Wuhan Coronavirus Resource Thread

[Tanaji]

I think this thread should have a sticky on top for these questions

[rsingh]

BTW Aaj Tak Anchor Rohit Saldana latest victim of Corona. RIP.

[Ambar]

Incredibly sad ! Om Shanti ! He was one of the few rational journalists in India, and probably the only sane non-partisan voice on Aaj Tak.

[Cyrano]

The latest policy of 50% central govt, 50% states and private hospitals policy will be a royal mess in implementation. End to end. This govt listens to and acts on wrong criticisms at the wrong time.

The right method would be centralised purchase, (less paperwork for all and faster), deploy vaccination stocks and medical teams (dont need a full hospital) in special camps managed by armed forces (since most of them have been vaccinated), deploy them in combination with local hcw staff and focus such vaccination drives to vaccinate everyone above 18 in hardest hit areas. Implement lockdown like last year everywhere. Let enemies know any funny business during this time will get response crossing all thresholds.

States to focus 100% on patient care.


Modi kuch nahi kara to bhi dictator hai. Ab dictator banke kaam karne ka waqt aagaya hai.

sab ka aamod = sab ka barbaad.

Critics be damned local or foreign.

If opposition makes too much noise, declare national emergency.

Have a heart to heart talk with hizzoners and ask them to get in line.

Enough image conscious chutiyapa.

Unfortunately nothing else will work.

[darshan]

One of the education points that I would have liked to see starting late February was average cost of hospitalization. Numbers don't scare people but money talks. Pros/Cons?

During the lull time, many hospitals in GJ were practically recruiting positives and putting them in "observation". Something that carried on till second week of March. Average cost was around Rs 2lakhs in private hospitals.

Another side point:
Once the wave was confirmed all of these would have been asked to be at home care and would not have qualified in triage. So one can say that lot of reserve resources were burnt up in February and just as the wave started. Some room for optimization.

[amol]

A friend lost 2 aunts earlier this week in Delhi due to COVID. The death certificate for one says cause of death as Natural Causes and the other says complications due to pneumonia, not COVID.

Apparently there's immense pressure on doctors to lie and cover up the numbers.

[darshan]

Under Indian constitution, do states ever reimburse the central govt for taking care of responsibilities of the state?

[Cyrano]

No the center may subtract from future state allocations, politics permitting. Most states are running deficits intentionally so that they can demande more central funds and their accounts are "maya" onlee.

[sajo]

Author Vikram Sampath is battling for his life on ventilator support in Bangalore.
His second volume on Savarkar is due for release in May.

[Sicanta]

I was mistaken. Uttar Pradesh has opened slots for 18-45 vaccination from tomorrow onwards.

[Jay]

The right method would be centralised purchase, (less paperwork for all and faster), deploy vaccination stocks and medical teams (dont need a full hospital) in special camps managed by armed forces (since most of them have been vaccinated), deploy them in combination with local hcw staff and focus such vaccination drives to vaccinate everyone above 18 in hardest hit areas. Implement lockdown like last year everywhere. Let enemies know any funny business during this time will get response crossing all thresholds.

States to focus 100% on patient care.

A 1000 times this. Some in the administration need to develop some thick skin and focus on managing the pandemic, not the messaging, this is not the time for it.

[Thakur_B]

Is it possible to have corona virus in your body and not show any symptoms? How does it work and what precautions can be taken to avoid infecting anyone else?

Jamwal ji, a colleague got infected along with me, he did not have any symptoms. We both recovered with RT PCR report coming as negative. He had recovered quite nicely. He had got his family tested at both instances, however as soon as they tested negative (2 week gap between tests) the entire family is down with severe symptoms. Mother's oxygen has dropped under 80 with all standard covid symptoms. She had tested negative both times.

The new strain is wicked, resilient and hard to catch. The mutations may have allowed it to increase the time period in which it survives in the body. The old 14 day protocol needs to be reviewed in view of current cases.

[Zynda]

^^The above is scary...I understand currently the protocols have been modified. If a person is showing Covid symptoms but their RT-PCR test is negative then additional blood work along with lung CT scan is performed to ascertain Covid. I hope ICMR is busy asking either Universities or NIV to come up with a reliable & quick way of determining Covid +ve for this newer variant.

BLR hit 26K cases today I think...am thinking it is just a matter of time before many more are infected. Tough times ahead...

[VipinM]

I cant quote everyone's post but thanks everyone for your support and messages. I really appreciate it.

Connecting with my family/spouse and immersing myself in work has helped me a lot. A personal experience i want to share with all of you.

My entire family was down with mild flu, fever etc. way back in November. Me and my mom got fine after having some antibiotics from a local physician. He suggested blood test for dad and it came typhoid positive. Anyways long story short Dad was actually covid positive (SPO2 down to 88 and delirious etc) and it was nightmare even back then to find an ICU bed. Finally had to contact some "contacts" and he got admitted to Fortis Gurgaon.

Thankfully he is fine now and no post covid symptoms. My point in relating this that i can imagine what most of folks with covid and their relatives/friends must be facing now. Its a terrifying thought. Hopefully we will come stronger once this is over. and folks final thoughts: Please take care and be safe.

PS: I love this forum

[Mort Walker]

Good luck VipinM.

I had family in November that got infected, tested positive RT-PCR, then got AZ vax 1st shot, then got covid 2nd time confirmed by RT-PCR. Took 9 days for fever to abate.

[Suraj]

The earlier high rate of vaccination was due to the fact that SII had stockpiled vaccines and we were probably running through that stockpile. Hence vaccines are available plentifully at vaccination centres. That has been exhausted. A back of the envelope calculation: SII produces 70m a month or thereabouts. This is about 2M a day on average. If we are going at 3M a day clearly it’s not enough. Ignoring BB and Gavi commitments for now as it is small.

Scaling up the rate of production is happening but it is not easy due to all factors such as quality control processes, having adjuvants available etc etc. By June we should have at least 100M a month over BB, Sputnik and SII. Later in the year ZyCovid should come on line

Analyzed in detail weeks ago :
https://twitter.com/surajbrf/status/138 ... 86881?s=21
https://swarajyamag.com/politics/the-co ... -happening

[disha]

I am sorry but there is nothing equalizer about Covid. When it's all said and done, the poor and lower middle class will have paid the biggest price as usual. This is true in every country..

The poor and lower middle class anyway pay the biggest price, pandemic or not.

The equalizer is that now the upper middle class and the elite realize that their "connections" and "money" can help only so much.

Sad. But True.

[sajo]

VipinM sir, COVID anxiety is real. All around me, the general feeling is of being doomed. The biggest fear is now not "if me or my loved one gets infected" but "what if me or my loved one needs to be admitted". The general mood in all phone conversations, text conversations are morose, especially for those who are sailing in the middle-class-no-connections-lots-of-dependents boat.
With remdesivir being blackmarketed to the Hilt right under the noses of MVA government, the cost of the drug alone runs into lakhs, all in cash. Not particularly religious, I now find solace by remembering lord Hanuman, even for a few minutes of the day.

[Thakur_B]

A friend lost 2 aunts earlier this week in Delhi due to COVID. The death certificate for one says cause of death as Natural Causes and the other says complications due to pneumonia, not COVID.

Apparently there's immense pressure on doctors to lie and cover up the numbers.

Amol ji, that has always been the case. The cause of death is always cardiac arrest, pneumonia or organ failure in death certificate.

However earlier the death count due to covid was always factored for eventually in government figures. It's in the second wave where death due to covid related complications are being brushed under the carpet and that is where my anger originates from.

All state governments are lying regarding the death toll. The actual numbers are 5-10 times higher than being reported. In my hometown, the nearest shamshan is carrying out 60-80% funerals as per covid protocol. Covid related deaths have superceded deaths due to other causes a couple of weeks back and the government figures are not even a tenth of what is happening on ground.

[disha]

Anti vaccine campaign shouldn't have stopped the Govt from fast tracking vaccine orders and stockpiling them and Govt should have anticipated the negative media campaign considering it's going on for last 7 years and every Modi hater was waiting for exactly what's going on currently. They all wanted bodies to pile up and health case system to break down and Govt by being careless gave it to them on a platter.

Government depends upon the Babooze to run everything. State governments do need to play their part. For example, take the case of Mah and nearby Guj. Why do we see so much of rona-dhona from Mah and mishaps (including ICU patients dying due to fire) and fewer from Guj? Guj hotspots are Ahmedabad, Surat, Vadodra. And here is the state government doing:

Meanwhile, in an affidavit filed by Gujarat chief secretary Anil Mukim before the Supreme Court on Thursday, it was submitted that as on April 28, 49,332 patients were on oxygen support in the state.

The affidavit also added that the state has a provision of 54,579 oxygen beds across the state, including 6,669 isolation plus ICU beds without ventilators and another 6,574 isolation plus ICU beds with ventilators. The submissions indicate a 90 per cent occupancy of available oxygen beds.

In Ahmedabad, the issue is acute in special community localities. In Surat, there is a large migrant population working in dingy closed locations polishing diamonds and manufacturing textiles, garments.

And before we hit the panic button, please do remember that Delhi is not India. India is not Delhi. Same for Bangalore, Mumbai, Ahmedabad, Surat and Lucknow.

Changing gears to vaccines:

Just to note that vaccines are "manufactured" in BSL4 certified "manufacturing" plants. I had made some posts on how the vaccines are "manufactured".

No way Govt could have fast tracked vaccine orders and stockpiled them. No way.

Asking for Govt. to order vaccines in advance and stockpiling them will be akin to Govt ordering women to produce babies in 9 days from conception to delivery and then training for few hours to fight at Galwan. Not going to happen.

[Suraj]

The right method would be centralised purchase, (less paperwork for all and faster),

This was quite literally what was going on. The states were opposed to it. The fundamental reason for it is that the states - in the face of crisis - wanted more, and argued they'd get more independently. They forget that all other states are thinking the same.

Sometimes in politics and organization the right way to prove something wrong is to give the person everything they demand and wait for them to prove themselves wrong. Some will manage well, some not so well. This is a normal process.

There's no black and white here. Thru the first 3 phases, the centre managed allocation based on reported severity, population and other factors. However states are not alike in their ability to track or manage this. This is fundamentally what drove them to demand greater independence. This is also normal - some actually react well to being challenged.

Fine, the center let them have it - paid for by the states. "Allow the states to order independently and let centre pay for it" is an interesting idea, but misaligned fiduciary duty.

deploy vaccination stocks and medical teams (dont need a full hospital) in special camps managed by armed forces (since most of them have been vaccinated), deploy them in combination with local hcw staff and focus such vaccination drives to vaccinate everyone above 18 in hardest hit areas.

With the exception of the focus on particular hard hit areas, this was also what was already going on. The center merely ensured two things:
* The price must be zero or a fixed amount. Pricing flexibility at state level would have been a very bad idea.
* Registered locations only. This enables centralized tracking. Actual on the ground management will be by state anyway since health is a state imperative.

In my view, the equilibrium here will be the following:
* The center, having already ordered at least 175 million doses through June, has its orders in place. Most states now have orders too.
* In my view, the manufacturers will continue exactly the same allocation policy as center for those whose orders are in place.
* States need to reconsider their whole argument about independent purchasing, because it's harder to fight each other rather than just blame the center, which they always do anyway. Federalism = blame the big guy instead of slapping each other.
* Some states won't be able to order for lack of funds, or will be delayed. Center will implicitly make up the difference so that it is not 50/50 share of orders at each state level. In effect, in some states the situation changes little from present.

[darshan]

Govts depend on non villagers and UPSC graduates to come and propose. Actually if one were to look at in the details, within the same piece of pie to deal with the virus, GJ govt had erred on the precaution towards the wave and was active in procuring remedisvir while waiting for vaccination to get going. The govt body certainly made the correct decision to fund the bucket about what if till the vaccination. In my opinion the option presented to them was incorrect as remedisvir would not have prevented the mayhem that's going on right now. Neither would have helped much. However, the acting can only happen on presented information.

[SRajesh]

Just read on the net that 'Dhar Ka B..' has lost her father to COVID last week.
She is giving interviews to Pee Pee C and the Libtard Western media of Mudi's inefficiency

[darshan]

India to import 4,50,000 vials of Remdesivir; 75000 vials reaching today
https://www.deshgujarat.com/2021/04/30/ ... ing-today/
....
HLL Lifecare Ltd, a Government of India owned company has ordered 4,50,000 vials of Remdesivir from M/s Gilead Sciences Inc USA. and Egyptian Pharma Company, M/s Eva Pharma. It is expected that Gilead Sciences Inc. USA will dispatch 75,000 to 1,00,000 vials in the next one or two days. Further one hundred thousand quantities will also be supplied before or by May 15. EVA pharma will supply approximately 10,000 vials initially followed by 50,000 vials every 15 days or till July.
.....

[chetak]

Global Times@globaltimesnews China state-affiliated media · Apr 27

India, which gifted vaccines to #SouthAsian countries over geopolitics, cannot provide enough vaccines to these countries. #China – with a complete industrial chain for vaccine production and technologies, could offer stable help to those countries. https://globaltimes.cn/page/202104/1222292.shtml

[darshan]

Sankrant Sanu सानु संक्रान्त ਸੰਕ੍ਰਾਂਤ ਸਾਨੁ
@sankrant
Better but Oxygen levels are not back to normal yet without being on Oxygen. Waiting.
https://mobile.twitter.com/sankrant/sta ... 6587559936

[chetak]

[Zynda]

Karnataka's positivity rate has reached a whopping 25 per cent!!!

[Cyrano]

"Fine, the center let them have it"
No Suraj sir, its not fine. Who pays for it, center or state is irrelevant, its tax payer's money in the end.

The govt i'm afraid has made a mistake in adopting this policy and not continuing as before and putting its muscle behind it by bringing in central forces and the army. Because ordering by each state with its own babudom will be a mess. Center is doing the work of ordering the other 50% anyway.

In the face of multiple orders, demand far greater than supply, SII, BB etc will have to arbitrate who gets a lot and when. Like AZ in Europe. They dont have the Real time pandemic data the center has. They aren't equipped to deal with this kind of stuff, and will be pressured, questioned, criticised, even attacked.

To save maximum lives, the produced vaccines must be delivered near just in time to people with minimum time loss while scrupulously respecting the cold chain. The center has done it so far, now each state has to learn.

It requires an Amazon level supply chain management by each state based on evolving situation in their state. Many states will struggle, may be eventually get it right. But at what cost? Thousands of lives.

This multi track vaccine rollout free by central govt for some catgs, free or paid by state govts for some catgs, paid by individuals but injected by private sector - when supply is behind demand is a disastrous idea in the current circumstances. Whats the big deal if some states continue blaming the center? Has it ever been otherwise?

[Tanaji]

Cyranoji,

Deans has said this before, but the issue here is not who buys what. The issue is our capacity in producing vaccines. None of the states will quarrel if SII had enough stock. Come July and this bickering should go away. Lets hope it won’t be too late

[ritesh]

Karnataka's positivity rate has reached a whopping 25 per cent!!!

Things are getting worse

Noob question to seniors...
Were reports like the one below were deliberately publish to make people throw caution to wind with regards to wuhan virus??

https://fortune.com/2021/02/03/delhi-co ... -immunity/

Health authorities took blood samples from 28,000 people across 11 districts in Delhi and found that 56% tested positive for coronavirus antibodies, the proteins that the immune system produces in response to an infection.

Remember reading quite a few articles from varied sources in and around similar time.

Quoting one more.
https://health.economictimes.indiatimes ... t/80110827

"That depends on how many people have been infected. Considering that we went through two important periods without any significant upturn - Dussehra to Diwali festive season and Bihar elections - I think that there would be enough infected people and we will not see a second wave," said the virologist.

[sudeepj]

Our vaccine production rate is similar to what US produces.And it has just been 4 months. If we had started when US had, we would vaccinate the same number of people, if not more.

Our population is 4 times that of the US. As a result of this virus, we have lost nearly 15% GDP and counting. This could have been avoided by proper planning. If SII/BB vaccination capacity had been increased, especially after the fire that reduced their existing capacity, If the courts/press/central govt. had been hyper vigilant and ring sealed Maharashtra in March, If a concerted PR campaign to adopt masks and to alert people that Covid was exploding (Clear to many by mid march, including casual randos like me, who posted here.. Every post I made about being cautious was responded to be some pollyanna..)..

For the want of a nail, the kingdom was lost.

[Cyrano]

SII's monthly production will always be far behind demand for many months to come. We are not in a polio vaccine type preventive immunisation drive. Virus is spreading out of control and you know the rest of whats Happening.

Let's say they produce 100M vaccines each month.
50% center takes.

Remaining 50M must be distributed among 28 states, (assuming they all have signed contracts and placed orders and made payments all in record time, and have perfectly worked out how to collect, transport, store, distribute and administer vaccines which center is doing till now) based on orders placed and volume ordered by each. Most states will order more than 50/28 that is 1.7M.

Its not like 30th of each month 50m vaccines drop out of production like monthly salary. Happens in batches. Sometimes they fail QC and are discarded, nevermind.

So we are expecting SII to arbitrate for 50% each batch of production which state will get how much. On what basis will they do that? And the very states that can't manage O2 will now manage vaccines. Great.

At 300k cases per day half way up the Bell curve since two weeks, let's say we'll average 300k / day for 8, more likely 12 weeks since bells have long tails in reality. thats 300k*7*12 = 2.5 crore infections before july arrives. May be not perfect math but it can only be worse the way things are going. And its impossible to deal with that.

I'm hearing horror stories from doctor friends on the frontline that many of their fellow doctors dont understand the covid treatment protocol from ICMR. They are being asked to first kill immune response using steroids and then give Remdesivir (which in another form costs 1 dollar/dose) to stop virus replication. Meanwhile the millions of virus copies invest liver, lungs, kidneys and kill the patient unless he is very lucky. Cytokine storms are not seen in current variants. So ICMR protocol itself is outdated wrt ground reality. Most doctors brave as they are werent trained for this many are clueless and are making fatal mistakes not knowing why and how they are killing patients, even themselves or their relatives if they're sick and in hospital. Thats why the bodies are piling up. One of my doctor friends MD, cancer specialist and immunologist, 25 yes experience, was on phone yday. I called him to wish on his birthday. He said the above and broke down crying. He was in his hospital toilet. Left me speechless.

If we dont lockdown now, there wont be doctors and HCWs left to vaccinate, virus or exhaustion or both will claim them.

I'm not trying to fearmonger , one has to just look at current situation, positivity and death rates to get chills down the spine.

We still have a chance to save lives by vaccination. Treatment esp hospitalisation is worse than lottery.

Lockdown and centrally controlled vaccination teams dousing spread based on real time data. Thats what we need, since yesterday.

[darshan]

Back in March things weren't over capacity so it was easier to get information from people admitted into hospitals to cross correlate treatments. Presently, it is bit tough. Hopefully there's back door information sharing across India about what's working and what's not.

[fanne]

My dad is a doctor and handled Covid policy. He is now retired and in a small town. Few things that he is saying
-Younger deaths are baffling. It could be the new strain of virus, but most likely, it is because the younger ones are also infected in the family and are doing the most running around to arrange care. With very hot summer weather and no rest, they are succumbing to a combination of Covid and lack of rest/hydration etc.
- In smaller towns, where the medical facility is not advanced, even when one has symptoms starting, people are going on full-blown covid medication. 3-4 days later when all the results have come back and they are covid +ve, the fact that they started medicine early helped. In bigger cities, precious days are getting lost because of waiting for results etc. The Covid medication as such does not have that big of side effects (within limits)
- Vaccination is helping BIG BIG time. Everyone in my family (as there are many doctors) got vaccinated and some of my older relatives did catch COVID. Some of them had serious comorbidities, but the vaccination saved them. Things did not get worse because of the vaccine. Please advise your dear and near ones or whoever will listen to get vaccinated.
-Will to live and positivity is perhaps the biggest determiner. Please do not spread fear and negativity
-For some reason, being at home is turning to be better than hospital for not very serious patients. perhaps being near dear ones etc is helping
-Prone position breathing helps a lot. I will keep on adding more and more.
- I pray for everyone and for myself and my loved ones as well. May mother protect all her children!!

[partha]

^^^
+1. Lockdown is needed at least in urban centers. It will slow down the spread and give some breathing room for govt to chart out a strategy.

@Surajji, thanks for pointing to your twitter thread.

[Suraj]

"Fine, the center let them have it"
No Suraj sir, its not fine. Who pays for it, center or state is irrelevant, its tax payer's money in the end.

Oh it matters. Having to pay for something out of one's own budget enables responsibility. Effectively being bankrolled by someone else is not. Remember, the goal of this change was to fix what was alleged to be less than optimal allocation of resources by center. One does not fix it by implementing something guaranteed to fail.

In the face of multiple orders, demand far greater than supply, SII, BB etc will have to arbitrate who gets a lot and when. Like AZ in Europe. They dont have the Real time pandemic data the center has. They aren't equipped to deal with this kind of stuff, and will be pressured, questioned, criticised, even attacked.

The EU isn't quite a positive example of anything in this pandemic. They're essentially just the same - N states fighting Pfizer for deliveries.

[nam]

Our vaccine production rate is similar to what US produces.And it has just been 4 months. If we had started when US had, we would vaccinate the same number of people, if not more.

Our population is 4 times that of the US. As a result of this virus, we have lost nearly 15% GDP and counting. This could have been avoided by proper planning. If SII/BB vaccination capacity had been increased, especially after the fire that reduced their existing capacity

The comparison with US is to show that even if there is unrestricted funding, like how US has done, production capacity cannot be exponentially increased within 3-4 months. If it was so easy, US would have finished vacation by now.

Vaccines are not toys that one can produce with eyes closed. There are lives at stake. SII and BB both require some time to lay out quality control process for large scale production of a NEW vaccine. Otherwise we will end with 200 million unusable doses produced in a month. JJ lost the entire lot of their production, due to QC issues.

No amount of money is going to give one QC overnight. No amount of money is going to get us 1 Billion doses of a NEW vaccine in 3 months!

[nam]

Despite the criticism and hindsight suggestions, a $2000 per capita country is right at the top of the table in vaccine production. There are only 5 countries who have a vaccine and we have the lowest per capita out of them!

Once the production stabilized, GoI should fund a massive increase. Even if GoI doesnt provides, SII will have no issues getting funds from the market.

There is a massive demand worldwide.

Any venture capital will close it's eyes and invest. Banks will close their eyes and provide loan.

[Cyrano]

Remdesivir seems to be an extremely questionable drug if not a total hoax.

https://www.francesoir.fr/societe-sante ... remdesivir

I remember a report on this drug was published by Lancet just before EU approval and was retracted right after

Under its previous name Veklury the same drug was sold at à fraction of the price.

Why is ICMR still recommending Remdesivir/Veklury ??