Coronavirus SARS-Cov2 (COVID-19)

[prasen9]

I like the closing travel very much. Now, if we have a small number of cases, we can grab them and keep it out. Maybe.

[jayakris]

I like the closing travel very much. Now, if we have a small number of cases, we can grab them and keep it out. Maybe.

Sure. I wanted it closed tomorrow, that is all. But okay, I understand that airlines travelers need to be given at least a couple of days of warning to change plans. If we have no international travelers coming in from Sunday night onward, maybe, just maybe, we could have a chance to focus on the "trace, track, test" scheme for all patients that turn positive from now on and stop the spread in its tracks. Let us see where we are in a week's time. Cross your fingers.

If we can get through without too much damage in the religious gatherings tomorrow, there is a chance. At least, I think nobody is going to organize any big crowd events from now on, and the mosque/temple/church people are all at least aware of things and will be generally careful. Criticial time, really, this upcoming week.

Also, Indians' extensive training in going through all our bandh and hartal days will come in handy now! It is the kind of thing on which people around the world have no training!

[Varma]

Kolhapur: Couple beats youth for sneezing in public

Amid the ongoing Corona virus scare, a man was thrashed by a couple at Kolhapur's Gujari after he did not wear a mask and sneezed in a public place. It all started when the couple was crossing a busy street on their motorcycle when the youth, who was also on a two-wheeler, sneezed near them. The couple warned him against sneezing in public and asked him why he wasn't wearing a mask. When the youth did not entertain the warning, the couple decided to teach him a lesson and asked him to stop his vehicle

Just in case the virus from this guy's sneeze missed reaching the couple, they made sure to stop him, hold him and give him a bunch of slaps on his face. Good way to gather enough virus for their entire neighborhood

- Varma

[Atithee]

Who needs enemies when you have friends? Does anyone know about this outfit—The Wire? I’ve not seen any news site so biased against India as this one. Here’s an example:

https://thewire.in/health/covid-19-icmr ... rveillance

A lot of this could be true but I’m talking from years of watching their articles.

[jayakris]

Yeah, The Wire publishes a lot of poorly formulated articles like this. The journalist could be right on many of these things though. My point is that, if community transmission were happening, we would know by now. Definitely some doctors somewhere would find a patient and it will come out that if the authorities had focused on testing in the area where the patient came from, the community transmission could've been stopped/reduced. It will happen on the very first such case. But it hasn't happened. So, the starting assumption from all these journalists that it must be happening, must be questioned.

As always, we just need to wait and find out. As days go by, the Government looks better and better in what they have been doing. But just one day is enough for it all to crash and burn, when some 5 patients are admitted in hospitals from some community somewhere, and hell will break loose. Just pray, as I always say. Alone, in your home

[arjun2761]

Who needs enemies when you have friends? Does anyone know about this outfit—The Wire? I’ve not seen any news site so biased against India as this one. Here’s an example:

https://thewire.in/health/covid-19-icmr ... rveillance

A lot of this could be true but I’m talking from years of watching their articles.

I have also wondered that given the limited testing for SARS-COV-2 virus (not just in India but also in the US for example), are some random old people dying but those deaths are being attributed to complications from the flu? However, I think there is an established network of some sort for measuring flu incidences and deaths, and so hopefully if there is spike in flu deaths that it would have been detected by the relatively sophisticated data analytics which are now quite prevalent.

[prasen9]

About 34,200 people die per year in the U.S. due to flu, adding a few hundred here and there will not make a difference. What would make a difference is if it is spatially and temporally clustered and a lot of folks turn up in one particular hospital, that would come up with the data analytics machinery or even by plain observation. So, if in some geographical area someone got the coronavirus and died without spreading it too much, some of those cases would not be caught/registered. But, if there is an outbreak, then it would show up. Which means the error, while it is there, is perhaps small.

[Sin Hombre]

Those flu stats are spread over the year and across the country. It is pretty evident spatial clusters will overwhelm local hospitals.

Here, in downtown Chicago, I can hear the ambulance every 10 minutes. Normally you hear it a couple of times a day.

[prasen9]

Which is what I said. Spatial clusters only happen if there is spread. So, in places where the carrier dies fast and the disease does not spread, you may have missed some cases. Spatial clusters are more likely to be detected in urban areas. Almost half the U.S. lives in rural areas. We may be missing many cases in the rural areas due to lack of tests. About 100 die per day due to the flu amortized over the year, much more during the winter. If the death rate for people with the flu is 0.5% many more get the flu. Right now about 61 died yesterday due to the coronavirus. So, it is not that much more. The difference may be between how many are hospitalized because of the flu and how many due to the coronavirus. It is highly likely that cases were not diagnosed as coronavirus especially before the testing kits were readily available, in rural areas, and in urban areas before the spatial clusters formed.

[jayakris]

Coronavirus: Why is India testing so little?. This article by Soutik Biswas, the BBC India correspondent, is not much of a "hit piece" and has somewhat of a balanced tone. He says that we have tested 14,175 people as of Thursday evening. But people are still puzzled. He says this:

Why is a densely populated country with more than a billion people testing so little? The official assumption is the disease has still not spread in the community. As early "evidence" health authorities say 826 samples collected from patients suffering from acute respiratory disease from 50 government hospitals across India between 1 and 15 March tested negative for coronavirus. Also, hospitals have not yet reported a spike in admissions of respiratory distress cases... "It is reassuring that at the moment there is no evidence of community outbreak," says Balram Bhargava, director of the Indian Council of Medical Research (ICMR).

That part about what the hospitals are saying, is the only evidence that not much community spread has happened, at least till 7-8 days ago, well after the big wave of infected arrivals from Italy and the Middle East started. Maybe... just maybe... this virus dies much faster than they all were expecting in high temperature with no air-conditioning.

Many of them believe India is also testing below scale because it fears that its under-resourced and uneven public health system could be swamped by patients. India could be buying time to stock up on testing kits and add isolation and hospital beds.

We may not be deliberately stockpiling or anything, but the delay in a break-out has certainly allowed the Government to get prepared for an Armageddon flare-up, if it were start at some point.

Here is another article that just came out, with some thoughts from Dr Anurag Agarwal, Director, Institute of Genomics and Integrative Biology - Now is not the time for lockdown
This made me wonder. Can we make a case that doing a lockdown too early would possibly harm our ability to do a lockdown when it is actually needed?

[prasen9]

Yes, this is a very valid point. People will not stay locked down for a long time. Or at least there will be some leakage in the adherence. If you assume that lockdown can be done for a limited amount of time, the question is when. If you lock down before the curve heads up, you will lose a lot in an economy and people will just die for lack of money. Or they will come out earlier not being able to tolerate a longer lock down and if the disease has just started to spread then, you are toast. So, if you assume that lock down can be effectively held for a finite period, then it is absolutely important to time it right. If there indeed is no community spread and everything has been contained, maybe a semi-lockdown with a travel ban is likely a better option than total lockdown.

[sameerph]

How do we know what is the right time to start a lockdown and how much time it should last ?

I guess very difficult for a governement to take a decision as it may be blamed on either side for being not imposing it on time or imposing it too early.

Btw, is the entire US currently in lockdown or only some measures for social distancing ?

[jayakris]

Yes, this is a very valid point. People will not stay locked down for a long time. Or at least there will be some leakage in the adherence. If you assume that lockdown can be done for a limited amount of time, the question is when. If you lock down before the curve heads up, you will lose a lot in an economy and people will just die for lack of money. Or they will come out earlier not being able to tolerate a longer lock down and if the disease has just started to spread then, you are toast. So, if you assume that lock down can be effectively held for a finite period, then it is absolutely important to time it right. If there indeed is no community spread and everything has been contained, maybe a semi-lockdown with a travel ban is likely a better option than total lockdown.

You articulated well what I was thinking too. It is rather futile to do it before the curve starts going up. But meanwhile, it may really help blunt the speed at which the curve goes up if we have taught everybody to exercise social distancing, and about the hand-to-nose-and-mouth infection problem. We may not even need a lockdown if the growth of the curve can be controlled that way. Nobody has done that so far, but maybe India and Africa have a chance to try it.

[jayakris]

Btw, is the entire US currently in lockdown or only some measures for social distancing ?

It depends on the state (and in some cases by county), but pretty much everything is going into lockdown. San Franciso area in Northern California has been in "shelter-at-home" mode for about 5 days. Verma and I have effectively been in a curfew for the last 2 days in Orange County in Southern California, as the County health commissioner ordered a ban on all gatherings for anything other than essential activities which does not include office work. So everybody has been sitting and working from home, other than those in essential services (banks, grocery, medicines, car repair places, restaurants serving order-pickup, delivery services, etc). Schools, Theaters etc are all closed. Universities doing classes fully online. It's not like the police is going around and catching people, but nobody has been getting out, other than to go get groceries. But just a couple of hours ago, the Governor of California ordered stay-at-home for all of California. Some similar things are happening in many (most) states, but there is no nation-wide curfew ordered. In fact, the president really cannot order it, and the state governors need to it - though if Trump actually were to order it on the pretext of the National Emergency already in place, he will may away with it and people will probably obey it.

Here is the CNN news on the California order - California orders its nearly 40 million residents to stay home

[jayakris]

With about 50-55 cases in two days (still not community spread, except for the one case in Chennai), I think we have this in so many places in India now. About 201 cases now. Something may break out somewhere soon. Feeling very uneasy. Let us pray.