Wuhan Coronavirus Resource Thread

saip · Post by **saip** » 25 Aug 2020 00:30

About the Oxymeter, I am not sure what instrument was used. This was purchased in Nellore. I normally advise them to calibrate it by checking it on themselves. I bought one (on Amazon India delivered to them in HYD) to be used for Mil but that was in HYD. My MiL's OX levels were low, around 80. But I had them check their own levels and they came out normal like > 98. So the meter seems to be OK. There is a third reading these meters are giving the PI% or the strength of th pulse. In my MiL's case it is very low like <1%. I am really shocked at the rapidity of the onset of this infection. Allowing people to gather in such large numbers and not enforcing C19 protocols is really sad. Andhrs seems to have overtaken MH in new cases. AP CM seems to one of the idiots who has dropped the ball.

Ashokk · Post by **Ashokk** » 25 Aug 2020 14:59

India inches closer to the beginning of the end of COVID-19 pandemic

Following India’s assiduous fight against the rapidly evolving COVID-19 pandemic since the past six months, the country finally sees signs of green shoots with the faster recoveries and sharp decline of new cases. Tracking the coronavirus pandemic in India for the past several months, Times Fact-India Outbreak Report, released its latest projections and highlights that India is projected to peak with 7.87 lakh active cases on September 02 according to most likely scenario, after which the curve may hit a plateau till September 16, following which the cases are projected to show a steady decline. The report shows that following India's peak, daily active case counts are projected to decline by November 17.

Showing positive signs of flattening the COVID-19 curve, the report indicates that a continued vigilance to practise social distancing and safety measures will be critical to stabilize and control the pandemic and in achieving India’s recovery from COVID-19.

Times Fact-India Outbreak Report: Key takeaways

R0 for India is slowly going down to 1.55 from 1.63 in last 20 days. The growth rate of India has come down to 2.5%. The recovery rate has gone up to 74%. However, there are still huge number of cases being reported daily (65K - 70K) cases per day.
The net new additions (Confirmed – Recovered) cases have come down from 16,000 per day to 10,000 per day.
The report adds projections for 17 new cities and districts including Madurai, East Godavari, Patna, Thiruvananthapuram, Srinagar amongst others. With the major cities displaying consistency in slowing the rates of daily COVID-19 cases, the focus has turned to the smaller cities. A substantial chunk of India's latest cases is now being recorded in India's Tier-2 and Tier-3 cities.
All the major states are beginning to peak in and around first 15 days of September with R0 close to are below 1.5
Cases of Karnataka, Bihar and Andhra Pradesh have been growing rapidly with 12, 12 and 14 days doubling time respectively.
Most of the states has been able to keep the growth in control and a lot of the urban areas have seen the peak (Delhi, Mumbai, Pune, Thane, Chennai etc.).
Growth rates for Maharashtra, Tamil Nadu, Telangana, Gujarat, West Bengal, Delhi, Madhya Pradesh and Haryana has significantly come down below 3% (7 Days Average).
There are high growth states Andhra Pradesh (AP) and Odisha (OD) where the growth rate is in 7% - 10% and the doubling rate hovering around 6 -7 days.

Times Fact-India Outbreak Report: State and City Wise Projections

saip · Post by **saip** » 25 Aug 2020 18:53

Anyone know quarantine rules for International Passengers reaching DELHI then HYDERABAD from USA?
Just got the news that my Sister In Laws's husband passed away. Symptoms to end just 6 days. He was 63 but diabetic.
TIA

vijayk · Post by **vijayk** » 25 Aug 2020 19:16

saip wrote:Anyone know quarantine rules for International Passengers reaching DELHI then HYDERABAD from USA?
Just got the news that my Sister In Laws's husband passed away. Symptoms to end just 6 days. He was 63 but diabetic.
TIA

So sorry to hear. Condolences to the family.

https://blog.wego.com/hyderabad-quarant ... acilities/

Quarantine rules in Hyderabad
While the quarantine and testing rules for domestic travelers vary from state to state, for international travelers, it remains the same mostly. So, as per the guidelines of the Ministry of Home Affairs, all international passengers landing at the GHIAL (GMR Hyderabad International Airport Ltd.) managed airport must go into obligatory seven-day institutional quarantine. A week-long home quarantine with self-monitoring should ensue next. Passengers have to bear the cost of the institutional quarantine and before confirming their flight booking, they would also need to sign an undertaking for the same.

Passengers will be allowed to check-in to their choice of institutional quarantine center only after thermal screening at the airport by the Airport Health Official (APHO). If passengers are symptomatic, health authorities would decide what quarantine and testing requirements are to be followed next. Although the state has not specified quarantine mandates for domestic flyers, they are advised to be in home quarantine for two weeks post their journe

Who can be exempted from institutional quarantine?
The ministry gives allowance to certain categories of travelers to break loose from the mandatory institutional quarantine. But only compelling reasons for human distress are valid for this privilege. Pregnancy, severe illness, or death of a family member can be mentioned in the undertaking if a passenger wishes to home quarantine for two weeks instead of the initial institutional quarantine. Travelers accompanied by children below the age of ten are also eligible. Passengers traveling to Hyderabad or any other city need to apply for the same at the online portal of newdelhiairport.in, at least 72 hours before their boarding.

In a new set of regulations (released on August 2) that superseded the previous guidelines of international arrivals, travelers will also get a release from the mandatory institutional quarantine if they can produce an RT-PCR test report on arrival. Note that the test can not be any older than 96 hours. You must also upload the documents online with a declaration of the test report’s authenticity. This rule would come into effect on August 8.

In all these cases of exemption, having the Arogya Setu app installed on mobile phones is mandatory. Along with these new guidelines, the Central government has also installed mass screening systems at Hyderabad’s airport.

Ambar · Post by **Ambar** » 25 Aug 2020 19:28

saip wrote:Anyone know quarantine rules for International Passengers reaching DELHI then HYDERABAD from USA?
Just got the news that my Sister In Laws's husband passed away. Symptoms to end just 6 days. He was 63 but diabetic.
TIA

Om shanti. I think the quarantine is 1 week although given the number of cases i am not sure how much they are enforcing it now. But if you are traveling its better to quarantine for your own safety and those around you. Just heard that Karnataka has finally decided to stop stigmatizing people by putting flags/stickers on their doors saying someone is covid positive. So many lives could have been saved if private labs could have joined testing efforts right from the beginning and also putting covid positive signs on people's doors discouraged many from getting themselves tested.

saip · Post by **saip** » 25 Aug 2020 20:22

Thanks guys. But on second thoughts we decided not even try to go. No point in exposing ourselves during travel and stay in India as we ourselves are in high risk group.

Jayram · Post by **Jayram** » 25 Aug 2020 21:58

Saip,
If it helps our extended family is going thru this as well and both of my cousins decided to go back to India to deal with thier loss of their fathers. One of them has created a helpfull blog in the last 2 weeks or so to talk about her experience from travel including conditions of when quarntine will be waived. The link to that blog is here https://www.instagram.com/p/CD3siZBgp_e/.
It may be helpfull for you to get that information to make a decision.
My heartfelt condolences on your and your families loss at this difficult time.

saip · Post by **saip** » 25 Aug 2020 23:57

Jayram:
Thanks a lot. But looking at the list of definition of family for exceptions it does not seem to include siblings' spouses.

vijayk · Post by **vijayk** » 26 Aug 2020 06:29

https://nypost.com/2020/08/25/we-could- ... -is-ready/
We could ‘beat’ COVID-19 before a vaccine is ready

Is a vaccine the only way to return to normal after COVID-19? New research into the virus suggests not — that the infection rate may drop to tiny levels before then.

Since the spring, scientists have known the virus’s infection fatality rate — how many people it kills compared to the number it infects — is under 1 percent, perhaps as low as 0.2 percent. That lower figure translates into one death for every 500 people infected.

We have also known that deaths are seriously skewed by age. The media says older people are at “more” risk from the novel coronavirus than younger people. That’s true, but it understates the reality. Most people do not realize that the risks to people over 80 is hundreds or thousands of times higher than those younger people face.

The fatality rate for children, meanwhile, is very small. In July, Dr. Robert Redfield, the director of the Centers for Disease Control and Prevention, said it’s about one in a million infected.

Of course, most of the media simply ignored Redfield’s comment — maybe because it would have made parents less afraid to send their kids to school.

But the fatality rate is only half the puzzle when scientists try to figure out what the final death toll from the coronavirus might be. And even with a small rate, the numbers are staggering. If the entire nation was infected, it would mean potentially 500,000 or more Americans dead.

But if the virus runs out of steam more quickly and the epidemic fades before everyone is infected, the number of deaths will be lower.

Epidemiologists call the level where the epidemic ends the “herd immunity” threshold. Herd immunity does not mean that the virus has completely disappeared, only that it can no longer infect a critical mass of people and become an epidemic again.

Figuring out when a virus has reached herd immunity is very tricky, even trickier than estimating the death rate. It depends heavily on the virus’s reproduction number, or R — how many people one infected person infects in turn.

The higher the R, the more quickly a virus will spread, and the more people must be infected before the epidemic breaks. Coronavirus seemed at first to be highly contagious, and most scientists initially believed that 60 percent to 80 percent of people might need to be infected before herd immunity was reached

sudarshan · Post by **sudarshan** » 26 Aug 2020 07:00

From above:

...

Figuring out when a virus has reached herd immunity is very tricky, even trickier than estimating the death rate. It depends heavily on the virus’s reproduction number, or R — how many people one infected person infects in turn.

The higher the R, the more quickly a virus will spread, and the more people must be infected before the epidemic breaks. Coronavirus seemed at first to be highly contagious, and most scientists initially believed that 60 percent to 80 percent of people might need to be infected before herd immunity was reached.

But the R for the coronavirus seems to vary wildly at different times and places. Also, some people may have some pre-existing immunity because of their exposure to other coronaviruses.

A growing number of scientists believe the threshold for herd immunity may be much lower. Some predict it might be 40 percent. Others say it could be as low as 20 percent — meaning that the epidemic will burn out after only 1 in 5 people is infected with and recovers from the virus.

...

These are the very things I've been posting about on this thread for the past couple of months. Especially about the HIT being as low as 20%, or even lower, and also about the futility of estimating this HIT, let alone using it as a planning guide. Guess these views are going mainstream.

Hope the above is true, every time there's a hopeful sign, this virus pulls a new stunt in a new location.

Heartfelt condolences to all who lost loved ones. There are a couple of remaining hot-spots, let's hope the end is in sight in those places as well.

nandakumar · Post by **nandakumar** » 26 Aug 2020 11:03

My daughter with a six year old boy and a four month old baby left Chennai for Guwahati. The plane landed in Guwahati at 11.15 am. First they were taken to Government designated hospital from the airport. That itself took 3 hours. By the time they came out of the hospital with Covid negative test result, it was 6 pm. Thankfully the hospital authorities allowed the baby to be taken home ahead of the test result. But the mother and 6 year old child had to wait till 6 PM to leave for home.

vijayk · Post by **vijayk** » 27 Aug 2020 08:05

https://theconversation.com/india-is-ke ... why-144772
India is key for global access to a COVID-19 vaccine – here’s why

sudarshan · Post by **sudarshan** » 29 Aug 2020 20:24

The case pattern in India is unlike in most parts of the world, judging by charts alone. There's been a slow, steady build-up for months in India. It doesn't seem to be a testing artifact, since the deaths have also been showing that same build-up.

Other parts of the world are showing two distinct peaks (so far) in their case counts. This is very obvious in Australia and Japan, and now in Europe. A lot of it is due to testing, since the daily deaths counts don't show the exact same pattern as the case counts. But there were two distinct peaks in the deaths counts also.

In the USA, the second peak hit before the first had fully subsided, so the case counts flattened and then rose again (what Chola saab refers to as "unflattening" the curve). Testing had ramped up five-fold in the USA between the time of the first peak and the second, so a lot of the "second peak" was actually due to testing increases. But not all - this can be clearly seen in the graph of the positivity rate. The second peak was about half as severe as the first (going by positivity rate), but the case counts deceptively show the second peak being more than twice as severe as the first.

The second peaks in a lot of these other countries look similar to the overall picture in India. Many of these countries initially had meagre testing, showing positivity fractions of 20% to 40%. So the first peaks seemed to ramp up rapidly (again, an artifact of the testing strategy), whereas the second peaks seemed to ramp up slower (there was sufficient testing going on by then).

In India, the positivity fraction was low from the beginning, showing that there was sufficient testing all along. So I think the slow ramp up in India is actually a better representation of the actual dynamics of spread of this disease - it was much more gradual than the sharp case count rises in Europe or the USA would indicate.

Now it seems that in India, the "second peak" might have also simply merged with the "first peak." It's interesting, looking at the charts - Europe, Aus, Japan showing distinct peaks, USA showing a first peak plateauing before shooting up again, whereas in India both peaks are practically merged together. But you can see an inflection point in the India curve, where the rate of rise drastically increases - that's probably the second peak taking over from the first. This is around June 15th, the same time as the start of the second peaks in Aus/Japan/USA!

The "second peak" seems to be distinct and real (the positivity fraction shows it clearly in some countries), but it was not as severe as the case counts seemed to indicate, because testing had ramped up massively in most of those countries. As I said, in the USA, the second peak seems to have been half as severe as the first (judging by positive fraction), but increased testing showed it to be more than twice as severe.

In the USA, for the second peak, there was about a 3 week lag from the time of the case count rise, to the time of the deaths count rise - that seems about right. But in Europe so far, in the second peak, cases have been rising for a month and a half (6 weeks), yet the deaths count has stayed close to zero all along. That seems pretty baffling (seems to be a good sign though, hope it is).

India seems to be at the height of the second peak now - it wasn't very evident from the charts, but the pattern seems to be the same as the two distinct peaks elsewhere, just with both peaks merged together almost to the point of indistinguishability.

(Note: Deliberately referring to it as "second peak" not "second wave" - it seems to be due to lockdown-release effects, rather than actual die-down and resurgence of the disease like in 1918).

Ambar · Post by **Ambar** » 29 Aug 2020 21:21

I hope you are right and this is indeed the 2nd peak or 2nd wave and the virus will go away from our lives permanently. For those of us who are unfortunate enough to have already lost our loved ones it doesn't mean much which wave we are in but for the sake of humanity i sure hope this ends soon. I don't know if India is in the 1st peak or the 2nd peak or the 3rd peak but cases and deaths are hitting new highs every day and it would be even higher if we had better record keeping of tests and cases. While testing in India has increased, its intensity has decreased. This is not based on rumors but from actual people who've been effected, in 2 southern states atleast for mildly symptomatic and asymptomatic are no longer being tested again. Even those who are positive and have been institutionally quarantined they've stopped doing exit tests. One can only imagine the havoc it must be creating in some of the less fortunate northern and eastern states.

Speaking to doctors who've been in the thick of things since March , they have different opinions on what works and what doesn't but they are unanimous in agreeing that this virus is unpredictable. Patients written off as gone have lived and patients who were recovering have suddenly died. Then there's the mystery of low deaths in densely populated South east asian countries like Singapore, Malaysia, S Korea, Philippines etc where as its had a devastating effect on US, Europe, Mexico, Brazil,India, and few latin american countries. Even within worst effected countries there is disparity - California was with New York, New Jersey, Massachusetts when the march-may surge started, but while the north eastern US states have fared well since then, CA is losing hundreds every day even in this 2nd peak.

Lastly, there is now disturbing news of repeat infections among those who had recovered from covid. While the reinfection cases in US , Hongkong and Europe made front page news, in India where people are obsessed with Sushant Singh's death or upcoming IPL, a sad and curious death of a young doctor from Chattisgarh has gone unreported. Dr Yogesh Gavel, a 35 year old doctor from Chattisgarh had come down with Coronavirus in June, rested, fully recovered and tested negative and came back to duty before getting re-infected in August. He sadly never recovered and died of multi organ failure last week. His may be the first confirmed death through reinfection. The optimist in me hope all this ends within the next 6 months but the way the virus is i wouldnt be too surprised if stays on for much longer than that.

sudarshan · Post by **sudarshan** » 29 Aug 2020 23:17

Ambar ji, I'm also hoping and praying, just trying to get some advance gyan and insight, is all. There are many hopeful signs, and while I'm not able to find anything about Dr. Gavel, I've noticed in the past, that sometimes, what initially seems to be alarming news, turns out to have some hidden twist which makes it not so bad. I seriously hope these reinfection incidents turn out to be something else, if not, it is scary. Yes, the virus is unpredictable, but it seems that might be because of inability to estimate initial infection load. Doctors unfortunately rack up huge doses of the virus day by day.

Just as an example that our perceptions of what is going on don't always align with what is actually going on - regarding what you said about California versus NE USA - please see the chart below. CA did not go through anything like what the north east did, during the first peak, CA is only now catching up. Again, this is just to show that what we perceive is often not the case on deeper analysis, nothing else. Likewise, I hope and pray that seemingly scary news today turns out not so scary on deeper analysis tomorrow, it does happen more often than one would think.

In the plot below, cases are on the left axis, deaths on the right. These are also not raw day-by-day numbers, these are 7-day windowed averages. What CA went through in the first peak was a fraction of what the NE went through. And deaths-wise, CA is still undergoing only a fraction of what the NE went through in March/ April. The case load increase seems to be because of testing increases (in the case of CA, it might actually be a 10-fold increase in testing since March/ April).

EDIT:

Oh, California also has more than twice the population of NY state.

END EDIT

Ambar · Post by **Ambar** » 30 Aug 2020 03:06

Sudarshanji, both IMA (Indian medical association) FB page, and the FB pages of state chapters of IMA have been collecting data on the deaths of healthcare providers, news of Dr Yogesh Gavel's death is on Indian covid warriors, Karnataka Medical Association and IMA's official pages. IMA says over 86000 healthcare providers have been infected by covid, and just like India's overall cases and deaths, 75% of healthcare providers covid cases are reported from MH, Kar, TN, AP,TL and KL - again i suspect because of better record keeping and testing compared to other states. IMA says around 573 healthcare workers have now died of covid, and majority of them are general practitioners who are first in line to treat patients.

Sadly it looks like we have now overtaken mexico's total number of deaths and are now in 3rd place. We are also on course to overtake Brazil's total cases in the next week or so. No one in India could have predicted we'll be in such a precarious position back in mar/apr when it looked like the pandemic had spared us.

chola · Post by **chola** » 30 Aug 2020 15:25

The situation in the US is more under control but still dire -- especially with schools starting and the spread among students at major colleges already even before the full season begins.

The key is after the harrowing heights of July -- when they had 77K new cases in one day and Fauci said the country was heading towards one lakh daily -- the red states began capping the opening of food and entertainment establishments, especially bars. There were fears that the northeast would be hit by a second wave because of the surge in the south and west but that hasn't materialized.

So things are looking a bit better but a lot of anxiety whem school season starts. We are keeping our grade schooler daughter home by taking a remote option. Our son, a preschooler, we can continue to home school though we can already see that it will take a toll on our work -- when we are already working staggered schedules that always see one of us working late into the evenings while the other can look after the children.

I still constantly worry about my parents while my parents worry about aunties and uncles in Chennai who in turn are worried about my parents in the states. We are in a state of constant worry across the globe because of this stupid virus.

vijayk · Post by **vijayk** » 30 Aug 2020 23:05

I just want to do Oxford to do a large scale testing ... million+ quickly. This is not going down ... People are not being careful. Too many mistakes. No social distancing. Lives are being lost at an alarming rate in India

chola · Post by **chola** » 31 Aug 2020 00:27

vijayk wrote:I just want to do Oxford to do a large scale testing ... million+ quickly. This is not going down ... People are not being careful. Too many mistakes. No social distancing. Lives are being lost at an alarming rate in India

From what I read, you cannot go straight into full million plus testing with the first batch. These things are actually grown in vats and they are weakened or killed virus. You can imagine the safety concerns if things are not test properly before given to vast numbers. And unlike testing chemicals on a rabbit's eye for cosmetics (as an example) where the good or bad effects are immediate those for a trial vaccine might not appear for weeks and you are testing on humans.

In the US, even with the heavy push from Trump admistration and all the political and economy pressure to go fast, no one is willing to bypass the established Phase I,II,III trials.

Phase I: small scale for testing safety and dosage
Phase II: expanded safety
Phase III: large scale efficacy (and of course more safety)

But even Phase III is in the thousands not hundreds of thousands certainly not a million.

I think only Russia and Cheen have allowed innoculations of vaccines before Phase III. Not sure we want to be in that company.

nandakumar · Post by **nandakumar** » 31 Aug 2020 11:34

According to Government regulations you need between 3000 to 5000 patients to be administered across 25 centres for phase III human trials..

chola · Post by **chola** » 31 Aug 2020 15:12

The slow boil of the chini virus in India is very worrisome. We haven't seem the suddenly upticks that led to immediate catastrophies in other countries like Italy or the US. But the other countries also peaked rather quickly.

India can't seem to find the peak and is in a nearly perfect logrithmic pattern of compounding growth.

We know the second wave will come. France is experiencing it now. It peaked, troughed and is now peaking again.

In the US, the first wave of infections peaked, plateaued and then the second wave hit while the first wave was never put down (unlike France) and it crested on top of the first, now we hope the second wave is plateauing:

I think the lockdown had spared India the sudden upticks seen in the US and Italy but the first wave is slowly making its way from the cities through the rural areas even as the infections had receded a bit in the big metro areas. But if we do not peak soon from the first wave then when the second wave hit (with loosening of lockdown measures) we will see the same situation as the US. Where one wave never subsides before the second one hits.

We are seeing a bit of that now. Delhi has rising infections again after bringing them down greatly while the first wave is still going into the rural areas.

nam · Post by **nam** » 31 Aug 2020 15:35

So far, I can gather is people get infected in crowded place & work location. Even if the person is infected, based on the viral load, if the person manages to isolate himself on the first sign of symptoms, he can prevent infecting his family.

If you and your family have the option to not go to crowded close place(crowded transport, worship, wedding, work location) , you can prevent yourself from getting infected to a large extend. Be in open space, avoid people. Looks like crowded closed place, with no proper air flow is the prime candidate and enough viral load to get people infected.

People who have no choice, will get infected. I guess this is what we are seeing in India. The best way for the older people, is stay at home. No wedding, no worship. Good natural airflow in the house. No air conditioners.

The entire bachan family got infected. Pretty sure due to their air conditioned household.

Cyrano · Post by **Cyrano** » 31 Aug 2020 16:17

France is seeing a serious uptick in number of new cases. This is due to the irrepressible need to take summer vacations. Though people have by and large tried to follow social distancing and wore masks, especially in indoor public spaces, the very fact that millions of people have moved about in summer has led to this spike. There is some fatigue setting in among all people, frustration that normal way of life is disturbed without an end in sight. This is the biggest danger in containing the spread from here on.

I'm expecting the spike to continue due to schools reopening this week, despite distanciation measures that will be taken.
- Mask wearing is compulsory for all adults & children when they leave home and go out, in Paris region, big cities and cluster communities.
- Children above 11 to bring 3 masks to school every day, to change during the day. Disposable and washable cloth masks are both allowed.
- Bring all required stationery items (no lending pencil/rubber etc), hand sanitiser, water bottle.
- Lunch in school limited to junior-high classes since refectory capacity is halved due to distancing.
- Sr-high students won't be served lunch in school, lunch boxes not allowed. So they have to go out of the school, presumably go home to eat lunch and come back. Lunch break extended to 90mins. --> This will be a headache to manage and kids let out in the middle of the day will not do a lot of good to contain spread. But this is a kind of poor compromise.
- Overall the French Govt is trying to cope without very clear idea where all this will lead. Can't blame them since no one really knows.

For all those who are pro schools reopening "without distancing measures", especially in the US, they seem to forget that teachers risk getting infected too. There is typically 1 teacher to 30-50 students most of whom will be asymptomatic. Most teachers are in senior age groups, and are more vulnerable to the virus. People seem to forget that no healthy teachers = no schools.

And what is this indignation and resistance about wearing masks? I wear a mask > I protect others. Others wear a mask > I am protected. To whatever extent that may be, its definitely better than not wearing masks. It beats me why this simple fact is missed by so many.

darshan · Post by **darshan** » 31 Aug 2020 16:33

Muharram procession in pandemic: Anand Police book crowd of 500-600
https://www.deshgujarat.com/2020/08/31/ ... f-500-600/
Khambhat: Anand Police has booked over 500 people who gathered for Muharram procession in Khambhat town in breach of police notifications pertaining to Covid-19 pandemic. A procession of Muharram, despite ban passed through the city by the time police reached to disperse the crowd. FIR filed against a crowd of about 500-600 people involves sections of the Disaster Management Act, Epidemic Diseases Act, violation of police notification, unlawful assembly. In addition to this, those who were not wearing mask would face Rs. 1,000 fine.

sudarshan · Post by **sudarshan** » 31 Aug 2020 20:49

@Ambar - let's see saar, they said the peak would be in early September. Hoping for that.

@Chola - that's what I was saying in my post. But I was also saying that the second peak was already upon India (IMHO). The plots you show, with bars, don't really show the inflection around June 15th. It is better seen in a chart with lines or dots. So it seems that the second peak in India simply merged with the first one. A more extreme case of what you show in the plots for the US. Don't know, maybe just wishful thinking on my part, but June 15th is also the time when the second peak was seen in Aus, Japan, US. Europe was more delayed.

Ambar · Post by **Ambar** » 31 Aug 2020 22:31

Yesterday's 78600 new cases in India was the highest single day count among any nation since the pandemic began. The worrying trend is that the new highs are not because of our over-populated metros but because of rising infections in small towns and villages. We've been in a full blown community transmission for a while now, and the mar-may numbers were likely low because we did not ramp up the testing until late may. Europe is clearly in a 2nd wave but the deaths are nearly the same as these countries would experience during the regular flu season, so it does look like the worst is over for Europe. US and Brazil too have started to taper , they've been reporting lesser and lesser new cases for few days now and death being a lagging indicator has followed. Its only India , Mexico and off late Colombia that are yet to drop.

chola · Post by **chola** » 31 Aug 2020 22:36

@amar_p
@sudarshan

Thank you for very informative posts. I was afraid that the second wave might be here as the big cities Delhi, Chennai, Bengaluru, etc. are seeing renew spikes after bringing down the rate a few weeks ago.

And judging by the French experience, the second wave will inevitably come because human beings can only take lockdown measures for so long. Fatigue inevitably comes into play. The French is doing most things right, IMHO, but still the second wave is coming.

The key is snuffing out the current wave as much as possible so that you don't have the compounding effect of waves cresting on top of each other.

I hope India is not in a situation where we can't even see the troughs because the waves are coming so fast with each loosening of Unlock X.0.

saip · Post by **saip** » 01 Sep 2020 08:42

Is ivermectin being prescribed in India as a treatment of COVID19? Both my nephews tested positive for COVID (they were in close proximity with my sis in law's husband who passed away) and they are prescribed Ivermectin. Both of them are young - 35-40. But I am worried.

chola · Post by **chola** » 01 Sep 2020 17:07

My god, the herd immunity crowd will never allow the US to get a full grip on the situation.

https://www.msn.com/en-us/news/politics ... r-BB18yWoH

A new coronavirus adviser is pushing the White House to adopt a "herd immunity" strategy that would allow the disease to spread through most of the population to build resistance, five sources told The Washington Post on Monday.

Scott Atlas, a healthcare policy fellow at Stanford University's conservative Hoover Institution think tank, joined the Trump administration earlier this month as a top pandemic adviser. His expertise is in neuroradiology, and he "does not have a background in infectious diseases or epidemiology," The Post said.

The Post's sources said Atlas had proposed that the US adopt Sweden's pandemic response, which relies on keeping the economy open so healthy people can build immunity to the disease through the spread of infection.

Ambar · Post by **Ambar** » 01 Sep 2020 17:22

saip wrote:Is ivermectin being prescribed in India as a treatment of COVID19? Both my nephews tested positive for COVID (they were in close proximity with my sis in law's husband who passed away) and they are prescribed Ivermectin. Both of them are young - 35-40. But I am worried.

Not that i know of but then again a lot of experimental drugs are being used to see what works and what doesn't. Ivermectin was used in few Latin American countries with mixed results from what i remember. Your nephews should be ok given their relatively young age and no underlying morbidities.

Btw, is the death of former President Pranab Mukherjee the most high profile death in India we've had so far because of covid ?

chola · Post by **chola** » 01 Sep 2020 17:40

^^^ I think so. Irrfan Khan died at hospital from infection and first thought that might have been covid but it proved to be a GI infection.

Not death but Amitabh Bachchan, Aishwarya Rai and the whole family getting infected was probably the most high profile globally.

M_Joshi · Post by **M_Joshi** » 01 Sep 2020 18:34

^^ Not to forget Amit Shah, Usain Bolt, Novak Djokovic, Madonna, Kevin Durant, Tom Hanks, Boris Johnson & Prince Charles also tested +ve & recovered.

darshan · Post by **darshan** » 01 Sep 2020 18:41

Jyoti CNC gets DGHS approval for manufacturing of Dhaman-3 ventilators; machines sent for US FDA and European certifications for export
https://www.deshgujarat.com/2020/08/28/ ... or-export/
Rajkot: Rajkot based Jyoti CNC today made announcement that it has received DGHS (Director General of Health Services) certification for its Dhaman-3 ventilator.

‘DGSA has certified Dhaman-3 as a complete ventilator,’ CMD of company Parakramsinh Jadeja told media persons in a briefing, adding that as per schedule, the company delivered Dhaman-3 for testing in July. Testing started on July 17.

Jadeja also announced that his company won central government order of 5,000 Dhaman ventilators. He said the order is expected to be delivered in two and half months period round.
......
Jadeja said, Couple of companies from abroad are coming over here for contract manufacturing. From next week, machine we have sent will undergo US FDA test. It takes longe time for US FDA approval. We have European subsidiary company and we have sent machine for European certification as well. We will first get European certification and we will start selling it in Europe. Dhaman-3 order close to 60,000 ordered, 5000 order received by Jyoti CNC. As per schedule July we had delivered for testing. 17 July testing started. Dhaman-3 is advanced version with 8 mode facilities. All test, DGSA has certified as complete Ventilator.

sudarshan · Post by **sudarshan** » 01 Sep 2020 21:16

Reports of goings-on when US colleges are reopening and dorms are filling up. It seems in Penn State Univ, students had a nice big gathering and party (without masks, obviously

) until the police showed up an hour later to break it up, and now cases are going up in the area. While it seems everybody is glued to their phones these days, especially students, it seems, they still crave that physical interaction and drinking session, and aren't content with just stewing in the virtual world. They just can't leave this pandemic alone to die out, have to keep stirring it up.

saip · Post by **saip** » 01 Sep 2020 21:58

How are recoveries being tracked in India? I know when someone tests positive the lab reports to someone in the govt and the count goes up. But unless he has symptoms or admitted into hospital no one may be following him up. So if he 'recovers' at home, his number may not be counted in the recoveries. So, are we undercounting recoveries and may be there are not that many active cases in India?

darshan · Post by **darshan** » 01 Sep 2020 22:00

Malaysia bans Indians from entering the country due to growing number of COVID-19 infections
https://www.wionews.com/india-news/mala ... ons-324511

darshan · Post by **darshan** » 01 Sep 2020 22:20

Health Ministry To Deploy Central Teams In UP, Odisha, Jharkhand And Chhattisgarh After Surge In Covid-19 Cases
https://swarajyamag.com/insta/health-mi ... d-19-cases

Karnataka Can Go Clubbing From Tonight As Unlock Four Opens Bars At 50 Per Cent Seating Capacity
https://swarajyamag.com/insta/karnataka ... g-capacity

Ambar · Post by **Ambar** » 02 Sep 2020 00:45

saip wrote:How are recoveries being tracked in India? I know when someone tests positive the lab reports to someone in the govt and the count goes up. But unless he has symptoms or admitted into hospital no one may be following him up. So if he 'recovers' at home, his number may not be counted in the recoveries. So, are we undercounting recoveries and may be there are not that many active cases in India?

I had made a post on this a page or so ago, every state is following a different protocol but given the case load they are no longer doing repeat tests in TN and KAR after 14 days, irrespective of whether a person is in hospital, institution or at home. Again, i wouldnt be too surprised if there is variation in this too between one district to another, but their current lab capacity just does not allow them to do repeat tests. I believe such cases after 14 days are automatically added to recovery unless the patient is so sick that they are re-tested and re-admitted.

As for Malaysia banning Indians from entering, its hard to make the world look at our per million cases/deaths - which is not alarmingly high, but everyone looks like near 80k new cases/1100 deaths per day when all including US, Brazil and Mexico are now reducing. Usually Mar-Sept is peak flu season in India, and i am hoping the cases will begin to drop from October onwards.

Bottomline, the central govt did what they could with a healthcare system neglected for over 70 years. Most people with means wouldnt go to a govt hospital for normal illness let alone go for serious illness like this flu, but they've been forced to given that the pvt sector ran away from the fight or are robbing patients/families blind. Its upto people now to take precautions, not go out unnecessarily , avoid crowds and keep the elderly & the sick away. I know its easier said than done given the difficult condition that hundreds and millions live in.

vijayk · Post by **vijayk** » 02 Sep 2020 23:01

From a friend who just joined Corning

They received a 204M grant from the Federal govt. HHS for the supply of Vials for COVID vaccine. Corning Valor vials are the fastest filling, 50% more than others.
Currently 3 manufacturing plants in the US are running to full capacity and they are exploring more sites to need the target of delivering them by January. Once the vaccine is approved and ready by any of the pharma majors, these vials will be diverted to them for filling and supply.
Got to know in the last 2 weeks what’s happening behind the scenes. Until 2 weeks ago while we were bidding they used the code word HMU (High volume manufacturing unit).

https://www.statnews.com/2020/09/02/exp ... one-right/
Experts see a chance for a Covid-19 vaccine approval this fall — if it’s done right

There is growing concern that the Food and Drug Administration, under political pressure, could approve a Covid-19 vaccine before it has robust safety and efficacy data.

The consequences of such a decision could be significant, particularly if the vaccine is ultimately shown to be less effective than early data suggest. But an approval before the completion of large, Phase 3 trials does not have to be problematic. Experts aren’t ruling out the possibility that a vaccine could be cleared this fall if it is very effective.

“There are mechanisms by which products that have a good amount of data can be made available in a controlled way,” said Natalie Dean, an assistant professor of biostatistics at the University of Florida who specializes in vaccine study design.

But Dean also sees risks.

“If you make a decision based on promising but not convincing data, and then you discontinue your randomization,” she said, “you discontinue your evidence-generating process. You can never go backward. You can never go back and generate your evidence.”

Related: In the race for a Covid-19 vaccine, Pfizer turns to a scientist with a history of defying skeptics — and getting results
Here is how a fast approval might play out, if all goes well — and some warning signs that a science-based process is not being followed.

The FDA has laid out clear criteria for the full approval of a vaccine: It should reduce the rate of symptomatic Covid-19 disease by 50%. Equally important is that the data should suggest it’s highly unlikely that the vaccine could possibly be less than 30% effective. Any vaccine less effective than that would be useless.

The agency also said that there should be safety data of a year or more for at least 3,000 patients. There’s no way to shorten that timeframe, and it is one of the reasons experts believe the FDA could grant a Covid-19 vaccine an emergency use authorization, rather than full approval.

It’s also possible that the studies could be ended early based on an interim analysis of data.

vijayk · Post by **vijayk** » 03 Sep 2020 07:56

https://www.cnn.com/2020/09/02/health/n ... index.html
Novavax coronavirus vaccine is safe, published results show

Early stage clinical trial results show the Covid-19 vaccine candidate made by Novavax is safe and elicits an immune response, according to a study published Wednesday in The New England Journal of Medicine. The results had previously been announced by the company in early August.

What we've learned about Covid-19 seven months after the first US case
Using a randomized, placebo-controlled trial -- the gold-standard method of study -- scientists gave the vaccine or a placebo, an inert substance like saline, to 131 healthy adults in May. Eighty-three people got the vaccine with adjuvant, an agent to boost the body's immune response. Another 25 got the vaccine without the booster and 23 got the placebo. Participants also received a second injection 21 days after the first.
The volunteers came from two locations in Australia and they were all under the age of 60. People who had Covid-19 or who had recovered from Covid-19 were excluded from the trial.

After the second vaccination, most people didn't have any problems, or they were mild. One person had tenderness after the second shot and eight had joint pain and fatigue.

The vaccine seemed to generate an immune response. All the volunteers who got the vaccine developed neutralizing antibodies after the second dose.
At day 35, participants who got two doses of the vaccine with the adjuvant developed neutralizing antibodies at levels more than four to six times greater than average than the antibodies developed by people who had recovered from Covid-19. Antibodies are the proteins the body naturally produces to fight off an infection or toxin.
The vaccine also seemed to generate T-cells, the type of immune cells that also help protect the body from infection, in the 16 volunteers who were randomly selected and tested for T-cell response.