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Published on: May 15, 2020
4 minute read
By: Dr Rajan Choudhary

Living With COVID And Returning To BAU!

Hurdles to Business As Usual – Hurdles to Life as Usual – Living with COVID!

Obstacles to re-open the country

As we come to the 2-month mark of lockdown, its effect on the populous is becoming apparent. The extreme restrictions have had a significant impact on people’s physical health, mental health, and general livelihood, and many people are itching for life to get back to normal. Many countries including New Zealand, Germany, Italy, and Spain have seen the first peak of COVID infections pass, and some have already begun reopening parts of their economy. This has led to concerns from public health officials that relaxing the lockdown too early and too liberally will lead to a rapid increase in infection rates. Indeed, Germany has already seen an increase in R0 above 1 (one infected person will infect more than one person, causing the disease to propagate).

Trying to work out how to reopen a country without causing another spike in COVID deaths is probably the biggest issue faced by public health officials across the world. And trying to convey clear instructions to the public is an issue some countries are currently struggling with. In the next few blogs we will look at the issues faced, what has worked and what needs improvement, and what we as the public can do to keep ourselves safe.

THE MASKS WE WEAR

We have discussed masks at the start of the pandemic, and we have discussed masks as the pandemic has progressed. Why are we bringing it up again?

Masks have been a heated point of contention, but their role in public health has matured over the past few weeks. At the beginning of the pandemic, masks were a rare commodity, with DIY stores running dry of masks, stories of people stealing masks from clinical environments, and very confusing advice on whether the public should wear masks in public.

At that time the WHO had recommended only infected patients and those working with infected people wear masks, to save on the precious PPE for medical professionals. N95 respirators are seen as the gold standard in protective equipment, and hospitals are still struggling to provide staff with enough respirators, let alone the public. Concerns have also been raised on whether using masks will provide a false sense of security, especially if they stop washing hands or touch the infected parts of the masks.

But now we are past the first COVID peak, and advice on masks has changed. People should wear a mask if they are in public. Germany has implemented this advice, as has Austria for its public markets. In the US many stores are requesting public wear masks before entry. Rather than surgical masks or respirators, the use of homemade or purchased cotton masks has been encouraged.

LET’S LOOK AT WHY

Surgical masks and respirators aim to protect the user from inhaling microscopic aerosolized COVID particles. Cotton masks do not function this way. Instead, they prevent the wearer from spreading COVID by catching much larger droplets that is coughed/sneezed or generally breathed out.

The majority of people with COVID-19 are able to spread the infection to others up to 3 days before they show symptoms. Indeed as many as 50% of infections seem to occur from pre-symptomatic individuals. During this time they produce the greatest amount of viral particles, and these particles can stay in the air for several hours. Someone with asymptomatic COVID walking around in public or in a shop could infect lots of people.

So wearing a mask, even if you are not symptomatic or around infected patients helps prevent the spread of the infection. We know already just how infective COVID-19 is, so any measures that reduces infection even a little will end up reducing spread drastically on a population level. It has been compared to seatbelts – one person might not feel the benefits, but they save thousands of lives across the country on a yearly basis.

IS THERE ANY EVIDENCE?

In our blogs, we often talk about the importance of evidence. We look at the quality of evidence, how different types of research gives good and bad evidence, and why we should always give evidence-based advice.

So is there any evidence supporting masks? We have evidence that cloth masks can stop 99% of droplets that are coughed up, and whilst it doesn’t block aerosols or actual viral particles it still has a significant impact on transmission. We also have strong evidence from high infectivity in choir groups and at call centers that the majority of transmission is via the air, rather than from surfaces.

But what about the highest level of evidence? Comparing people who do or don’t wear masks is not a study that can be easily performed or one that has been performed adequately. But why should you wait? There is minimal to no risk associated with wearing a cloth mask, it offers some protection to you and a lot of protection to the public. In these cases, we should take a precautionary approach.

We don’t have any high-quality evidence looking at hand washing or physical distancing. But precautionary measures enforced have helped reduce infectivity. The same applies to masks. The best we can offer is an Australian study looking at mask use during influenza. They found observational data suggest that transmission of viral respiratory infection was significantly reduced during the SARS epidemic with the use of face masks as well as other infection control measures” and “in an adjusted analysis of compliant subjects, masks as a group had protective efficacy in excess of 80% against clinical influenza-like illness.”. In compliant users, masks were highly efficacious.

So that’s our advice. If you're going to go out in public, wear a mask.

If you don’t have a mask, you can order one online. Or be adventurous. Make one out of an old T-shirt or sock. Here are some ways to make one without needing to sew.

https://www.theguardian.com/us-news/2020/may/11/make-non-medical-coronavirus-face-mask-no-sewing-required masks

https://www.youtube.com/watch?v=r51YroAFPds DIY Face Mask

MORE INFORMATION

https://www.fast.ai/2020/04/20/skeptics-masks/#mightnt-people-handle-their-masks-wrong-and-make-things-worse Masks - FAQ

https://www.bmj.com/content/369/bmj.m1435 face masks for the public

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30918-1/fulltext wearing face masks in the community during the COVID-19 pandemic: altruism and solidarity

https://twitter.com/trishgreenhalgh/status/1253244613927874560 twitter trisha

Dr Rajan Choudhary, UK, Chief Product Officer, Second Medic Inc

www.secondmedic.com

Read Blog

How Artificial Intelligence Is Transforming Patient Care in India

As a clinician working closely with patients across urban clinics and remote teleconsultation setups, I have seen firsthand how delayed diagnosis, fragmented follow-up, and specialist shortages affect outcomes in India. Artificial intelligence is not a futuristic concept in Indian healthcare anymore. It is actively reshaping how we diagnose diseases, monitor patients, and prevent complications.

AI, when used responsibly under clinical supervision, is becoming a critical support system for doctors and a powerful safety net for patients navigating a complex healthcare ecosystem.

Why India’s Healthcare System Needs AI

India’s healthcare challenges are deeply structural. A large population burdened by lifestyle diseases, combined with uneven access to medical expertise, creates gaps that traditional systems struggle to bridge.

In daily practice, we increasingly see patients presenting late with diabetes, hypertension, heart disease, or cancer. Many ask a simple but important question: why was this not detected earlier? The answer often lies in limited screening, overloaded clinicians, and lack of continuous monitoring.

Chronic conditions dominating Indian clinics today include:

Diabetes affecting over 100 million individuals.
Hypertension rising even among young adults.
Cardiovascular disease driven by late detection.
Increasing cancer incidence with delayed diagnosis.

AI matters here because it supports earlier identification of risk patterns, reduces diagnostic delays, and allows clinicians to focus on decision-making rather than data overload.

How AI Is Changing Medical Diagnosis

One common concern patients raise during consultations is whether AI can truly diagnose diseases accurately. In practice, AI does not replace a doctor. It acts as a high-speed analytical assistant.

AI in Imaging and Diagnostics

AI systems can rapidly analyse:

X-rays and CT scans.
MRI images.
Mammograms.
Pathology slides.
Cardiac and neurological imaging.

These tools flag abnormalities within seconds, allowing doctors to prioritise critical findings. Clinical studies published in peer-reviewed journals have shown that AI models can match specialist-level accuracy for specific imaging tasks when used correctly.

From a physician’s perspective, the real benefit is not speed alone. It is consistency. AI reduces the risk of missed findings during high-volume diagnostic workflows, especially in resource-constrained settings.

Can AI Monitor Patients Outside Hospitals

Patients managing chronic illness often ask whether technology can help them avoid repeated hospital visits. AI-enabled remote monitoring is one of the most meaningful advances in this area.

AI-Supported Remote Patient Monitoring

AI continuously evaluates trends in:

Blood pressure.
Heart rate variability.
Blood glucose patterns.
Oxygen saturation.
Physical activity and sleep quality.

Rather than reacting to a single abnormal value, AI identifies worsening trends over time. Clinically, this allows early intervention before complications escalate.

Evidence from global health system studies shows that continuous monitoring can significantly reduce avoidable hospital admissions, particularly for diabetes, heart disease, and elderly patients.

Using AI to Predict and Prevent Chronic Diseases

Preventive healthcare remains underdeveloped in India. Most patients seek care after symptoms appear. AI helps shift this model.

By analysing medical history, lifestyle habits, vitals, and environmental factors, predictive models can estimate:

Future heart attack risk.
Progression of diabetes.
Decline in kidney function.
Stroke probability.
Asthma exacerbation triggers.

Patients often ask if AI can really prevent disease. Prevention here means early warnings. When risk patterns are detected early, doctors can adjust treatment plans, recommend lifestyle changes, and prevent irreversible damage.

Personalised Treatment in a Diverse Indian Population

Indian patients differ widely in genetics, diet, stress patterns, and cultural habits. Standardised treatment protocols often fall short.

AI supports personalised care by analysing:

Medication responses.
Dietary intake.
Blood markers.
Sleep and stress trends.
Coexisting medical conditions.

For example:

In diabetes care, AI helps personalise carbohydrate distribution and medication timing.
In hypertension, it identifies sodium sensitivity and stress-related spikes.
In hormonal conditions like PCOS, it aligns nutrition and activity with cycle patterns.

From a clinical standpoint, personalised insights improve adherence and reduce relapse rates.

AI-Enabled Telemedicine and Smarter Consultations

Telemedicine has become an essential part of care delivery in India. Patients frequently ask whether online consultations are as effective as in-person visits.

AI enhances telemedicine by:

Structuring symptom inputs before consultations.
Routing patients to the appropriate specialist.
Generating concise medical summaries for doctors.
Supporting follow-up reminders and medication adherence checks.

When used correctly, AI reduces diagnostic delays and improves consultation efficiency without compromising safety.

Expanding Healthcare Access Beyond Cities

A major question in public health is whether AI can truly improve rural healthcare access. In practice, it already is.

AI enables:

Remote diagnostics supported by portable devices.
Virtual specialist consultations for rural clinics.
Smartphone-based imaging and screening tools.
AI-guided triage in underserved regions.

By reducing dependence on physical proximity to specialists, AI helps bridge longstanding geographical barriers in India’s healthcare system.

Safety, Ethics, and the Role of Doctors in AI Care

Patients rightly express concern about safety, privacy, and over-reliance on technology. These concerns are valid.

Responsible AI use in healthcare requires:

Transparent algorithms.
Explicit patient consent.
High-quality, verified medical datasets.
Strict data privacy safeguards.
Continuous clinical supervision.

In ethical practice, AI outputs never replace medical judgment. Doctors remain accountable for decisions. Human-in-the-loop verification is essential to ensure patient safety and trust.

What This Transformation Means for Indian Patients

Artificial intelligence is fundamentally changing patient care in India by making healthcare more proactive, more precise, and more accessible. From early diagnosis to personalised treatment and continuous monitoring, AI empowers both patients and clinicians with data-backed clarity.

SecondMedic’s patient-first approach integrates AI as a clinical support system, not a replacement for doctors. By combining medical expertise with digital intelligence, the goal remains simple: better outcomes, earlier intervention, and care that adapts to each patient’s real-world needs.

As clinicians, our responsibility is to ensure that technology serves patients ethically and effectively. When used with care and oversight, AI has the potential to redefine healthcare delivery across India in a way that is inclusive, preventive, and sustainable.

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