Wuhan Coronavirus Resource Thread

[Karan M]

If you close the stock market you spook the FII so that they won't return for a while, and further roil the markets.
Just ignore the market for a while. I am 38% down on my stock market investments and prepping myself for it to go down by a further 20-30% till things stabilize.

Everyday life is > stock market IMHO, and this is where my greatest worries are. Getting supplies, fresh groceries, etc.

I am bullish on India and remaining invested. The current fall was a good opportunity for me to sell and repurchase the same mutual funds
- giving me a notional short term capital loss, which I can (over the next 8 years if required) set off against real capital gains tax.

Genius. Just plain genius. I didn't think of this at all.

[Karan M]

Garooda - if you think the information is accurately transcribed and can help Indian doctors, then post.

[Suraj]

I am bullish on India and remaining invested. The current fall was a good opportunity for me to sell and repurchase the same mutual funds
- giving me a notional short term capital loss, which I can (over the next 8 years if required) set off against real capital gains tax.

Genius. Just plain genius. I didn't think of this at all.

Depends on wash sale rules. In the US the rule prevents selling at a loss and buying back 'substantially the same security' within the next 30 days and reporting that loss for tax purposes. However, given the circumstances, the US may suspend wash sale rules this year. I don't know if India has such rules. I assume not, in which case booking a loss for tax purposes is a smart tactic.

[Karan M]

Would we prefer 21 days of increasing panic as infection counts head upwards and our cities become pandemic areas, or 21 days wherein GOI finally has breathing space (no pun intended) to put measures in place? This is all due to those a-holes who went around breaking quarantine and those jerks who thought their qudrati biryani was enough to sit and engage in bigoted displays of street power. Both groups have now forced the GOI's hand. Congratulations. You put the whole country into a lockdown. There was no other option.

Yes, a more protracted period of community transmission by people either unaware of their own contact with others, or those willfully negligent (these are often the first order transmitters) have made it worse and resulted in a longer lockdown period needed than would otherwise be the case.

The Japanese managed better because they were draconian in their measures at the outset. They were mocked then but not anymore. This lockdown helps curtail our major cities from having multiplying case counts like NYC has right now - time will tell if we acted swiftly enough.

This is exactly what is happening in UK. Boris Johnson did not want to lockdown anything, even kept the school open. But slowly the daily death and infection rate is forcing his hand. One by one everything is getting closed.

Last week on a bright day, people went out and about. Now there is furious call to lockdown the entire country, as people as not taking the issue seriously.

Yeah, I mean which world are the folks arguing against this as being "too early" in? Ideally you want it stopped earlier. That's how the math works. What's the point of doing these sort of things late. You want it stopped before it goes massive.

As Dean's has eloquently put it, I only see upside from containing this crisis. Already many folks abroad are looking surprised at India's numbers unable to believe we have low Tx rates. If somehow, we contain this at a low level, India's economy and standing will both advance by leaps and bounds, not to mention puncture the years of propaganda against this GOI. That has economic ramifications too.

[Gyan]

India is largest producer of chloroquine. Its 130 rupees a blister pack. But dont use with out doctor prescription.

Chloroquine is Rs. 10 a pack and Hydroxychloroquine is Rs. 100 a pack. Uber cheap.

[Karan M]

Genius. Just plain genius. I didn't think of this at all.

Depends on wash sale rules. In the US the rule prevents selling at a loss and buying back 'substantially the same security' within the next 30 days and reporting that loss for tax purposes. However, given the circumstances, the US may suspend wash sale rules this year. I don't know if India has such rules. I assume not, in which case booking a loss for tax purposes is a smart tactic.

I don't think we have that here. We do have a limit set on "when you buy it" i.e. you can't offset losses from an asset purchased 3 months earlier.

I am guessing the markets will remain roiled for around 2-3 months at least. I will need that much time, given the shut down, and the fact my demat account went inactive due to lack of trading the whole year and then selling and buying each unit back is a painstaking exercise.

[Gyan]

India is largest producer of chloroquine. Its 130 rupees a blister pack. But dont use with out doctor prescription.

Right, from what I read it is toxic so it can't be used as a preventative. But once you are infected this medication works.

Chloroquine is not toxic in prescribed dose. Guess who is fear mongering? Why?

Quinine has been taken as prophylaxis to malaria for 200+ years by 10s of millions of people every year.

Rather than fuxking up the economy, use of Chloroquine as prophylaxis should be increased, if it works that is.

For USD 100 Million, entire Indian population can be put on prophylaxis for 2 months (though I am not recommending this). One should use it for high risk and potentially infected persons as prophylaxis immediately

Even for malaria, medicine is normally given on clinical diagnosis, way before tests come back +Ive

[Garooda]

Garooda - if you think the information is accurately transcribed and can help Indian doctors, then post.

Thanks Karan. Let me check with the Doc friend to see if he can point me to a valid source that I can post.

[Mollick.R]

First Biocon MD Mrs. Kiran Mazumdar Shaw highlighted this on 21st March.....

Next we get to see that IISC -Bangalore is working on solution of same problem on 22st March.....

& Today (circular is dated 24th March though) see another GOI entity (BHEL a PSU) is involved on same .......

BHEL does have some niche electronics manufacturing/assembling (mostly control systems (C&I) related with of power plants and industry) capacity in it's EDN Bangalore plant.

The result of this effort will be bear fruit or not only time can tell, but one must laud the swiftness and agility with which decisions are taken to evaluate possibilities.

[Karan M]

Gyan - can we please leave this to the ICMR? They have the data on whom this treatment is working for, and whom its not working for.

And "prophylaxis" sounds very tempting, until and unless we realize it can also lead to the mass development of chloroquin resistant malaria and cross-sensitivity means other resistant strains of microorganisms may also develop.

Right, from what I read it is toxic so it can't be used as a preventative. But once you are infected this medication works.

Chloroquine is not toxic in prescribed dose. Guess who is fear mongering? Why?

Quinine has been taken as prophylaxis to malaria for 200+ years by 10s of millions of people every year.

Rather than fuxking up the economy, use of Chloroquine as prophylaxis should be increased, if it works that is.

For USD 100 Million, entire Indian population can be put on prophylaxis for 2 months (though I am not recommending this). One should high risk and potentially infected persons on prophylaxis.

Even for malaria, medicine is normally given on clinical diagnosis, way before tests come back +Ive

[Mollick.R]

Bengaluru based Skanray starts work on new ventilator design that would speed up production locally

BY , ET BUREAU | MAR 23, 2020, 12.12 PM IST

MUMBAI: Skanray, the Bangalore based exporter of ventilators is drawing plans to locally assemble nearly 1 lakh ventilators in the country as India prepares to gear up its emergency situation in an event of the large number of critically ill covid-19 patients.

Skanray is working out the design with Defence Research and Development (DRDO) Niti Ayog, Director Health Services and Karnataka
government. The company said it has received financial and technical commitment from philanthropist Sudha Murthy, Biocon founder
Kiran Mazumdar Shaw and Dr Devi Shetty of NH Hospitals. The company is also speaking to other manufacturers to share their design,
this it said it is doing because of the emergency need of the equipments.

On Sunday evening, Chairman of Mahindra and Mahindra also said in a tweet on that the company will start work on developing
ventilators.

Last week ET reported that ET has shortage of ventilators as new critical components from Europe was not coming through because of
shutdowns and airline ban. The company’s 350 odd R&D team has been reshuffled to start the work on manufacturing the machines
suitable to the epidemic model. “We have started the process and by May (the time when we think that the epidemic will see rise in
critical cases) we should be ready to deliver the orders. We are looking at a model that has low dependent on imports”, said
Vishwaprasad Alva, MD Skanray to ET. Mr Alva said that the company requires Rs 400 crore to initiate its manufacturing process, which
it said the philanthropists and medical experts will help the company secure. “The above corporates have told us that they can help
speed up the activity of the manufacturing once we get an order. They will look at order inflow and provide working capital or help secure
credit line”, added.

In India, more than 1 lakh and fourteen thousand have been screened for Covid-19 and over 14 thousand have been tested. On Sunday
the number of positive patients was 283, out of which 24 had recovered and five deaths.
If the number of critical cases goes up, India’s capacity to handle those who need respiratory support will be stretched. Estimates
according to local manufacturers suggest that there are about 30,000 ventilators in India — every state has a different number.
Skanray says to speed up the production, the government has to airlift certain components that is stuck in other countries, this will save
20 days of the production time by cutting the time taken for customs clearances.

https://economictimes.indiatimes.com/in ... s?from=mdr

[Mollick.R]

Bengaluru-based Skanray aims to make 1 lakh ventilators, opens up design IP

Updated : March 23, 2020 09:44 PM IST

#Skanray Technologies is ramping up production of ventilators.
#To do that, it is sourcing components from other industries.
#It has also opened up its design IP for others to copy.

s India prepares to deal with the fast-spreading COVID-19 epidemic in the country, Bengaluru-based ventilator exporter Skanray Technologies has ramped up its capacities to support the requirement of the critical care equipment.

The company plans to utilise the network of component suppliers & local manufacturers to ramp up production to 1 lakh in 2-3 months time.

“The idea is to share the design and certain critical components with other companies, which can locally manufacture these ventilators quickly. We are opening up our design IP,” Vishwaprasad Alva, Founder and Managing Director of Skanray Technologies told CNBC-TV18.

Skanray is working with government's think-tank Niti Aayog, the Defence Research and Development Organisation (DRDO), Director General of Health Services and the government of Karnataka on design and supply of locally-sourced components.

The DRDO, in particular, is helping Skanray find equivalent components from other industries. DRDO will help source local components from aeronautical, entertainment and auto industry that can be used in ventilators with a few design changes.

“This is the only way to overcome the shortage. There are components like flow and volume censors that are used in aeronautical industry, which can be used in ventilators too. We just need to alter the design and check for safety,” Alva said.

The company plans to manufacture 1 lakh locally-assembled ventilators in the next two-three months. The company currently has the capacity to manufacture 200 units, and is planning to gradually scale up to make 5,000 units in a month’s time before ramping it up to 30,000 and then to 1 lakh.


Healthcare experts say India could need 1,00,000 ventilators depending on how the COVID-19 epidemic spreads across the country. The SARS-CoV-2, the virus that causes the COVID-19 disease, affects both upper and lower respiratory tract and critical patients require ventilator support.

The government of Karnataka has placed an order for 1,100 ventilators with Skanray.

The company says orders for 7000 more ventilators are in the final stages from state governments of Maharashtra, Andhra Pradesh, Kerala, Tamil Nadu. We will be finalising these orders in a few days, Alva said.

The central government has yet not placed any orders with any company as yet.

“The government should consolidate its requirements quickly and place the orders, so we have a clear understanding of what the government wants and we can plan accordingly.”

Skanray has already manufactured one model with lower import content and the redesign was drawn in just 15 days, he added.

The critical components needed for medical devices sector has seen a sharp rise in demand.

However, components for other industries are in good supply and that situation can be utilised in favour of critical equipment manufacture in India.

Currently, no company manufactures 100 percent indigenous ventilators in India. Most companies either import, assemble or partially produce it with components sourced from Europe, US and China.

But this supply has been hampered with the countries restricting critical exports owing to the COVID-19 pandemic.

Other companies like Vadodara-based Max Ventilators and Air Liquide manufacture partially. The rest either import or assemble ventilators in India.

GE Healthcare and Philips import ventilators and other critical care equipment from their global manufacturing hubs.

The government is in talks with all manufacturers to ramp up capacities and collaborate on design elements that can be locally produced.

Skanray makes compressor-based ventilators, which the company says will be optimum for use for care for critical COVID-19 patients. The cost ranges from Rs 5 lakh to 12 lakh.


https://www.cnbctv18.com/healthcare/ben ... 540741.htm

[evm]

Guys.. i am a general physician. And let me tell u what chloroquine does. It decreased the binding of coronavirus to human cells in lab by 10%. Nowhere sufficient to prevent infection. And nobody knows if this action is still present outside the lab. There are some other minor actions which decreased viral load slightly, but demonstarted only in lab.
Coming to toxicity.. for malaria treatment, we just give it for 3 days. Even prophylactic dose for malaria is far less than what they have been suggesting for coronavirus prophylaxis. At that does, when taken with other drugs such as azithromycin, commonly used for pnemonia, will cause heart rythm abnormality and sudden death. This has already happened. So, just forget about this chloroquine. What Modi did today is absolutely needed and is the only option. Any doctor would suggest the same.

[ramana]

Welcome Dr. EVm.

Thanks for the specific input. I hope you get to post more as you joined now!!!
ramana

[evm]

Thank you ramana sir. My name is uday. I just used my brother's account as i dont have an account on BRF. I will create one for myself and post more.

[ramana]

Thanks, Dr. Uday, We do have a few hakims from India, UK, and US here.
When you login put Dr Uday as user id so we don't lose you.

And tell us you have registered here so we can activate the account pronto.

[chanakya_neeti]

https://twitter.com/centerofright/statu ... 43520?s=20

https://twitter.com/Iyervval/status/124 ... 55649?s=20

https://www.biorxiv.org/content/10.1101 ... 1.full.pdf

[Neela]

https://twitter.com/centerofright/statu ... 43520?s=20

https://twitter.com/Iyervval/status/124 ... 55649?s=20

https://www.biorxiv.org/content/10.1101 ... 1.full.pdf

Can someone translate this for engineers? I did read Abhijit"s translation and didnt get it.

[evm]

I know about the maps.. apparently they were made to show that places with more malaria, had less deaths from coronavirus. They wanted to tell that chloroquine, used for malaria had a preventive effect on covid. Which is absolutely false. When was the last time anybody in these countries had taken chloroquine. And how long is that going to stay in the body. May be a week. I can show atleast a 10 differences between the 2 maps like temperature, diet etc. Unless the causality is proved, nothing can be established.

[evm]

Ramana sir, i just created an id with username dr.uday. please activate my account.

[Mort Walker]

Welcome Dr. Uday!

Do you have any comments on the treatment of the Italians in RJ? They were claimed to be cured with the use of Chloroquine and other drugs.

[sanjaykumar]

^^Please see my comment above.

Short RNA sequences when bound to complementary sequences in the viral genome can activate enzymes that degrade the viral RNA. This group reports a wuhan virus mutation that is a target for such a silencing human RNA. Meaning that it should now cause the activation of endonuclease enzymes to break down the viral genome.

I would ask how widespread is this strain of virus in India and how stable is this particular mutation. Further if it is evolutionarily maladaptive, there is strong selection pressure to select against it. That is this strain does not get to reproduce much.

[anmol]

Trump is right about the coronavirus. The WHO is wrong,' says Israeli expert | haaretz.com

By Oded Carmeli Mar 21, 2020

Dr. Dan Yamin has developed models for predicting the spread of infectious diseases, and helped curb the Ebola epidemic. He says the coronavirus could take some 13,000 lives in Israel – but there's cause for optimism

“The virus spreads in a geometric progression,” Benjamin Netanyahu declared last week, going on to explain to the lay public what that means: “One person infects two people. Each of them infects two more. The four infect eight, the eight infect 16, the 16 infect 32, the 32 infect 64, the 64 infect 128 – and so on and so forth.”According to the prime minister’s logic, 100 percent of the Israeli population will become carriers of the coronavirus within a short time. On the other hand, according to that same logic, 100 percent of the population will also come into contact with each other within a short time. Is this really the situation?Haaretz Weekly Ep. 70Haaretz “We do not move about in space like particles,” says Dan Yamin, of Tel Aviv University’s industrial engineering department. “Try to remember what you did yesterday. Even without all the social distancing measures, you probably would have met the same people you met today. We move across networks of social contact. So, from a certain stage, it will be difficult to infect even those who bear a potential for becoming infected, because the carriers don’t wander around looking for new people to infect.”

Dr. Yamin is an engineer, not a physician. But in 2008, when he was a graduate student at Ben-Gurion University in Be’er Sheva, a certain research study caught his eye.

“It was an analysis of a dynamic model for the spread of smallpox,” Yamin, 38, says. “The researchers used tools from game theory. It was so interesting that I decided to conduct a similar study on influenza – which turned into a doctoral thesis on disease-spread models.

“If, 40 or 50 years ago, epidemiology researchers came exclusively from the field of medicine, today we understand that in order to predict the spread of diseases, it’s also necessary to understand how humans behave as a collective, to be able to analyze big data and to have the ability to create models and perform mathematical simulations – and for that you need engineers.”

Yamin encountered his first real epidemiological crisis while doing postdoctoral work at the the Center of Infectious Disease Modeling and Analysis at Yale University’s school of public health.

“At Yale we worked for three weeks, with almost no sleep, to create models based on engineering tools for the spread of Ebola. The dilemma of the Liberian health ministry regarded whom to prioritize, given a serious shortage of isolation facilities. The Liberians assumed that it would make more sense to quarantine those who were ill with less serious symptoms, because the others could not be saved in any case.

“We showed that it was precisely the patients with the most acute symptoms who are the most infectious, both because of the high viral load [meaning, the amount of a virus in one’s body] and also because of the increase in the number of encounters between people: The acute patients were dying, so everyone came to take their leave from them,” Yamin says. “I was pleased that Liberia adopted our recommendations and isolated those who were seriously ill. In retrospect, we know that that new policy helped curb the epidemic.”Yamin currently heads the Laboratory for Epidemic Modeling and Analysis in TAU’s engineering faculty. His primary field of work is development of models for the spread of infectious diseases, with an emphasis on viruses responsible for respiratory ailments, such as flu and RSV (respiratory syncytial virus), which causes bronchitis. He is actually somewhat optimistic about the models he has developed for the spread of the coronavirus, which is also a respiratory disease.

“The big, open question is what the chance is of dying from the virus,” Yamin explains.

“When you ask epidemiologists what the most important datum is concerning a virus, they will say it’s the rate of the basic reproductive ratio, or R0 [often called “R nought”] – the average number of people a sick person will infect. That’s an interesting question, but a theoretical one.

“The R0 of measles is 12, meaning that each person who is ill with measles infects 12 people on average. However, only 5 percent of the population can actually be infected, because most of us have been immunized or had measles in the past. So that is the upper limit of its spread.”But we know that the R0 of the coronavirus is 2, and we still don’t know whether anyone is naturally immune to the disease.

Yamin: “The overwhelming majority of people are apparently not immune, because it’s not a common disease. After all, there is no precedent for such an infectious and violent type of virus from the corona family, so it’s safe to assume that the majority has not been exposed to the virus before this and that they can be infected. However, that’s not to say that the majority of the population will actually contract the disease.

“The basic principle is that a virus with an R0 of 2 in a non-immune population can be expected to infect 50 percent of the population. After that the R0 will reach a value of 1 or less, and the disease will be contained. By the way, it will recede in a converging exponential; in other words, the coronavirus can be expected to disappear from this region with the same dizzying speed with which it entered our lives.”But we don’t know for certain whether a person can be infected twice.

“No, but with the majority of viruses, if you’re infected and you have recovered, you won’t be re-infected, because of immunological memory. And if you are infected again, the symptoms will be less acute the second time. The exception to the rule is influenza: Its mutation frequency is so high that you can be infected by it year after year. Last year alone, the flu underwent 17 mutations. Whereas the last time we heard about corona was 17 years ago, with SARS. In other words, the coronavirus did not undergo mutations at the same frequency as the flu. Of course, the mutations themselves are a function of the number of infections: The more infections there are, the greater the likelihood that mutations will occur. But in practice, the most rapid mutations occur in animals, and they only infect us then, and obviously it’s less probable that we will be infected again by a bat in the near future.

“By the way, viral mutations are more frequent in bats, whose immune system is astonishingly weak, while their social network is extensive and characterized by a lot of interaction.”So we’re talking about maximum rate of infection – that is, of becoming a carrier – of 50 percent. That’s still a lot of patients, a lot of hospitalizations and mainly a lot of deaths.“Again, the most interesting issue for decision makers is the mortality rate. When we look at the dry data, we see a very high mortality rate, of 4 to 7 percent, in countries like Italy and Spain, alongside far lower numbers in countries like Germany and South Korea.

“And then there’s China, though it’s very difficult to believe the numbers coming out of there – and in any event no country in the West can allow itself to adopt the measures that China adopted to contain the spread. Now ask yourself: How do you check the mortality rate in all those countries? You take the total number of deaths and divide it by the total of reported patients.”So the research is biased.

“Very biased. If I can only carry out few tests, I will test those who have the highest chance of becoming ill, and then, when I check the mortality rate among them, I will get very high numbers. But there is one country we can learn from: South Korea. South Korea has been coping with corona for a long time, more than most Western countries, and they lead in the number of tests per capita. Therefore, the official mortality rate there is 0.9 percent. But even in South Korea, not all the infected were tested – most have very mild symptoms.

“The actual number of people who are sick with the virus in South Korea is at least double what’s being reported, so the chance of dying is at least twice as low, standing at about 0.45 percent – very far from the World Health Organization’s [global mortality] figure of 3.4 percent. And that’s already a reason for cautious optimism.”‘Worst-case scenario’Let’s move from percents to people.

“Just a minute. Although we’re both Westernized countries, we are absolutely not South Korea. South Korea has one of the highest proportions of elderly people in the world, whereas Israel tops the graph in fertility, and we have a very young population. So, if we use the upper limit [of mortality] of South Korea and normalize the mortality rate for the population in Israel, we are talking about the probability of a mortality rate of 0.3 percent among those who have been infected.

“Now we’ll go to a severe scenario in which no one is immune and every second person is sick, so that the disease is incapable of spreading further – namely, a situation where there’s a maximum infection rate of 50 percent.

“We are a country of nine million citizens. So in the worst-case scenario, we are talking about 4.5 million Israelis who will become ill with the coronavirus. Multiply 4.5 million by 0.3 percent and you get 13,500 Israelis who are liable to die from the disease. By comparison, 700 to 2,500 Israelis die every year of complications from other respiratory ailments.”But German Chancellor Angela Merkel talked about a rate of infection of 70 percent in Germany.“And Netanyahu talked about a mortality rate of between 2 percent and 4 percent. And do you know what’s most absurd? That in the final analysis [U.S. President Donald] Trump was right. Not that the coronavirus is just plain flu – it absolutely isn’t – but as he put it: ‘This is just my hunch – way under 1 percent’ [will die].’

“We must be cautious, of course, but at the moment a high probability is emerging that the risks are far lower than what the World Health Organization presented. Under two assumptions – that the health system doesn’t collapse and that life continues as usual – we are not likely to see more than 13,500 victims of the coronavirus in Israel.” (About 45,000 people die in Israel in a normal year, which would make for a rise of approximately one-third.)But, social distancing should lead to fewer cases of infection and death, no?

“No, because we won’t be able to isolate ourselves completely or forever. At some stage, we will have to resume a regular routine, and then the R0 will stabilize at 2 again. Effectively, we are delaying the inevitable. I have no criticism of the decisions made until now. On the contrary: With such a large area of uncertainty, Israel’s decision makers are considering not only a reasonable scenario but also a margin of safety.

“In my opinion, the Health Ministry deserves tremendous credit for being ahead of the world by having instituted no few measures. In the same breath, the public needs to understand that these measures of social distancing mean that we will find ourselves with corona for a longer period, even to 2023.”That long?

“Take the swine flu, from 2009. Reliable models show clearly that it was contained in Israel because its appearance coincided with the Jewish holidays in the fall [when people weren’t out much in public]. From the virus’ point of view, the timing wasn’t good for it in Israel. By contrast, in the United States there was significant infection in 2009-2010. But in the end, it balances out. So we saw swine flu in Israel both in 2009-10 and in 2010-11, whereas in the United States it just came and went. The American population as a whole was exposed to the virus at high rates, so those who fell ill and recovered served as a ‘human shield’ for those who did not get sick.”So what you’re saying is to tear the bandage off in one fell swoop, and explose everyone at once, the way they tried to do in Britain.

“We need to make decisions based on the most precise models possible. What should be done? Of course, we must significantly increase testing, using the rapid PCR test, and that is what is actually being done. In parallel, serologic tests should be conducted. These differ from regular tests in that they examines an individual’s immunological reaction to exposure. That’s the only way we will be able to get an accurate picture of the distribution of the virus in Israel, and thereby also of the mortality rates.”What will that test be able to tell us?

“It will solve the riddle of the young people: It’s still not clear whether young people are infected by the coronavirus but don’t develop symptoms, or are simply immune and thus don’t become infected. This is different from most respiratory ailments. With those illnesses, like RSV or flu, this is a key population: The 5-to-19 age group is not at risk but they are responsible for infecting others.”Because children don’t wash their hands, and they drool on themselves?

“It’s not only a function of hygiene, it’s mainly a function of contact between people. Picture the average old person. How many different people does he encounter in a day? And what is the nature of those encounters? The older we get, the less we caress and kiss others. Also, children constitute the only age group that comes into contact with all other age groups – not just theirs. That’s why it is the key population in spreading respiratory diseases.”As soon as we know whether children infect others with corona, we will know whether the schools can be opened.

“Yes. And there are also other potential pockets of infectiousness that can be isolated on a specific basis. In a study based on cellphone data that we conducted in Israel recently on contact networks of flu, we found two locales that are more ‘responsible’ than their relative proportion of the population should be for spreading infectious diseases: Tel Aviv and Petah Tikva.

“Regarding Tel Aviv it’s clear. It’s the hub. A million Israelis enter the city [on a normal] day. The Tel Avivians are like Saudi sheikhs – they just wait for people to come to them. Whereas Petah Tikva is the exact opposite: Everyone flees. But seriously, Petah Tikva is a very diversified city socioeconomically, with a rich mosaic of ultra-Orthodox. Orthodox, secular, poor, rich. That’s what makes it, together with Tel Aviv, a focal point for the spread of respiratory ailments: Petah Tikvans encounter everyone. Whereas, in most places, people tend to meet up with people who are like themselves. I myself live in Ramat Gan. My neighbors are from [the mostly ultra-Orthodox city of] Bnei Brak, but it’s not reasonable to assume that I will be infected by them. [Yamin is not Haredi.] We saw cases of measles [in 2019] in Bnei Brak and Brooklyn of a sort that did not get to Ramat Gan. On the map of viruses, Bnei Brak is closer to Brooklyn than Ramat Gan. So, with a high probability, we can say that our situation is not good – but it’s not apocalyptic.”

[evm]

Thank you sir.
I really dont understand why they(media) are using the term 'cured ' here. It will anyway get cured by itself unless the patient dies. Only thing we need to see is, if the patient is getting less sick, has the duration of ventilator requirement reduced, duration of hospitaly stay is reduced, or the mortality rate is less in the treated group. Lopinavir- ritonavir, chloroquine, remedesvir all were tried in limited number of patients on trial basis not just India but china, UK, italy. No drug showed stasticial proven benefit. Even the apparent benefit is not significant enough. My guess is that the RJ patient just recovered by supportive treatment alone.

[Suraj]

It's heartening to see how the industry - both public sector entities like BHEL and private sector - is rallying to the cause, identifying who has capacity, and immediately arranging to ramp up production and distribution. The common citizenry as well, needs to coordinate distribution efforts for masks and other basic protective equipment. Ideally all of this production should be tax exempt. Production rate for masks and gloves needs to be ramped up orders of magnitude to ensure they can be replaced per use or every N hours as guidelines indicate.

Now is NOT the time to emphasize any negative attributes of Indians. It's the time to coordinate and arrange.

[shaun]

Lock down will always bring trouble and hardships to our daily life , but the most important thing for all citizen is basci needs , i.e. how to keep running the kitchen and that can be achieved by tweaking the existing e commerce platform in India. Govt can tie up with this e commerce sites to deliver the most basic food needed for a healthy survival. A list can be prepared and only items listed should be available in their portals . These e commerce sites should be suplimented by PDS having all the listed items . A part from delivery agents of e commerce sites , people from post office and govt and private agencies who are into mail and delivery services should be roped in. DBT scheme for daily wagers is a must.

[evm]

I am not emphasizing any negative attributes of Indians. Just of media. In every country. This hype of creating a cure of the virus has been going on in every country and is getting proved wrong. Indian doctors have not claimed they found a cure. The media did. Many of my physician friends are part of these trials in US and UK and i have first hand info. So wanted to share. These reports of cures are giving a sense of false hope to people. Donot expect any drug or vaccine in next few months. Social distancing is the only way.

[evm]

And dont believe, the infection rate and fatality rate figures of europe. The infection rates are much higher and the fatality rates lower. My friend is ENT surgeon in London. His hospital had a patient with covid initially and every doctor in the department got infected later from one another including my friend. Only 2 doctors were tested and rest everyone was asked to go home without testing. These cases dont even figure in actual numbers as they are not tested. My friend had moderate fever and bodyaches for a week and is absolutely fine now. This is the case with all of his friends there. According to him, the situation is not that scary unless the patient is suffering from some other chronic disease. But it is scary from the 'economy' perspective.

[JTull]

https://twitter.com/centerofright/statu ... 43520?s=20

https://twitter.com/Iyervval/status/124 ... 55649?s=20

https://www.biorxiv.org/content/10.1101 ... 1.full.pdf

Corona virus has entered India thru travellers from Italy, Spain, UK and USA.

If it is virulent in all these places, there's absolutely no evidence that it counter that it won't be virulent here. People like Iyervval claim to be experts in game theory, thermoclines, pandemics, and everything under the Sun. Let's not lower the discourse here by giving credence to these articles.

[evm]

If there are any virologists on this group, i have a question. Do the seasonal coronaviruses and this covid19 have shared epitopes on the surface proteins? Because antibodies to these shared epitopes may confer some immunity against covid19. It may be especially be useful in our country where we regularly suffer from bouts of cold the entire year.

[evm]

https://twitter.com/centerofright/statu ... 43520?s=20

https://twitter.com/Iyervval/status/124 ... 55649?s=20

https://www.biorxiv.org/content/10.1101 ... 1.full.pdf

Corona virus has entered India thru travellers from Italy, Spain, UK and USA.

If it is virulent in all these places, there's absolutely no evidence that it counter that it won't be virulent here. People like Iyervval claim to be experts in game theory, thermoclines, pandemics, and everything under the Sun. Let's not lower the discourse here by giving credence to these articles.

Abaoulutely. There is no chatter anywhere that the virus has mutated after wuhan happened. This is wishful thinking by iyyerval.

[sanjaykumar]

?? There is much data on the sequences-of course mutations are evident, as would be expected for viruses especially RNA viruses. These mutations are related to replication fidelity rather than UV, chemical etc mutagenesis. Consider that it has been 3 or 4 months since the first cases. The virus must be dozens of generations old for some new infections.

Anyway I hope this on epitope prediction helps answer the other point.

https://www.sciencedirect.com/science/a ... 6414002330

An overview of bioinformatics tools for epitope prediction: Implications on vaccine development

[Aarvee]

If there are any virologists on this group, i have a question. Do the seasonal coronaviruses and this covid19 have shared epitopes on the surface proteins? Because antibodies to these shared epitopes may confer some immunity against covid19. It may be especially be useful in our country where we regularly suffer from bouts of cold the entire year.

from: https://wwwnc.cdc.gov/eid/article/25/10/19-0051_article

The first challenge is that 90% of the human population have antibodies against common cold–causing human coronaviruses (HCoVs) that could cross-react, resulting in false positives in serologic assays, especially in persons infected with viruses belonging to the same genus of β-coronaviruses as human seasonal coronaviruses OC43 and HKU1 (26). The spike protein, specifically its N-terminal S1 domain, is highly immunogenic and divergent among HCoVs, so it is an ideal candidate for virus-specific serologic assays

I have not come across published literature that compares epitopes of the wuhan strain and seasonal strains yet Sir. There was some talk about using plasma from recovered patients as a therapeutic option.


From: https://science.sciencemag.org/content/300/5624/1394
Characterization of a Novel Coronavirus Associated with Severe Acute Respiratory Syndrome

Although overall sequence conservation is low (Fig. 2B), the predicted E, M, and N proteins of SARS-CoV contain conserved motifs that are found in other coronaviruses. Consistent with the E proteins of other coronaviruses, the predicted E protein of SARS-CoV contains a hydrophobic domain (residues 12 to 37) flanked by charged residues and followed by a cysteine-rich region. The N-terminal domains of coronavirus M proteins are exposed on the viral surface, whereas the C terminus is inside the viral membrane. Most coronavirus M proteins, including the predicted M protein of SARS-CoV, contain three hydrophobic transmembrane domains in the N-terminal half of the protein, although some viruses have four. A highly conserved amino acid sequence [SwWSFNPE (26)], immediately following the third hydrophobic domain, is SMWSFNPE in the SARS-CoV M protein. The M proteins of coronaviruses are invariably glycosylated near the N terminus. Group 1 and group 3 coronaviruses are N-glycosylated, whereas those of group 2 viruses are O-glycosylated (27, 28). The predicted M protein of SARS-CoV has an NGT near its N terminus, suggesting that this protein is N-glycosylated at position 4.

The predicted N protein of SARS-CoV is a highly charged basic protein of 422 amino acids (range for other coronaviruses, 377 to 454) with seven successive hydrophobic residues near the middle of the protein. Although the overall amino acid sequence homology among coronavirus N proteins is low (Fig. 2B), a highly conserved motif [FYYL-GTGP (26)] occurs in the N-terminal half of all coronavirus N proteins, including that of SARS-CoV. Other conserved residues occur near this highly conserved motif (fig. S3).

Basically, there are some highly conserved epitopes in the spike proteins. But are the spike proteins from the wuhan strain cross reacting with antibodies from older corona strains, not sure.

Some additional papers for whoever is interested.

Evaluation of Serologic and Antigenic Relationships Between Middle Eastern Respiratory Syndrome Coronavirus and Other Coronaviruses to Develop Vaccine Platforms for the Rapid Response to Emerging Coronaviruses
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952667/

Microbiologic Characteristics, Serologic Responses, and Clinical Manifestations in Severe Acute Respiratory Syndrome, Taiwan
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3016775/

[ramana]

Dr,Uday Your account is activated.
Welcome.

[ramana]

Dr Uday, Sanjay and other hakims,
Please read this and decode it.

https://www.biorxiv.org/content/10.1101 ... 1.full.pdf

[SriKumar]

the 21-day lock down....is there a provision for an open timeslot for people to buy vegetables/rice and medicines? Will medical shops be open during this time duration? expecting to prepare for 21 days in 1 day is untenable. Has lockdown started already?

[sanjaykumar]

Ramana, that is the paper referenced earlier. Also Abhijit Mitra-Iyer tweeted it but I fear he got his hopes high without good reason.

[Bart S]

the 21-day lock down....is there a provision for an open timeslot for people to buy vegetables/rice and medicines? Will medical shops be open during this time duration? expecting to prepare for 21 days in 1 day is untenable. Has lockdown started already?

Yes to all.

Keep in mind that Sec 144 is different from a curfew. Curfew has been applied only in some states like Punjab. For the rest you can still go out, but alone and just to get basic essentials or for emergencies. Though I think that it will take a few days for the process to get debugged and you can expect a few hassles if you are unlucky. You don't need to rush out to buy 21 day stock, if anything it will get easier to buy things after a few days of the lockdown once the panic and confusion settles down a bit.

[Bart S]

Lock down will always bring trouble and hardships to our daily life , but the most important thing for all citizen is basci needs , i.e. how to keep running the kitchen and that can be achieved by tweaking the existing e commerce platform in India. Govt can tie up with this e commerce sites to deliver the most basic food needed for a healthy survival. A list can be prepared and only items listed should be available in their portals . These e commerce sites should be suplimented by PDS having all the listed items . A part from delivery agents of e commerce sites , people from post office and govt and private agencies who are into mail and delivery services should be roped in. DBT scheme for daily wagers is a must.

Well, at the moment the exact opposite has happened. Due to ham headed state govt officials, despite the order clearly stating that ecomerce will be allowed (in some states like TN, both on the earlier state govt order and now the central govt one) Amazon and Big Basket operations have been stopped as have Zomato, Swiggy etc. And despite the statement that movement of goods are allowed and only movement of people are restricted, most logistics trucks are stopped and queued up at state borders.

Apart from making things difficult for common people, this is also handicapping critical industries that need to run to meet needs.

Govts at all levels need to get their act together and clean up this mess soon.

[SriKumar]

the 21-day lock down....is there a provision for an open timeslot for people to buy vegetables/rice and medicines? Will medical shops be open during this time duration? expecting to prepare for 21 days in 1 day is untenable. Has lockdown started already?

Yes to all.

Keep in mind that Sec 144 is different from a curfew. Curfew has been applied only in some states like Punjab. For the rest you can still go out, but alone and just to get basic essentials or for emergencies. Though I think that it will take a few days for the process to get debugged and you can expect a few hassles if you are unlucky. You don't need to rush out to buy 21 day stock, if anything it will get easier to buy things after a few days of the lockdown once the panic and confusion settles down a bit.

Thanks saar... So this is a section 144 then, but more restricted