Wuhan Coronavirus Resource Thread

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Re: Wuhan Coronavirus Resource Thread

Post by Zynda »

Change in Covid testing strategy: Karnataka hits rapid antigen mode to ramp up testing
Bengaluru: Karnataka has shifted its Covid-19 testing strategy by pushing for more rapid antigen tests, to cope with heightened pressure to ramp up testing as the state experiences a sharp rise in coronavirus infection.

ET has gathered that the state has now set a target of 35,000 antigen tests per day starting next week and has procured 200,000 kits to be distributed to 30 districts. The target for Bengaluru city is 11,500 antigen tests per day.

“In the task force meeting we have decided to procure an additional 400,000 antigen test kits in order to ramp up testing in containment zones,” the medical education minister’s office said.

In the last six days, the state has tested a total of 24,000 samples on antigen. Samples tested on RT-PCR on Thursday were 21,000. RT-PCR testing volume has remained constant for the last 10 days.

While the time-consuming RT-PCR is considered the gold standard in Covid testing, the rapid antigen tests are less sensitive and not so accurate. According to the Indian Council of Medical Research (ICMR), the sensitivity of antigen is 50.5% to 84%.

The ICMR in its advisory has said people who get positive results on the antigen test need not be retested using RT-PCR, but those who get negative results must be retested. The state health department, however, has tweaked the guidelines and said only symptomatic negative reports on antigen must be tested using RT-PCR. This, some say, could lead to many asymptomatic cases testing negative and they could possibly spread the infection to others.

State officials said scaling up antigen tests would serve many purposes. It will reduce the backlog of samples, minimise the time taken to test samples and ease the burden on government and private labs, many of which are testing more than their capacity.

“We are universally testing SARI (severe acute respiratory infection) and ILI (influenza-like illness) cases. So, if an antigen test is negative in a person with respiratory or influenza-like symptoms, then the sample will be tested again on RT-PCR. We will continue to test 60% of samples on RT-PCR and 40% on antigen,” said CN Manjunath, the in-charge of lab testing in the state.

Karnataka is using RT-PCR and antigen alongside CBNAAT and TrueNAT tests, but these two tests are done in relatively small numbers. The backlog of samples was 25,178 as on July 20. Data show that some testing labs were exceeding their capacity, while some had not geared up yet. For instance, the Nimhans lab has tested 125% of its capacity, and private labs like Narayana Netralaya, Xcyton Diagnostics, St John’s Medical College, KIMS and Cancyte Technologies are taking an extra load ranging from 248% to 186% of their capacity.
Testing times for covid warrior

Posting excerpts...
A covid warrior had to struggle for three days running from one fever clinic to another to get a covid test done. The fever clinics he visited were empty, and yet he was sent back due to the non-availability of doctors. The techie, who has been volunteering with the DIPR, is down with fever, muscle pain and severe headache since last Friday.
Lack of enough man power in India is turning out to be an issue. Perhaps, this is due to non-involvement of various private diagnostics labs or perhaps many of the private labs don't want to offer their services to Covid testing.

‘Rapid’ antigen test results come after 2 days
Akash’s father tested positive for Covid-19 on Monday when the entire family took rapid antigen tests at the Thindlu Public Health Centre (PHC) near Vidyaranyapura. Akash’s wife and daughter were asked to go home after they were informed that they will get the results within a few hours. The Bruhat Bengaluru Mahanagara Palike (BBMP) staff called the family only on Wednesday morning and said that Akash’s four-year-old daughter has tested positive and hence, the mother and the child will be taken to the Covid Care Centre (CCC).{Shouldn't testing positive on antigen means that they already have anti-bodies and currently are not carrying an active infection?}
Dr CN Manjunath, director of Sri Jayadeva Institute of Cardiovascular Sciences and Research and nodal officer for testing in Karnataka, said, “The antigen test is immediate or better than RT-PCR. What is happening is, the staff is collecting the data and then process and updating them and then, they are informing the patients, which is probably taking time. Maybe the communication process is slow and is taking time to reach people.

“Also, this is not about shortage in laboratories. These lab technicians get infected a lot of times and go into quarantine. So, there are a lot of internal logistical issues. However, they should speed up the communication process,” he added.

Dr Satyanarayana Mysore, HOD of Pulmonology at Manipal Hospital, said, “The process of swab collection is taking time. Secondly, these are bio-hazard samples and technicians need to be careful before they get infected. Also, we need a doctor (a micro-biologist) to sign the report. I guess the delay in timing is happening because of this. In some places, once the samples are collected, there are no porters available to take the samples to the laboratories. Overall, communication with patients and citizens need to be faster.”
We don't hear these issues in Western countries. USA was/is doing a lot more testing than we are and I wonder how long is the delay between sample submission & test result.
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Re: Wuhan Coronavirus Resource Thread

Post by Zynda »

https://twitter.com/BangaloreMirror/sta ... 9329165312
Bengaluru: India's biggest COVID care centre will open in BIEC tomorrow
In other positive news, SII has submitted an application to DGCI to start Oxford vaccine's Ph-2 & Ph-3 trails in India from August.
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Re: Wuhan Coronavirus Resource Thread

Post by darshan »

IIT Kharagpur develops rapid portable COVID-19 test kit at Rs 400
https://www.wionews.com/india-news/iit- ... 400-315954
At a time when Coronavirus is gripping the entire country, researchers at IIT Kharagpur have developed a portable rapid low-cost test kit to detect Covid-19. This first-of-its-kind device can test each sample at the cost of Rs.400 and the test results can be ascertained within an hour. The results will later be available in a smartphone application.

Prof. Suman Chakraborty from the Mechanical Engineering Department, IIT Kharagpur, and Dr. Arindam Mondal from the School of Bio Science, IIT Kharagpur, came up with the concept of a portable non-invasive rapid detection test for COVID-19. This test kit takes the testing mechanism to a whole new level that comes at an affordable cost and minimal infrastructural support.

“The unique portable device developed by the IIT Kharagpur researchers has not only been validated for the diagnostics of COVID-19, but also been designed to be capable of detecting any other kind of RNA virus by following the same generic procedure. The impact of this, therefore, is long lasting, empowered by the capability of detecting unforeseen viral pandemics in the coming years that may potentially endanger human lives time and again,” said Mondal.

This apart, IIT Kharagpur is ready for commercialization of the product. Any corporate or start-up can approach the Institute for technology licensing and commercial scale of production. The Institute is open to tie-ups, including a mode where the government intervenes with regards to meeting our low-cost healthcare objective for the under-served community as a policy measure to protect the interest of public health amidst the pandemic situation, instead of merely developing a strong profit-oriented model.
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Re: Wuhan Coronavirus Resource Thread

Post by sudarshan »

Chola, thanks.
hanumadu wrote:^^^My point was that the whole concept of HIT is useless if we define it by what measures we take to avoid infeciton. I have no problem with parachutes or with social distancing or what ever measures we take to find a balance between economy and minimizing death and suffering.

What is the point of claiming we have achieved HIT if we are still going to have a -10% or -5% GDP growth rate?
So you do see how useless the concept is in practice, right? This is what I was talking about, when the media was saying the following things:

* Stupid France, why are they opening up now, when they are so far from the HIT of 60%?? They are going to *** themselves! (France is still doing fine, regardless of how far it is from that deemed HIT value).

* We should not open up until antigen tests show that we are past the HIT (of 60% - but this number is immaterial, the statement is equally silly regardless of what number you put in there).

* OMG, the epidemic has been going on in Germany for two months, yet they are so far from the HIT (of 60% - again, the actual number is immaterial), we have a long way to go!

* OMG, even NYC shows such a small infected fraction, we have so long to go, help, we need a vaccine now!

This concept of HIT should not be used for planning, because it is so hard to estimate, and more importantly, it is such a vague and fuzzy and *dynamic* number. We should be taking our cues from the data, if the slope of hospitalizations and deaths is negative enough, that is a cue that we can cautiously open up. Watch the data, forget mathematical models of HIT and what is the "mitigated HIT" or "unmitigated HIT." Actually, in your other post, when you talk of "mitigated HIT" - while that is a step up from talking of "THE HIT," it is still a fallacy. Now the implication is that there are two HITs (one "mitigated" and one "unmitigated"), that is not the case, the HIT is a fuzzy, smeared number which can take a whole range of values, depending (among several other things) on the extent of risk which the population takes. Thus this estimation of HIT and treating it as a metric to be achieved, is impractical.

What I've been saying all along - indefinite general lockdowns are a bad idea. Protect the vulnerable, make efforts to get the sick ones the care they need, but carry on with economic activity, with adequate social distancing. Forget this notion of "what is the actual HIT and are we really at that level, that we can risk opening up." That is a media construct. Go with hard data instead.

(Also, you see how counterproductive it is when 'dem folks in Alabama or Texas take their cues from that deemed HIT value and try to race for it).
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Re: Wuhan Coronavirus Resource Thread

Post by sudarshan »

chola wrote: The worst case scenario is when the curve unflattens:
Image
Now that I think about it, the above plot is actually a good example of what I was saying about the HIT value being dynamic. The epidemic in the US had got close to winding down (can be loosely interpreted as herd immunity). Then the behavior of the population changed, and that changed the HIT itself.

Like I said - guy jumps off a plane, deploys parachute, coasts, gets overconfident that his coasting velocity is in the right range, rips off parachute, ends up accelerating to new (and much higher) terminal velocity. The US is right now accelerating to a new terminal velocity (heading for a HIT which is in line with the new behavior of the population). We'll just have to wait for that transient situation to stabilize.
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Re: Wuhan Coronavirus Resource Thread

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darshan
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Post by darshan »

Floods in Assam and Bihar. There should have been more news coverage about how chinese virus is being handled in this areas.
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Re: Wuhan Coronavirus Resource Thread

Post by chetak »

Image
anmol
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Post by anmol »

Over 1 lakh COVID-19 tests conducted in UP on Sunday, says Amit Mohan Prasad

2 minutes

Updated: Jul 27, 2020 19:35 IST

Lucknow (Uttar Pradesh) [India], July 27 (ANI): Over one lakh samples were tested for COVID-19 in Uttar Pradesh on Sunday, informed state's Principal Health Secretary Amit Mohan Prasad.
Speaking here at a press conference on Monday, Prasad said, "Yesterday, 1,06,962 COVID-19 samples were tested in the state. As of now, no state in the country has done per day testing in such amount."
He added that the total count of samples tested for coronavirus to date in the state stood at 19,41,259.
According to data from the Uttar Pradesh government, 3,578 new cases of COVID-19 have been reported in the state in the last 24 hours.
"1,192 people have been discharged in the past 24 hours. The total number of discharged persons in the state has climbed to 42,833. As many as 31 people have succumbed to the disease in the last 24 hours, while the death toll stood at 1,456. The active cases in the state are 26,204," the state government said in a statement.
On Saturday, Uttar Pradesh Chief Minister Yogi Adityanath had directed officials to ramp up COVID-19 testing in the state and take the number of tests per day to 1 lakh by July 27. (ANI)
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Re: Wuhan Coronavirus Resource Thread

Post by A Nandy »

https://timesofindia.indiatimes.com/ind ... 199535.cms
Speaking after virtually launching Covid-19 testing facilities, th Prime Minister said that these hi-tech state-of-the-art testing facilities will boost the testing capacity by almost 10,000 daily tests in each of the three cities.

He added that these labs will not be limited to testing for Covid-19 only, but in future, will also be able to test for Hepatitis B and C, HIV, dengue and several other diseases.

The Prime Minister said that apart from developing the physical infrastructure, the country has also managed to swiftly ramp up human resources including paramedics, Asha workers, Anganwadis etc, who have played a significant part in controlling the spread of the pandemic.

He also spoke about the need to work on continuously attaching new and retired health professionals with the health system in order to prevent fatigue from setting in our corona warriors.
No news about how to make medical education more accessible to the public so we have better ratios.
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Post by nam »

How many people have been tested so far? I saw a news report that we are planning to scale up to 1M test per day. At that rate, within a year, we will run through 30-40% of the population.

I wonder how many tests are carried out on the ones, just because people "feel" they have covid?

Israelis are working with DRDO to create a rapid test kit. We need this kind of kit, which can give results in minutes and can be used in social place like airport.
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Re: Wuhan Coronavirus Resource Thread

Post by chaitanya »

^ nam-ji, ICMR's website has been significantly updated to serve the COVID testing info on their main page: https://www.icmr.gov.in/
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Post by anmol »

Date: 28/07/2020 -- Testing: Status Update

Accumulative total of 1,73,34,885 samples have been tested up to 27July2020.

Number of samples 5,28,082 tested on 27July 2020.

https://www.icmr.gov.in/pdf/covid/updat ... AM_IST.pdf
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Post by Mort Walker »

^^^New testing centers are being opened up that can each do 10K tests a day. By the end of August, I suspect India will only be 2nd to the US in testing. Just as Trump claimed last week that India was 2nd behind the US in testing.
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Post by nam »

Our testing kit production must have really scaled up. Time to give the Chini producers a run for their money by exporting in numbers.
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Post by sajo »

^^Are those massive numbers Anti-gen tests or RT-PCR tests?
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Re: Wuhan Coronavirus Resource Thread

Post by chola »

Light appearing at the end of this long dark tunnel. Oxford-AstraZeneca has chosen 5 sites in India for final phase of testing.

https://m.businesstoday.in/story/corona ... 11277.html

Coronavirus vaccine news update: India readies 5 sites for trials; Oxford, Pfizer advance to late-stage

BusinessToday.In | July 28, 2020 | Updated 13:59 IST

Coronavirus vaccine news: Serum Institute of India CEO Adar Poonawalla had earlier stated that the company would reserve 50 per cent of the vaccine doses for use in India

The world is watching with bated breath as the top coronavirus vaccine contenders race towards the finish line. Moderna, Oxford University-AstraZeneca and Pfizer-BioNTech that are spearheading the search for a COVID-19 vaccine have advanced to the final stages of the trial. India, which is one of the vital pieces of this puzzle, has also identified five sites for the trials of the Oxford-AstraZeneca vaccine.

...

Oxford University-AstraZeneca: Phase 3 trials of the COVID vaccine candidate have already begun in Brazil. Now the government has chosen five sites in India for the third and final phase of trials of the candidate. The details of the sites have not been disclosed. The Oxford vaccine is being manufactured by Serum Institute of India. The manufacturer had earlier sought permission for the first two phases of trials in the country from DCGI. The third phase of trials would be conducted in India including 10,000 volunteers.

Secretary of Department of Biotechnology (DBT) said that the trials are significant as it would show findings from within the country. SII CEO Adar Poonawalla had earlier stated that the company would reserve 50 per cent of the vaccine doses for use in India.

Moderna: The company has launched a 30,000-subject trial for regulatory approval and widespread use by the end of the year. The first large study of a coronavirus vaccine began on Monday morning in Savannah. The volunteers have been picked from diverse backgrounds. The COVID vaccine is backed by a $955 million government funding and would be tested at 89 US sites. If the trial is successful, the company would release 500 million doses by 2021. The early results of the trials would be available in November-December. The Moderna coronavirus vaccine is being developed with National Institutes of Health (NIH).

Pfizer-BioNTech: US drugmaker Pfizer and German company BioNTech have said that they have begun their late-stage human trials for their coronavirus vaccine. Like Oxford-AstraZeneca, the COVID-19 vaccine trials would include 30,000 subjects globally. The trials would be conducted across 120 sites globally including 39 US states. If approved the vaccine would be forwarded for regulatory review as early as October. The makers plan to supply up to 100 million doses by end of 2020 and 1.3 billion doses by end of 2021.

Bharat Biotech: The coronavirus vaccine trial for the company's candidate COVAXIN has started in Odisha's Institute of Medical Sciences (IMS) and SUM Hospital. The selected volunteers will be given two doses within a gap of 14 days. The volunteers need to be healthy and disease-free and can screen themselves through a simple questionnaire available at the website. The trials for COVAXIN are also underway in AIIMS Delhi, Post-Graduate Institute of Medical Sciences in Rohtak, Nizam's Institute of Medical Sciences (NIMS) in Hyderabad, SRM Medical College Hospital and Research Centre in Kancheepuram and two private hospitals in Uttar Pradesh - Prakhar Hospital in Kanpur and Rana Hospital and Trauma Centre in Gorakhpur.
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Post by nam »

The good thing about this virus is that majority have in built immunity in the body. This means we just need to know the level of antibodies that is required to kill the virus and vaccine dosage should generate the same level of antibodies. You know what is required to save a person.

This is not the case with other viruses, where the body doesn't have natural immunity. Hence you don't find vaccines for things like HIV or takes really long to develop for other diseases.

I do wonder though, how will it deal with the late trigger of the natural antibodies, which is what we are seeing now. People symptomatic after 5 days, means the natural antibodies are getting triggered very late. Probably the cause for the storm, as the virus load is too large by this time and the immune system overreacts.

And another reason why it was important to delay the peak. Although it might be bit late for India. We are racing towards the peak in major cities.
Last edited by nam on 28 Jul 2020 15:38, edited 1 time in total.
nam
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Post by nam »

The Chinis would have started their vaccine trails earlier than anyone else. Wonder why they are not first in the queue!
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Post by Krita »

sajo wrote:^^Are those massive numbers Anti-gen tests or RT-PCR tests?
I guess more than 40 percent is Antigen.
Negatives of Antigen are tested again with RTPCR.
True positives and false negatives.
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Post by Sachin »

nam wrote:The Chinis would have started their vaccine trails earlier than anyone else. Wonder why they are not first in the queue!
May be they fear that it would also reconfirm the fact that the virus was triggered by them? And it was just another way for China to make money (by selling medicines, like the other cheap goods they mass produce).
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Re: Wuhan Coronavirus Resource Thread

Post by chola »

Sachin wrote:
nam wrote:The Chinis would have started their vaccine trails earlier than anyone else. Wonder why they are not first in the queue!
May be they fear that it would also reconfirm the fact that the virus was triggered by them? And it was just another way for China to make money (by selling medicines, like the other cheap goods they mass produce).
If they can sell it, they would do it. They are mercantile as f. There is no doubt in my mind that if they had a working vaccine right now, they would be blow-horning it to the world. They don't.

The irony is they probably don't have the cases in Cheen to finish testing and no one from the US or the West or India or even Brazil would trust them in trials.

They do have vaccines in advance stages though, at least that is what they say:
https://www.wsj.com/articles/china-says ... 1595521469
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Post by nam »

They have Pak, Iran, some of the ASEAN countries to test out the vaccine. They could easily influence WHO and get it tested in South America for example.

I have been reading that Chinis are adverse to western medicine. They are in to TCM (traditional chini medicine). Even then CCP should be able to find enough victims...
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Re: Wuhan Coronavirus Resource Thread

Post by chola »

nam wrote:They have Pak, Iran, some of the ASEAN countries to test out the vaccine. They could easily influence WHO and get it tested in South America for example.

I have been reading that Chinis are adverse to western medicine. They are in to TCM (traditional chini medicine). Even then CCP should be able to find enough victims...
You just hit that nail on the head:
https://www.india.com/news/world/china- ... s-4096004/

Beijing: Chinese Foreign Minister Wang Yi on Monday held the first joint virtual conference with his counterparts from Pakistan, Afghanistan and Nepal during which he mooted a four-point plan to contain the COVID-19 pandemic, boost economic recovery and resumption of the BRI infrastructure projects.

Afghanistan’s acting Foreign Minister Mohammad Haneef Atmar and Nepalese Foreign Minister Pradeep Kumar Gyawali attended the virtual meeting, according to a Chinese Foreign Ministry press release


...

Wang said all the four countries should carry out regional cooperation on joint prevention and control of the pandemic drawing the experience of China and Pakistan, according to the press release.

He said when the Chinese vaccine is developed, China will improve the accessibility of vaccines to the three countries and help them strengthen their public health systems.
It'll be a race between India and these chini guinea pigs (emphasis on pigs for pakis.)

I would put my bet on AstraZeneca.
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Re: Wuhan Coronavirus Resource Thread

Post by sudarshan »

57% of people in slums and 16% outside slums have been exposed to the China virus in Mumbai.

From a serosurvey. Seems like overall, 40% of people have been exposed in Mumbai. Calculated IFR from the above seems to be between 0.05% and 0.1%.
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Post by Jarita »

^^^ combined with older coronaviruses this should confer herd immunity
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Post by DrRatnadip »

sudarshan wrote:57% of people in slums and 16% outside slums have been exposed to the China virus in Mumbai.

From a serosurvey. Seems like overall, 40% of people have been exposed in Mumbai. Calculated IFR from the above seems to be between 0.05% and 0.1%.
We are hardly getting pts from slum areas now.. Last month most cases were from slums..
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Post by sudarshan »

DrRatnadip wrote:We are hardly getting pts from slum areas now.. Last month most cases were from slums..
Good to have that real-world corroboration of the measured phenomenon.

I've been searching for a while for time series data on cases and deaths, broken down by states, for India. Can't seem to find any. Anybody here know of such a source?
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Re: Wuhan Coronavirus Resource Thread

Post by anmol »

sudarshan
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Post by sudarshan »

anmol wrote:Try this --> https://www.covid19india.org/
Thank you, that does have the time series data I'm looking for, but is there any way to download it?
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Post by sudarshan »

So it was in "api," that's what I was looking for.

Thank you heaps!
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Re: Wuhan Coronavirus Resource Thread

Post by chola »

DrRatnadip wrote:
sudarshan wrote:57% of people in slums and 16% outside slums have been exposed to the China virus in Mumbai.

From a serosurvey. Seems like overall, 40% of people have been exposed in Mumbai. Calculated IFR from the above seems to be between 0.05% and 0.1%.
We are hardly getting pts from slum areas now.. Last month most cases were from slums..
Doctor, if this is the case can we allow it to happen safely to the rest of the population? To go from most cases to hardly any in a month means that herd immunity works right?

This is getting attention around the world:
https://www.bloomberg.com/news/articles ... rest-areas
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Re: Wuhan Coronavirus Resource Thread

Post by DrRatnadip »

chola wrote:
DrRatnadip wrote:
We are hardly getting pts from slum areas now.. Last month most cases were from slums..
Doctor, if this is the case can we allow it to happen safely to the rest of the population? To go from most cases to hardly any in a month means that herd immunity works right?

This is getting attention around the world:
https://www.bloomberg.com/news/articles ... rest-areas
We are in community transmission phase since long now.. So there is no doubt disease will sweep throughout population and herd immunity will take over.. We cant stop it now..It is likely that covid will settle as endemic infection in certain areas and keep reappearing as sporadic outbreaks, similar to swine flu..
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Post by Manish_P »

China made medical instruments as dangerous as the Chinese virus

Mumbai: Man purchases oxymeter which also shows heartbeat of pencil!
Image

When a worried Andheri resident purchased an oxymeter, he only intended to monitor the oxygen level of his loved ones and himself in the pandemic. But he was shocked when he happened to clip it to a pencil, and it read both its oxygen level and heart rate! Kushal Dhuri, who works for a political party, is furious with the China-made device, and says people should stop buying oxymeters that are made in China.

'So, my pencil breathes!'

Speaking to mid-day, Dhuri said, "In the name of medical equipment online and in the market, many unreliable Chinese goods are being sold. These cannot be trusted as they are playing with the lives of people. I would like to appeal to people to stop buying Chinese manufactured oxymeters as the one I bought shows the heart beat and oxygen level of a pencil. Such an oxymeter can cost someone his/her life."
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Post by nvishal »

^ There is an led that illuminates through your finger. A photodiode on the other end captures the light flickering and sends to a chip that creates an estimate. The pencil is either not wide enough to cover the diode or the light is scattering over the pencils varnish surface.

These 6 month course waala Journalists keep making a fool of themselves and the paper company they write for.
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Re: Wuhan Coronavirus Resource Thread

Post by nam »

With the opening up of major cities, people who have no choice to maintain distancing like the ones having to travel in trains, buses to work, live in crowded places will have the virus spread through them. By the end of the year, I guess most of the dense cities will have their round of infection.

One who can work from home and isolate their family from public travel, might be lucky not to get infected.

So i guess the peak is about the ones, who are most likely to get infected. Once they have gone through, it tapers down. My view is that it takes 2 months, once it starts surging to taper down, like it is happening in Delhi & Mumbai.

For the entire country, we will still see high numbers, as one city after the other will have their 2 month cycle. There have been concerns over rural spread, however I feel it is is the cities which will be most effected. Villages generally are less dense, lot of open spaces.

Once a community spread starts, it will be a 2 month cycle.
nam
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Joined: 05 Jan 2017 20:48

Re: Wuhan Coronavirus Resource Thread

Post by nam »

Wouldn't it be a good idea to start giving HCQ to the population, as a malaria prevention, given it is monsoon, with the added benefit of covid?

The irony is if people get malaria, their chances of reduced covid infection increases!
chola
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Joined: 16 Dec 2002 12:31
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Re: Wuhan Coronavirus Resource Thread

Post by chola »

It looks like the second wave is finally beginning in the Far East.

Cheen, Korea, Japan, Hong Kong, Vietnam are all seeing upticks.
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