Wuhan Coronavirus Resource Thread

Vadivel · Post by **Vadivel** » 25 Apr 2021 13:25

Whatsapp Forward.

Sharing below a post from Hanuman Mal Bengani the ex CEO of Linde India.
Linde is one of the largest oxygen producers in India

“Having spent my life time of 45 years in oxygen industry and involved with setting up 50% of production capacities in india ( as business head of Linde) I can share few things which will probably clear some of your thoughts. First few facts

1) Industrial and medical oxygen are same product produced in same plant, stored in same tanks and filled in same cylinders. For medical oxygen the gas company just have to analyse each batch and certify. No other difference. In fact for industrial we need 99.5% pure oxygen where as for medical as per pharmocopea all over world is 93+\-3%.
2) There is absolutely no shortage of oxygen product in india. You will be surprised to know that less than 1% of oxygen production capacity is used for medical purposes. Even in corona times it may go up to three times or even 5%. But that's it.
2) I would estimate total oxygen production capacity in india to be around 100,000 tons per day ( or may be more) and around 80% of oxygen production capacities are with steel companies where oxygen gas is produced and used in iron making as well as steel making. Yes, Relinace Jamnagar has 22000 tons per day capacity for petcoke gassification.
3) Most of captive plant are in East india, some in west ( Mumbai and Gujarat) and some in Karnataka. These plants typically produce 5-10% of product as liquid which is stored in large tanks. This liquid is used by them as back up when plant is down and also to meet peak demands.
4) There are several stand alone liquid oxygen plants owned by gas companies like Linde and Innox where they produce liquid oxygen and sell to various customers through tankers and tanks. 5) Several refillers around country buy liquid from gas companies and fill gas cylinders after vaporising liquid
6) Oxygen is generally delivered to end user by three means. Directly through pipe line from plant to end user which is say 80% of product. 15% or so is delivered in liquid form through tanks and tankers and less than 5% through cylinders

*So why are we facing crisis today ?* I think combination of followings

1) Shortage of distribution assets ie road tankers, storage tanks and cylinders. Mind you these are expensive. Each road tanker costs 45 lakhs on road and a cylinder costs around 10,000 in which you sell oxygen just worth Rs 300. These assets have been built by gas companies based on normal times. There is only that much one can do with these assets
2) Logistics management. Most of Plants are located in select geographies. So distribution assets travel fair distance ( 200-1000 kms) to deliver to customer. Now even with good roads a tanker takes around 7-10 days to make a round trip and a cylinder also takes that much turn around.
3) Desire of gas companies to focus on what maximises their profits

Last but not least this wave came so quick it took our government administration with pants down. Had they thought of this impending danger and prepared, a major crisis could have been avoided. But that's easy said than done knowing our democratic set up. Now Govt are taking steps. In hindsight I think Govt could have planned followings

1) Strict advisory to gas companies to use all distribution assets for medical purpose only from day one. They could provide compensation to gas companies for this just like MSP for food grains.
2) Advise all captive plants owners not to use a drop of liquid oxygen from plant / tank for their process use until they are full.
3) Using rails to transport through green door track
4) All hospitals could have installed PSA captive plants. PMO had announced 200 crores for all district hospitals and they could have around 500 plants. In usual public sector tendering process not even 15% of that has been used
5) CEO of large hospitals are also equally responsible. When they charge such huge money from public, they should have better prepared them selves. For what they get fat salaries and bonuses. Once this crisis is over I think some heads of CEO of large hospitals must roll.
No more for now. Any one wishes to know more may contact me on one to one basis.”

Cyrano · Post by **Cyrano** » 25 Apr 2021 14:24

****** Posted ********

Why aren't prominent (actually ALL) Indian-Americans not raising their voices against Biden admin's vaccine hoarding and denial policies that are hurting 1.3 billion people back home?

IAs need mobilise themselves and others, and write to, tweet, call, email.... and implore US admin at every level to change these short sighted, poorly thought out policies. Toolkits can be used for good too.

Attending Howdy Modi is the easy part of being true to one's roots. Standing up in times like these and using one's influence at any level is such an obvious thing to do. Every day and hour counts now !

May be some US based BRFites can take the lead and do this to whatever extent they can?

isubodh · Post by **isubodh** » 25 Apr 2021 15:07

Vadivel wrote:Whatsapp Forward.
Linde is one of the largest oxygen producers in India
.”

Last year it was shortage of ventilators. NASA, ISRO, IIT, PSU and Pvt sector was all designing cheap ventilators. Some were being producing the models too.
This year no one is talking about ventilators and all about Oxygen. Is the ventilators shortage fully over now that no more talks about it or the protocol for treatment has changed ?

nam · Post by **nam** » 25 Apr 2021 15:29

In BLR more than 700 people are testing +ve per hour...the positivity rate is at 15%!! AIIMS director has also recommended doing a lockdown in areas where positive rate is higher than 10%...unfortunately, most of the high positive rate areas are also the ones which are major economic centers. At least a week (ideally 2) is required in BLR to put a pause on infection rates...but knowing BSY, he will not do a lockdown.

It is a simple requirement to protect one-selves from the Chinese virus. Stay away from people. Don't go in to closed and crowded place. That's all.
Despite a ragging pandemic, our people won't follow this simple rule. What use is a lockdown?

Stay in your house,
don't meet relatives or neighbors.
no parties or weddings.
kids don't go to school.
Work from home, if possible.
Force the elders of the house.. to stay inside the house.
Maintain distance if you have to deal with people.

You don't need a lockdown to achieve this. The government is not forcing you to go to the mall, by keeping it open.

Raja · Post by **Raja** » 25 Apr 2021 15:35

That is a massive failure in understanding how society and humans work.

Why do we need any fines or rules? If everyone just did what they were supposed to do, we would be a superpower in 10 years. So simple.

nam · Post by **nam** » 25 Apr 2021 16:08

Issues with societal behavior is not a justification of personal irresponsibility. If someone wants to risk their life because they feel "bored" at home, it is their issue.

I see lot of request for beds,oxygen, hospital on twitter for older people. I am tempted to ask were these older people vaccinated and if not, why not?

People who have access to twitter, surely have access to cowin portal to book vaccination for their family members. If someone wants to believe conspiracy theories about vaccine and ends up with their loved ones in the hospital, they are responsible for their situation.

Nsmith · Post by **Nsmith** » 25 Apr 2021 16:24

Checking-in from Chhattisgarh again.

By the grace of god, we have all recovered from COVID-19 after 17 days of home isolation. What worked for us: having enough rooms to isolate each positive member of the family, a trusted doctor available on the phone at least once or twice a day, constant monitoring of SpO2, pulse and temp, having enough financial resources that we were able to arrange for medicines, food from a caterer, a driver who could pick up all of these things from shops... and shit loads of good luck.

We've already lost a staff member (a car driver with two young kids). Another family member in Nagpur is still battling for his life - he's on ventilator for the last 10 days... While his body has mostly fought off the virus, his lungs are severely affected and he's on invasive ventilator support. The doctors are not sure if/ when he'll recover. Bad bad news all around.

Before I comment on the wider issues, if any BRfite of their loved ones contact the bug, I'll recommend please start any deep breathing exercises and resting in a prone position to maintain your O2 levels. As long as you can maintain your O2 saturation above 93-94%, you'd (hopefully) not require institutional medical support, which we all know, is under tremendous strain across the country and in many places has virtually collapsed.

Now coming to *why* we're in such a bad state - I guess we all collectively dropped the ball sometime in Jan-Feb, and also deliberately ignored the early warning signs in the second/third week of March. After the vaccine drive was announced, most of us (including many who are decision makers in our respective organizations) were planning on reopening. The phrase I heard being bandied was "we need to learn to live with the virus". Even my own office (we've all been working from home since march of last year) had announced reopening with 50% strength in April... The public at large accepted the hubris that we'd *beaten* Corona and that the worst was behind us.

The government isn't blameless either. I know this is not a political thread and I'll share thoughts on the impact of this wave on BJP's poll prospects in the appropriate thread... However, the people responsible to track Covid, the infectious disease experts, the health ministry, the health minister... Should have rung the alarms bells sometime in the third week of March. All governments (both center and states) have been caught with their pants down and IMHO have reacted 25-30 days too late to this wave.

If you spend some time on https://www.covid19india.org/ or even go back and read your local news papers from March 15 until March 30... It is quite evident that both the number of daily cases and the test positivity rates shot up by 5-10x from the 30 day trailing minima that was achieved in Jan (and maintained until late Feb). While hindsight is 20-20, all cities/ districts that had either a test-positivity-rate greater than 5% OR where the test-positivity-rate had jumped 5x or 10x from the February average, should have imposed local lockdowns (and not this night curfew/ weekend curfew business) before Holi itself. That definitely would have flattened the curve and blunted this crazy y axis jump we're witnessing this month.

srai · Post by **srai** » 25 Apr 2021 16:57

Vadivel wrote:...

4) All hospitals could have installed PSA captive plants. PMO had announced 200 crores for all district hospitals and they could have around 500 plants. In usual public sector tendering process not even 15% of that has been used

...

Great point!

A plant like these hardly takes up any space. All hospitals should have one IMO.

srai · Post by **srai** » 25 Apr 2021 17:03

chanakyaa wrote:From @Suraj in Swarajya

Switching Tactics: Why India Must Temporarily Prioritise First Doses Mid-Wave

+1

srai · Post by **srai** » 25 Apr 2021 17:33

X-posting from LCA thread

Technology trickle-down: Tejas fighter's oxygen plant pressed into Covid-19 duty

...

In an innovative example of sophisticated defence technology being directly adapted to combat the Covid-19 pandemic, the On-Board Oxygen Generation System” (OBOGS) developed for the Tejas light combat aircraft, has been translated into a civilian-use oxygen generation plant that can produce 1000 litres of oxygen every minute.

Defence Minister Rajnath Singh was briefed on Tuesday on this innovation by the Defence Research and Development Organisation (DRDO). The technology has been transferred to the private industry and the Uttar Pradesh government has already placed an order for five such plants, according to a Ministry of Defence (MoD) statement on Tuesday.

DRDO chairman, Dr Satheesh Reddy informed the defence ministry that more plants can be supplied by the industry to cater to the burgeoning hospital requirements.

...

Reddy offered that a supplemental oxygen delivery system that the DRDO had developed for soldiers posted at extreme high-altitude areas, could be used for Covid-19 patients, as their medical conditions were similar in both cases. The DRDO expects the product, which is based on SpO2 (Blood Oxygen Saturation), to be available in the market soon.

Developed by a DRDO laboratory called Defence Bio-Engineering and Electro Medical Laboratory (DEBEL), Bengaluru, the system delivers supplemental oxygen based on the SpO2 levels and prevents the person from sinking in to a state of Hypoxia, which is fatal in most cases.

Hypoxia is a state in which the amount of oxygen reaching the tissues is inadequate to fulfill all the energy requirements of the body. This situation gets replicated in Covid-19 patients due to the virus infection.

Reddy also informed Rajnath that the DRDO has restarted a Covid-19 facility in New Delhi and efforts are being made to soon increase the number of beds from 250 to 500.

Reddy also said that the Employees' State Insurance Corporation (ESIC) Hospital in Patna, had been converted to a Covid-19 hospital and it had started functioning with 500 beds.

The DRDO chief said that his organisation was working “on a war footing” to operationalise a 450-bed hospital in Lucknow, 750-bed hospital in Varanasi and 900-bed hospital in Ahmedabad.

...

Tejas OBOGS

Compact enough to be put into an emergency/ICU ward itself directly providing on-demand oxygen to beds!

Cyrano · Post by **Cyrano** » 25 Apr 2021 18:42

And export it all over the world in the future.

DrRatnadip · Post by **DrRatnadip** » 25 Apr 2021 18:50

srai wrote:
Vadivel wrote:...

4) All hospitals could have installed PSA captive plants. PMO had announced 200 crores for all district hospitals and they could have around 500 plants. In usual public sector tendering process not even 15% of that has been used

...
Great point!

A plant like these hardly takes up any space. All hospitals should have one IMO.

Big Hospitals can afford such plants.. Unfortunately most small and medium sized cant afford to install and maintain these plants.. Last wk I enquired regarding one such plant.. Quoting cost was 24 L for a plant which can produce 20 jumbo O2 cylinders per day.. Maintenance cost for such machines is also very high.. If big consumers of medical oxygen start using oxygen generation plants then needs of small and medium sized hospitals can be easily catered by suppliers..

DrRatnadip · Post by **DrRatnadip** » 25 Apr 2021 19:00

isubodh wrote:
Vadivel wrote:Whatsapp Forward.
Linde is one of the largest oxygen producers in India
.”
Last year it was shortage of ventilators. NASA, ISRO, IIT, PSU and Pvt sector was all designing cheap ventilators. Some were being producing the models too.
This year no one is talking about ventilators and all about Oxygen. Is the ventilators shortage fully over now that no more talks about it or the protocol for treatment has changed ?

-Ventilater shortage is still there.. Skilled manpower to manage pts on ventilaters is severely lacking..
-We are using made in India ventilaters now and they are equally effective compared to their foreign counterparts at 1/3rd price..
- Treatment protocols are fairly standardized now.. we are getting good results using some additional inhalational agents like N acetyl cystin, Tobramycin, and budesonide.. IV immunomodulaters also seem to work in selected pts..
- There is slight decline in pt flow noted in last two three days.. I Hope peak is over and this tsunami is over soon.. Though less likely possibility of decline due to overwhelmed testing system and delayed reporting can not be denied..

saip · Post by **saip** » 25 Apr 2021 20:33

DrRatnadip wrote:
Big Hospitals can afford such plants.. Unfortunately most small and medium sized cant afford to install and maintain these plants.. Last wk I enquired regarding one such plant.. Quoting cost was 24 L for a plant which can produce 20 jumbo O2 cylinders per day.. Maintenance cost for such machines is also very high.. If big consumers of medical oxygen start using oxygen generation plants then needs of small and medium sized hospitals can be easily catered by suppliers..

How many Jumbo cylinders are used in a large hospital in a normal day?

Ambar · Post by **Ambar** » 25 Apr 2021 21:31

While we'll be kidding ourselves if we think the local and state governments will extract lessons from this pandemic and invest in improving public healthcare in future, i hope atleast for-profit hospitals in India make investments on hiring more staff, install more capacity for o2, ventilators, ICU beds, ambulances etc. Even before the pandemic, the intensity of flu every year has been increasing especially in the last 12 yrs after the H1N1 scare in 2009 . Add to this the worsening lung health of many Indians including those in their teens and 20s thanks to the relentless construction everywhere, its particulates and choking pollution in our cities is making things so much worse. Pneumonia after flu seems to have become so common now compared to 20 yrs ago, don't know if its the air quality, the lung health or just the virus is getting stronger each year.

In the end all the sacrifices, deaths, destroyed families and businesses will be wasted if we don't learn and take steps improve the quality of life for the average Indian citizen in the years to come. And if there's one thing to learn from China it is to never trust anyone and to be independent in everything, from defense to entertainment to manufacturing to healthcare.

nam · Post by **nam** » 25 Apr 2021 21:32

Smaller hospitals should consider setting one up at a shared cost. Or even have a deal with big hospitals, so that it become economical.

Regarding the infection rate, I am noticing less plea for hosiptal beds and oxygen compared to couple of days back, on the social media,specially Delhi and Mumbai.

Raja · Post by **Raja** » 25 Apr 2021 22:02

Can we really expect hospitals to invest money for once in hundred years pandemic levels of infections? That's a lot of excess capacity in normal years.

nam · Post by **nam** » 25 Apr 2021 22:28

https://mobile.twitter.com/SubhadipNand ... 0153974790

As the tweet mentioms, people are trying to hoard oxygen cylinders and are not able to provide covid proof, while trying to buy

Kya log hai..

Dilbu · Post by **Dilbu** » 25 Apr 2021 22:38

GOI has decided to one setup oxygen plant in every district of the country. This will be installed immediately as part of govt hospitals in district headquarters.

sanjaykumar · Post by **sanjaykumar** » 25 Apr 2021 22:40

What is the principle of oxygen production? Presumably it is concentrating of atmospheric oxygen. ?

Tanaji · Post by **Tanaji** » 25 Apr 2021 22:54

Raja wrote:Can we really expect hospitals to invest money for once in hundred years pandemic levels of infections? That's a lot of excess capacity in normal years.

Multiple hospitals can definitely pool together to get captive oxygen generation capacity. Cost of a O2 generator cannot be more than 10 crores which is peanuts compared to what the corporate hospitals charge and the subsidies they get.

Plus this is not going anyway any time soon given the rapid mutations we see.

Mort Walker · Post by **Mort Walker** » 25 Apr 2021 23:05

Dilbu wrote:GOI has decided to one setup oxygen plant in every district of the country. This will be installed immediately as part of govt hospitals in district headquarters.

There are over 700 districts across the country. If that can be done it would be great. It may not help immediately, but certainly over time.

Medical oxygen is about 40% O2, not like industrial oxygen at 99%. Industrial oxygen requires more compression, cooling and safety.

Nalla Baalu · Post by **Nalla Baalu** » 25 Apr 2021 23:09

sanjaykumar wrote:What is the principle of oxygen production? Presumably it is concentrating of atmospheric oxygen. ?

Its separation of Oxygen from other atmospheric constituents. For bulk capacity cryogenic distillation and for smaller in-situ its pressure swing adsorption. Former operation is in liquid phase and the latter gaseous. Checkout the following wikipedia link: Air Separation

sanjaykumar · Post by **sanjaykumar** » 25 Apr 2021 23:23

Yes of course, fractional distillation of cryogenic atmospheric gasses. Thanks.

durairaaj · Post by **durairaaj** » 25 Apr 2021 23:25

DrRatnadip wrote:...

Questions to DrRatnadip:
1) Why is it ivermectin, not in your protocol?
Is there any reaon, that is not known in the public sources. Some reserach journals mention, that the concentration required for pharmacokinetics may be significantly higher than the limits approved for human use. Despite this, few journals report positive outcomes in less rigorous studies.
2) Is the decrease in influx of patients observed in Pune/Mumbai region?

DrRatnadip · Post by **DrRatnadip** » 25 Apr 2021 23:30

durairaaj wrote:
DrRatnadip wrote:...
Questions to DrRatnadip:
1) Why is it ivermectin, not in your protocol?
Is there any reaon, that is not known in the public sources. Some reserach journals mention, that the concentration required for pharmacokinetics may be significantly higher than the limits approved for human use. Despite this, few journals report positive outcomes in less rigorous studies.
2) Is the decrease in influx of patients observed in Pune/Mumbai region?

-We use Ivermectin in all pts
- Decrease is observed in pune, though its too early to comment..

sanjaykumar · Post by **sanjaykumar** » 25 Apr 2021 23:35

I have previously posited that 'oriental' populations have experienced coronaviruses previously. Other populations, Europe/India are evolutionarily relatively naive.

https://www.biorxiv.org/content/10.1101 ... 401v2.full

Applying this approach to each of the 26 human populations from the 1,000 genomes dataset, we find a very strong enrichment of sweep signals in CoV-VIPs across all top-ranked gene set sizes that is specific to the five East Asian populations (whole enrichment curve for nSL and iHS combined FPR=2.10−4; Figures 1 & S2; Methods). No enrichment is observed for populations from other continental regions, including in neighboring South Asia (whole enrichment curve for nSL and iHS combined FPR>0.05 in all cases; Figures 1 & S2). Further, no enrichment is detected for VIP sets for 17 other viruses in East Asian populations (whole enrichment curve for nSL and iHS separately or combined, P>0.05 in all cases; Figures S3 & S4). Taken together, these results suggest that coronaviruses, or another type of viruses that used similar interactions with human hosts, have driven ancient epidemics in ancient human populations that are ancestral to modern East Asians.

There are many assumptions and statistical manipulations reported. I have not read the paper carefully, they may have biased their methods to find the signal they expected to find.

chetak · Post by **chetak** » 26 Apr 2021 00:02

Jay · Post by **Jay** » 26 Apr 2021 00:08

chetak wrote:

If India anywhere to be found in the list of "many nations learning the lesson"?

darshan · Post by **darshan** » 26 Apr 2021 00:32

DrRatnadip wrote: -We use Ivermectin in all pts
- Decrease is observed in pune, though its too early to comment..

In GJ, remedesvir was pretty much only thing kept in protocol till it became hard to obtain. However, Ivermectin was proposed long ago. But still it wasn't brought into GJ protocols till couple weeks ago. Is there any study that says that remedsvir is a league ahead of other solutions?

One lesson learned:
Starting from the late Feb, it had taken lot of convincing to people that it's not the weddings and look at canaries. The canaries being ardent and careful people making necessary medical visits. Most of the infected people I know had got infected during their visit to get a shot. These people are extremely careful and only went out for medical visits. Them getting infected should have had more weight in modeling to make decisions that there's something a miss here and virus is much more prevalent and infectious. Perhaps it makes sense for physicians to be on look out for patients that are very careful and getting infected. This may have been a good indicator of upcoming wave.

rsingh · Post by **rsingh** » 26 Apr 2021 01:00

One thing is sure. We are getting a better and efficient infrastructure in health care. I hope that extra capacity that we are creating converts in permanent capacity. People are more aware of health problems . Mask culture is going to stay ( at least in polluted cities). Situation has compelled people to adopt a healthier life style.

Zynda · Post by **Zynda** » 26 Apr 2021 01:16

BLR has the highest active case loads in the country...1.6L cases...twice that of Delhi/Mumbai.

I know it will be painful but we do need a full lockdown for 2 weeks to bring down the count to more manageable levels. Supposedly a cabinet meeting is gonna be held tomorrow to decide future course of action.

Bart S · Post by **Bart S** » 26 Apr 2021 01:45

Zynda wrote:BLR has the highest active case loads in the country...1.6L cases...twice that of Delhi/Mumbai.

I know it will be painful but we do need a full lockdown for 2 weeks to bring down the count to more manageable levels. Supposedly a cabinet meeting is gonna be held tomorrow to decide future course of action.

Central or state?

srai · Post by **srai** » 26 Apr 2021 01:49

Tanaji wrote:
Raja wrote:Can we really expect hospitals to invest money for once in hundred years pandemic levels of infections? That's a lot of excess capacity in normal years.
Multiple hospitals can definitely pool together to get captive oxygen generation capacity. Cost of a O2 generator cannot be more than 10 crores which is peanuts compared to what the corporate hospitals charge and the subsidies they get.

Plus this is not going anyway any time soon given the rapid mutations we see.

According to DrRatnadip, he was quoted 24 lakh for a system with a capacity of 20 jumbo cylinders a day. Assuming that would be considered a “medium” sized plant. Ongoing operational and maintenance costs also need to be budgeted for.

Smaller/ medium sized hospitals that can’t afford a plant of their own could buy into a plan that caters for their required minimum capacity from those that can afford one. Costs could also be recouped through a refill service to individuals. Some excess capacity should be in reserve for non-normal situations like mass events or pandemics.

And there is always room from external third party suppliers to augment further capacity.

Ideally, a mix of above would be good to have in place so that no single point of failure results in acute shortages.

Cain Marko · Post by **Cain Marko** » 26 Apr 2021 02:02

nam wrote:
In BLR more than 700 people are testing +ve per hour...the positivity rate is at 15%!! AIIMS director has also recommended doing a lockdown in areas where positive rate is higher than 10%...unfortunately, most of the high positive rate areas are also the ones which are major economic centers. At least a week (ideally 2) is required in BLR to put a pause on infection rates...but knowing BSY, he will not do a lockdown.
It is a simple requirement to protect one-selves from the Chinese virus. Stay away from people. Don't go in to closed and crowded place. That's all.
Despite a ragging pandemic, our people won't follow this simple rule. What use is a lockdown?

Stay in your house,
don't meet relatives or neighbors.
no parties or weddings.
kids don't go to school.
Work from home, if possible.
Force the elders of the house.. to stay inside the house.
Maintain distance if you have to deal with people.

You don't need a lockdown to achieve this. The government is not forcing you to go to the mall, by keeping it open.

I have to agree. Wtf is the matter with people. It's like they won't go to the bathroom unless govt forces them to.

Nevertheless, all govts should barrage the public with constant reminders to do the needful.... Keep your distance, wear masks, and wash your hands. Human mind is such that constant reminders help.

fanne · Post by **fanne** » 26 Apr 2021 02:07

what about Tejas/LCA OBOGS? It is very small but cost-wise - how much is it? Logic would require that it will be very cheap compared to the 24l plant which looks like 100 times its size. If it is cheaper (if DRDO forgoes the IP cost, or gets a fraction of it to recover R&D cost), maybe that is the answer. If it is Sub 10 lakhs (or God help us - Sub 5 lakhs), have it subsidized and installed in almost all hospitals. With being present everywhere, local support technicians will crop up automatically.

sanjaykumar · Post by **sanjaykumar** » 26 Apr 2021 02:09

The Indian public refused masks, physical distancing, vaccines.

I don’t really care about politics. But yeah I can see it’s Modi’s fault.

Tanaji · Post by **Tanaji** » 26 Apr 2021 02:13

I think India should put more effort in sequencing of the virus to identify the various mutants floating around. Time and again people are saying they have no clue where they got infected from. In wave 1 we did not see the ramp up so quickly and people were more relaxed then.

More efforts need to be put in ramping up the sequencing of positive samples...

Sraiji,

The 24 lakh thing , is that an O2 concentrator or a system that delivers proper 99.99% oxygen which is then down mixed to whatever level the patient required? I find it hard to believe that medical grade can be got in 24 lakhs using either cryogenic or pressure swing adsorption methods.

Manas · Post by **Manas** » 26 Apr 2021 02:26

The GOI got caught flat footed couple weeks ago as the cases spiked. IMO it certainly should have been on better guard. While one is yet to see the impact of Kumbh Mela and Election rallies (as it takes 5-14 days for itto get reflected in case loads and another week to 10 days in hospitalization, death counts) one cannot ignore the potential tigger point of Holi and the wedding season. Most of the uptrend started after Holi and western Indian states that did not host Kumbh or conduct elections. The local state govt ineptitude (regardless of the party in power) and sundry lobbies (like the movie industry which for ex. strongly lobbied against shutting down movie theaters 3-4 weeks ago) also deserve blame.

Looks like the last 72 hours the GOI is moving on a war footing and will regain its balance with mobilizing oxygen supply infrastructure and makeshift hospital facilities. It is heartening to see offers of support and help from UAE, Saudi Arabia, Singapore, U.K. France, Germany etc. Indian industry can operate at a global scale now and is stepping up big. Regardless, of what, how much the U.S. eventually does help India - hopefully this is a good first demonstration to India and Indian Americans that the U.S. left wing socialists are no better than Congress, Communist seculars in India. Lot of virtue signalling, hate thy country, our country is evil and a blind dislike, hatred for strong nationalist leaders/leadership. While Modi's reputation will be tarnished a bit from the mishandling of the 2nd wave - the country will unite and get through this phase.

The most criminal, inexplicable aspect of the Biden admin behavior (regardless of how they treat India & the export embargo on raw materials) is sitting on the 40M doses of AZ vaccine stock pile which will have no use in the U.S. and it probably is not even going to get approved for a few more weeks or months. They could have at least exported this stockpile to the GAVI alliance where 10's of countries that relied on SII/Indian exports would get replacement supply in lieu of India's slow down of exports.

The last few months I have thought of the need for setting up a "health emergency force" along the lines of NDRF. Specially trained reserve pool of Drs and nurses of 2-3 battalions strength in treating patients in a NBC exposure/attack as well as pandemic scenario with ready national stock pile of medical supplies for "emergency surge" scenarios. During normal times they could be deputed nationwide to train health care staff on handling such scenarios, mass casualty events etc as well deployed during other natural disasters both in India and to help out other poorer nations. This will go a long way in extending and strengthening India's soft power. I hope something like this will come to fruition as a lesson learnt from this pandemic (in addition to creation of permanent, better health infrastructure at district and tier 4, 5 cities, towns around the country). India has gotten better and lot a learnt of lessons on the national security front over the years due to Paki and Chinese perfidy. The need for better health infrastructure needed a wake up all. COVID has provided that much needed kick in the rear end. Modi govt has done well in tackling the water, sanitation, roads, bridges, power etc infrastructure to make for the 60 years of lethargic progress - but hopefully its eyes have been open with this 2nd wave to make health infrastructure a national priority.

nam · Post by **nam** » 26 Apr 2021 02:32

Majority of the infection is through family members. There will one or two family member, who will bring the virus in to the home. It is not 350K of unique infections.

It doesn't help that in India, joint family is very common. In West, one person infected, would infect his/her spouse or if kids their 2 or 1 parent.

In India, an entire family chain could be infected.