Examining Corona Patient without PPE.

Professor at Kasturba Hospital, Sewagram Dr Indrajit Khandekar hasn’t worn the entire PPE kit while on duty for 15 days in Covid ward and has treated around 90 Covid patients. His colleagues wore complete personal protective equipment (PPE) and he only wore a N95 mask.

Wearing PPE makes me feel very uncomfortable, lowers my confidence and I can't do the job assigned to me properly so I don't wear PPE kit when examining corona patients, said Dr Khandekar.

That doesn’t mean I’m careless. I do not wear PPE because I also believe that many people get infected regularly with the viruses whenever there is change in weather. I get infected with such viruses 2-3 times a year and the symptoms like fever, cold, cough, loss of taste etc come more or less according to our immune system at that time. It's just that I don't keep such a virus in my head for 24/7. So, for me, corona is a germ, like earlier viruses that had killed millions in the past. Covid may have infected me and will continue to do so even in future.

PPE causes a lot of sweating after a while, the whole body gets wet, you can't even go to the bathroom so you drink less water. This has an adverse effect on the health of health workers as they stay in PPE for more than 6 hours. Also, all these things unknowingly lead to neglect of patients which increases the morbidity and mortality of covid patients due to medical errors.

Not allowing relatives to visit covid patient is inhuman and cruel. Patients on Oxygen needs constant help for daily routine work.

Dr Indrajit Khandekar s experience of working in Covid Ward for around 5-6 hours daily. 

 

Awarded for contribution in areas of legal reforms and its utility in Forensic Medicine.

Appreciated and #felicitated in recognition of valuable contribution for my work in areas of legal reforms and its utility in Forensic Medicine. This was done in XXIII annual state conference of Medicolegal Association of Maharashtra (MLAM)- held at TN Medical College and Nair Hospital- #Mumbai.

I am thankful to Dr Shailesh Mohite sir, Dr Rajesh Dere sir, Dr Pawan Sabale for giving this recognition.

I am also thankful to my HOD Dr Tirpude sir, and my colleagues Dr Mureky sir, Dr Pravin Zopate and Management of my institute MGIMS for their constant support and encouragement.

Just sharing list of my unique contributions:

1) Played key role in banning most unscientific and inhumane ‘Finger Test/ #Virginity test’.

2) Instrumental in bringing new state and DHR-ICMR national guidelines for medicolegal examination of rape survivors.

3) Founder of unique Clinical Forensic Medicine Unit (CFMU).

4) Key role in developing clinical forensic and MCCD (Cause of death) Software.

5) On his study reports 4 public interest litigations were filed in High Courts and even state assembly (Vidhansabha) took cognizance of his 2 reports.

6) Appointed as a coordinator of IAFM committee for 174 CrPC amendments.

7) Recently his work was also highlighted in Parliament of India.

8) NCERT has accepted his suggestion to include names of genitalia in std I-II textbooks as well as sex education in schools in step wise manner.

9) Has played key role to stop unnecessary postmortems, unnecessary semen collection of rape accused.

10) Convinced Central Govt to constitute a national level committee to work for upgradation of forensic medical post-mortem services of the country.

11) Convinced govt to stop practice of asking question by police, “whether rape victim is habituated to sexual intercourse?

12) Convinced the state govt and court for computerization of postmortem reports.

13) Played key role in shifting the subject of Forensic Medicine to final MBBS (Part I).

14) He is Official trainer for state police department & author of well received Marathi book 'Medicolegal investigation of crime’ for police officials.

15) He has delivered more than 300 guest lectures.

16) Author, teacher, speaker, has interest in policy reformation and Now working on sex education for school kids via YouTube channel

Consensual #sex between #minors- why boys are only booked under POCSO act? Criminalization of consensual sex of minors..

 Consensual #sex between #minors- why boys are only booked under POCSO act?

We had raised this issue in 2017 and had filed multiple RTIs to know about the various studies done by the parliament and whether the experts views were taken when they decided to criminalize even consensual sexual activity amongst the minors. For details, please read the press news attached herewith.

Now (2021), it is happy to note that Supreme Court of India has decided to work on the said issue. For details, please click the link.

https://www.thehindu.com/.../sc-to.../article34200856.ece

NEET PG | Algor Mortis with MCQs | Thanatology- Part 1 | MBBS. Forensic Medicine | Postmortem Change.

https://www.youtube.com/watch?v=oVqzymbh9w8

#NEET PG #Algor Mortis. Forensic Medicine - Thanatology Part 1 (Postmortem changes/ Signs of death)| By Dr Indrajit Khandekar | This video, covers about #Algor mortis (Cooling of dead body after death) for MBBS students, University examination and Students preparing for NEET PG exam (NEXT exam). Along with specific theory part it covers important MCQs on it. It also highlights some MCQs on which confusing information is available in textbooks. It also highlights what students can do when such confusing MCQs comes. So, please watch this video attentively. If you like it, then please subscribe this channel, like and share it. LINKS of all his other channels. 1. TELEGRAM Channel Link: https://t.me/drindrajitkhandekarfmtmb... OR SEARCH @drindrajitkhandekarfmtmbbsneetpg OR Dr Khandekar NEET PG MBBS Forensic on Telegram. 2. To join his FACEBOOK PAGE: https://www.facebook.com/drindrajitkh... 3. To join him on TWITTER: https://twitter.com/drikhandekar 4. To join him on INSTAGRAM: https://www.instagram.com/drindrajitk... 5. To join his BLOG: https://drilkhandekar.blogspot.com/ 6. To know WORK DONE by him in relation to policy reformation, education, crime investigation etc., please click the link https://drilkhandekar.blogspot.com/20... 7. Link of YOU TUBE channel https://www.youtube.com/channel/UCUT5... Topics which he covers in different videos: 1) Forensic Medicine for MBBS students and students preparing for NEET PG. 2) Sex education 3) Medico-legal tips for doctors 4) Crime investigation tips for police officials (In Marathi) 5) Current affairs (not routine) like Covid.

Biodata of Dr Indrajit Khandekar.

 To know about various works done by Dr Indrajit Khandekar in relation to policy reformation and other work, Please click HERE

For #Police_officials: #Weapon_query (In Marathi). पोलिसांसाठी: हत्यारांची डॉक्टरांकडून तपासणी. Examination of weapon by doctor.

To watch full #video on YouTube please Click here.

What precautions police shall take while sending weapon to doctor for medicolegal examination?

खालील मुद्यांचा या व्हिडीओ मध्ये समावेश आहे:

ज्या प्रकरणात गुन्ह्यात वापरलेले हत्यार सापडले आहे त्या प्रकरणात हत्यारांचे काय करावे? हत्यार डॉक्टरांकडे तपासणीला पाठविण्यापूर्वी कोणती काळजी घ्यावी.

हत्यार कोणत्या डॉक्टरांकडे तपासणीला पाठवावे?

प्राथमिक “इंजुरी रिपोर्ट” कुणाकडून प्राप्त करावा?

हत्यार डॉक्टरांकडे तपासणीला पाठविताना काय प्रश्न विचारावे? व कोणते प्रश्न विचारू नये?

#forensicmedicine, #forensic, #Crime #crimescene #police #weapon

Excessive Fear of #Corona: Unrealistic, unnecessary. Treat #corona as a #disease and not disaster.

 

Govt took cognizance of his letter about #Covid Vaccine.

 Hope Government will inform all possible information about vaccine to public.

For example, its effect as past flu vaccines are effective for around #only_90_days; so one has to take yearly minimum 2 dosage (repeated vaccination), its Vaccine effectivity (past flu vaccine has effectivity only around 9 to 29%). And major factor is, studies shows that #repeated_vaccination by same vaccine decreases antibody titre means #immunity. So, whether this will applicable to covid vaccine or not?

Lets talk about sex. #Masturbation (Male/Female) and myths (हस्तमैथुन- समज, गैरसमज)

Was speaker in Webinar "#Lets_Talk_About_Sex" organized by IMA-MSN MH along with ISAY, AMSA India, AIMSA, SNO & Agents of Ishq.

I spoke on #Masturbation (Male/ Female) and Myths (हस्तमैथुन- समज, गैरसमज) on 26.07.20.

For Doctors: How to prepare consent form for different medical procedure as per Supreme Court guidelines?

To avoid problems (like the case described in the news paper- please read attachment) we need to follow the guidelines issued by #Supreme_Court in Samira Kohli Case.
At most of the places #blanket_consent_form (single form for all procedures) is used which has already been declared #wrong by Supreme Court.
#How_to_prepare_consent_form as per #Court guidelines for different procedures?
To get the copy of the format that can be used as a baseline for preparing consent forms for different procedures, please click the link of #TelegramChannel

https://t.me/drkhandekarsmedicolegaltips OR to download it Click Here .
Hospitals can prepare already #printed but #separate_format for individual major procedures. DO NOT use single format for different procedures.
#consent #medicolegal

© Dr Indrajit Khandekar

In Marathi: Attributing cause of death to a #single_virus i.e., #Covid_without_testing for others: It is scientifically correct?

https://www.facebook.com/669417836443837/posts/3273409769377951/

Attributing cause of death to a #single_virus i.e., #Covid_without_testing for others: It is scientifically correct? All causes death in India: Impact of Covid Pandemic. #Covid #Pandemic

As per study published in #Lancet-2019 (Funded by GOI), in India around 96.5 lakh deaths in a year 2017. Out of these around 25 lakhs by #communicable infection diseases (6900 per day). Out of 25 lakhs around 4.7 lakh deaths are of young age (15-44 yrs) persons. Respiratory infections cause around 3.4 lakh deaths (930 per day), and TB around 3.75 lakh deaths (1027 deaths daily). Every year such deaths occur with slight fluctuations.
Total #Natural deaths-71.22 lakh. Total Unnatural deaths (accidents, suicides, homicides)- 9.21 lakhs. Deaths where Cause not known- 2.38 lakh. Out of 96.5 lakhs around 15.5 lakh deaths are of young age (15-44 yrs) persons.

If we study the last pandemic of 2009 (swine flu H1N1) in USA and India, then we come to know that even after adding the deaths due to pandemic virus, there is no increase in overall number of deaths due to communicable infection and even there is no increase in overall number of deaths due to respiratory infections or overall natural deaths. Means only name of the virus was changed, for cause death in place of another virus. This is due to non-testing of other viruses in pandemic situation. Thus, pandemic deaths were not additional deaths.

During this Covid pandemic, if we study the data from Italy, we can come to know that last winter Italy has around 34000 deaths due to Swine flu Influenza virus. But this winter there are only 258 deaths due to said virus (this is because these cases were tested before arrival of Covid) and after arrival of covid there is no swine flu Influenza deaths, because all subsequent deaths were tested for covid virus only; so labelled as Covid deaths.

In Covid phase, even in India we are not doing test for other viruses except Covid. So, in India also, covid deaths will not be additional deaths and our yearly routine death rates due to infection causes or rates due overall natural deaths will not increase.
But, unfortunately, this year till date we have added 50-65% suicides (i.e., unnatural deaths) as additional deaths.

An autopsy study has revealed that people who are suspected to die from viral respiratory pathogens, more than one virus and bacteria are often found causing death. A positive test for coronavirus does not mean necessarily that this virus is always primarily responsible for a patient’s demise. But as we are not testing for other viruses, all other respiratory infections deaths appear to be labelled under Covid and that’s why COVID-19 being the underlying cause of death more often than not and the same is inflating the numbers of COVID deaths and is #misleading the public about the actual number of these deaths.

Means, in Covid death also, there might be other viruses and bacteria (which we are not testing right now) equally responsible for the death of the said person. #Without_testing_for_other_viruses and bacteria that are routinely causing lakhs of deaths in India, attributing death to the single tested virus i.e., covid is #scientifically_incorrect.

Testing only for covid, does it mean that all other viruses and bacteria’s that are causing lakhs of death are vanished due to appearance of covid?

I hope our policy makers will take into account such already available data before taking any policy decisions and once again reconsider their decisions on handling of covid pandemic before it becomes too late.

Compiled by Dr Indrajit Khandekar.
Professor- Forensic Medicine

Give Cause of Death as #Covid even if test is negative or inconclusive or awaited: After WHO now ICMR instructed Indian doctors.

Give Cause of Death as #Covid even if test is negative or inconclusive or awaited: After WHO now ICMR instructed Indian doctors. I questioned the said guidelines. We doctors never received such guidelines for suspected viral deaths in past. In past doctors use to write Virus not identified if test is negative or inconclusive. Mid Day Mumbai 26.05.20
#covid #Causeofdeath #

Investigate the influence of Pharma companies on WHO before approving any #Covid_vaccine or drug for Indian public:

#Investigate_the_influence_of_Pharma companies on #WHO_before approving any #Covid_vaccine_or_drug_for_Indian public: Doctor demands to PMO

There is need to enquire & investigate about the financial link of WHO with Pharma companies before approving any vaccine or drug for Covid 19 for Indian public because #past_experience suggest that possibility of influence of pharma companies including vaccine manufacturers on WHO policies regarding pandemic & vaccine recommendations cannot be ruled out without proper inquiry said Dr Indrajit Khandekar, Forensic Medicine expert in Wardha in a detailed 51 page representation to the Prime Minister #Shri_Narendra_Modi.

Dr Khandekar who is the man behind banning unscientific finger test of rape victims & who has filed various PILs in high court for policy reformation, to back his claim of inquiry noted in a representation to the PMO that during the 2009 pandemic* of #swine_flu (H1N1 virus) #allegation_was_levelled_against_the_WHO that “In order to promote patented drugs and vaccines against flu, #pharmaceutical_companies_have_influenced_scientists and official agencies of WHO, responsible for public health standards, to alarm governments worldwide. They have made them squander tight health care resources for inefficient vaccine strategies and needlessly exposed millions of healthy people to the risk of unknown side-effects of insufficiently tested vaccines.”

On these allegations an #inquiry against WHO was conducted by the #Committee_of_the_Parliamentary Assembly, #Council_of_Europe in *2010* said Dr Khandekar.

Regarding vaccine effectivity the assembly inquiry report had noted that on average, perhaps 1 adult out of a 100 vaccinated will get influenza symptoms compared to 2 out of 100 in the unvaccinated group and also noted that there is no credible evidence that vaccination has any effect against complications such as pneumonia or death.

During inquiry, WHO refused to release the names of his members of the Committee who were directly involved in handling of the pandemic including vaccine recommendations and their declarations of financial interest in relation to pharma company. Parliamentary Assembly seriously regretted this refusal and said so any current research on the matter depends entirely on the results of investigative journalism.

Like swine flu we Indians should not suffer due to inefficient and insufficiently tested vaccines or drugs for Covid-19; hence, I have requested PMO to look into this issue said dr Khandekar.

हमें कोविड के साथ रहना और जिना सीखना होगा. Living with Corona Covid. C

हमें अब कोविड -19 साथ ही रहना सीखना होगा. Live with Corona- Covid-19. Covid is here to stay longer.

क्या कोविड -19 वायरस लंबे समय तक हमारे साथ रहेगा? क्या हमें अब इसके साथ ही रहना सीखना होगा?

क्या हमारा हर बार का "कोल्ड एंड फ़्लू सीजन" अब "कोल्ड एंड फ़्लू एंड कोविड -19 सीज़न" हो सकता है?

पिछले कई सालो में हमने ऐंसे वायरसोंके साथ जीना सीखा है जो हमारे श्वासतंत्र पर अचानक हमला करके हमें मौत के मुहं तक ले जा सकते हैं- जैसे स्वाइन फ्लू, 4 से अधिक कोरोना वायरस, और अन्य मानव श्वसन वायरस और वे अभी भी हमारे साथ मे हैं। आपको ये जान के हैरानियत होंगी की डब्लू. एच. ओ. (WHO) (Ref 1) के हिसाब से हर साल (Annual epidemics) पुरे विश्व मे सिजनल इंफ्लूएन्झा (Seasonal Influenza-Flu) से 290000 से 650000 लोगों कि मौत होती है. 2017-2018 के सर्दी (Winter) के सीजन मे अकेले यु. एस. (US) मे 61000, इटली मे 17000 से ज्यादा, और भारत मे 1128 लोगों कि सिजनल इंफ्लूएन्झा से मौत हुई थी (Ref 2, 3, 4). और ऐसा हर साल के सीजन मे होता है. और फिर भी हम इनके साथ सालोसे जी रहे है. तो क्या हमें कोविड -19 के साथ भी जीना सीखना होगा?

हार्वर्ड एपिडेमियोलॉजी के प्रोफेसर मार्क लिपिसिच ने कहा है कि दुनिया की लगभग 40 से 70 प्रतिशत आबादी अगले साल तक कोविड -19 वायरस से संक्रमित हो जायेगी. (उदा: जैसे इंफ्लूएन्झा (स्वाईन फ्लू) के साथ हम ऐसा ही होता हुआ देख चुके है)। लेकिन साथ ही वे यह भी दृढ़ता से कहते हैं कि इसका मतलब यह नहीं है कि हर किसी को इससे गंभीर बीमारी होगी या मौत का खतरा होगा. उनमें से ज्यादातर को कोई लक्षण ही नहीं रहेंगे या फिर बहुत हल्की बीमारी होंगी, और इस तरह वायरस तो फैलता ही रहेगा (Ref-5)।

डब्ल्यू एच ओ (Ref-6) और ब्रिटिश मेडिकल जर्नल (Ref-7) में हाल ही मे प्रकाशित एक अध्ययन के अनुसार, कोविड -19 वायरस से संक्रमित 80% लोगों में बिमारी के कोई लक्षण नहीं पाये जा रहे हैं. भारतीय चिकित्सा अनुसंधान परिषद (ICMR) के महानिदेशक श्री. बलराम भार्गव,  (Ref-8)  ने भी इस पर अपनी सहमती दि हैं।

ज्यादातर लोगों में कोविड के कारण लक्षण नहीं दिखाई देते हैं या कम आते हैं, इससे ये साबित होता है कि इस वायरस कि घातकता (खतरा- virulence) बहुत कम है।

यांनी, जिस तरह से पिछली विश्वव्यापी महामारीयों में कई लोग नहीं जानते थे कि वे वायरस से संक्रमित हुये हैं, क्योंकी उनमे बिमारी के लक्षनों की कमी थी या सिर्फ हल्के फ्लू जैसे लक्षण थे; उसी तरह, ज्यादातर लोगों को इस बार भी पता नहीं चलेंगा कि कोविड ने उन्हें संक्रमित किया है। और कोविड उसी तरह फैलेंगा जैसे ये पिछले वायरस अब हर जगह फैल चुके है।

द लांसेट मेडिकल जर्नल में 29.02.2020 (Ref-9) की प्रकाशित एक अध्ययन के अनुसार कोविड- 19 से संक्रमित मगर रोग के लक्षण न दिखाने वाले लोगों का पहले से ही व्यापक रूप से फैलाव हो चुका है, इसलिए आगे आनेवाले सालों में बडे शहरों में कोविड- 19 का स्वतंत्र संक्रमण बार-बार देखणे में आ सकता है (जैसे कि फ्लू के साथ हो रहा है)।

टॉम जेफरसन (An epidemiologist and honorary research fellow at the Centre for Evidence-Based Medicine at the University of Oxford) ने ब्रिटिश मेडिकल जर्नल मे बताया हैं की अगर कोविड-19 के ऐसे लक्षण न रहने वाले लोगों मे से अगर सिर्फ 10% लोग बाहर हैं, तो इसका मतलब है कि वायरस हर जगह फैल चुका है। इसका मतलब हमने जबसे कोविड के फैलाव को समझना शुरू किया उसके बहोत पहलेसे हि (यांनी लंबे समय से) यह वायरस लोगों में घूम रहा था. इसलिए, इस संभावना से इनकार नही किया जा सकता की एक बहुत बड़ी आबादी पहले से ही कोविड-19 से संक्रमित हो चुकी हैं। टॉम जेफरसन ने यह भी कहा कि, यदि इतने सारे लोग पहले से ही संक्रमित हैं, तो लॉकडाउन पर सवालिया निशान पैदा होता हैं? (Ref-10)।

भारत जैसे बड़ी आबादी वाले देश में कोविड-19 से संक्रमित बिना लक्षण वाले लोगों को खोज पाना और क्वारंटाइन करणा न केवल कठिन है, बल्कि असंभव है.

विशेषज्ञों के अनुसार, कोविड -19 संभवतः पहले से मौजूद मानव श्वास रोगों के वायरस सेट का एक स्थायी हिस्सा होगा। (Ref -11 और 12)।

इंसानों में अभी तक पहले से मौजूद चार कोरोना वायरसों के लिए लंबे समय तक प्रभावी प्रतिरक्षा (इम्युनिटी) अभी तक विकसित नहीं हो सकी हैं। इसलिये विशेषज्ञों का मानना है कि अगर कोविड -19 भी पिछले कोरोना वायरसेस का ही अनुसरण करता है और इसी तरह फैलना जारी रखता हैं तो आगे से सभी हमारे "कोल्ड और फ्लू के मौसम" अब "कोल्ड और फ्लू और कोविद-19 मौसम/सीज़न" हो सकते है।(Ref-13)

विशेषज्ञों के इस अनुमान के बाद अब ऐसा लगने लगा हैं की कोविड -19 वायरस यहां लम्बे समय तक रहने के लिए आया है। इसलिए, जैसे हमने पहले आ चुके 4 से अधिक कोरोना वायरस, स्वाइन फ्लू और अन्य श्वासरोग वायरसों के साथ रहना और जिना सिख लिया है वैसे ही कोविड-19 के साथ रहना और जिना सिखना पडेंगा।  

यदि हम पिछले महामारीयों पर नजर डालेंगे तो समझ पायेंगे कि कोई नया वायरस स्वयं ही निर्धारित करता है कि उसे आपके साथ कितने समय तक रहना हैं. हमारा दुर्भाग्य हैं कि मानव यह समय निर्धारित नहीं कर सकता।

संकलन:

डॉ। इंद्रजीत खांडेकर

प्रोफेसर। फोरेंसिक विज्ञान विभाग, एमजीआईएमएस सेवाग्राम।

For further details please click the blog link https://drilkhandekar.blogspot.com/

References:

1.       Influenza (Seasonal). 6 November 2018. WHO. https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal)

2.       Estimated Influenza Disease Burden, by Season — United States, 2010-11 through 2018-19 Influenza Seasons https://www.cdc.gov/flu/about/burden/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fflu%2Fabout%2Fdisease%2Fus_flu-related_deaths.htm

3.       National Centre for Disease Control, Ministry of Health & Family Welfare. Govt of India. https://ncdc.gov.in/index4.php?lang=1&level=0&linkid=119&lid=276 

4.       Loksabha Question- Answers http://164.100.24.220/loksabhaquestions/annex/173/AU3422.pdf

5.       You’re Likely to Get the Coronavirus. Most cases are not life-threatening, which is also what makes the virus a historic challenge to contain. The Atlantic. FEBRUARY 24, 2020 https://www.theatlantic.com/health/archive/2020/02/covid-vaccine/607000/

6.       WHO Coronavirus disease 2019 (COVID-19) Situation Report – 46 (06.03.2020) https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200306-sitrep-46-covid-19.pdf?sfvrsn=96b04adf_2

7.       Covid-19: four fifths of cases are asymptomatic, China figures indicate. BMJ 2020;369:m1375 doi: https://doi.org/10.1136/bmj.m1375 (Published 02 April 2020) https://www.bmj.com/content/369/bmj.m1375?=&utm_source=adestra&utm_medium=email&utm_campaign=usage&utm_content=daily&utm_term=text

8.       http://timesofindia.indiatimes.com/articleshow/74760073.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst

9.       Joseph T Wu, Kathy Leung, Gabriel M Leung. Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study. Lancet 2020; 395: 689–97. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30260-9/fulltext

10.    Covid-19: four fifths of cases are asymptomatic, China figures indicate. BMJ 2020;369:m1375 doi: https://doi.org/10.1136/bmj.m1375 (Published 02 April 2020)

11.    New Coronavirus May Circulate Forever as a Seasonal, Endemic Pathogen, Experts Fear https://www.sciencealert.com/the-new-coronavirus-could-circulate-forever-says-experts

12.    Could We Be Living With COVID-19 Forever? https://www.discovermagazine.com/health/could-we-be-living-with-covid-19-forever

13.    You’re Likely to Get the Coronavirus. Most cases are not life-threatening, which is also what makes the virus a historic challenge to contain. The Atlantic. FEBRUARY 24, 2020 https://www.theatlantic.com/health/archive/2020/02/covid-vaccine/607000/