Wuhan Coronavirus Resource Thread

[chandrasekaran]

Not only that, even if GoI were to reimburse the expense, a lot of administrative overhead will be added to ensure there is no corruption here. Also, I fail to see, why people who can afford to travel abroad, fly back from New Delhi, Travel in Air Conditioned coaches can't afford to spend for the tests. By all means, make it free for people who cannot afford, but I am sure 70%+ can afford to pay up.

Really saddened to see such directions being forced on the administration when it's already at its seams.

[chetak]

Not only that, even if GoI were to reimburse the expense, a lot of administrative overhead will be added to ensure there is no corruption here. Also, I fail to see, why people who can afford to travel abroad, fly back from New Delhi, Travel in Air Conditioned coaches can't afford to spend for the tests. By all means, make it free for people who cannot afford, but I am sure 70%+ can afford to pay up.

Really saddened to see such directions being forced on the administration when it's already at its seams.

not to mention the many false test certificates that will soon surface inspired by our jugaad pasand population

[anmol]

Where Have All the Heart Attacks Gone?


Except for treating Covid-19, many hospitals seem to be eerily quiet.

By Harlan M. Krumholz, M.D.

• April 6, 2020

The hospitals are eerily quiet, except for Covid-19.

I have heard this sentiment from fellow doctors across the United States and in many other countries. We are all asking: Where are all the patients with heart attacks and stroke? They are missing from our hospitals.

Yale New Haven Hospital, where I work, has almost 300 people stricken with Covid-19, and the numbers keep rising — and yet we are not yet at capacity because of a marked decline in our usual types of patients. In more normal times, we never have so many empty beds.

Our hospital is usually so full that patients wait in gurneys along the walls of the emergency department for a bed to become available on the general wards or even in the intensive care unit. We send people home from the hospital as soon as possible so we can free up beds for those who are waiting. But the pandemic has caused a previously unimaginable shift in the demand for hospital services.

Some of the excess capacity is indeed by design. We canceled elective procedures, though many of those patients never needed hospitalization. We are now providing care at home through telemedicine, but those services are for stable outpatients, not for those who are acutely ill.What is striking is that many of the emergencies have disappeared. Heart attack and stroke teams, always poised to rush in and save lives, are mostly idle. This is not just at my hospital. My fellow cardiologists have shared with me that their cardiology consultations have shrunk, except those related to Covid-19. In an informal Twitter poll by @angioplastyorg, an online community of cardiologists, almost half of the respondents reported that they are seeing a 40 percent to 60 percent reduction in admissions for heart attacks; about 20 percent reported more than a 60 percent reduction.And this is not a phenomenon specific to the United States. Investigators from Spain reported a 40 percent reduction in emergency procedures for heart attacks during the last week of March compared with the period just before the pandemic hit.

And it may not just be heart attacks and strokes. Colleagues on Twitter report a decline in many other emergencies, including acute appendicitis and acute gall bladder disease.The most concerning possible explanation is that people stay home and suffer rather than risk coming to the hospital and getting infected with coronavirus. This theory suggests that Covid-19 has instilled fear of face-to-face medical care. As a result, many people with urgent health problems may be opting to remain at home rather than call for help. And when they do finally seek medical attention, it is often only after their condition has worsened. Doctors from Hong Kong reported an increase in patients coming to the hospital late in the course of their heart attack, when treatment is less likely to be lifesaving.

There are other possible explanations for the missing patients. In this time of social distancing, our meals, social interactions and physical activity patterns tend to be very different. Maybe we have removed some of the triggers for heart attacks and strokes, like excessive eating and drinking or abrupt periods of physical exertion. This theory merits research but seems unlikely to explain the dramatic changes we’re observing.We actually expected to see more heart attacks during this time. Respiratory infections typically increase the risk of heart attacks. Studies suggest that recent respiratory infections can double the risk of a heart attack or stroke. The risk seems to begin soon after the respiratory infection develops, so any rise in heart attacks or strokes should be evident by now. We urge people to get flu vaccines every year, in part, to protect their hearts.

Also, times of stress increase the risk of heart attacks and strokes. Depression, anxiety and frustration, feelings that the pandemic might exacerbate, are all associated with a doubling or more of heart attack risks. Work and life stress, which also may be higher with the acute disruptions we’ve all been going through, can markedly increase the risk of a heart attack. Moreover, events like earthquakes or terrorist attacks or war, in which an entire society is exposed to a stressor, are risk factors for heart attacks. Finally, Covid-19 can actually affect the heart, which should be increasing the number of patients with heart problems.

Experts are bringing together data to confirm these patterns. We hope to gain a greater understanding of their causes and consequences.

Meanwhile, the immediate message to patients is clear: Don’t delay needed treatment. If fear of the pandemic leads people to delay or avoid care, then the death rate will extend far beyond those directly infected by the virus. Time to treatment dictates the outcomes for people with heart attacks and strokes. These deaths may not be labeled Covid-19 deaths, but surely, they are collateral damage.

The public needs to know that hospitals are equipped not only to care for people with Covid-19 but also those who have other life-threatening health problems. Yes, we in health care are working to keep people out of the hospital if we can, but we can safely provide care for those people who are not sick from Covid-19. Masks and protective gear for health care workers and patients go a long way to ensure a safe environment. Also, people with chronic conditions need to know that avoidance of needed care could ultimately be as big a threat as the virus itself.

As we fight coronavirus, we need to combat perceptions that everyone else must stay away from the hospital. The pandemic toll will be much worse if it leads people to avoid care for life-threatening, yet treatable, conditions like heart attacks and strokes.

Harlan Krumholz, M.D., is professor of medicine at Yale and director of the Yale New Haven Hospital Center for Outcomes Research and Evaluation.

[anmol]

Laboratory preparedness for SARS-CoV-2 testing in India: Harnessing a network of Virus Research & Diagnostic Laboratories

Indian Journal of Medical Research

March 6, 2020

Here we describe the role of a countrywide network of VRDLs in early diagnosis of COVID-19.

IJMR Research Articles on Coronavirus "India & COVID-19"

[nam]

UK ICU stats have shown an interesting data.

73% of the ICU patients are men.

This seems to push largely men in to ICU.

Any theory why this could be? Is it because men need more oxygen level compared to a woman, due to extra muscle mass?

[Mort Walker]

^^^Women drive their husbands to an early grave.

[saip]

Smoking in men more than women?

[Rahul M]

UK ICU stats have shown an interesting data.

73% of the ICU patients are men.

This seems to push largely men in to ICU.

Any theory why this could be? Is it because men need more oxygen level compared to a woman, because of extra muscle mass?

Smoking?

[suryag]

Smoking in Germany is as bad or as good as in UK

[Gerard]

China should be sued for $6.5 trillion for coronavirus damages says top UK think tank

According to the report, Coronavirus Compensation? by conservative London think tank The Henry Jackson Society, China could be sued under 10 possible legal avenues, including the International Health Regulations, which were beefed up after the SARS outbreak, which China also tried to cover up.

The report said had China provided accurate information at an early juncture, "the infection would not have left China."

China only reported the disease to the WHO on December 31 and said there was no evidence of human-to-human transmission.

Yet whistleblower medics, including Li Wenliang, were reprimanded for raising the alert. Some were confident the disease was spreading between humans before this date.

[Deans]

you know what's freaking me out,
india has 175 corona deaths. my earlier 1 death per 50 cases, gives 8750 infections. maharastra alone has 72 deaths, putting the possible infections at 3600.

so far total indian cases are 5741. and mh has 1135 cases. mh has huge difference b/w projected and the cases reported, like 2465 cases. rest of india has very little gap, 4606 against estimated 5150. even basic maths showing gloomy picture for mumbai.

my numbers can be wrong. better be safe than sorry. be careful with everything, mh people. wash hands and stay at home.

another odd state is madhya pradesh with 290 cases and 21 deaths. estimated cases for them is like 1050. huge difference.

I too assumed (in earlier posts) a fatality rate for India, for under 2%. Maharashtra, Guj and MP are worrying, with fatality rates over 5%.

[nam]

It seems 3.9M men and 3.2M women in UK smoke. This is from the Office of Stats. Ofcourse people lie about smoking..

But then the difference should not be 73 to 27%, men to women..

There was another data on how people with body mass index of 17 and less, were .7% of the ICU. Fundamentally really lean people.. 18-25 were around 25-27%

There is lots we don't know about this virus.

[Gerard]

Didn’t one study find more expression of ACE2 receptors in men?

[Raja]

I too assumed (in earlier posts) a fatality rate for India, for under 2%. Maharashtra, Guj and MP are worrying, with fatality rates over 5%.

Or the detection rate is significantly lower than in other countries.

[disha]

Didn’t one study find more expression of ACE2 receptors in men?

Yes, but where?

This study throws more light into it https://www.deccanherald.com/science-an ... 22861.html

Coronavirus targets the cilia

The scientists discovered that certain progenitor cells in the bronchi are mainly responsible for producing the coronavirus receptors. These progenitor cells, they said, normally develop into respiratory tract cells lined with hair-like projections called cilia that sweep mucus and bacteria out of the lungs.
...
...

According to the study, the ACE2 receptor density on the cells increased with age, and was generally higher in men than in women.

[nam]

I got curious if the volume of oxygen used by a person on a daily basis makes any difference.

So decided to check mountainous regions. Ladakh & Uttarakand: 14 & 35 cases so far.. no deaths. Very low example size, but interesting.

People in Ladakh would have lungs tuned for low oxygen level.

[Shaashtanga]

Not sure is this has already been shared on this thread - Covid-19 had us all fooled, but now we might have finally found its secret.

In the last 3–5 days, a mountain of anecdotal evidence has come out of NYC, Italy, Spain, etc. about COVID-19 and characteristics of patients who get seriously ill. It’s not only piling up but now leading to a general field-level consensus backed up by a few previously little-known studies that we’ve had it all wrong the whole time. Well, a few had some things eerily correct (cough Trump cough), especially with Hydroxychloroquine with Azithromicin, but we’ll get to that in a minute.

There is no ‘pneumonia’ nor ARDS. At least not the ARDS with established treatment protocols and procedures we’re familiar with. Ventilators are not only the wrong solution, but high pressure intubation can actually wind up causing more damage than without, not to mention complications from tracheal scarring and ulcers given the duration of intubation often required… They may still have a use in the immediate future for patients too far to bring back with this newfound knowledge, but moving forward a new treatment protocol needs to be established so we stop treating patients for the wrong disease.

The past 48 hours or so have seen a huge revelation: COVID-19 causes prolonged and progressive hypoxia (starving your body of oxygen) by binding to the heme groups in hemoglobin in your red blood cells. People are simply desaturating (losing o2 in their blood), and that’s what eventually leads to organ failures that kill them, not any form of ARDS or pneumonia. All the damage to the lungs you see in CT scans are from the release of oxidative iron from the hemes, this overwhelms the natural defenses against pulmonary oxidative stress and causes that nice, always-bilateral ground glass opacity in the lungs. Patients returning for re-hospitalization days or weeks after recovery suffering from apparent delayed post-hypoxic leukoencephalopathy strengthen the notion COVID-19 patients are suffering from hypoxia despite no signs of respiratory ‘tire out’ or fatigue.

Here’s the breakdown of the whole process, including some ELI5-level cliff notes. Much has been simplified just to keep it digestible and layman-friendly.

Your red blood cells carry oxygen from your lungs to all your organs and the rest of your body. Red blood cells can do this thanks to hemoglobin, which is a protein consisting of four “hemes”. Hemes have a special kind of iron ion, which is normally quite toxic in its free form, locked away in its center with a porphyrin acting as it’s ‘container’. In this way, the iron ion can be ‘caged’ and carried around safely by the hemoglobin, but used to bind to oxygen when it gets to your lungs.

When the red blood cell gets to the alveoli, or the little sacs in your lungs where all the gas exchange happens, that special little iron ion can flip between FE2+ and FE3+ states with electron exchange and bond to some oxygen, then it goes off on its little merry way to deliver o2 elsewhere.

Here’s where COVID-19 comes in. Its glycoproteins bond to the heme, and in doing so that special and toxic oxidative iron ion is “disassociated” (released). It’s basically let out of the cage and now freely roaming around on its own. This is bad for two reasons:

1) Without the iron ion, hemoglobin can no longer bind to oxygen. Once all the hemoglobin is impaired, the red blood cell is essentially turned into a Freightliner truck cab with no trailer and no ability to store its cargo.. it is useless and just running around with COVID-19 virus attached to its porphyrin. All these useless trucks running around not delivering oxygen is what starts to lead to desaturation, or watching the patient’s spo2 levels drop. It is INCORRECT to assume traditional ARDS and in doing so, you’re treating the WRONG DISEASE. Think of it a lot like carbon monoxide poisoning, in which CO is bound to the hemoglobin, making it unable to carry oxygen. In those cases, ventilators aren’t treating the root cause; the patient’s lungs aren’t ‘tiring out’, they’re pumping just fine. The red blood cells just can’t carry o2, end of story. Only in this case, unlike CO poisoning in which eventually the CO can break off, the affected hemoglobin is permanently stripped of its ability to carry o2 because it has lost its iron ion. The body compensates for this lack of o2 carrying capacity and deliveries by having your kidneys release hormones like erythropoietin, which tell your bone marrow factories to ramp up production on new red blood cells with freshly made and fully functioning hemoglobin. This is the reason you find elevated hemoglobin and decreased blood oxygen saturation as one of the 3 primary indicators of whether the shit is about to hit the fan for a particular patient or not.

2) That little iron ion, along with millions of its friends released from other hemes, are now floating through your blood freely. As I mentioned before, this type of iron ion is highly reactive and causes oxidative damage. It turns out that this happens to a limited extent naturally in our bodies and we have cleanup & defense mechanisms to keep the balance. The lungs, in particular, have 3 primary defenses to maintain “iron homeostasis”, 2 of which are in the alveoli, those little sacs in your lungs we talked about earlier. The first of the two are little macrophages that roam around and scavenge up any free radicals like this oxidative iron. The second is a lining on the walls (called the epithelial surface) which has a thin layer of fluid packed with high levels of antioxidant molecules.. things like abscorbic acid (AKA Vitamin C) among others. Well, this is usually good enough for naturally occurring rogue iron ions but with COVID-19 running rampant your body is now basically like a progressive state letting out all the prisoners out of the prisons… it’s just too much iron and it begins to overwhelm your lungs’ countermeasures, and thus begins the process of pulmonary oxidative stress. This leads to damage and inflammation, which leads to all that nasty stuff and damage you see in CT scans of COVID-19 patient lungs. Ever noticed how it’s always bilateral? (both lungs at the same time) Pneumonia rarely ever does that, but COVID-19 does… EVERY. SINGLE. TIME.

— — — — — — — — — — — — -

Once your body is now running out of control, with all your oxygen trucks running around without any freight, and tons of this toxic form of iron floating around in your bloodstream, other defenses kick in. While your lungs are busy with all this oxidative stress they can’t handle, and your organs are being starved of o2 without their constant stream of deliveries from red blood cell’s hemoglobin, and your liver is attempting to do its best to remove the iron and store it in its ‘iron vault’. Only its getting overwhelmed too. It’s starved for oxygen and fighting a losing battle from all your hemoglobin letting its iron free, and starts crying out “help, I’m taking damage!” by releasing an enzyme called alanine aminotransferase (ALT). BOOM, there is your second of 3 primary indicators of whether the shit is about to hit the fan for a particular patient or not.

Eventually, if the patient’s immune system doesn’t fight off the virus in time before their blood oxygen saturation drops too low, ventilator or no ventilator, organs start shutting down. No fuel, no work. The only way to even try to keep them going is max oxygen, even a hyperbaric chamber if one is available on 100% oxygen at multiple atmospheres of pressure, just to give what’s left of their functioning hemoglobin a chance to carry enough o2 to the organs and keep them alive. Yeah we don’t have nearly enough of those chambers, so some fresh red blood cells with normal hemoglobin in the form of a transfusion will have to do.

The core point being, treating patients with the iron ions stripped from their hemoglobin (rendering it abnormally nonfunctional) with ventilator intubation is futile, unless you’re just hoping the patient’s immune system will work its magic in time. The root of the illness needs to be addressed.

Best case scenario? Treatment regimen early, before symptoms progress too far. Hydroxychloroquine (more on that in a minute, I promise) with Azithromicin has shown fantastic, albeit critics keep mentioning ‘anecdotal’ to describe the mountain, promise and I’ll explain why it does so well next. But forget straight-up plasma with antibodies, that might work early but if the patient is too far gone they’ll need more. They’ll need all the blood: antibodies and red blood cells. No help in sending over a detachment of ammunition to a soldier already unconscious and bleeding out on the battlefield, you need to send that ammo along with some hemoglobin-stimulant-magic so that he can wake up and fire those shots at the enemy.

The story with Hydroxychloroquine
All that hilariously misguided and counterproductive criticism the media piled on chloroquine (purely for political reasons) as a viable treatment will now go down as the biggest Fake News blunder to rule them all. The media actively engaged their activism to fight ‘bad orange man’ at the cost of thousands of lives. Shame on them.

How does chloroquine work? Same way as it does for malaria. You see, malaria is this little parasite that enters the red blood cells and starts eating hemoglobin as its food source. The reason chloroquine works for malaria is the same reason it works for COVID-19 — while not fully understood, it is suspected to bind to DNA and interfere with the ability to work magic on hemoglobin. The same mechanism that stops malaria from getting its hands on hemoglobin and gobbling it up seems to do the same to COVID-19 (essentially little snippets of DNA in an envelope) from binding to it. On top of that, Hydroxychloroquine (an advanced descendant of regular old chloroquine) lowers the pH which can interfere with the replication of the virus. Again, while the full details are not known, the entire premise of this potentially ‘game changing’ treatment is to prevent hemoglobin from being interfered with, whether due to malaria or COVID-19.

No longer can the media and armchair pseudo-physicians sit in their little ivory towers, proclaiming “DUR so stoopid, malaria is bacteria, COVID-19 is virus, anti-bacteria drug no work on virus!”. They never got the memo that a drug doesn’t need to directly act on the pathogen to be effective. Sometimes it’s enough just to stop it from doing what it does to hemoglobin, regardless of the means it uses to do so.

Anyway, enough of the rant. What’s the end result here? First, the ventilator emergency needs to be re-examined. If you’re putting a patient on a ventilator because they’re going into a coma and need mechanical breathing to stay alive, okay we get it. Give ’em time for their immune systems to pull through. But if they’re conscious, alert, compliant — keep them on O2. Max it if you have to. If you HAVE to inevitably ventilate, do it at low pressure but max O2. Don’t tear up their lungs with max PEEP, you’re doing more harm to the patient because you’re treating the wrong disease.

Ideally, some form of treatment needs to happen to:

Inhibit viral growth and replication. Here plays CHQ+ZPAK+ZINC or other retroviral therapies being studies. Less virus, less hemoglobin losing its iron, less severity and damage.
Therapies used for anyone with abnormal hemoglobin or malfunctioning red blood cells. Blood transfusions. Whatever, I don’t know the full breadth and scope because I’m not a physician. But think along those lines, and treat the real disease. If you’re thinking about giving them plasma with antibodies, maybe if they’re already in bad shape think again and give them BLOOD with antibodies, or at least blood followed by plasma with antibodies.
Now that we know more about how this virus works and affects our bodies, a whole range of options should open up.
Don’t trust China. China is ASSHOE. (disclaimer: not talking about the people, just talking about the regime). They covered this up and have caused all kinds of death and carnage, both literal and economic. The ripples of this pandemic will be felt for decades.
Fini.
- https://web.archive.org/web/20200405061 ... 182386efcb

[Deans]

Or the detection rate is significantly lower than in other countries.

Given India's demographics, our fatality rate should have been 2% (assuming our medical facilities are the same as world average). Though they are not, we have the advantage of relatively few cases, so the hospitals are not overwhelmed. One possibility is that people are seeking treatment relatively late.

[disha]

Or the detection rate is significantly lower than in other countries.

Or the co-morbidities are higher than other countries?

For example, if you look at some of the Thoo-blighies, they are obese with at least two co-morbidities -> Diabetes and High Blood pressure. I will not be surprised if their Heart Health is also bad (a third co-morbidity).

The death rate *must* *not* be compared between Germany/India., US/India or S.Korea/India. The death rate should be compared within the S. Asian nations like S. Lanka and B'Desh.

To immediately latch on to "detection rate" is a vanity metric. It is useless since it does not give any information. And to use that to scream more tests, more tests, more tests is another useless decision. It is not going to help.

All people with High BP, Diabetes should stay away. Since for several it is a lifestyle disease, they can start doing Yoga and Pranayama. Simple exercises go a long way.

[saip]

I got curious if the volume of oxygen used by a person on a daily basis makes any difference.

So decided to check mountainous regions. Ladakh & Uttarakand: 14 & 35 cases so far.. no deaths. Very low example size, but interesting.

People in Ladakh would have lungs tuned for low oxygen level.

I was trying to get some statistics from Ecuador where we heard bodies are being left in the streets. There are two cities of similar size, Guayaquil (2.8mil) and Quito (2mil). They differ in altitude. While Guayaquil is at sea level, Quito is at 9500'. Out of 93 reported deaths 60 are from Guayaquil. Deaths in Quito I could not get but must be lower. So may be higher altitude and lung capacity may have lower mortality.

[vijayk]

- https://web.archive.org/web/20200405061 ... 182386efcb

This was deleted from medium and this is just an archive ...

[vijayk]

https://www.rediff.com/news/interview/c ... 200408.htm
'BCG vaccine can be a game-changer against coronavirus'

It is against this background that Rediff.com's Shobha Warrier spoke to the well-known immunologist Dr Gobardhan Das, a professor at the Special Centre of Molecular Medicine at Jawaharlal Nehru University. He is also an adjunct professor, pathology and genomic medicine at the Houston


Dr Das has been requesting the authorities at the health ministry through his Twitter handle for more than a month to start once again immunising India's health workers and the elderly with the BCG vaccine.

"I believe that in India, not only micro bacteria-like organisms, we are often exposed to environmental micro bacteria. So, we are far more resistant to infections like COVID-19," Dr Das, below, says in the first of a two-part interview:

Some of the studies show that countries that had given BCG vaccine to children -- like Brazil, India, Japan, etc -- have shown fewer COVID-19 infected cases and low mortality rate compared to the countries that no longer use the BCG vaccine, like the US and the European countries.
Do you think there is a direct link between the BCG vaccine and resistance to the coronavirus?

Yes. In my opinion, there is indeed a link between BCG vaccination and resistance to COVID-19.

I believe that in India, not only micro bacteria-like organisms, we are often exposed to environmental micro bacteria. So, we are far more resistant to infections like COVID-19.

You take Spain, which has 125,000 infected cases while neighbouring Portugal has only 11,000 cases.

While in Portugal, the BCG vaccine is administered, it is not in Spain.

In Brazil, where BCG vaccination started in 1920, there are only around 11,000 infections.

Japan, which started BCG vaccination in 1947, has 3,500 infected people.

Iran that started the BCG vaccine in 1984, has 58,000 cases.

That's why I say there is a direct co-relation between the incidence of COVID-19 and the BCG vaccination.

BCG vaccination is against a bacterial infection and this is a virus. How does a vaccination that is for bacterial infection work for against a virus?

BCG is nothing but a micro bacterial strain. Immunologists call it adjuvant which is used to facilitate hyper immune responses. In adjuvant, often micro bacterial parts are used, and it is the best adjuvant.

Because of the micro bacteria, our immune response is always higher than those who are not exposed to the micro bacterial antigens.

For example, in the US, they are not vaccinated with any micro bacteria, and the incidence of getting exposed to any micro bacteria is also much less.

Therefore, their immune response is lesser than that of Indians.

You mean, it is not about bacteria or the virus, but about the general immune system?

That is correct. Also, when you immunise with BCG, in immunological terms you get something called Trained Immunity or we call it 'Immunological memory' which lasts long.

When you immunise with BCG to protect against TB, it actually protects against so many other infections. For example, leprosy.

We still do not know the exact mechanism, but this vaccine actually protects against various other infections too.

Scientifically speaking, how does the BCG vaccine work against the coronavirus?

There are two points I have to say. One is, our immune response is higher than many other people. Because our immune response is high, it helps in our response to the virus.

Secondly, because of the BCG vaccine and the adjuvant effect, the moment any virus or any antigen comes in, the trained immunity we have, can eliminate them effectively.

We have been administering the BCG vaccine from 1947 onwards. So, do you feel it is due to the BCG vaccine that India has fewer infected cases and low mortality rate?

Yes. In India, there are three factors that are working in our favour.

First is the early lockdown which the rest of the world failed to do, has had a huge impact.

Second is the human immune response which is already high because of the exposure to various micro bacterial organisms.

If you compare our immune response to that of those from the so-called clean countries, there is always a difference.

This basic immune response of ours is actually favouring us. We are much more resistant to infections than our western counterparts.

Third factor that is helping us is the BCG vaccine that we have been given as children.

So, relatively speaking, we are safer than countries like the US, Italy, Spain, etc.

But you have to remember that it does not mean we do not have to adhere to the precautions. We have to strictly practice social distancing, washing hands, etc.

A lot of other countries testing this too but what has been missing is total response from Dr. HarshVardhan. He has been less than forthcoming. Never comes in front of any thing. Never articulates> Looks like pretty good performer but not a orator or even someone who takes advantage of our situation and takes leadership role.

Just ignores every thing ... May be we needed someone who could have demonstrated some leadership and articulate the experience.

[pankajs]

Folks on SM and BRF are either "We must stand with friends like America" or "We must extract the maximum price".

Both of them miss the nuance in foreign policy.
1. There are no permanent friends or enemies amongst nations.
2. Bulls make money bear makes money but pigs get slaughtered.

Therefore,
1. We must help out countries that are friendly to the extent possible for multiple reasons.
a. Out destiny is liked to the global destiny and India is unlikely to prosper while the rest of the world goes to the dogs
a. Create goodwill around our neighborhood and the globe with spare supply **to the extent possible**
b. Enhance partnership for future co-operation / Open doors for future opportunities by becoming a reliable provider of goods and services.

2. While we are in no position to "gift" supplies to any great extent we must also not charge black market rates. The supplies should be charged at commercial rates which allows the manufacturers its margins.

Anything more will play foul to the objectives listed under the previous point.

https://twitter.com/realDonaldTrump/sta ... 9408498693

Donald J. Trump @realDonaldTrump

Extraordinary times require even closer cooperation between friends. Thank you India and the Indian people for the decision on HCQ. Will not be forgotten! Thank you Prime Minister @NarendraModi for your strong leadership in helping not just India, but humanity, in this fight!

Can there be better PR than this on a Global scale?!!

[shaun]

SARS-CoV-2 (COVID-19) Testing: Status Update 08 April 2020 9:00 PM IST
A total of 1,27,919 samples have been tested as on 08 April 2020, 9 PM IST. 5114 individuals have
been confirmed positive among suspected cases and contacts of known positive cases in India.
Today, on 08 April 2020, till 9 PM IST, 13,143 samples have been reported. Of these, 320 were
positive for SARS-CoV-2.

[pankajs]

https://www.wionews.com/india-news/indi ... ain-291412
India gives green signal to hydroxychloroquine order placed by Spain

The Indian government has given a green signal to hydroxychloroquine (HCQ) order placed by Spain. The order was placed two months ago.

The drug has been hailed as a gamechanger in fighting COVID-19.

Earlier in the day, External Affairs Minister S Jaishankar had a telephonic conversation with his Spanish counterpart Arancha González. A tweet on the talks by EAM said, "We agreed that effective COVID response requires global cooperation" and 'India has responded positively to the urgent pharmaceutical requirement of Spain."

[disha]

I got curious if the volume of oxygen used by a person on a daily basis makes any difference.

So decided to check mountainous regions. Ladakh & Uttarakand: 14 & 35 cases so far.. no deaths. Very low example size, but interesting.

Or higher UV radiation in Ladakh?

Cleaner air followed by higher UV radiation means the virus may not survive long outside. Hence the R0 (transmissivity) decreases. Hence lower cases. Also Ladakh and Uttarakhand do not have extreme-dense and multiple population clusters!

[chola]

Signs of the second wave in Cheen.

And they just lifted lockdown a few days ago
https://www.foxnews.com/world/another-c ... s-lockdown

Wuhan may be celebrating, but another Chinese city has gone into lockdown over coronavirus

...
Suifenhe, a city along China’s northern border with Russia, is now ordering residents to stay inside and only go outside for necessities once every three days, Reuters reports, citing state media.

https://www.dailymail.co.uk/news/articl ... urant.html

Fears of new coronavirus crisis in China as seven people testing positive are linked to the SAME restaurant

[Shaashtanga]

- https://web.archive.org/web/20200405061 ... 182386efcb

This was deleted from medium and this is just an archive ...

Yes, but has it been posted on BRF? I checked this thready (went back quiet a few pages but didn't see). Here is the guy who posted original link - https://twitter.com/agaiziunas

[BSR Murthy]

I got curious if the volume of oxygen used by a person on a daily basis makes any difference.

So decided to check mountainous regions. Ladakh & Uttarakand: 14 & 35 cases so far.. no deaths. Very low example size, but interesting.

Or higher UV radiation in Ladakh?

Cleaner air followed by higher UV radiation means the virus may not survive long outside. Hence the R0 (transmissivity) decreases. Hence lower cases. Also Ladakh and Uttarakhand do not have extreme-dense and multiple population clusters!

The altitude factor is interesting. I was actually looking at Ecuador which is pretty hard hit with Covid 19 and which has both high altitude and sea level cities. The vast majority of the disease and deaths were in the port city of Guayaquil, while the high altitude capital city Quito escaped with much fewer cases. The reports generally attributed this to different school schedules. Of course there are other differences like socioeconomics and congestion. On the other hand Aspen is transferring their sick Covid 19 patients to lower lying cities because of lower oxygen levels in high altitude places in Colorado which might impact the respiratory function adversely.
https://www.miamiherald.com/news/nation ... 16021.html
https://www.aspenpublicradio.org/post/c ... ions-least

[Shaashtanga]

Immediate Treatment for Early Stage SARS-CoV-2 Infections Recommended To Be Supported Nationally Starting Now
A strategic principle and practical approach to rapid response to novel pandemics

Authored by Dr Ben Kaplan Singer, MD; Dr Daniel Stickler, MD; Dr Avery J. Knapp Jr., MD; with many contributing doctors.

https://t.co/a5D8oX7Wd4?amp=1

[Rahul M]

This was deleted from medium and this is just an archive ...

Yes, but has it been posted on BRF? I checked this thready (went back quiet a few pages but didn't see). Here is the guy who posted original link - https://twitter.com/agaiziunas

Posted and discussed threadbare over the last few pages.

[vijayk]

https://twitter.com/kunfaaya/status/1247914543549841409

LEENA
@kunfaaya
Dharavi, Bombay. Lines for foo


check the video ...

[vimal]

https://twitter.com/kunfaaya/status/1247914543549841409

LEENA
@kunfaaya
Dharavi, Bombay. Lines for foo


check the video ...

The guy shooting the movie is talking in Tamil so not 100% sure of location.
BTW the entire MSM was raving and ranting about how great MH CM is doing in containing the virus.
What happened to the containment?

[Kaivalya]

For folks who dont understand tamil

1. The video camera holder is saying that the queue stretches all the way to food near police station

2. The video date seems to be March 27th based on comments

3. Dharavi has a lot of tamil migrants who are workers


In the bigger scheme of things MH,MP,KL and WB last seem to be the stragglers in dealing with the situation. This is just my constant tv news surfing anecdotal opinion

[disha]

The altitude factor is interesting. I was actually looking at Ecuador which is pretty hard hit with Covid 19 and which has both high altitude and sea level cities. The vast majority of the disease and deaths were in the port city of Guayaquil, while the high altitude capital city Quito escaped with much fewer cases. The reports generally attributed this to different school schedules. Of course there are other differences like socioeconomics and congestion.

On the other hand Aspen is transferring their sick Covid 19 patients to lower lying cities because of lower oxygen levels in high altitude places in Colorado which might impact the respiratory function adversely.

Thanks for the data point. Transmissivity (R0) and patient management are two different things. First one is how likely you are going to get the virus? And second is how will you fare once you get the virus?

For the second item, once people in Aspen get it, they need oxygen and hence they are shifted to a place where they can breathe easily. For the former, UV has an impact. It reduces transmissivity.

[hanumadu]

Since there is some indication that high temperatures might be mitigating the spread of the virus, is there any advisory to switch off air conditioners, especially in public places and offices. Since, closed places like offices and restaurants are where people are more likely to be close to each other and many people touching the same surfaces and things, it should be all the more reason to shut off ACs in them.

[BSR Murthy]

The altitude factor is interesting. I was actually looking at Ecuador which is pretty hard hit with Covid 19 and which has both high altitude and sea level cities. The vast majority of the disease and deaths were in the port city of Guayaquil, while the high altitude capital city Quito escaped with much fewer cases. The reports generally attributed this to different school schedules. Of course there are other differences like socioeconomics and congestion.

On the other hand Aspen is transferring their sick Covid 19 patients to lower lying cities because of lower oxygen levels in high altitude places in Colorado which might impact the respiratory function adversely.

Thanks for the data point. Transmissivity (R0) and patient management are two different things. First one is how likely you are going to get the virus? And second is how will you fare once you get the virus?

For the second item, once people in Aspen get it, they need oxygen and hence they are shifted to a place where they can breathe easily. For the former, UV has an impact. It reduces transmissivity.

Thanks Captain Obvious!

[Bart S]

Folks BD and SL are getting into the hot zone, will try to trawl through some english dailies there and post here. BD's karkhanas where people are packed up like Sardines are perfect petridish for CV, hope the GoBd is congnizant and aware of the challenges. SL is a relatively simpler case

BD seem to have outsourced their problem to us, with about 800 Bangladeshi Tableegh people circulating in India and caught so far. There are probably more hiding out in WB.

[Bart S]

Maharashtra Government seems to have bungled this up.
8 Corona deaths in Pune alone today, with 5 yesterday. As per news channels it's a total of 14 this week.
Instead of encouraging doorstep deliveries of essentials through e-commerce, they are hell bent on thrashing delivery boys. That's what an xpressbees guy (firstcry) told me. They could have totally gone online themselves connecting farmers and producers to consumers, with the help of large number of taxi drivers, rickshaw drivers. And now with total sealing of areas, even essential items would not be allowed to pass.

So Anurag Kashyap and the rest of the Bollywoodiyas were lying?

It looks like muslim power loom owners in Malegaon where still running their mills with impunity (while keeping the shutters down on the outside for appearances) because the local MLA is a Muslim.

[disha]

Since there is some indication that high temperatures might be mitigating the spread of the virus, is there any advisory to switch off air conditioners, especially in public places and offices. Since, closed places like offices and restaurants are where people are more likely to be close to each other and many people touching the same surfaces and things, it should be all the more reason to shut off ACs in them.

I think it is not temperature per se. Or even humidity. Both together may weaken the virus in that it might keep the transmissivity (R0) low OR humans do not dry out their throat making it susceptible to virus. Since I have seen people catch cold in peak summer as well.

UV may have a role to play and the solar radiation that is prominent in summer (April/May/June) has higher UV flux. Note that the pollution in cities reduces the solar radiation (and so do the dust, clouds etc).

Do we have BSL 3-4 labs that can do tests on virus at different places? It will be as simple as putting the virus in an open petridish out in the sun at different altitudes and measure after <n> time how many virus survive.