The lockdown is nearing three months now.Covid 19 has changed the way we do a lot of things.For one it has not killed as many people in the third world as it has in the west.
Two main causes for death have been attributed to blood clots and severe hypoxia leading to organ dysfunction.In the west ,blood clots are just rampant even otherwise.
However,in India, I realise that thrombosis is not common.Therefore I wonder if that accounts for lesser number of deaths in India.,because the fact remains that the quality of care is much more organised and evidence based in the West as compared to our country. There is the reality that there is much more accountability as far as human lives are concerned in the West as compared to the South Asian countries. Allthough there have been studies done in the recent past to try and prove otherwise , we hardly get any patient with complaints suggestive of thrombosis in a normal outpatient department in India as compared to the west where it is one of the most common ailments in an acute care setting. It could be attributed to use of oral contraceptives widely amongst women and more long distance air travels or better segregation of high risk cases but our patients in India definitely do not require prophylactic anticoagulants to be prescribed as a routine in their inpatient charts unless they are seen to be high risk as opposed to the West where it is compulsory unless it is contraindicated.
In the west thrombosis is a leading cause of morbidity which warrants separate DVT clinics,nurses and departments.Is it so in India?
That is just my observation from working minutely in two very different settings.It might actually be a more feasible theory than wild assumptions about tuberculosis and malarial infections being the reason.
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