Wuhan Coronavirus Resource Thread

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Suraj
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Re: Wuhan Coronavirus Resource Thread

Postby Suraj » 07 May 2021 22:09

Bart S wrote:
Suraj wrote: States have to independently arrange for their own stock. The latter is a lot less regular - Gujarat is fast out of the blocks but others haven’t even entered the stadium.


Plenty of other states were out of the blocks just as fast but there is simply not enough supply. That is the crux of the matter.

To make matters worse the center has said that the stocks supplied by it earlier cannot be used by the states for their own vaccination programs, even temporarily and bureaucrats have apparently crafted some complex and impractical process around returning unused vaccines.

To me, that argument lacks enough data connecting the conclusion with the cause. Yes the literal visible situation is that vaccinations that are the states' domain is much fewer in number than central one - the latest data saying 900K by states, 1.6M by center, despite them getting 50% stock each.

What causes this ? How does the ordering get fulfilled ?
1. States get fulfillment in the sequence they place orders . This is somewhat unfair since one large order can block other states.
2. States get fulfilled in proportion to size of orders placed. Somewhat better but doesn't address greater urgency in some states.
3. Some combination of prioritization ?

Separately, how to states handle transport ? All the vaccines clear central QA at NCL Pune. India has a 28000-node fridge and freezer network supporting national immunization campaigns. These are all capable of 2-8 degree storage (regular fridge temp) and many can handle colder -20 freezer temp needs.
1. Do states leverage the central distribution network and vaccine cold storage network ? Or do the have their own ?
2. How do they transport vaccines from Pune or Hyderabad or elsewhere ?
3. How do host states avoid pressurizing manufacturers to prioritize them over other states.

The main reason I have not supported the states' demand for individual access (despite the center giving them their demand) is that it places a moral hazard on the manufacturers just like what Pfizer faces - the week Pfizer switches to country A, more people die in country B. Until May, the center used data from the states to determine how to allocate vaccines. When the wave hit and everyone suddenly wanted to be the highest priority, this became problematic.

The US faced similar pressures, but by the point the US started vaccinating in numbers, they were on the receding side of a second wave. This is one reason I mentioned we were unlucky - we started the process of investing in significant Covaxin capacity back in November (Bharat Biotech, IIL, BIBCOL, NIV all got funding then) but it was due to come online in May-July - BB has already scaled up from 5m/month in Jan/Feb to 15m in March, 20m in April, 30m this month and 60-70m in July quoted by Krishna Ella.

Please avoid the tendency to just instinctively respond with 20/20 hindsight that they should have begun capacity expansion earlier than November and gotten it ready by now and not July. There is no productive value to understanding the situation in such a response. All people are armchair experts with such hindsight, but it's not valuable to the purpose of understanding the situation in depth.

The reality is that unlike other countries that were hit by major waves last year, we have substantial vaccination cover of at risk group at this point:
Image
https://twitter.com/kashmiriRefuge/stat ... 96774?s=20

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Re: Wuhan Coronavirus Resource Thread

Postby vijayk » 07 May 2021 22:11

Zynda wrote:Apart from vaccines, we need them drugs like the above. I don't think we will be able to vaccinate around 70% at least till middle of next year. Till that time, there probably will be more waves. So drugs are as essential as vaccines. I do hope ICMR/DGCI will approve some of these drugs ASAP. May be doctors like Ratnadip will be able to provide better picture on the effectiveness of these newer drugs.


Is there any rapid reaction teams that focuses on this?

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Re: Wuhan Coronavirus Resource Thread

Postby Kakkaji » 07 May 2021 22:14

Mort Walker wrote:It’s nice of the UK to send the 5 million doses to India. The US has no timeline for the 20 million AZ doses they promised to send.


UK did not send any. It is 5m doses of Covishield produced in India, for export to UK, that are being diverted by the Indian manufacturer to meet the domestic demand in India. These doses never left Indian shores.

I don't think the UK needs these doses any more. They are well-covered by their domestic production. Additionally, SII is now investing over 200 million pounds to set up manufacturing facilities there.

So, no generosity/ sacrifice by UK for India in this case IMHO.

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Re: Wuhan Coronavirus Resource Thread

Postby Suraj » 07 May 2021 22:21

I made this point recently when I posted about the Pfizer vaccine situation (https://twitter.com/surajbrf/status/138 ... 30565?s=20) - importing vaccines is simply not going to work for India. Especially so with Pfizer, but true for pretty much any major vaccine. This is because airplanes are restricted in how much dry ice they can transport due to sublimation and cabin pressurization risk, and thus an aircraft can carry the same amount of Pfizer doses as a trailer truck.

If you look at Pfizer supplies, it is concentrated in US where it is trucked from Kalamazoo, and in EU/UK where it is trucked in from Puurs, Belgium. These are the two Pfizer plants. All others get 300-500K doses per plane every week/fortnight/month. Do the math on that - there's no way Pfizer imports work, and even if some other vaccine has less ultra cold transport requirement (more doses/kg of dry ice) there's still a limit due to the sheer difference in air freight vs trucking rate.

Summary - India's going to solve its vaccine needs almost entirely by itself. We're fortunate we are able to do that - and with Covaxin and Zycov-D, we don't even have any IP restriction preventing us.

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Re: Wuhan Coronavirus Resource Thread

Postby Amber G. » 07 May 2021 22:24

Mort Walker wrote:
CT scans are unnecessary in mild cases. They can expose you to high radiation. I had an abdominal CT scan some 6 years ago in the US and the incompetent radiology technician ran me through the machine 3 times to get a good scan. Turned out all I had was severe gastritis. A chest X-ray = 0.1 mSv and abdominal CT scan = 10 mSv. A person is typically exposed to 2-3 mSv/year from background. About 100 bananas will give you 0.25 mSv.

The claim of 300-400 times an x-ray is correct in real world practice.

This subject been discussed in BRF in past. (and I had *many* posts over many years in Physics, Nuclear or Fukuisima dhaga). There is a lot of misunderstanding about effects of low-level radiation (< 100 msv), reputable textbooks are of help here.

FWIW: Few basic points:
Chest X-ray - 0.1mSv, CT scan = 10 mSV ( typical about 2-12 mSV), BeD (Banana Equivalent Dose = roughly equal to K40 radiation from 1 banana) = .0001 mSV (100 bananas are about .01 mSV - at least that is what some physics professors will say :) it even has a wiki page :)).

Average Exposure per year due to back ground radiation is about 3 mSV but in Chennai is is about 10 mSV, some place in Kerala - it is about 50 mSV and there are places in the world with annual values > 200 mSV (where people live healthy life and statistically do *not* have high rate of cancer etc).

Much confusion comes because of now discredited (but once taken at face value) LNT hypothesis where low-level radiation effect was highly exaggerated (without scientific results etc but accepted as it was better than nothing).
(To be clear - we understand effects due to radiation higher than what sometimes called threshold value which is of the order of 100 mSV, With 1000mSV you will definitely be sick, and with 2500 mSV or greater , if you don't get a treatment there is about 50% chance that you will die - but that is roughly about 100 CT scans or more )

I just had a CT scan .... the last thing I (or my doctor) worried about was about 10mSV of radiation -- even though I know some people worry about even an X-ray. My advice (which I give to my own family, which consists of doctors etc) the yearly dose of 100 mSV (about 10 CT scans per year) is nothing really to worry about... I know even some text-books (especially the old ones) differ from my take but there is really no credible evidence that low-level (or the order of few mSV's) has measurable negative effect.
Added later: To be clear I am *not* saying that *all* radiation is harmless -- just wanted to give scientific perspective .
Last edited by Amber G. on 07 May 2021 23:23, edited 3 times in total.

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Re: Wuhan Coronavirus Resource Thread

Postby Bart S » 07 May 2021 22:33

Atmavik wrote:
darshan wrote:I'm part of the senior citizen group and many in this groups are giving up resources to help upcoming generation.

The risk assessment has changed. Hopefully that answers uniform access to vaccination.



Sir we need the seniors vaccinated first as they are at the highest risk of hospitalization. If young have health issues then this makes sense.

Younger folks should hunker down as vaccine production ramps up. There is hope on the horizon as we will have around 200 million doses/month by September.


Since our primary vaccine seems to be Covishield (Oxford/AstraZeneca) perhaps a good strategy would be to follow the UK's 12-week timing for second dose (Covaxin would still need to follow the specified 4-6 week gap). Apart from actually providing better efficacy, this will also let more people be vaccinated at least with one dose, and reduce the pressure on the system a little bit. However for this to work, people must be guaranteed their second dose at around the 12-week mark with adequate vaccines and slots reserved for them, otherwise if it goes by the current chaotic method they could be left high and dry and without protection after 12 weeks.

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Re: Wuhan Coronavirus Resource Thread

Postby darshan » 07 May 2021 22:55

Here we go again. US people are worried about Indian deaths.
New Study Estimates More Than 900,000 People Have Died Of COVID-19 In U.S.
https://www.npr.org/sections/coronaviru ... -19-in-u-s
...
Researchers at UW also released an updated forecast for the COVID-19 death count worldwide, estimating that roughly 2.5 million more people will die of COVID-19 between now and Sept. 1, driven in part by the dramatic surge of cases in India.
....

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Re: Wuhan Coronavirus Resource Thread

Postby nam » 07 May 2021 23:03

Other than the Meltdown in Delhi, other states seems to managed the peak decently.

The current infection numbers and deaths, are way more than what was during the Delhi mayhem, however I don't see the level of desperatation, that was couple of weeks back.

People are not desperately seeking beds and oxygen.

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Re: Wuhan Coronavirus Resource Thread

Postby Aldonkar » 07 May 2021 23:44

Kakkaji wrote:
Mort Walker wrote:It’s nice of the UK to send the 5 million doses to India. The US has no timeline for the 20 million AZ doses they promised to send.


UK did not send any. It is 5m doses of Covishield produced in India, for export to UK, that are being diverted by the Indian manufacturer to meet the domestic demand in India. These doses never left Indian shores.

I don't think the UK needs these doses any more. They are well-covered by their domestic production. Additionally, SII is now investing over 200 million pounds to set up manufacturing facilities there.

So, no generosity/ sacrifice by UK for India in this case IMHO.


At the height of out second wave (around the time the UK-variant was detected) The UK supply of vaccine was threatened by the EU (most of the AZ and Pfizer production is based in Belgium) and production problems in the AZ factories in the UK. It appears the the UK gov or AZ secretly did a deal for SII to supply 10 million doses of AZ vaccine to the UK as the EU had banned exports to the UK.

SII managed to send 5 million doses which helped the UK maintain its vaccine momentum to the anger of the EU - remember the story of the Italian factory which was raided supposedly because it was supplying the UK?

However by then India had got it vaccine program going and the Indian gov stropped exports of vaccine to get the country maximum supply ant balance of the secret order was held up. The UK vaccine program hit a lull and the UK tabloids blamed India for the hit claiming that it had defaulted by 5 million doses. Remember that the original contract between AZ and SII said that the European factories would supply the developed world and SII would supply India and the underdeveloped world ie. the low income countries.

Now the UK gov, having sourced enough vaccine, has waived the claim to the 5 million doses from that "secret" deal. It is good PR as India needs it more than the UK.

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Re: Wuhan Coronavirus Resource Thread

Postby darshan » 08 May 2021 00:52

Drive Through Covid19 vaccination centre in Ahmedabad by AMC from May 8
https://www.deshgujarat.com/2021/05/07/ ... rom-may-8/
..
The vaccination site will be managed by Ashirvad Foundation. One can come in car, taxi or rickshaw and get Covid19 vaccine jab sitting in the vehicle itself for free of cost as per the announcement made by the AMC. Prior registration will not be required, as walk-in registration is available with Aadhar card. Similar drive-through vaccination was successfully done for 200 persons in Bhuj. Such drive-through is also organized in Gandhinagr too.

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Re: Wuhan Coronavirus Resource Thread

Postby Tanaji » 08 May 2021 01:24

There was a drive through site in Dadar, Mumbai for seniors. It might still be operating. There is talk of sending teams to high rise estates where hundreds of families live.

Good idea imho. The new BMC commissioner seems to get it right.

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Re: Wuhan Coronavirus Resource Thread

Postby Tanaji » 08 May 2021 01:39

In other news the chinese Sinopharm vaccine has been approved by WHO for Gavi usage. I am actually surprised that it took so long given that WHO is controlled by China…

https://indianexpress.com/article/world ... ne7306289/

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Re: Wuhan Coronavirus Resource Thread

Postby Cain Marko » 08 May 2021 01:53

darshan wrote:Here we go again. US people are worried about Indian deaths.
New Study Estimates More Than 900,000 People Have Died Of COVID-19 In U.S.
https://www.npr.org/sections/coronaviru ... -19-in-u-s
...
Researchers at UW also released an updated forecast for the COVID-19 death count worldwide, estimating that roughly 2.5 million more people will die of COVID-19 between now and Sept. 1, driven in part by the dramatic surge of cases in India.
....

NOte how the article mentions underreporting by India, Japan, US et al., BUT not a word about Chinese reports. Just take them as they are - considered true and duly given the pass. NPR is a third rate outlet. :x

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Re: Wuhan Coronavirus Resource Thread

Postby Kakkaji » 08 May 2021 02:21

OK, here are the official numbers on vaccination for today:

COVID-19 Vaccination Update- Day 112

India’s Cumulative Vaccination Coverage exceeds 16.71 Cr doses

More than 2.96 lakh beneficiaries of age group 18-44 Vaccinated today till 8 pm

More than 21 lakh vaccine doses administered today


Looks like there is dip in total doses administered from yesterday :(

My calculations for the day's percentages:

1. Doses administered from Cental Government's procurement = 18,30,768 = 86% of total

2. Doses administered from State Governments' and Private Hospitals' procurement = 2,96,289 = 14% of total

One reason for the dip in total doses in Phase 3 from Phase 2 is that the private hospitals and clinics that were receiving supplies out of the Central Government's purchases are not getting them anymore. Except for a few very large private hospitals such as Apollo, other private entities cannot afford to procure on their own.

My relative, who runs a diagnostic clinic and who was administering 200 doses per day in Phase 2, has closed vaccinations for now. He cannot afford to procure on his own from the vaccine manufacturers. So, he is now waiting for his state government to decide if it wants to supply him doses from its own procurement. He has not heard anything yet, so that is 200 doses per day that is out of daily vaccination capacity for now.

Anyone get vaccinated at Apollo or other private entity in Phase 3? What was the charge and what was the vaccine?

TIA

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Re: Wuhan Coronavirus Resource Thread

Postby Atmavik » 08 May 2021 02:30

nam wrote:Other than the Meltdown in Delhi, other states seems to managed the peak decently.

The current infection numbers and deaths, are way more than what was during the Delhi mayhem, however I don't see the level of desperatation, that was couple of weeks back.

People are not desperately seeking beds and oxygen.



i am worried this will spill over to other cities. politicians dont want to impose a lock down and no one is listening.

this is Hyderabad today.

Image

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Re: Wuhan Coronavirus Resource Thread

Postby Amber G. » 08 May 2021 06:19

Bart S wrote: <snip>

Sorry, but this model continues to be quite unreliable, for all the hype about it and attention paid to it in high places. There is frequent changes and moving of goalposts done citing 'phase shifts' including one today. There is limited use for it if it can't serve a predictive function with any accuracy, despite whatever excuses are made.

From the perspective of laypersons who were eagerly following it, it has been thoroughly discredited.

Okay.
My take is quite different.

As some one said "All models are wrong but some are useful".

My favorite quote is from Neils Bohr - "Prediction is really hard - especially about the future." :).

Yes, I know all the hulla-gulla done by many newspapers and abuses thrown on these scientists (while mis-reporting them). Sane advice to those all who think that these prediction are nonsense: is to just ignore these and not waste their time.

My take:

When all is said and done:
- The graphs/modeling done (For example see <here .. graphs I posted in brf >...Most will say have been *extremely* good till about the end of February 2021. From the peak in September 2020 to gentle decline in the beginning of 2021 - model computed data followed *very* closely with the actual data. Thus the model earned a well deserved global reputation and very high praise among scientists.

- This model fit very well for many other countries ( I know US, Canada, and Italy data). (This is all published and have been very well respected).

- For B117 strain - please do see this post of mine https://forums.bharat-rakshak.com/viewtopic.php?p=2480713#p2480713 .. This was around End of January... See the graphs and warning. (This is why dangerous variants are very scary and make prediction very difficult)

(To be clear - NO model can predict properties of future variants - UK's B117 (and P1) had unusually high transmissivity ..how fast it was spreading in Mumbai or Punjab depended on many factors but -- if that data was fed into the model one can see how peaks can take place)

- Unfortunately there were a few posts of mine seem to be deleted by a brf admin - around this time -- and I stopped spending time in brf for a while..

True - Second wave was not projected by SUTRA model till late march but then this is *NOT* astrology. The model is based on certain parameters - if the parameters changes (like introduction of 50% higher transmissive variant) ground realities changes.

The *main* benefit of these models is to give help to GoI in deciding how different scenarios will play out - (eg how much a lock-down will help etc) so that it can make informed decision. This is why GoI/DST formed the modeling team last year - and by all accounts DST found it very helpful.

Bottom line: audience for those graphs is mainly other scientists and decision makers - some mathematical background is needed to understand/analyze these graphs.

(I do have historic graphs drawn at different times since April parameters -- will be interesting and educational to see how well they fin the actual data -- At this time my confidence is quite high - the required stability in the model has achieved so unless we enter new phase the graphs ( city and state level) will be quite good)

It may be that brf is not a place to discuss this so I will stop. :).
Last edited by Amber G. on 08 May 2021 08:43, edited 1 time in total.

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Re: Wuhan Coronavirus Resource Thread

Postby Kakkaji » 08 May 2021 07:42

This story gives the status of vaccine procurement by private hospitals.

It is behind the paywall on my laptop, but I can read the full story on my cell phone:

Amid supply crunch, private hospitals eyeing import of Covid-19 vaccines

As supplies of Covid-19 vaccines in India face constraints after vaccination was opened to all above 18, private hospital networks say they are exploring the option of importing vaccines as well as augmenting supplies. Two major hospital groups, Apollo Hospitals and Fortis Healthcare, said they are open to exploring opportunities to import.

Suneeta Reddy, managing director (MD), Apollo Hospitals Group, said it had planned the vaccination drive early and has supplies from both the manufacturers — Serum Institute and Bharat Biotech. Apollo is vaccinating 30,000 people a day now.


The story further says that the Association of Healthcare Providers (AHPI) is collecting demand assessments from 4,000 private hospitals and is planning to do collective purchase of vaccines for all its members.

It says the vaccine makers have assured that the supplies to the private sector will be streamlined by mid-June.

I think that by July, the daily vaccination in India will be well above 5m per day. Keeping my fingers crossed in the meantime.

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Re: Wuhan Coronavirus Resource Thread

Postby Atmavik » 08 May 2021 08:18

^^ that’s good to know. Every bit helps.

I had hoped our IT companies like Infy, wipro, etc.. would also import vaccines for their employees. But sadly no such news so far.

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Re: Wuhan Coronavirus Resource Thread

Postby putnanja » 08 May 2021 08:57

Had an unfortunate death in a close family member yesterday in Karnataka, left behind 2 very young kids. Symptoms (fever and tiredness) started last saturday, took mediciens. On Monday went to doctor and got Covid test done, result came positive on Tuesday. Doctor advised home isolation and medicines. Was ok till Thursday. On early Friday morning, felt very tired after visit to bathroom and almost collapsed. Got ambulance and by the time he was taken to hospital, was declared brought-in dead. Docs said might have had a blood clot due to covid and died from cardiac arrest. Wife also tested positive. Both under 45 & not vaccinated.

Coincidentally today, read this article about heart attacks due to clots due to Covid
https://www.msn.com/en-in/health/medica ... li=AAggbRN

Please everyone take care and check with patients regularly on whether they have any chest pain etc. In our case, he never mentioned anything, so don't know what happened. It was a sudden shock and everyone is still trying to come to terms with it.

Damn the horrible Chinese communist party! I hope they rot in hell for the havoc they have wrecked in the world!

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Re: Wuhan Coronavirus Resource Thread

Postby Amber G. » 08 May 2021 09:07

SriKumar wrote: some viruses are more infectious than others. This aspect needs to be confirmed and considered quite apart from what is modifiable and what is not.

Transmissivity of variants like B117 was a very high concern - for example see my post in brf about 3 months ago posted below. If it gets introduced and spread it will spread very fast and may soon become predominant .. many (most ?) people, it seem do not have much understanding of exponential growth -- screening and good masking in January/February frame in Maharastra and Punjab was very essential.

I called and warned everyone who will listen to me about the this effect - the spreading power (and it was also spreading among younger people - so makes it even more spreadable ) asked them to stock up on good masks, O2 concentrators, and avoid crowded area and travel and get vaccinated *as soon as possible * before the possible second wave erupts. (Thankfully most of my family and friends here in US, Canada and India listened - nearly 100% got vaccine as soon as they were eligible - went on to stock up on good masks, things like oximeters and concentrators etc - I am thankful for that now).

Here is the old post from Jan 24 (explaining R factors in easy terms etc) :

Amber G. wrote:This B117 strain is serious *extremely* serious!
Suppose we have 1000 cases/day now... with an R=0.86 we could reduce it to 500/day in 2 weeks.

But with contagiousness of B117 variant that has ~60% higher R, in 2 weeks, 3000 new cases/day instead ..

Image

Serious warnings are being issued (or will become a BIG news in coming weeks even in non-scientific world ) here in USA but it seems that it has not sink in yet ..(True for other parts where this strain is becoming more predominate).

One serious datapoint is Israel - which at present is in full lockdown.. still numbers keep going up, barely able to control it. With a tightened lockdown the numbers are going down slightly--- but this is happening in a country where almost 1/4 of population is now partially vaccinated AND we are on lockdown.

(I have called several of my friends/relatives - many of them doctors - to alert and pass some of the recommendations - especially those who have to be out - to stay safe and have discussed some extra precautions it with them - even some of them were not aware with the latest data or seriousness).
<snip>

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Re: Wuhan Coronavirus Resource Thread

Postby Amber G. » 08 May 2021 09:22

putnanja - Condolences. PLEASE stay safe and keep others safe.

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Re: Wuhan Coronavirus Resource Thread

Postby pgbhat » 08 May 2021 10:00

BTW those in Bengaluru, Kerala good news is 45+ vaccination slots do not seem much like a problem. I see it open at least in a few places when I login to CoWIN daily. My dad got his second dose yesterday from a govt hospital. My mom is due for second dose as well soon ( she is now in 6-8weeks window). 18+ is not happening though, slots are filled and too little.

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Re: Wuhan Coronavirus Resource Thread

Postby partha » 08 May 2021 13:18

putnanja avare,

Condolences. Saddest cases are those of kids losing parents.

A distant relative of mine lost his mother (aged, natural causes) and hence was forced to leave house to perform last rites. He caught covid and passed away. He had only taken first dose of vaccine.

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Re: Wuhan Coronavirus Resource Thread

Postby Cain Marko » 08 May 2021 14:04

putnanja wrote:Had an unfortunate death in a close family member yesterday in Karnataka, left behind 2 very young kids. Symptoms (fever and tiredness) started last saturday, took mediciens. On Monday went to doctor and got Covid test done, result came positive on Tuesday. Doctor advised home isolation and medicines. Was ok till Thursday. On early Friday morning, felt very tired after visit to bathroom and almost collapsed. Got ambulance and by the time he was taken to hospital, was declared brought-in dead. Docs said might have had a blood clot due to covid and died from cardiac arrest. Wife also tested positive. Both under 45 & not vaccinated.

Coincidentally today, read this article about heart attacks due to clots due to Covid
https://www.msn.com/en-in/health/medica ... li=AAggbRN

Please everyone take care and check with patients regularly on whether they have any chest pain etc. In our case, he never mentioned anything, so don't know what happened. It was a sudden shock and everyone is still trying to come to terms with it.

Damn the horrible Chinese communist party! I hope they rot in hell for the havoc they have wrecked in the world!

Condolences Putnanjaji, terrible story and news. God give you and your family strength.

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Re: Wuhan Coronavirus Resource Thread

Postby Cyrano » 08 May 2021 14:41

Thanks for your posts Amber G.
Is there a summary of the assumptions (or parameters, impact (+/-) and their weightages) of the models you are following? Unless someone understands the assumptions and agrees that are realistic, expressing confidence or lack thereof on any model is usually a gut reaction based to what the model is forecasting.

putnanja garu, my condolences.

The Govt's Phase 3 vaccine policy is leading us to a royal mess as I feared. Mamata moving SC against it will be followed by other non-BJP states. And hizzoners are going to weigh in on everything making it more difficult for the center to do any coordinated action, and a colossal waste of time for all. The whole system is looking like a basket of crabs at the moment. :(

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Re: Wuhan Coronavirus Resource Thread

Postby Cyrano » 08 May 2021 14:48

As if we don't have enough troubles mucormycosis is another lurking danger now. I have heard reports that this could be a hospital transmitted disease (inadequate sanitisation/sterilisation of equipment or poor maintenance of O2 delivery system) but at this stage, its not sure if hospitals are the main source of getting it.

Covid-sparked fungal infection assuming epidemic proportions

MUMBAI: Twenty-nine-year-old Suhas, a businessman, thought he had defeated coronavirus when he came out of a non-invasive ventilator and went home after two weeks. But soon he started experiencing pain and swelling on the face. A quick CT scan confirmed the doctor's fears - he had contracted mucormycosis, a potentially fatal fungal infection. He recently underwent a surgery at Global Hospital in Parel, where doctors had to remove his upper jaw to arrest the spread of the fungus to the brain.

Triggered by coronavirus, mucormycosis, which has a mortality rate of over 50% and can lead to blindness, is sweeping through parts of the state. City hospitals that are treating dozens of such cases from northern Maharashtra and Vidarbha said its spread is assuming epidemic proportions, so much so that regions have started facing a shortage of anti-fungal medicines. Global Hospital, which has started a dedicated clinic for mucormycosis after witnessing a surge in cases during the first wave, has 18 patients admitted at present.

ENT surgeon Dr Milind Navalakhe, who is a part of the team that runs the clinic, said they have admitted 31 patients, of which 25 are from outside the city. "Cases of mucormycosis have exploded in the state, and the government needs to urgently intervene. Medical centres across Maharashtra, particularly, Vidarbha, must be seeing a 100%-200% rise in cases," he said. At the Global centre, six patients have lost their entire upper jaw, while one has lost an eyeball due to the infection.

Parel's KEM Hospital has 25 patients undergoing treatment for mucormycosis. Dr Hetal Marfatia, head of ENT, said almost all patients are from far-off districts and have come at an advanced stage. The infection typically starts growing from the nose, upper jaw and travels to the brain. "Once it reaches the brain, it's almost a death sentence," she said, adding that from treating a handful cases annually, the hospital is now seeing three-four referrals daily.

ENT surgeon Dr Sanjeev Zambane said he has been seeing a minimum of two mucormycosis cases in a day. The bigger challenge now is treatment, since anti-fungal medicines are not just in short supply but also very expensive.

In pre-Covid times, the 'black fungus' mucormycosis used to be rare and seen mainly in immunocompromised people. However, after the pandemic, three factors have led to an exponential rise- Covid itself, diabetes and abuse of steroids that lower immunity.

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Re: Wuhan Coronavirus Resource Thread

Postby chetak » 08 May 2021 15:39

Image

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Re: Wuhan Coronavirus Resource Thread

Postby sooraj » 08 May 2021 16:25

DCGI approves anti-COVID drug developed by the DRDO for emergency use

Drug 2-DG comes in powder form in sachet & taken orally by dissolving it in water

Clinical trial showed 2-DG drug helps in faster recovery of hospitalised patients, reduces supplemental oxygen dependence

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Re: Wuhan Coronavirus Resource Thread

Postby anmol » 08 May 2021 16:58

Potential cancer drug repurposed for Covid-19 by DRDO, Dr Reddy's gets DCGI nod for emergency use
Swati Bharadwaj / TNN / May 8, 2021, 15:52 IST

HYDERABAD: A potential cancer drug repurposed for Covid-19 treatment -- 2-deoxy-D-glucose (2-DG) – has received the Drugs Controller General of India (DCGI) nod for emergency use as adjunct therapy for hospitalized moderate to severe Covid-19 patients.

The anti-Covid-19 therapeutic application of the drug was developed by the Institute of Nuclear Medicine and Allied Sciences (INMAS), a Defence Research and Development Organisation (DRDO) lab, in collaboration with pharma major Dr Reddy’s Laboratories.

The drug, which comes in a sachet in powder form, has to be taken orally by dissolving it in water. The drug works by accumulating in the virus infected cells and prevents virus growth by stopping viral synthesis and energy production.

“It’s selective accumulation in virally infected cells makes this drug unique. Higher proportion of patients treated with 2-DG showed RT-PCR negative conversion in Covid-19 patients,” INMAS-DRDO said.

According to INMAS-DRDO, the clinical trial results showed that the molecule helps in faster recovery of hospitalised patients and reduces their dependence on supplemental oxygen.

“In the ongoing 2nd wave of the pandemic, a large number of patients are facing severe oxygen dependency and need hospitalization. This drug is expected to save precious lives due to the mechanism of operation of the drug in infected cells. As it reduces the hospital stay of Covid-19 patients, it will also help reduce the burden on the country’s health infrastructure,” it explained.

Being a generic molecule and analogue of glucose, it can be easily produced and made available in plenty in the country, INMAS-DRDO added.

Research into repurposing the drug for Covid-19 was started by INMAS-DRDO scientists in April 2020, during the first wave of pandemic, and laboratory experiments were conducted with the help of the Centre for Cellular and Molecular Biology (CCMB), Hyderabad.

The Phase-II trials conducted on 110 patients in 17 hospitals found that patients using the drug showed a faster recovery and a 2.5 days difference in terms of the median time for achieving normalization of certain vital parametres as compared to standard of care (SoC).

The Phase III clinical trial showed that a significantly higher proportion of patients that took the drug improved symptomatically and became free from supplemental oxygen dependence (42% vs 31%) by Day-3 in comparison to SoC, indicating an early relief from oxygen dependence.

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Re: Wuhan Coronavirus Resource Thread

Postby arvin » 08 May 2021 17:27

Wow. Kudos to the DRDO lab- Institute of Nuclear Medicine and Allied Sciences (INMAS) for adapting this drug for Covid-19 treatment.
This will have a direct impact on how fast a bed and oxygen can be freed allowing more patients to be treated in the same period.
This is meant for moderate to severe patients. Interesting to see the effect this will have on hospital loads.

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Re: Wuhan Coronavirus Resource Thread

Postby uddu » 08 May 2021 17:31

^^^Once the sachet is available beyond the moderate and severe cases, can this be given to whoever is covid positive? Will that help such patients as well to recover faster and without any side effects. Dr.Reddy's may have to make about 5 lakh sachets per day initially.

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Re: Wuhan Coronavirus Resource Thread

Postby arvin » 08 May 2021 18:25

These drugs might be targeting specific conditions that might exist only in moderate to severe cases that is beyond the control of immune system. So maybe that is why are not recommending it for mild cases which are self curable by rest and nutrition.

Israel has also repurposed a anti cancer drug and it is showing promising results. It goes by the name EXO-CD24 .

https://www.timesofisrael.com/new-israe ... -hospital/

The preparation is inhaled once a day for a few minutes, for five days,” Arber said. “The preparation is directed straight to the heart of the storm — the lungs — so unlike other formulas… which selectively restrain a certain cytokine, or operate widely but cause many serious side effects, EXO-CD24 is administered locally, works broadly and without side effects.

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Re: Wuhan Coronavirus Resource Thread

Postby darshan » 08 May 2021 19:27

Few points that I understand about the 18 - 45 vaccination:

1) cheapest, fastest, and safest during the ongoing wave as high risk would have to be risk managed to make sure that they stay safe while getting vaccinated. Younger population can stay masked under the various conditions while making less mistakes. If they do manage to pick up the chinese virus, then also likely to consume less hospital resources.

2) dead wage earner means dead family. Simple risk management where all such families would want the wage earner to be the safest. Hence, uniformity is needed for vaccination based on wage earner metric.

3) resourceful were already getting their whole families vaccinated by hook or crook. I have seen many even fly out of India to get vaccinated. Not resourceful people would have easily made the choice to get their young ones vaccinated compared to elders. Now the choices are there to be made even for non resourceful.

4) economic future as country has high young population and that's the working population. chinese have taken away lot of economic future by using the virus and India needs to salvage whatever for young ones. Else, everyday would be a death like under poverty.
Last edited by darshan on 08 May 2021 19:37, edited 1 time in total.

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Re: Wuhan Coronavirus Resource Thread

Postby darshan » 08 May 2021 19:36

This sort of comparisons need to be ongoing on all platforms. Hopefully, govts like GJ start coming out and explaining why states like Delhi are bad.

Gujarat hasn’t reduced Covid19 tests, then what actually matters is positivity rate which is 8.5% : Rupani
https://www.deshgujarat.com/2021/05/08/ ... -5-rupani/
...
‘Gujarat conducted 1.39 lakh tests yesterday against 1.07 lakh in Bihar, 61,000 in Chhattisgarh, 52,000 in Haryana, 1 lakh in Andhra Pradesh, 77,700 in Rajasthan, 64,500 in West Bengal and 79,000 in Delhi. So we are conducting sufficient tests,’ he said.
...
Rupani said Gujarat in the second wave witnessed 14,500 cases and then it has come down to 12,000. He said the State has increased covid beds from 41,000 to 1 lakh in hospital across the State. The State has increased its oxygen supply from 250 tons to 1100 tons, and by God grace no hospital has felt shortage of oxygen. Uninterrupted supply of oxygen has continued without a break. Rupani said there has been five-six fold increase in number of covid cases in the second wave of pandemic compared to the first wave.
...

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Re: Wuhan Coronavirus Resource Thread

Postby darshan » 08 May 2021 19:47

Not sure if timings leveraged the sun and open air to the maximum while keeping things open.

MK Stalin imposes state-wide lockdown amid covid surge from Monday
https://www.wionews.com/india-news/mk-s ... day-383626
....
The lockdown will begin from 4 am on May 10 (Monday) and continue till 4 am on May 24, if not extended further.
....
However, to ease the shift from day-to-day functioning to a strict lockdown, Stalin has permitted shops to stay open over the weekend, between 6 am to 9 pm.
...
However, standalone grocery, vegetable shops and supermarkets will be allowed to operate till 12 pm without AC, and services such as Dunzo, Swiggy and more can operate to home deliver essentials. All other restaurants and hotels have been ordered to stay closed for dine-in options. Hotels, that already have guests staying with them, can only offer food through room service.

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Re: Wuhan Coronavirus Resource Thread

Postby fanne » 08 May 2021 19:56

quick question for Dr's here- Can taking baby aspirin as blood thinner (as it is OTC) help people avoid blood clot-related issues due to Covid. What are the side effects?

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Re: Wuhan Coronavirus Resource Thread

Postby saip » 08 May 2021 20:13

I have been taking baby aspirin (81mg) for years now and have felt no side effects. I am diabetic but well controlled sugar levels. Only time I was asked to stop taking it is when I had to undergo some procedure like knee surgery etc. So I guess every bit helps and this baby aspirin might help too.

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Re: Wuhan Coronavirus Resource Thread

Postby chanakyaa » 08 May 2021 20:23

Good news with respect to the growth of new cases is that the weekly growth rate of new cases dropped below 1% over the past one week. A week before, the rate of growth of new cases was between 2%-3% and 3 weeks before that the rate of growth was between 4%-7%.

fanne's question above made me think (and ask) about another medicine (otc Diamox or generic Acetazolamide) to cure low oxygen condition. I remember using Diamox to prevent altitude sickness on my Ladakh trek.

https://en.wikipedia.org/wiki/Acetazolamide#High_altitude_sickness
...
High altitude sickness
In the prevention or treatment of mountain sickness, acetazolamide forces the kidneys to excrete bicarbonate, the conjugate base of carbonic acid. Increasing the amount of bicarbonate excreted in the urine causes the blood to become more acidic.[10] As the body equates acidity of the blood to its CO2 concentration, artificially acidifying the blood fools the body into thinking it has an excess of CO2, and it excretes this perceived excess CO2 by deeper and faster breathing, which in turn increases the amount of oxygen in the blood.
...

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Re: Wuhan Coronavirus Resource Thread

Postby Zynda » 08 May 2021 21:46

This is the situation in BLR. BBMP has stopped supplying vaccines to most private vaccination centers & hospitals. Only a few big chain hospitals are getting vaccines from BBMP or have managed to secure order through other routes. Currently, most of the vaccines are going to Government hospitals and corporation health centers. Again very limited vaccinations are being done for 18-44 group...mostly in big chain private hospitals. Current vaccinations going on in Government centers are mainly for 2nd dose people and for 1st dose who are in >45 age group. Most private centers are saying that they are expecting stocks to receive only after June 1st week. They were receiving stocks from BBMP till April 30th. Read some where that Private hospital network are now pooling resources together and are placing huge orders with SII & BB directly. I guess situation wrt 18-44 vaccination won't pick up pace massively before June 15th...

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Re: Wuhan Coronavirus Resource Thread

Postby Kakkaji » 08 May 2021 22:20

Today's PIB Release on vaccination numbers:

COVID-19 Vaccination Update- Day 113

India’s Cumulative Vaccination Coverage exceeds 16.92 Cr doses

More than 2.86 lakh beneficiaries of age group 18-44 Vaccinated today till 8 pm

More than 18 lakh vaccine doses administered today

2,86,800 beneficiaries of the age group 18-44 years received their first dose of COVID vaccine today and cumulatively 17,76,540 across 30 States/UTs.

As on Day-113 of the vaccination drive (8th May, 2021), total 18,93,258 vaccine doses were given. 7,83,895 beneficiaries were vaccinated for 1st dose and 11,09,363 beneficiaries received 2nd dose of vaccine as per the provisional report. Final reports would be completed for the day by late tonight.


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