Coronavirus SARS-Cov2 (COVID-19)

[jayakris]

Here is a good investigative article - Did ventilators from PM Cares Fund fail or states failed to manage them? (India Today)

Turns out that states like Punjab (who complained about Centre's ventilators not working) never really installed all the ventilators they got late last year in October, and never figured out how to operate them properly. This was despite letters from the Centre, and requests from the manufacturer on status of installation. The Punjab guys even flat out told the company that they didn't need the units!! ... They left them in storage, and now they say they don't work and blame the Centre. Unbelievable, how much politics the states are playing. Everybody seems to know (even in BJP states) that the easy thing is to just blame Modi for everything because the whole country seems to buy it! Smart guys, these politicians.

It is interesting that the only place from where there were no complaints was Kerala. I don't know how that state does all these things so well. The technicians were ready, they took the courses, they cared, they set up the units, and every unit the PM sent is being used by Pinarayi and his team. Have to give a lot of credit for Pinarayi and Modi, that despite serious political differences, these two have actually worked quite well together all along.

[suresh]

The ventilators from one manufacturer from Gujarat that were purchased using PMCares Fund were of poor quality and did not work. There was some criticism then but one would think that one year is more than enough to sort that out.

[suresh]

I don't understand why Karnataka has to do fewer tests on Sunday when their TPR is way too high. Can't they get to doing 1.5 lakh tests per day? I don't know how TN manages to do enough tests on Sunday's as well. They are not in great either but Karnataka is making them look good.

[jayakris]

The ventilators from one manufacturer from Gujarat that were purchased using PMCares Fund were of poor quality and did not work. There was some criticism then but one would think that one year is more than enough to sort that out.

Suresh, that complaint was investigated by India Today in the report above. Not sure if it was a valid complaint.

[suresh]

The ventilators from one manufacturer from Gujarat that were purchased using PMCares Fund were of poor quality and did not work. There was some criticism then but one would think that one year is more than enough to sort that out.

Suresh, that complaint was investigated by India Today in the report above. Not sure if it was a valid complaint.

I believe it was valid -- saw several reports on it. It is almost a year ago and so I don't have links handy. In any case, if they ventilators are still not working, I would fault the states on it.

[jayakris]

I don't understand why Karnataka has to do fewer tests on Sunday when their TPR is way too high. Can't they get to doing 1.5 lakh tests per day? I don't know how TN manages to do enough tests on Sunday's as well. They are not in great either but Karnataka is making them look good.

A lot of the Sunday tests reported by TN are probably tests done earlier (or put into the system on Sunday by the labs). The labs may be clearing up things and scheduling things that way. The states doing a lot of AG tests are the ones that reduce the testing on Sunday, because AG tests are almost always reported the same day. The RT-PCR tests are all basically done with a 1 to 3 day schedule by the labs (if they are overwhelmed, may be even 4 to 6 days), and they seem to stretch it into Sundays. A couple of states like Gujarat do some 3-day type of smoothing of cases, tests and deaths, and they also don't show much Sunday drop, despite doing a lot of AG tests. My impression is that RT-PCR tests do not drop more than 20 to 30% on Sundays (because they are from earlier days mostly). TN is still better though - showing less than 10% change on Sundays.

Karnataka is quite a corrupt and inefficiently administered state. The current BJP Government looks no different than other outfits in KAR earlier. Maybe worse. No surprise that they ran out of test kits and had to reduce tests.

[jayakris]

The ventilators from one manufacturer from Gujarat that were purchased using PMCares Fund were of poor quality and did not work. There was some criticism then but one would think that one year is more than enough to sort that out.

Suresh, that complaint was investigated by India Today in the report above. Not sure if it was a valid complaint.

I believe it was valid -- saw several reports on it. It is almost a year ago and so I don't have links handy. In any case, if they ventilators are still not working, I would fault the states on it.

I also had a vague memory of seeing some reports, so I just did a news search back to last year. It seems Jyoti CNC of Gujarat is the firm under question. Their first make, Dhaman-1 was not very good, it seems. It was approved by last August, in a hurry and probably without proper testing, but their Dhaman-3 seems to have been better tested and approved. That company was making ventilators for the first time, but I think most Indian companies doing it last year with PM Cares funds were. I saw newspaper reports of all the accusations in August, but no mention of it after that. That is possibly a sign that it was all cooked up charges, like many that are routinely leveled against Modi and anything from Guajarat (which will all be by "Modi's friends"!). Actually, some (many?) such charges have merit (and the Jyoti CNC charge may have had too, initially)... But if so, the issue would linger. In this case, it doesn't seem to have. Jyoti CNC was saying that foreign manufacturers were running propaganda against them (but that is an expected excuse too; need not be true).

Bottom line - I didn't see The Hindu writing an article on a scandal ... I do trust that newspaper to calmly talk about a scandal and give details if there is one, and they are truthful in what they report even if I don't trust their opinions because they are good at twisting things and creating "impressions" in a very intelligent way. Anyway, no mention of Jyoti ventilators not working till a couple of weeks ago in the press when PUN and MAH kicked things up. That is some 8 to 10 months. Nobody was going to let Modi go scot-free for this many months on that ventilator "scam", so I am assuming there was none. If the ventilators weren't working, we would've heard of it all along, because at least half the ones from the company were installed and were being used in many places. But then we saw the Punjab case of the state not even caring to get the company to check the ventilators. I think people are latching on to an old story to cover their behinds for not even setting up the ventilators sent to them by the Centre. It seems small things like ordering a coupling for their specific oxygen lines were the reasons for not even installing them. Idiots.

I think Jyoti CMC is not making the greatest ventilator out there, but I doubt other Indian companies are GE, Phillips or Hamilton either. So picking out the Gujarat company to criticize seems to be politically-motivated.

Again, we are in a world where one has very few trustworthy sources on the truth of any matter, so who knows!

[jayakris]

Ladakh Update: 5400 cases in the second wave until a week ago. Only 35 deaths. That is 0.65% CFR which is exactly half of the 1.30% CFR, basically the national average, that they had before that (130 deaths in 10K cases). So, vaccination has certainly helped in Ladakh.

[jai_in_canada]

Our first wave ended somewhere in mid September 20 and then the numbers kept coming down till mid February. So, it was close to 5 months gap between end of first wave and the start of second.

Jay, are you saying third wave can start as early as in 3-4 weeks time. Any specific reason you feel that the gap between second and third wave will not be as much as between first and second? Is it based on pattern of other countries waves?

The first wave was a gradual build from March to Sep. And it gradually came down from Sep to Feb. Not saying that pandemic waves are necessarily symmetrical. There are kinds of shapes for different countries. We cannot base our predictions for India based on any other country's wave shape. Very different demographics, population density, climate, pollution, humidity, use of public transit, adherence to mask discipline, access to medical care etc. But my hope is that India Wave 2.0 turns out to be like a raging forest fire that burnt through the most flammable victims, and now has run out of fuel. If that is the case then the decline should be just as sharp as the ascent. I expect it to smoulder for a long time to come, but I am hoping that there isn't another wave in the next few months.

[depleter]

No matter when the 3rd wave comes, if we want to decrease deaths, vaccination is the way through. But vaccine hesitancy will be a huge hurdle.
According to IMA only 66 percent of the doctors are fully vaccinated till now. 269 doctors died during the 2nd wave and only 3% i.e, 8 people had vaccination(only mentioned "had vaccination", fully vaccinated or only 1 dose is not mentioned) . But still, 5months after the start of vaccination process if only 66% of the doctors got vaccinated, I estimate other people to have more hesitancy especially when rural areas come into the picture.

[jai_in_canada]

Vaccines are being touted as the only way out of this pandemic. But if their efficacy turns out to be less than 75% and vaccine hesitancy is above 25% then vaccines will do squat to quell this pandemic.

A doctor friend of mine quoted the same stats on vaccine hesitancy among doctors. At his hospital over 50% haven't received the shot. Another doctor in LA told me similar things. So I.dont think it is unique to India. I wonder if polling can more objectively assess the extent of vaccine hesitancy.

Getting America vaccinated: How hesitancy was overcome & everyone was told, “it’s up to you”
https://brandequity.economictimes.india ... u/82595264

[suresh]

Strange data from Rajasthan

May 16 +10290 in RAJ from 72779 tests @ 14.1% (156 deaths)
May 17 +11597 in RAJ from 36176 tests @ 32.1% (157 deaths)
May 18 +8398 in RAJ from 74,896 tests @ 11.2% (146 deaths)

[jayakris]

Vaccines are being touted as the only way out of this pandemic. But if their efficacy turns out to be less than 75% and vaccine hesitancy is above 25% then vaccines will do squat to quell this pandemic.

You are such a vaccine skeptic that it puzzles me why you are, and makes me wonder if I am missing something in my thinking! .... Take 70%+ efficacy and 70% people as not hesitant (fitting your criterion), that is still around 50% people who don't get sick when they otherwise could have. And since the death rate is less than 1/10th in vaccinated people over un-vaccinated people even when you get the disease (and all approved vaccines seem to be highly effective against deaths), that is almost 70% deaths avoided (even with the "bad" vaccine of 70% efficacy). So ANY vaccine is useful to control the pandemic. I would even take a vaccine of only 50% efficacy that reduces death rate only to half, and give it to people because it will cut the deaths in the above example by some 35%. No control measure or medicine is that good against this pandemic. Am I not right?

Forcing people to wear masks by fitting everybody with a device on their faces and monitoring them under the threat of jail time, could work as well, but we can't do that!

[EDIT: I just read your post on the wife of your cousin in the other thread. Maybe you do have a reason to be a vaccine skeptic. But her case needs to be studied by the Government committee on adverse effects, it seems. Very unusual, and so sad to hear]

[jayakris]

Strange data from Rajasthan

May 16 +10290 in RAJ from 72779 tests @ 14.1% (156 deaths)
May 17 +11597 in RAJ from 36176 tests @ 32.1% (157 deaths)
May 18 +8398 in RAJ from 74,896 tests @ 11.2% (146 deaths)

Don't worry; that is actually usual from Rajasthan. It is simply from how the state reports it. They report only cumulative "samples received in state" and "samples positive in state" in the daily bulletins (excuse the state for poor English and vagueness; they have been consistent and prompt). So what is reported are samples collected today and will be tested over the next 2 or 3 days, but the positives reported are from tests on samples till 2 or 3 days before (except for AG tests which may be from yesterday. But both Covid19india and I can only report the difference between the "samples collected" numbers on any day. So the positivity does not apply unless you take a 4-day rolling average. I disregard the Monday number from Rajasthan for this reason, and always knew that about RAJ.

There are a couple of other states like that too. Actually most states report (on Monday) fairl unreliable numbers for Sunday because what they report may be test samples taken earlier. But Rajasthan, Kerala, and some others seem to have more strict ways of telling which samples were actually taken on Sunday itself, so their Sunday numbers are often distinctly lower (unlike say in TN or Gujarat which I tried to explain yesterday)

I have been looking at a 3-day average of positivity, nationally, for a long time in my spreadsheets for this reason. Maybe I should've posted that every day. Very smooth curve but I don't do that for each state.

[jai_in_canada]

Vaccines are being touted as the only way out of this pandemic. But if their efficacy turns out to be less than 75% and vaccine hesitancy is above 25% then vaccines will do squat to quell this pandemic.

You are such a vaccine skeptic that it puzzles me why you are, and makes me wonder if I am missing something in my thinking! .... Take 70%+ efficacy and 70% people as not hesitant (fitting your criterion), that is still around 50% people who don't get sick when they otherwise could have. And since the death rate is less than 1/10th in vaccinated people over un-vaccinated people even when you get the disease (and all approved vaccines seem to be highly effective against deaths), that is almost 70% deaths avoided (even with the "bad" vaccine of 70% efficacy). So ANY vaccine is useful to control the pandemic. I would even take a vaccine of only 50% efficacy that reduces death rate only to half, and give it to people because it will cut the deaths in the above example by some 35%. No control measure or medicine is that good against this pandemic. Am I not right?

I am just being my usual cautiously pessimistic self. It also probably goes back to my Master's thesis and first job where I built simulation models for manufacturing and distribution, where the goal is to test "what if...?" scenarios.

Here I'm going by what seems to be the most common goal expressed by epidemiologists, that is that it requires 65-70% of a population to be inoculated with a vaccine that is 95% effective to achieve herd immunity (which concept itself is questionable, as we discussed a few days ago). So my pessimistic side immediately asks "what if the vaccine is only 75% effective and only 75% of the population is willing to take it?"

To your point, and from data emerging from Israel, UK and even the US, even having 50% of the population vaccinated with even just the first shot makes an immediate difference in flattening the infection and death curves.

So despite my best efforts, optimism is gaining.

P.S. Also, we may not be that different in the way we look at things. I think you said that you are a contrarian who stands up for the person who is getting attacked as a fashion e.g. Modi. I do that sometimes. Also, if I find a lot of people thinking (hoping) a certain way, then I try to think contrary to that and play devil's advocate to see if their rationale stands up.