scrubbing things with disinfectant or soap or warm water is ok, even if it borders on OCD… However Do NOT wash eggs ! Definitely not!! The eggshell has pores , just the way your face has pores. Try running a wet finger on the surface of a dry egg, and you will feel a slight bit of slime. Simply put, there is a substance that blocks these eggshell pores which prevents entry for the harmful bacteria from outside. The egg shell pores become more porous when wet, making it easier for bacteria to get in. Do you want that ? Obviously not.

Fresh eggs, even those with clean, uncracked shells, may contain bacteria called Salmonella that can cause foodborne illness.

So what do you do?…. Simply wipe away extraneous dirt on the surface of the egg with a dry tissue or kitchen towel before storing in the fridge or use a dry toothbrush for gently scraping away at contaminants on the egg shell surface. DO NOT wash before storing.

You can help keep eggs safe by storing them safely! * Firstly prefer to buy eggs only from a proper vendor who stacks and stores eggs properly, or if you are the supermarket type of grocery shopper, select the cartonized eggs. * Check the eggs you buy to make sure that the eggs are clean and the shells are not cracked. * Preferably store promptly in your refrigerator at a temperature of 4°C or below. * Use eggs within a maximum of two weeks when kept refrigerated.

How to know if you have any ‘bad eggs’ ….Sniffing either a raw or cooked egg is a simple but reliable way to tell if an egg has gone bad. You can shake it gently beforehand too, there is a particular feel you will get when an egg is bad… like a sloshing within the egg. The popular Float Test , wherein you simply place an egg in a glass or mug of water, and if the egg sinks it is good, i.e fresh, and if it floats , it is not fresh , is a simple screening technique. However, it cannot tell you if an egg has gone bad. Dont do this Float Test before storing in the fridge.. Remember, you dont want to wash your eggs!

However, the simplest way to check an egg, is to crack the egg into a clean bowl and give it a sniff. If anything smells ‘off’, discard the egg and wash the bowl with hot, soapy water before using again.

Be safe, stay safe! Eat an egg a day, a week, a month, or not at all! Just do not wash them before storing them.

Since mid March 2020, there was a perceived requirement for civil society to sort out the chaff from the wheat in light of the surplus of information flooding social media and inundating the poor home bound homebody with irrelevant and confusing information, mostly originating from either NASA, f-CDC, f-WHO (f is for fake), or the Renjhen MinJhin Hospital in China (there is no such hospital) or even some Italian hospital.

So what should the homebound person do? Believe in all that is out there? Or ask someone like me? I am a sifter of news and facts and a distiller of information and at times a translator of evidence. Modest description indeed.

Thus emerged a series of health advisories focused mostly on an urban , urbane, English speaking audience residing in cities of India, in claustrophobic colonies , cloistered within their homes.

These advisories were / are meant for circulation ad lib on social media. My name and contact details are incorporated therein, to ensure that people can reach out to me for any clarification or further information and advice and most importantly, suggestions for future iterations.

Please browse through the collection and download to peruse at leisure or circulate at your discretion. These will be updated with newer advisories as and when released.

Disclaimer : The contents of each advisory were current as on the date of release and have not been revised subsequently. You are solely responsible for any decisions you make based on the contents. There is no intent implied or otherwise, to suggest the advisories to be a replacement for current consultation with a registered medical practitioner for any medical or other ailment.

Please send across any issues (no individual treatment related queries please) you would like me to address.

Be Safe!

Is it ‘Social Distancing’ or should it be ‘Physical Distancing‘?

Little did the Lebanese-American writer Kahlil Gibran know of the far reaching portent of his oft quoted statement, “Let there be spaces in your togetherness…”, even more relevant, now in these modern COVID 19 pandemic times. One could possibly conjecture a metaphorical inspiration for the philosopher, from the post Spanish Influenza world of the 1920s?

In a pandemic affected society, we commonly use the words isolation (for cases), quarantine (for those exposed), and social distancing (for those in the larger community) in the context of the prevention and control measures being instituted across the world. We know people take away different, and sometimes contrary, meanings from well-worn words. So when coining new terms, how can we prevent people from getting the meaning wrong?

We do not want people to consciously or subconsciously understand the term ‘social distancing’ to imply or mean emotionally pulling apart from each other. All we want is for a greater physical distance to be maintained between people. This might seem like an alien concept for most of the developing world, where ‘personal space’ is a figment of a fertile imagination mostly. To be socially distanced in its local nuances, to most people would mean ‘cutting off ties’ , breaking away from relationships, verily giving up on family, which the entire clan may be a part of. In an increasingly interconnected world (through the ubiquitous internet enabled smartphone) to a disconnected society, where neighbours do not know each other, where one has more virtual friends than real ones, where society is in the throes of the pangs of modernization, do we actually need to imply even if incorrectly, that humans need to be ‘socially distanced’ from each other?

So why not let us call it ‘physical distancing’ from today onwards? If you wonder who should push for the change? Well, I think you should, I should, we all should! We could try out this concept by bandying it about with friends and family, and it might influence how they view it and change what they do. And the ripples may spread out to change what everyone says and does. Be the change you want to see!

Physical distancing will perforce be the new ‘normal’, once this pandemic blows over, whenever. Cough etiquette will become a part of social norms. We might actually become more hygienic in our personal habits and start living cleaner public lives. Civic administrations might actually start delivering on keeping cities, towns and villages clean. A good scare does this to people. The issue that remains though, is sustaining the change.  

The WHO has already been asking people to change from using ‘social distancing’ to ‘physical distancing’, but language is a funny thing. We in our millions create the definition of the word by its usage, an organisation cannot do this, however influential it may be. We need to be the change.

Be connected with the people and to the people, yet let there be visible gaps in your togetherness… (Preferably at least 6 feet of that gap!) And that is all the space one needs, horizontally, eventually…

In the initial days of the pandemic, it seemed apt for everyone to withdraw into their shells, pull up the moat bridges and draw up their defences, and be ‘socially distanced’. Now, we have learned that we truly do need each other, to stay balanced, stable and happy.  We need people for us to be human and not just a digital image online.  It is now being understood that the social connection is what is essential, while physical proximity can be given up!

We, the people, need to appreciate that ‘lock down’ does not mean ‘locked up’. It is not about breaking contact with your friends and family — but rather keeping at a safe  physical distance from them, to ensure no further spread of the disease.

We need to keep our social connect alive, our sense of humanity intact and have a common sense of purpose binding us together to combat this, and all future threats to humanity that may arise. Ironically, the same technologies we often blame for tearing apart our social fabric might be our best chance now, of keeping it together.

So in the interest of humanity and your own sanity, try and use new ways to connect at a distance. Sing songs and make music together from different balconies if you have the talent. Use the humble phone, or email, or video call, social media or new conferencing tools to keep in touch with friends and family alike. Enjoy sharing quizzes and board games across digital screens, or maybe just share a meal and a drink through digital media. If you have never learned these skills, now is the time! What else are you going to do locked in at home? Be socially connected and yet physically distant. We recently had a med school Batch Get Together online. The Zedd Batch Zoom Party so to say. What is stopping you?

Be physically distanced, NOT socially distanced.

Reach out, but touch me not !

Let there be spaces in your togetherness.

This post was written in collaboration with my batchmateZ Aravind, Narinder, Ranjith and Rohit.

I was privileged to have been invited in the recent past to give a TEDx talk at IISER Pune.

For those of you who are not aware, the IISER institutes were established by the Government of India at Berhampur, Bhopal, Kolkata, Mohali, Pune, Thiruvananthapuram and Tirupati to integrate and promote interdisciplinary science education and research. Over the past decade, the IISERs have been attracting talented young minds who want to pursue ‘pure sciences’. Through my interactions with the Faculty members at IISER Pune (my dear friend John with the theatrical talent and the literary bent of mind being the main man), while I was on the teaching faculty at the Armed Forces Medical College, I had the opportunity to academically interact with the students there, in person, on more than a few occasions , and came away impressed at their intellect , dedication and enthusiasm. It felt reassuring to learn that indeed the future of India as a scientific nation is well on its way to make its mark on time, with students such as those at the IISERs.

The Kumbh Mela in its various iterations is a phenomenal exposure to humanity, and not just the Coffee Table book variety, but the administrative machinations that are required for these…

Being a Public Health Specialist, I had acquired a taste for Mass Gathering Medicine , from early in my military career… hence when invited to give a TEDx talk at the IISER Pune, on a topic of my choice, well….

If you were to ask me today, on how this applies to the current COVID 19 pandemic, well I would say that crisis expansion facilities for those 80% of the corona virus infected, who do not need ICU facilities, the overwhelming majority, can be accommodated in ‘tent cities’ like the Kumbh Mela… We have the template ready… we have the tentage… Go ask the Wedding Planners.

This is India, we will survive.

Be safe

Everyone is locked down or locked in… Better surely than being locked up? Right?

Combating the COVID 19 pandemic requires various preventive measures to be instituted at the individual , family and societal levels. You can read more about these other measures elsewhere on the http://www.who.int (International) or http://www.mohfw.gov.in (India specific) websites.

From the food safety perspective, keeping fruits and vegetables safe for our consumption is a practice that we must all adhere to in routine, and not just in these COVID times.

The right time for food safety is now and everytime!

For cleaning vegetables and fruits with steeping in Potassium Permanganate crystal solution please click here….

For cleaning vegetables and fruits with usage of cooking soda please click here…. Its a link to some one else’s video. However I too endorse this as an alternative to PP crystals.

For cleaning milk packets please click here….

For a quick reminder of how to wash your hands … Surely, we all can do with a quick peek at this 1 min 26 sec video… and revise what we already know…

In case you would like me to answer more of your queries on issues related to food safety in the times of COVID 19 , go ahead , email me or comment below.

In the times of the COVID 19 pandemic sweeping across the globe, there are so many conflicting messages out there , for people to digest, some talk of prevention (which is the only way to safety at present), some talk of prophylaxis (which is only for high risk individuals i.e those healthcare workers who are caring for sick patients, and close household contact of confirmed cases), some talk of treatments and vaccination (which are in various stages of trials, and are not likely to be anywhere on the horizon till early 2021 maybe).

For this post, I choose to discuss with you , my discerning reader, on the vexatious issue of catching that cough or sneeze, that moment in time when you take a deep , often ragged breath and go “ah-chooo” or whatever, in your language of preference.

Now, the current guidance being given by the leading public health agencies across the world, is something that every parent teaches their child… Cover your mouth when you cough! But then we all already know that, or do we? What about the vast majority of people who do not know, or have never been told that they should cover their mouth when coughing or sneezing?

Cover your mouth when you cough! Makes sense right?

You dont want someone else to breathe in those droplets right? That is what airborne transmission means.

If those droplets are given the chance, they gradually settle down and contaminate surfaces, such as table tops, door handles, chair arm rests, the floor etc. A healthy person acquires infection from these by touching these contaminated surfaces with his hands and then touching his own face (nose, mouth, eyes). And this is Indirect Transmission.

Now, what are the choices you have, to cover your mouth when you are coughing or sneezing?

1. With the palm of your hand? Well, think of those droplets you have intercepted, thereby contaminating your own hands, which if unwashed immediately afterwards, with soap and water, or usage of an alcohol based sanitizer, will contaminate other surfaces, or transmit to others through hand shakes and the like.
2. With tissues? Well , these need to be disposed off carefully afterwards, and not carried around or thrown around indiscriminately. How many people in India keep tissues with them?
3. With the back of your hand? Well , usually the back of your hand does not come in contact with any one or any surface usually (unless of course you are giving someone a backhanded slap instead of a backhanded compliment). In this situation too, you would need to wash your hands with soap and water.
4. With the crook of your elbow? Let me explain this in a bit more of detail….First, think of a woman in a long sleeved garment (kameez) or a man with a full sleeved garment…. or a child similarly…. Now this person coughs or sneezes into his or her elbow…which is cloth covered…. All the sticky , gooey droplets (micro-organism laden) spray goes onto the cloth at the elbow. And remains there till the time that garment is washed, with other garments… 99.9% times not with hypochlorite solution, nor with a 60 degrees wash cycle (this is India)….

Next, think of a woman or a man with a half sleeved garment…. or a child similarly…. Now this person coughs or sneezes into his or her elbow…which is bare skin…. All the sticky , gooey droplets (micro-organism laden) spray goes onto the skin of the crook of the elbow. And remains there only till the time that person has a bath and remembers to wash the elbow. (again…this is India)….

And also , you yourself just think… when was the last time you washed just your elbow fold??

Now, please answer the following
1. Will the long sleeved clothing possibly get contaminated by infective sneeze droplets… and remain so…?
2. Will this potentially infected cloth contaminate other clothes at home?
3. Will the laundry / washing in rural India ever be adequate enough to ‘disinfect’ such clothes? i.e hot wash and bleach pre soaks?
4. How often will a person actually end up washing his crook of elbow?
5. Is it not easier to cover with back of palm and then wash that afterwards? And this is slightly better than covering with the palm of your hand?

Covering of mouth and nose is what is important!!

That is what is the bottom line.

“The how” is just an exercise in changing behaviours… All of us who are not teenagers today, were taught socially to cover our mouths when we coughed, with our palms… Now we talk of crook of the elbow, why not also the back of the hand, i.e when we dont have access to tissues. There was an old English adage, “the rich keep their colds in their pockets while the poor blow it out onto the road” this of course was in reference to the usage of handkerchiefs by the ‘elite’.

Please let me know your views on the above… it will be interesting to discuss this further.

We all would agree unanimously I am sure, that the cough does need to be covered… My query to you is… what is advisable to be communicated through a population focused messaging campaign?

On TV channels we often see healthcare personnel dressed in ‘space like’ gear on a biosafety protocol, investigating outbreaks or engaging in intriguing missions involving infectious diseases.

Most lay people do not understand that wearing protective gear, which actually protects against unknown and known infectious disease agents, is very cumbersome and not ‘glamourous’ . It is lifesaving, and it is in short supply most of the time. This PPE (Personal Protective Equipment) is worn by designated health care personnel in special circumstances to minimise the threat that infectious disease agents pose to their health and survival.

Healthcare personnel need to wear this PPE in the correct manner for it to be effective in its purpose. In the currently ongoing pandemic of COVID 19, PPE is essential for handling patients in the acute stage when they are infectious to those around them. PPE is not for the common man. Believe me, it is downright uncomfortable and sweaty and stressful.

Here is a short (5 min 49 sec) video made by a team of experts from the prestigious AFMC Pune, to communicate effectively, the recommended modality for wearing of PPE by healthcare workers…. https://youtu.be/OlOULwxmTCc

Please feel free to share the link. As and when the creators of the video upload the higher resolution video, this above link will be amended and linked suitably.

nCoV might seem a very exotic acronym. Something which is all kinds of secret agent stuff…. or I can simply let you know that its just one of those little micro organisms that is waiting on the sidelines, waiting to catch an immunologically naive global villager unawares. In this increasingly interconnected world, we are at risk of rapid spread of diseases of all hues across continents….. BTW the disease per se, has now been renamed to COVID 19. The name of the virus has evolved too…. In case you want more… https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it

As people the world over, got together to begin celebrating the end of 2019, the World Health Organization was alerted to several cases of pneumonia in Wuhan City, in the Hubei Province of China. (https://goo.gl/maps/ktL9XX8AjXWMobEX7) Click on this link and zoom out to get an idea of where exactly this city is in China.

The virus being reportedly implicated in this outbreak apparently did not match any other known virus. For infectious disease epidemiologists (popularly referred to as Disease Detectives , I think the CDC USA coined this term), this kind of situation is of serious concern as whenever a new enemy is detected, they are not familiar with its people attacking tactics.

In the first week of January, Chinese researchers confirmed that they had identified a new virus – a coronavirus, which is a family of viruses that include the ubiquitous common cold viruses, and also dangerous viruses such as SARS and MERS. This new virus was initially christened “2019-nCoV.” There, are you feeling reassured not that you have a name ? All the better to have a name that you can toss about here and there, when scaring children with bedtime tales of the Bogeyman. Read the earlier paragraph for the new name.

This Corona Virus usually causes respiratory illness and there is a standard advice that must be shared with all. We need to know how to protect ourselves and those we love, from getting not just this disease, but most respiratory route of spread illnesses.

WHO’s standard recommendations for the general public to reduce exposure to and transmission of a range of illnesses are as follows, which include hand and respiratory hygiene, and safe food practices: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

• Frequently clean hands by using alcohol-based hand rub or just regular soap and water;
• When coughing and sneezing cover mouth and nose with flexed elbow or tissue – throw tissue away immediately and wash hands;
• Avoid close contact with anyone who has fever and cough;
• If you have fever, cough and difficulty breathing seek medical care early and share previous travel history with your health care provider;
• When visiting ‘live’ produce markets in areas currently experiencing cases of novel coronavirus, avoid direct unprotected contact with live animals and surfaces in contact with animals;
• The consumption of raw or undercooked animal products should be avoided. Raw meat, milk or animal organs should be handled with care, to avoid cross-contamination with uncooked foods, as per good food safety practices.

And I would add on a few simple tips for you to think of adopting not just today or because of the nCoV outbreak…

Avoid Shaking Hands with people you meet casually… Do you know if the person has not sneezed or coughed into his palm before shaking your hand? Instead, a ‘Namaskar’ with folded hands is most suitable for conveying greetings and respect to those you meet.

Always keep a window partially open when using a split air conditioner , as there is no fresh air intake in such machines (I am sure you will not believe this! Google it if you want, or take my word for it… I am familiar with HVAC systems). You need the air change! Your split AC is just cooling and circulating the same air, after a bit of dust filtration , thats all.

Always try to sit near the window when in public transport or in cars, and try to get in some fresh air and not just recirculated air.

Practice with your family and friends, to cough and sneeze onto the back of your palm or crook of your elbow… Its not easy as it seems, we have been conditioned over decades of parenting to cover our mouth, but never been told the correct way, to prevent spread of infection. Think about this.

Try to avoid touching your nose and eyes with your hands when out of your home. You cannot wash your hands often enough , and we are all exposed to contaminated surfaces through the day, the lift buttons, the door handles, the staircase railing, the files and documents, the keyboard of our computers, etc… You know it all.

Avoid crowded indoor public spaces such as movie halls and restaurants, to the extent feasible. If you have to dine out, dine outdoors…

Be Safe! Think Hygiene at all times…

So that’s it ladies and gentlemen! It all remains the same, irrespective of new names! Be safe, be well!

Wellington, near Ootacamund in the Nilgiri mountains of Tamil Nadu, India, is where this photo essay is set.

Again, tis not I, it be my runaway batchmate, the Running Man! Remember him from those photos taken whilst running around Calcutta, from an earlier blogpost?

Summers are deliciously cool, high in the Nilgiri mountains, and the wise reader may wisely infer that winters would be truly cold. Well, on a fine Sunday, R man decided to work up a sweat, and thereby unfolds the tale of a runaround…

This post is a prime example of Vicarious Phlogging (photo blogging while jogging) …. All the viewing pleasure without the bothersome running… That we have outsourced to Ranjith. Till next Sunday, or whenever more scenic locales are run through…..