Wuhan Coronavirus Resource Thread

Primus · Post by **Primus** » 09 Mar 2021 19:34

^
We've all seen an overall general improvement in the usual infectious illnesses that surge at this time of the year. This includes the common cold, flu, food-borne illnesses and so on.

This flu season has had among the lowest number of patients. So far as per estimates, only 453 people have died of flu in the US (compared to 22,000 in 2019-2020, 34,000 in 2018-2019). Granted, the season is not over and the final estimates are not in, but this is the number estimated. More importantly, typically 35 million or so are affected every year.

This year from September onwards, the total number of positive specimens for flu around the US have been 1543 only.

Data from CDC

Primus · Post by **Primus** » 09 Mar 2021 19:37

Meanwhile, locally some patients are refusing the J&J vaccine on the grounds that it is developed from a cell line that can be traced back to an aborted fetus in the 1970s. Some Archdioceses in the US have advised their parishioners not to take it while others have said it is OK.

Cannot believe the control these priests (and mullahs as the case may be) have over their flock in 2021.

Aldonkar · Post by **Aldonkar** » 09 Mar 2021 19:56

Tanaji wrote:India surpassed UK in total vaccinated today. UK stands at 22,377,255 at the end of 08 March 2021.

This is despite UK starting of their vaccination program nearly a month earlier.

I salute the Indian government and the health authorities on their achievement.

Your post however comes across as lacking understanding. The UK has vaccinated some 33% of her population. India has vaccinated approx 1.7%. This is the figure you should be looking at. In fact, if you are determined to use absolute numbers, compare against China who have a similar population.

putnanja · Post by **putnanja** » 09 Mar 2021 20:34

Aldonkar wrote:
Tanaji wrote:India surpassed UK in total vaccinated today. UK stands at 22,377,255 at the end of 08 March 2021.

This is despite UK starting of their vaccination program nearly a month earlier.
I salute the Indian government and the health authorities on their achievement.

Your post however comes across as lacking understanding. The UK has vaccinated some 33% of her population. India has vaccinated approx 1.7%. This is the figure you should be looking at. In fact, if you are determined to use absolute numbers, compare against China who have a similar population.

Er, that's also not a proper comparison. The logistics and planning involved in vaccinating millions of people at much higher rate compared to developed country like UK is astounding, considering the challenges in India. I hope for once people would understand the challenges faced in vaccinating so many people on a war footing in a country like India. The rate of vaccination will only go up as govt gives permissions to private companies to start vaccinating their employees and dependents. Not to forget that the production of vaccine to meet demands is under strain too. SII has contracted to supply vaccines to multiple countries under covax and other programs, and to India too. Covaxin is yet to publish phase-3 results , so the percentage of covaxin is still less compared to SII's covishield.

Aldonkar · Post by **Aldonkar** » 09 Mar 2021 20:48

Er, that's also not a proper comparison. The logistics and planning involved in vaccinating millions of people at much higher rate compared to developed country like UK is astounding, considering the challenges in India. I hope for once people would understand the challenges faced in vaccinating so many people on a war footing in a country like India. The rate of vaccination will only go up as govt gives permissions to private companies to start vaccinating their employees and dependents. Not to forget that the production of vaccine to meet demands is under strain too. SII has contracted to supply vaccines to multiple countries under covax and other programs, and to India too. Covaxin is yet to publish phase-3 results , so the percentage of covaxin is still less compared to SII's covishield.[/quote]

In the post that I replied to, the writer did not not discuss constraints etc. I do appreciate the logistics, infrastructure problems and so on. Although I am UK resident, I am of Indian origin and have visited India many times.

However to compare absolute numbers for a country of 65 million wrt a country of 1.3billion is not a proper comparison too.
With regard to India being on a war footing, maybe this is true of Ladhak, but the rest of the country it is business as usual. You could also say that there are similar problems in the UK with the EU fighting the Brexit war in the east and the Scottish Nats fighting theier usual war in the North, though Nicola Sturgeon has shot herself in the foot.

putnanja · Post by **putnanja** » 09 Mar 2021 21:04

"on a war footing" phrase is typically used to convey sense of urgency, didn't mean entire country is getting ready for war.

Yes, its not proper to compare a developed country of 65 million wrt a developing country of 1.3billion. It should be a cakewalk for developed country to vaccinate its low population, given its infrastructure. If the developing country is beating it in rate of vaccination, that is something which needs to be applauded, unless the developed country is deliberately going slow and is in no hurry to vaccinate its population inspite of availability of vaccines.

darshan · Post by **darshan** » 09 Mar 2021 21:30

From India's perspective, it would be interesting to see statistics for malaria like illnesses compared to home food and better air quality. The food and air improvements were temporary. One long term thing that India got out of lockdowns was infrastructure building and that will have ripple effects towards better access to health care.

Uttam · Post by **Uttam** » 09 Mar 2021 22:14

While India has done a great job ramping up vaccination, there is still room for a lot of improvement. Here is a comparison of what's happening in other places.

Suraj · Post by **Suraj** » 09 Mar 2021 22:24

Raja wrote:
Suraj wrote:Vaccination rate officially crossed 2 million per day on Monday. Cumulatively north of 23 million now.
Awesome. But, lets not forget that we have a far bigger population than USA and UK. Not trying to belittle what we are achieving, but I want us to quickly reach a stage where there is no comparison between us and anyone else (especially UK) when talking in absolute terms. China is really the only competition, but so far they have been rather subdued on the vaccination front.

This "let us not forget {insert one factoid}" is a common language construct, but misused and offers no meaningful value. This is like Aussie cricket team saying they lost to India because we have 1.3 billion people. Not trying to belittle your claim but there's no directly useful information in raw population here.

Throwing in one stat and assuming people will make all the necessary connections is not helpful. You speak about large population. This means an HCW/FLW is a major serial spreading node, because a large number of people interact with them. If they are not vaccinated ahead of time, the entire process of vaccination could be compromised by HCWs themselves transmitting Covid to other staff and patients waiting. Depending on perfect protocol observation by everybody is a mistake. The government has to err on the side of caution, so that is what they did:
1. Phase 1 (Jan 16-Feb 28) only for HCW and FLWs. There are 9.6m registered HCWs in India. In phase 1 vaccinated 14.3 million people, i.e. essentially all the HCWs and a large number of FLWs.
2. Phase 2 (March 1 onwards) is only 60+ and 45+ with comorbidities. During this phase we've accelerated from 500K to 2m per day:

The US and UK both started with the much more expensive and high logistics requirement Pfizer and then Moderna in mid December. India cannot afford mass vaccinations with those - the cold chain requirement and cost would cause a public policy failure. It started with its own production.

The data shows:
1. The US took 2.5 months to get to the 2 million per day rate that India achieved within the first week of phase 2.
2. The UK vaccination story is one of stagnancy. One day a week of 500K but no improvement in vaccination rate. India has already overtaken the UK in cumulative vaccinations after starting phase 2 two and a half months after they started their corresponding one.

When you have a large country with a small number of HCWs and a large population, the smart thing to do is first immunize the HCWs while building your logistics. Then turn around and accelerate immunization. As of March 8, India topped the world in daily vaccinations, overtaking the US:

darshan · Post by **darshan** » 09 Mar 2021 22:28

It takes years to create HCW. Experience comes at a value. Sometime back I had posted an article about struggles of GJ govt to fill medical positions. If GJ is struggling then one can imagine many other places.

Suraj · Post by **Suraj** » 09 Mar 2021 22:41

Aldonkar wrote:
Tanaji wrote:India surpassed UK in total vaccinated today. UK stands at 22,377,255 at the end of 08 March 2021.

This is despite UK starting of their vaccination program nearly a month earlier.
I salute the Indian government and the health authorities on their achievement.

Your post however comes across as lacking understanding. The UK has vaccinated some 33% of her population. India has vaccinated approx 1.7%. This is the figure you should be looking at. In fact, if you are determined to use absolute numbers, compare against China who have a similar population.

Why is it lack of understanding ? There's no ceteris paribus in the underlying mortality data here. The UK *had* to start earlier because they repeatedly botched public policy associated with Covid. They didn't impose contact tracing, the PM tried to behave like he's Superman and almost died himself after getting Covid. In the US almost the same thing happened.

India was extremely cautious and erred on the side of caution. It gave India the public policy space to organize the vaccination program in a more sane manner, instead of trying to simultaneously vaccinate both a high risk group and the vaccinators (HCWs) at the same time.

India is ramping up vaccinations with astonishing efficiency after having done a strong job of keeping deaths/100 number - by far the biggest signal of policy action - down far below most of ROW. Here's data that actually makes sense in the context: biweekly Covid deaths/100. Most of Europe saw their winter surge stop only after they got vaccinations out quickly - at a significant public policy cost after previous failures:

India did not need to act in this manner because it acted with greater alacrity and effectiveness beforehand, and could plan and execute differently.

Uttam · Post by **Uttam** » 10 Mar 2021 03:00

There are very interesting data about the current vaccination campaign in this article.

Covid-19: 2.6 crore have registered for jabs, 75% online

with a majority of the appointments (around 75%) being booked online, rest are walk-ins

Men accounted for 58.5% of total registrations

about 18% of planned capacity was in the private sector

And the most interesting one:

The total planned capacity for the day’s vaccination was a shade over 36 lakh, but the current utilisation was just around 60%

Another article:

The 24 million doses, however, make up a little more than half the 41 million doses the Centre had procured from vaccine makers by early February — the health ministry had told the Parliament on February 12 that it had procured 41 million doses.

That means, there is no dearth of supply. And there is ample capacity in the system to vaccinate more people.

I think there is an opportunity to expand vaccine eligibility. The govt. should consider allowing everybody with comorbidity as well as everybody above the age of 45.

Suraj · Post by **Suraj** » 10 Mar 2021 05:21

Great news on the supply logistics. Yes, 60% utilization of 3.6 million daily capacity is about 2.1 million, which is what we saw on Monday.

Elsewhere, it is reported that Covaxin has "significantly higher immune response" with a 4-week dose interval as opposed to the original 2-week recommendation:
Bharat's COVID shot shows high immune response, further study needed for elderly

A COVID-19 vaccine developed by India's Bharat Biotech is safe and has shown high levels of antibody response in a mid-stage trial, but follow-on studies are needed to evaluate the shot for children and older people, a peer-reviewed study showed.

The vaccine, India's first successful home-made shot against COVID-19, has attracted interest from more than 40 countries. The company said last week it had shown 81% efficacy in preventing symptomatic COVID-19, based on interim analysis of late stage trials.

The double-dose vaccine showed significantly higher neutralizing antibody responses in Phase II than in Phase I due to the difference in dosing regimens that changed to a 4-week apart injection schedule from a 2-week course, researchers said in the study published in medical journal Lancet on Monday.

Less than 9% of the more than 18.2 million Indians vaccinated so far against COVID-19 had taken COVAXIN as of Tuesday, government data showed.

Many politicians in India, including Prime Minister Narendra Modi, have chosen to be inoculated with the homegrown shot instead of a rival one developed by AstraZeneca Plc and Oxford University.

India, the world's biggest vaccine maker, aims to inoculate 300 million of its 1.35 billion people by August. It has reported 11.24 million COVID-19 infections, the highest number in the world after the United States, with 157,930 deaths.

If we vaccinate lets say 14 million a week (2.3m/day not counting Sunday when the count always seems to dip - they could fix that), then they'll cross 300M by August. At 4M/day, they'll vaccinate over 550 million by August.

a_bharat · Post by **a_bharat** » 10 Mar 2021 08:37

^^^
You have to divide that number by 2 to account for two doses.

GoI seems to be more interested in scoring brownie points by giving away huge numbers of doses to others (including pakis

), than take up the vaccination on war-footing, scaling up to 10M/day and let the private sector participate more (Rs. 250 limit seems too low for me).

a_bharat · Post by **a_bharat** » 10 Mar 2021 09:10

The CoWin registrations and daily vaccination numbers already started to fall. Hope this fall is just an aberration.

GoI, stop being clever by half and vaccinate every one interested in getting vaccinated.

vera_k · Post by **vera_k** » 10 Mar 2021 09:25

The poor may be getting left behind in vaccination drive

Only about 10% of the people being seen here each day would be in the lower income group

Think opening up vaccinations on Sundays and other holidays will help so people can get vaccinated without having to take time off work. Alternatively, the government should think about paying people cash at government vaccination centers when getting vaccinated.

saip · Post by **saip** » 10 Mar 2021 09:33

a_bharat wrote:^^^
You have to divide that number by 2 to account for two doses.

GoI seems to be more interested in scoring brownie points by giving away huge numbers of doses to others (including pakis ), than take up the vaccination on war-footing, scaling up to 10M/day and let the private sector participate more (Rs. 250 limit seems too low for me).

Pakis are NOT given any vaccines by GOI as far as I remember. They were actually excluded when GOI gave vaccines to all in SAARC countries. But WHO has COVAX scheme under which Serum Institute made vaccines (Astra Zaneca) are supplied and they in turn go to Pakis. All 27 million of them for free. India too gets something like 92 million under the same scheme. Strangely WHO puts Pakis in some Mediterranean region with headquarters in Cairo. So I take it SII sends the vaccines to Cairo and then WHO sends them to Pakis. Shortest distance between two points is not a straight line. Shameless Pakis still get Indian made vaccines for free.

nandakumar · Post by **nandakumar** » 10 Mar 2021 11:09

a_bharat wrote:The CoWin registrations and daily vaccination numbers already started to fall. Hope this fall is just an aberration.

GoI, stop being clever by half and vaccinate every one interested in getting vaccinated.

I think this is already happening in a defacto sense. The above 45 age group with comorbidities that include only very stringent medical conditions are practically ignored. The persons in this age group are checked for their age and a perfunctory query about comobidity elicits a response, 'diabetes or hypertension' and the person is registered and shot administered. I saw this when I went to myself vaccinated.

asgkhan · Post by **asgkhan** » 10 Mar 2021 12:18

They should just open up vaccination for all age groups without any gate keeping. High time we got back to normalcy.

Raja · Post by **Raja** » 10 Mar 2021 12:39

It is not a foregone conclusion that there are not going to be any issues supply side. Government has ordered limited amounts of vaccines thus far. Having it open for all age groups without any gate keeping is probably premature.

BTW, it seems like Rajasthan is leading the tally of number of vaccinations. That is very surprising given that it is far from the most populated states. Any idea why?

vera_k · Post by **vera_k** » 10 Mar 2021 12:48

Seems Rajasthan is running out of vaccine supply and pausing vaccinations after today.

Rajasthan government says COVID-19 vaccines short in supply, Centre denies claim

“Bharat Biotech has not supplied 20 million doses it had agreed to so far and for every dose administered in India, the country is exporting three doses to other countries. The plan was to keep at least 50 per cent of the doses manufactured in India within the country."

Mort Walker · Post by **Mort Walker** » 10 Mar 2021 13:10

Raja wrote:It is not a foregone conclusion that there are not going to be any issues supply side. Government has ordered limited amounts of vaccines thus far. Having it open for all age groups without any gate keeping is probably premature.

BTW, it seems like Rajasthan is leading the tally of number of vaccinations. That is very surprising given that it is far from the most populated states. Any idea why?

RJ is the 6th most populous state with 7.7 crore (77 million). TN, GJ, KA, AP, OD, JH, and TG all follow in population.

sajo · Post by **sajo** » 10 Mar 2021 18:27

As of today (10-Mar-2021) , the COWIN Portal has stopped accepting registrations for those between 45 and 60 , even if they may have comorbidities.

Here's a screenshot, and yes, I confirmed it wont let you proceed with a popup warning.

Maybe supply constraints (or a system revamp, I am willing to go with the latter). A press conference scheduled for tomorrow at 4 PM would clear things up.I believe registration can still be done via Arogya Setu though.

Raja · Post by **Raja** » 10 Mar 2021 21:27

Do we have the numbers for today and yesterday?

Suraj · Post by **Suraj** » 10 Mar 2021 21:48

Tuesday total was 1.35 million . Today's 7pm update shows about 920K people vaccinated. Here are PIB PRs, which provide detailed data breakdown:
March 8 9pm update
March 9 7pm update
March 10 7pm update
Scanning the data, on Monday we had 1.6 million until 9pm. Tuesday and Wednesday we had only 900K-1M until 7pm. The difference is almost entirely accounted for by the difference in the over 60 age group. On Monday over a million in that age group were vaccinated. The two successive days, the number if down to 500-550K .

Not sure why the 60+ group dropped that much since Monday. Cowin site is not accessible outside India so I'm dependent on resident folks to parse and report data from there.

ranneel · Post by **ranneel** » 10 Mar 2021 22:14

Cowin Dashboard indicates 1.16 million vaccinations till 9 p.m today.

Suraj · Post by **Suraj** » 11 Mar 2021 04:15

The Subject Experts Committee recommends removing the clinical trial model label from Covaxin, now that its Phase 3 results are published:
Covaxin boost: SEC says drop clinical trial mode label

The recommendation by the Subject Expert Committee (SEC), if accepted by the chief of India’s top drug regulatory body, would mean that the vaccine can be administered with less stringent conditions and might lead to an increase in the uptake of the vaccine.

The development follows the Hyderabad-based vaccine maker’s announcement on March 3, based on interim data from late-stage clinical trials, that Covaxin had an efficacy of 80.6 percent — it was able to bring down symptomatic cases of Covid-19 by nearly 81 percent in those vaccinated as opposed to those who did not receive a vaccine.

The next step in the process is for the Drugs Controller General of India (DCGI), Dr V G Somani, to review the SEC’s recommendation and decide whether the Central Drugs Standard Control Organisation (CDSCO) will grant Covaxin this approval.

Authorisations granted to the Covid-19 vaccines in India so far do not allow for commercial sale — both Covaxin and Covishield have only been approved for use in India’s immunisation programme at this time.

nvishal · Post by **nvishal** » 11 Mar 2021 11:28

Affordable vaccines from India, China and Russia have flooded both developing and developed regions of the world. It has forced Pfizer to consider manufacturing in a low income country like India if officials expedite its approval. This situation is similar to the rise of cheap chinese fighter jets eclipsing the sales of f16/18s.

Meanwhile, bharat biotech has shipped around 200k of the total 700k vaccines ordered from Iran.

Cyrano · Post by **Cyrano** » 11 Mar 2021 17:08

Pfizer has been extremely haughty, always seeking exceptions and special treatment. Is there a need for GoI to accommodate its demands ? I don't think so.

nam · Post by **nam** » 11 Mar 2021 18:21

No harm in allowing Pfizer to produce in India and export. We cannot allow them to sell privately in India, until we allow our companies to do the same.

sampat · Post by **sampat** » 11 Mar 2021 20:30

Denmark suspends use of AstraZeneca COVID vaccine

An unconfirmed number of patients have developed blood clots after receiving the shot, according to health authorities. Iceland and Norway have also stopped administering the shot.

The Danish Health Authority on Thursday halted the use of the AstraZeneca coronavirus vaccine for 14 days.
It follows reports of "serious cases of blood clots among vaccinated people," a statement read.

However, the authority stopped short of saying there was a direct link between the vaccine and the blood clots, "at the time being."
"It is currently not possible to conclude whether there is a link. We are acting early, it needs to be thoroughly investigated," Danish Health Minister Magnus Heunicke said on Twitter.

Shortly after the announcement, Iceland and Norway both halted the rollout of the vaccine.

Uttam · Post by **Uttam** » 11 Mar 2021 20:46

sampat wrote:Denmark suspends use of AstraZeneca COVID vaccine

There are some strange politics happening in EU nations with regards to AstraZeneca vaccine. So far, they have raised a number of issues and retracted them. First, they restricted it to people below 65, then they said it is not good enough. On top of it, they were going after AstraZeneca for not increasing supplies. It has been really fishy!

Suraj · Post by **Suraj** » 11 Mar 2021 20:59

nam wrote:No harm in allowing Pfizer to produce in India and export. We cannot allow them to sell privately in India, until we allow our companies to do the same.

Pfizer was asked to do local trials to validate efficacy on our population . They declined to do so and reiterated their request to distribute on their terms . They were denied .

Uttam · Post by **Uttam** » 11 Mar 2021 21:56

There has been some deceleration over the last couple of days. Does anybody know what's happening? I couldn't find anything by searching the internet.

I know the above chart may not be completely up to date. But, the trend is still that of deceleration.

Suraj · Post by **Suraj** » 11 Mar 2021 22:49

Drop in daily over 60 vaccinations. Almost the entire drop from Monday is on account of the ~500K fewer +60 group vaccinations on Tuesday and Wednesday.

It's not clear if it's the people or the availability having hit saturation point. I'm going to assume based on the presumption that people don't change their mind on these things overnight all of a sudden, that this is a logistics problem. It'll be fixed, given their good record so far. It's a question of how soon.

Ambar · Post by **Ambar** » 11 Mar 2021 23:34

In Karnataka most district hospitals are now accepting walk-ins. You register at the counter when you go the hospital, no pre-registration is required on the app. Trouble is in Blr the wait times have increased significantly, 6 to 7 hrs in some instances . Before administering the vaccine the provider takes the BP reading of the vaccine recipient. In many cases the elderly who have waited for hours without food show either a drop in BP or a hike in BP so they are sent home without vaccine and asked to come at a later date. The good news is the hesitancy is dropping and pre-registration is no longer required (atleast not in KAR), the bad news is the wait times.

As the summer flu season sets in cases are increasing everywhere. Thane announced a lockdown in 16 neighborhoods until Mar 31st only to reverse it a day later. The only silver lining is the death rates compared to new cases is significantly low (similar trend compared to what the west went through this winter), but any GP with experience in treating virals in India will tell you that Apr-Aug is the critical period when cases rise everywhere. If it gets ugly in summer i hope this time we are prepared with beds, ventilators and o2 supply.

Suraj · Post by **Suraj** » 12 Mar 2021 00:04

Today's vaccination numbers are likely only half a million at most, due to it being Maha Shivaratri. That's what the PR from MoHFW says.

Uttam · Post by **Uttam** » 12 Mar 2021 00:44

Thanks for those details. I wonder if there is still a lot of hesitancy. It may be that the initial group that came out to get vaccinated was the one that had the least hesitancy. Now the remaining groups are of those who are still very hesitant to take and therefore the drop in numbers. As per the news I posted, the vaccination centers are only 60% utilized. We may need a concerted information campaign to help get over the hesitancy.

Along similar lines, we are noticing similar trends among seniors in the US. Vaccination rates among people over 80 seem to be stalling after 55%-60% of people are vaccinated. People least hesitant (or enthusiastic) about vaccination have already received their shots, the rest will need more convising.

Suraj · Post by **Suraj** » 12 Mar 2021 00:50

Given the drop for two days leading to a major festival, I wonder if this is related to Shivaratri vrat / shuddhi concerns leading to people waiting until after festival ?

Ambar · Post by **Ambar** » 12 Mar 2021 01:02

Daily metrics are of limited use in my opinion, you'll get a clearer picture middle of next week on the overall numbers. Even with new cases, recovered cases, fatalities the numbers drop significantly from Fri to Mon and begins increasing from Tuesday onwards. I think this is mainly because of lag in data reporting from centers on weekends and holidays.