Coronavirus SARS-Cov2 (COVID-19)

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jayakris
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Re: Coronavirus SARS-Cov2 (COVID-19)

Post by jayakris »

The interviewed lal path labs said that they just started testing yesterday and they can go upto 1500 tests a day.
It just doesn't seem like capacity is our problem. The ICMR guidelines posted on the 20th clearly says that any SARI patient with flu/cough symptoms needs to be tested ( no need for travel history or contact or anything). I am assuming that such samples are only just getting to the labs. I think there are some logistical issues, on collecting samples, and hospitals learning where to report SARI cases and then the personnel in charge of getting there and taking swabs, sending it to labs in charge of collection, who then forward it to the labs to test, etc. The earlier operation was a bit easier because the labs knew from where the calls to take sample would come, and organize their trips (the sample-takers need to be wearing PPE) by scheduling visits to various hospitals, and all that. It may take a few days for this to ramp up, now that I think about it. I think a lot of driving is involved, but at least now there is no traffic!

I have not seen articles on the details, so we don't know what kind of bottlenecks are happening as we transition to the new scheme of testing everybody. It is okay, if we are in a long-haul (which we probably will be) and the numbers rise up over the next couple of weeks. But we need to be testing at least 10K a day in a few days, if not 15K, which we can do.

But I am anxious to see the growth rate in numbers when we move to testing for community transmission (and tracing their contacts). It better not be 40%, or we will see 18K cases by the end of next week in 10 days. It better be somewhere in the 15% to 25% range (2500 to 6000 cases). If we have 18K case by next week, surely it will be in some one or two big metro areas and we cannot handle it right now. If it is in the lower range, it will probably distributed all around, and is not a big problem - hospital capacity wise. Let us watch and pray.



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Re: Coronavirus SARS-Cov2 (COVID-19)

Post by jayakris »

By the way, I don't think Dr.Lal was accurate in what he said - that a doctor who prescribes a test to a patient has to check if the patient has a travel history or has contacted a positive patient etc. That is no longer needed, as far as I know. Any SARI patient can be (and should be) given a test as per ICMR now. The doctor is also correct, in the sense that a person from whom this lab collects a sample on a home visit, would not be a SARI patient (who would usually be in some hospital already, and the hospital would normally send the sample to the Government labs for free tests, unless the patient insists on quicker results and offers to pay a private lab). So the non-SARI patients that this lab tests would normally be one who has a travel or contact-history which the prescribing doctor needs to give as a reason for the test. Not for the SARI patients.

But the logistical issues cause delays in all this. So it is probably too early to see the increased numbers after the change in strategy.



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Re: Coronavirus SARS-Cov2 (COVID-19)

Post by jayakris »

MHFA official numbers are at 694 (increase of 88 from 606 yesterday).

The actual latest numbers from Covid19india are at 720, an increase of 62 so far, and it may go up 5 or 10 more today. Just the threes and fours trickling in from so many states (except for the 9 in Kannur district in Kerala, which I need to look more into)

We can say "phew" for one more day now.



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Re: Coronavirus SARS-Cov2 (COVID-19)

Post by jayakris »

End of March 26th "Analysis" by Rev. Jayakrishnatennisepidomiologiananda :) [who acts like he knows the sport and the science]

Never in my wildest imagination did I expect us to show only 720 cases by now. Nine days ago, I was praying for 750 in 7 days and expected about 200-300 cases coming in by day for a total of 2000 by now. Somebody (God?) was hearing our prayers so far.

But it is way too early to say anything, even if the Indian curve has certainly flattened a little bit in the last 3 days. From a total ~120 on March 16th to ~475 over 7 days, we kept a 22% rate. At that rate we would've expected about 875 by now (around where Russia, who were closely tracking us a bit behind during the past two weeks has gone now, going past us yesterday). But our increase in the last three days has been at around only 13.5% per day.

But this is not a "final flattening" on the other hand, and it is definitely NOT showing the effect of the lockdown or anything. This is most probably showing the effect of the tracing and quarantining of the foreign-returnees and their contacts. The foreign returnee numbers were going up at essentially the steeply rising "foreign curve" (perhaps an avg of about 25% per day, from our "catchment countries") from March 15 to 22nd. The effect of their ability or inability to infect others would not have gone into our curve till about 3-4 days ago. So the arrival curve started getting affected by a "number of contacts" curve that is added to it, and that curve started rising seriously in the last 4-5 days but it actually dropped the total curve because of a much lower growth rate (may be 10%).

So the drop from 22 percent to 13.5 percent in the last three days is quite probably because the foreign-returnees have only been able to infect an average of 1.3 or so others in 4 days, as opposed to 2+ that is sustaining the 20-40% (but average 25% or so) rate in our catchment countries that have had no trace-test scheme like us. But now, a week later (the delay being due to infection time and a further 2-3 day delay to get the contacts' test results), the second curve is beginning to show its effect. The combination of the foreign arrival's increase rate and the contacts number is now showing a drop from 22% to 13.5%.

Now, if we wait 4-5 days, I think we will start seeing an increase due to the people that the contacts may have infected. A third curve. And many of those are community transmission cases (otherwise they would've been traced and gone into the total sooner). So, if the 13.5 remains for 2-3 more days, we will then start seeing a slightly higher rate. Maybe a lot higher, but probably not more than 20% if I were to guess. Then there is the effect of the lockdown. That is a 4th curve, you may call it, but it really is a drop-in-the-rate factor. That will kick in around the same time or a couple of days later and the rate may drastically drop to 10% or so, if all goes well.

But the 3rd curve could drastically go up if the Pune/Bombay hot spots (or Bhilwara or Kasarkot) out there have caused huge community transmission already. We would need some divine intervention for that not to have happened. Maybe we have got it. I hope so.

So there are some 4 different curves that are adding up at various time lags. But rates of the last couple of curves that started 5-8 days ago and 2-3 days ago are very hard to determine because that is all community transmission. We should be around 2000 (+/- 500) in another week. We need to see the curve after 7 days to get an idea where we are going after that. That will be the "final rate" we will see after a week or so when all effects are added together.

At that point, it will depend on the efficacy of wider testing for community transmission that we do from NOW. If the test numbers go up quickly now, the data will be more reliable and we can catch-and-quarantine a lot more to keep the rate at an overall growth of 15 percent or lower. If we screw up on testing, we will simply get the 25-35 percent growth rate seen elsewhere, after a delay of 15-20 days. Then, that delay will be all we would've accomplished, with all our hard work so far. And it will all go for a naught. We will be totally out of control of the situation even in 10-12 days if we screw up and find a 30% growth rate in 10 to 14 days. In even 10 days, it could all be out of control. I am doing mental simulation here without the "IndiaSim" type simulators that our favorite Dr. Bloviator mentions (which seems to be garbage-in-garbage-out for the context-specific factors that have affected things so far)

That means, if we are testing enough in the right places (no need for huge nationwide tests just yet) and cordoning off areas for contact-tracing, sanitizing etc, we can keep this from starting to grow from a very comfortable 2000 in another week, to a manageable 14K in 3 weeks (a 15% growth rate after a week, that is). On the other hand, if we do not test enough and miss the many community transmission cases that may be hitting the hospitals already, then we will grow after a week at a rate of at least 20% to 25K in three weeks or at a more probable rate of 30% to 80K in 3 weeks with everything out of control. All the strategizing will be of no use at all. Then we are looking at the Bloviator's numbers - some 50K growing to 1 million cases by early May. That is an optimistic figure. Easily 75K deaths in even 5 weeks.

We had better get our act together and test people like our lives depended on it (well it does) this week. Right now!!!



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Re: Coronavirus SARS-Cov2 (COVID-19)

Post by jayakris »

Now ICMR is not even posting the testing numbers. Yesterday they had what appeared to be a wrong number of positive cases (581) when the Ministry had already posted 606 earlier in the evening and when the state's confirmed numbers added up to 620+. Then they did not give a 10 am update today like they were doing earlier, and now have not posted the March 26th numbers even past midnight. Something is up, at ICMR on this matter. And that is extremely concerning, because testing in huge numbers right now is the only way to catch things early. Canbnot waste even 3-4 days.

Come on ICMR. Don't turn into CDC now :)



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Re: Coronavirus SARS-Cov2 (COVID-19)

Post by prasen9 »

And, before we could actually flatten COVID-19, now there is another pandemic DKE-19 that is hitting several parts of the world.
Sad story, more flattening needed



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Re: Coronavirus SARS-Cov2 (COVID-19)

Post by Atithee »

Some related news:

Rate of increase
https://timesofindia.indiatimes.com/ind ... 834200.cms

Ban on international flights extended
https://www.ndtv.com/india-news/ban-on- ... ak-2201247

Government to fund PF for three months for small employers
https://www.hindustantimes.com/india-ne ... 07GaM.html



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Re: Coronavirus SARS-Cov2 (COVID-19)

Post by jayakris »

No update on test numbers today from ICMR could very well mean that they did not get enough tests done. The numbers may have dropped for all we know to 500 or 1000 (as the airport-related immediate cases all stopped after the 22nd, and what they got till Tuesday have all been tested by Wednesday morning). That could mean that their "expanded testing scheme" is not working and people aren't sending SARI patients and others. That is terrible, if so. I am only guessing. Hope to see 25K to have gone up to 30K in an update by tomorrow morning and 35K by tomorrow night. Asking for way too much, I know.

The tests MUST be going on full swing these 4-5 days, or we will be in trouble, lockdown or not.

But I just don't think many people appreciate the real danger. Experts at ICMR knows, I am sure, but everybody else around the country needs to get off their asses and start sending samples. I think everybody is relaxing, thinking that the lockdown has solved the problems. It has not solved anything, if we don't test. It was for doing the testing and quarantining operation without an explosion of cases that lockdown was important. If we are relaxing now, it is way too dangerous, and that is why WHO warned us yesterday about it.



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Re: Coronavirus SARS-Cov2 (COVID-19)

Post by SaniaFan »

This is scary - this is from economics time live updates

The virus has moved into the slums
Even as India observes a 21-day nationwide lockdown to slow the spread of the novel coronavirus, an intimidating challenge has emerged
At least four people in Mumbai's slums and crowded chawls have tested positive, the Mumbai Mirror reports.
They include a 65-year-old resident of a chawl in Parel, a 37-year-old resident of Kalina's Jambhlipada slum, a 25-year-old man from a slum cluster in Ghatkopar, and a 68-year-old woman from the same slum.
The 65-year-old woman who tested positive in Parel ran a food mess in Prabhadevi and served many working in an upscale business centre next door, it reports, making contact tracing a mighty task.
The man in Kalina's Jambhlipada slum worked as a waiter in Italy. The slum has around 800 dwellings and less than hundred toilet seats.

Following link has update at 8:59AM.
https://economictimes.indiatimes.com/ne ... 38380.cms



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Re: Coronavirus SARS-Cov2 (COVID-19)

Post by jayakris »

Yes, the case of the old lady doing lunch-supply is a bad one (in Vashi, if I remember correctly). But then again, these things were expected. As long as we catch them relatively fast, we can cordon off areas and simply put an end to most of it, and slow down the spread. We will have to keep doing this kind of dousing of fire wherever it breaks. In a city like Mumbai, it causes a nightmare (like they are already facing, in tracing), but there is just no other way than to trace as much as you can, do community education on how they can prevent spread to some extent possible, place people in quarantine (which a fraction of them will break).. So on and so forth. It is going to be a part of life from now on for the health department staff. Positives will keep coming, but hopefully not all at the same time for hospitals to handle. But then again a lot of the poor people will just simmply not even know that it is Covid-19, and will go through it and be fine in 2 weeks. We just don't want to have the 15-20% of them needing ICU and ventilators showing up within 4 to 6 weeks like in NY. We just don't have hospital space and well over 10% of the patients could die. The death rate in poor communities may well be 5 to 10 percent in the end still, as it continues and infects a lot of people. Hopefully these death numbers won't happen in one month but in 4 months, by when some sort of effective therapeutic cocktails of existing drugs may end up being found.



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Re: Coronavirus SARS-Cov2 (COVID-19)

Post by jayakris »

Meanwhile, the snail pace of testing continues. ICMR finally had an update at 9 am March 27th just now. 27,688 samples tested from 26,798 individuals, for 691 positives. So, it is really the count from the 26th evening yesterday as ICMR finalized the daily number at 694.

It was 25,144 on 25th march 8 pm (which was about 2100 more than the previous day). The new total is about 2500 more. So there is a slight uptick. Actually the daily count has been going up by 100 to 200 every day over the last few days (it was around 1000 a day a week ago). But this won't do now. It needs to go up a lot more every day. Like 5000 in 2-3 days and then 10000 a day in a week's time. I know I'm hoping for too much.



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Re: Coronavirus SARS-Cov2 (COVID-19)

Post by sameerph »

USA goes ahead of China with highest number of cases now. No. of deaths are of course much much lower in US. I really

India number now 735 as per Covid India site - 135 in Kerala, 125 in Maharashtra, but Karnantaka, Rajasthan, Telangana,Gujrat,UP fast getting up.



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Re: Coronavirus SARS-Cov2 (COVID-19)

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Re: Coronavirus SARS-Cov2 (COVID-19)

Post by jayakris »

Omkara wrote:
Fri Mar 27, 2020 5:03 am
https://www.covid19india.org/
That is the site we are all following for the last couple of days, Omkara. Very up-to-date and reliable. I think even worldometers have started following their numbers!



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Re: Coronavirus SARS-Cov2 (COVID-19)

Post by SaniaFan »

But this site says deceased as 16 but i think it has risen to 20.