Coronavirus SARS-Cov2 (COVID-19)

[Kumar]

On Kerala testing:
Complete lockdown in Kerala on July 23-24; mass testing campaign with target of 3 lakh tests per day ordered
https://www.timesnownews.com/india/kera ... red/788265

More lies from the state Government. Yeah right. They are going to do 600K in two days. We heard this last week, and we got 30K extra tests on Thu/Fri. They said the results would come over the "coming days" but the days never came.

But again Kerala managed to make people believe that they did some mass testing last week. See this Hindu article that says there was mass testing last week, and even talks about specific results from that testing. A total lie, but The Hindu published that. Does anybody check anything? It is incredible what is going on in Kerala with the fooling-the-public campaign.

910k tests thru 15th thru 21st
Around 1 million test from 22nd thru 28th

So that promised test mela is a whopping 90k tests spread out thru 7 days


What is going to be the excuse for this?

[jayakris]

^^^ Haha. Thanks Kumar for checking. No, there will be no excuses given. The newspapers are in it with the politicians. They will not ask why they were fed lies. That is done only with the Center, whose bad-estimates and exaggerated (folish!) expectations are given as lies.

I know how Kerala operates these days. That is why I immediately sensed that it should all be a big fat lie. This is the same thing that goes on, in every facet of life in Kerala these days. The political parties that control the state (on the CPM and Congress sides) are only interested in going after BJP and not against each other, so lies go un-checked by anybody. The BJP politicians can sit there and cry, but there is nobody to pay attention to them and they are made into a jokes by the press/media/politicians, and thereby the voting public too. Many BJP guys in Kerala are not too smart and savvy, to add to it. Not having a decent opposition in the state is a baaaad thing in democracy. It played havoc in Maharashtra and kerala this time.

The Central Government tried to be really critical of Kerala this week, writing letters to the chief secretary and all that, but the news in the Malayalam press was that a bunch of Kerala MPs met the health minister Mandavia and that he praised Kerala for the great work in handling the pandemic. When it came out 2 days ago, I knew that these guys were on their offensive defense, and staying ahead of the game. They knew that the Centre was going to come down hard, and had to blunt it beforehand. So the Kerala MPs played the trick. Of course, if some MPs visit the health minister, it is all for optics only and everybody knows it. Mandavia was only going to treat them to some nice chai and say friendly stuff (no point telling them that the state Govt should get its act together; it will only look bad). So the MPs managed to keep the news going that Kerala is still doing great in pandemic control. "Look, we got more cases. See how efficient we are in detecting cases?" is always the Kerala health department's spin, and it works... Unbelievable. The smoke and mirrors that the Kerala politicians put in place is something to see. Anyway, I digress....

[jayakris]

We were in the lower half of Suresh's expected range today. +43,165 cases from about 2093K tests and 2.06% positivity. The seven-day average went up by 211 to 38,541...

Maharashtra keeps adding some old deaths, but now without saying how many. 285 there, so the death count stayed up at 640 today. I think some 150 are earlier deaths in MAH.

By Wednesday standards, the vaccination was good at around 4.3M again. I think we will cross 30M vaccinations this week. The ministry release on Wednesday morning said that 21.8M were with the states and that 12.1M was in the pipeline (that is the largest "in the pipeline" figure I ever noticed). The total of 33.9M is good and the stock continue to look healthy. Hopefully we will do 15 to 18M in the next three days and finish the at close to 470M total vaccinations (around 135M for the month).

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ICMR Update: 462,629,773 total tests... Wednesday tests: 1,728,795

[Rajiv]

The Vaccine program in Hong Kong commenced in March, but by June less than 20% of the population got themselves vacinated primarily due to the Chinese bias of refraining from getting vacinated.
The Govt holding stocks to cover more than its entire population was in a dilemma as these stocks if could not be utilized,  would have to be thrown in the gutter upon its expiry in September.

So they came up with a novel idea of a lucky draw for those vacinated with 1st prize being a flat worth 10M HKD, and than another package of 10 M HKD worth of lucky draw prizes which included Tesla,BMW, I phones etc.

And suddenly  2 months since they were announced, as of today 34.3% have received both the doses and 46% have received the first dose, so in coming 3 weeks the figure of completed vacinated will be 80% of the entire population, and with new registrations coming in on a average of 30k per day,HKG may well reach near 100% vaccination by the time the stocks expire in September.

Yes , Money makes the Mare Go...

[suresh]

@rajiv Nice story! Thanks for sharing it with us.

[jayakris]

Kerala is again showing no clear signs of nearing a drop. If there is a hint one day that it might be getting ready to get better, a day later things become unclear again....

It was +22,064 today, from 163,068 tests @ 13.52%, pretty close to the recent 2-month high of 13.63% from 6 days ago. The RT-PCR and good tests (57,183) were a notably higher fraction today at 35% though (as the RT-PCR results from "mass testing" came a day or two later than the AG tests, basically). So my adjusted TPR was 19.93% (it was highest 6 days ago, at 20.67%)... Anyway, I still think it is getting ready to drop soon. Let us wait and see.

[suresh]

The argument in favour of Kerala that is being bandied about is that (i) seroprevalance is low (44%) and hence more people can get infected, (ii) they do a good job of testing and are catching a lot more cases when compared to a state like TN.

[suresh]

Big States 29/7/2021 Thursday

KL - 22064
MH - 7242
AP - 2107
KA - 2052
TN - 1859 (the number of cases has gone up by around 100 today)
OR - 1615
AS - 1299
MZ - 1100 (Mizoram reenters the list today!)
MN - 1000

Total - 40338

We are going to have 44-45K cases today. We need to go under 34863 for the seven day average to go down. It is going up by a whopping 1400 today.

[jayakris]

We are going to have 44-45K cases today. We need to go under 34863 for the seven day average to go down. It is going up by a whopping 1400 today.

No surprise, I guess. Kerala had 12.8K seven days ago from 103K cases, and 22.1K from 163K tests today. That is 9.3K more after a week. Some 1350 rise in the 7-day average came from just Kerala today. It is all KER at this point.

[suresh]

^^ It is a great observation that the rise is mostly Kerala.

Looks like the number of people who think Kerala can do better is 2.

[jayakris]

What people like Dr. Kang and Rijo John miss is that Kerala has unnecessarily allowed some 15% more cases because of poor testing. That is mostly from a stinginess in testing (a reluctance to do mass testing all along) and over-reliance on controls. They all assume that Kerala's ability to find cases at a much higher rate than in other places in India is because of something that the Govt does. It is not. The state Government and machinery are filled with clueless people who got to their positions through nepotism and corrupution. It is all talk.

The substantially higher reach of testing into all areas of the state and all segments of population has nothing to do with anything that the state put in place. It is just that Kerala has hospitals by the truckloads and an extremely health-aware educated population. So it is no wonder that Kerala does find probably 80 or 90% of the cases out there, while the rest of India probably finds 25% to 40%...

But everything the state has been doing has been blunting the above advantage Kerala has. The main control device the state has is in testing - really the only thing the state can actually do, once community transmission starts and contact-tracing becomes pretty much useless. There were two parts to it -- (1) Having a high RT-PCR ratio, and (2) having mass testing at probably twice the rate KER was doing, if AG was going to be 65 to 70% of the tests. Both parts were miserably mishandled by the state of Kerala. That caused the wave peaks to be flat and the drops slow, and caused extra infections within households. That all adds to (in my estimation) something like an extra 15% of cases, and an extra 30% in the time period of the waves. The latter has had economic and psychological costs on people, that are not insubstantial. The people haven't had a break for almost 12 months. Come on.

The more I see Dr. Kang speak, the more naive she sounds in her analysis. What she is saying is not wrong, but she is missing serious aspects of the problem.

There is no Kerala "model", unless you are talking about getting the population to be literate and aware, that happened in Kerala over a century or more (only a smaller potion of it due to communists who take credit for it - but they are not the reason; it all started from having royal families with foresight who cared). Everything the state has done during the pandemic has been to misuse the tremendous built-in advantages Kerala had from an aware population and a great private-sector healthcare network.

[ornatebrute]

The main control device the state has is in testing - really the only thing the state can actually do, once community transmission starts and contact-tracing becomes pretty much useless. There were two parts to it -- (1) Having a high RT-PCR ratio, and (2) having mass testing at probably twice the rate KER was doing, if AG was going to be 65 to 70% of the tests. Both parts were miserably mishandled by the state of Kerala.

Afaik, antigen test is only a screening test even in Kerala. Whenever RAT is positive, we consider them as COVID +, but if it's negative, all are subjected to an RTPCR for confirmation. Atleast that's the policy followed all across medical colleges and even by ANMs/ASHAs in Karnataka. I'm sure even Kerala is doing the same . It's just that they are doing it with proper surveillance and reporting. That's all. The numbers are obviously going to rise during the third wave in the states that are showing <3% positivity rates on RTPCR, and it'll be difficult to fudge the cases and deaths, just like whatever happened during the second wave.

[jayakris]

^^^ That policy is just talk, ornatebrut, in all of India. NOBODY follows it anywhere in India. Neither does Kerala (actually Kerala probably tries, but it doesn't work, as I describe below).

The proof is very simple. That would make 90% of the AG tests to be repeated (because 90% are negative even in Kerala. 99% in the rest of India). That means RTPCR tests will be at least as much (and normally 2 times many) as AG tests, no? You cannot get 70% of the total tests to be AG tests if all AG test negatives are repeat-tested. You can't even get 30% tests to be AG tests with that policy. So that policy doesn't exist. Those like you, educated people, when told the policy will follow it, but 95% people don't, so the policy is useless.

It is mostly the people themselves who come forward to get tested in Kerala (unlike in UP/MP/Bihar, where a lot of people don't have a clue about what test it is and why they are even tested, and are mostly "herded in" for tests). In Kerala, somebody from a household goes to a hospital or clinic to get tested on some personal suspicion, he/she gets an AG test, and it is a blood test. They don't know about AG tests being only half as effective as the swab test. They assume they are negative, go on with watching TV tigether (they are all sitting at home in Kerala for 12 months, mostly) and give it to the others in the household. They may have been told "you need to come back for an RT-PCR to confirm" and they won't bother to. They aren't sick, and they got a negative blood test. What is there to confirm? That is why there is no repeat RT-PCR tests for even 10% of the AG test negatives. But in other states, the authorities don't even know how to get those people back for an RT-PCR and I think not even 5% AG negatives are repeat-tested. So Kerala is a bit better at it, but none of it helps.

If AG tests are done, that needs to be reckless testing of a lot of people (multiple people in every household). That doesn't happen in Kerala like elsewhere. So, the bad effect in AG tests are worse in Kerala that tries to do it carefully! (Counter-intuitive, I know!).

[suresh]

Afaik, antigen test is only a screening test even in Kerala. Whenever RAT is positive, we consider them as COVID +, but if it's negative, all are subjected to an RTPCR for confirmation. Atleast that's the policy followed all across medical colleges and even by ANMs/ASHAs in Karnataka. I'm sure even Kerala is doing the same . It's just that they are doing it with proper surveillance and reporting. That's all. The numbers are obviously going to rise during the third wave in the states that are showing <3% positivity rates on RTPCR, and it'll be difficult to fudge the cases and deaths, just like whatever happened during the second wave.

2/3 of Kerala's tests are RATs. If the policy that you state was followed, there should be a larger number of RTPCR tests done. It is impossible to ignore the high TPR and chalk it all down to Kerala's superior testing. This is what Kang/Rijo John and others are doing. Maharashtra with lower seroprevalance as well has a TPR that is 1/4 that of Kerala.

[jayakris]

So, we had +44.7K on Thursday, from about 2056K tests at 2.17% positivity... All the numbers getting bad, primarily due to Kerala, though there is also some small rise in the Northeast that is adding to it. The 7-day average went up by 1401 today, 39,942... There were 549 deaths.

The vaccinations were good, as we did 5.3M doses on Thursday. We've done almost 23M doses already this week with 2 days to go. We should finish the week in the 30M to 33M which is quite good.

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ICMR Update: 464,650,723 total tests... Thursday tests: 1,816,277... Lab count: 2796