[carboy]

Originally Posted by viscosity

Regarding railway coaches getting converted to Covid isolation wards, it seems no other country has done that so far. I am curious what does people think about it ? Is it a brilliant idea or just a bad idea which looks good in theory but will fail in execution ?

Most of the photos seem to be that of the lifeline express which exists from 1991 - https://www.thehindu.com/news/cities...le14493378.ece

Originally Posted by vibbs

In another news I also saw Assam Government got a 700 bed quarantine facility ready in two days.
It is good that the various state governments have started acting and hope we will be ready if there is a community spread.

Yes. Many state govts have been quite proactive & hope more will be soon. I donated to our state CM Relief Fund yesterday.

[doxinboy]

Originally Posted by poloman

the entire population is confined to homes?

You sure the entire population is confined to homes?

[poloman]

Originally Posted by doxinboy

You sure the entire population is confined to homes?

That is what the purpose of the lock down. Whom are they going to test? Random population or patients coming to hospital?

[_chikku]

Many are talking about testing here. What is the reason? Same question was asked by CNBC to a Fortis person just now in a news. He says people are tested only if doctors are recommending it. He also said there is no shortage of testing infrastructure. People who are complaining we are not testing enough due to lack of infrastructure should be asked how many of them have tested for HIV?

[doxinboy]

Originally Posted by poloman

That is what the purpose of the lock down. Whom are they going to test? Random population or patients coming to hospital?

India was one country with least number of tests in the world. If we dont test, how do we know who is infected? Earlier due to acute shortage of testing kits, only suspected patients from travel history and their family were subjected to test if they showed flu like symptoms. The premise was that it was confined to stage 2.

However, with new cases emerging, there is a fear of community transfers, so the previous method dont hold water. It is for this reason the government is rapidly opening "Fever Clinics". The purpose is to identify the symptomatic patients within the community and send them to testing to see if they are positive. This is only possible if testing kits are available and quarinteen facility are in place.

I read somewhere that the real numbers is beyond 21k, if that is true, we dont have a choice but speedup the testing to isolate the positive cases and arrest the spread. Do we have a choice?

[hydraulicsteer]

Originally Posted by _chikku

Many are talking about testing here. What is the reason? Same question was asked by CNBC to a Fortis person just now in a news. He says people are tested only if doctors are recommending it. He also said there is no shortage of testing infrastructure. People who are complaining we are not testing enough due to lack of infrastructure should be asked how many of them have tested for HIV?

That is an unreasonable argument. HIV is not as contagious as this virus. Blood is the only carrier of HIV infection, for Coronavirus even air can be a carrier. HIV is low morbidity, low mortality vs the COVID’s high morbidity, low mortality.

Attaching here an interesting relation of lockdown period vs new cases.

[poloman]

Originally Posted by doxinboy

I.

However, with new cases emerging, there is a fear of community transfers, so the previous method dont hold water. It is for this reason the government is rapidly opening "Fever Clinics". The purpose is to identify the symptomatic patients within the community and send them to testing to see if they are positive. This is only possible if testing kits are available and quarinteen facility are in place.
?

Then why should we have a complete lock down? The idea behind complete lock down of 21 days is even if some one has virus, he won't be able to transfer to others since he is at home. Lot of people may not be symptomatic at all. How are they going to test them? Random testing at homes?

[sid__kaps]

Our Cabinet Secretary Ragiv Gauba says that there are no plans to extend the lockdown. As much as I would want to believe this, I feel it's unlikely. Fingers crossed though.

[bblost]

Originally Posted by _chikku

how many of them have tested for HIV?

When my wife was pregnant, I was tested for HIV.
Its standard operating procedure in most large clinics.

I also get tested for HIV at least two times a year because I am a regular blood donor and its a standard operating protocol.

[msdivy]

Originally Posted by hydraulicsteer

Attaching here an interesting relation of lockdown period vs new cases.

Considering how coronavirus propagates, lockdown isn't going to eliminate the virus. There will be asymptotic persons who will carry it around and spread to those who lack immunity for this variant. Lockdown will give time for healthcare units to ramp and handle large influx of patients.

Originally Posted by viscosity

Regarding railway coaches getting converted to Covid isolation wards, it seems no other country has done that so far. I am curious what does people think about it ? Is it a brilliant idea or just a bad idea which looks good in theory but will fail in execution ?

That is an excellent plan to increase hospital bed strength. Note that not all covid-19 infected patients require intensive care. Just isolation & basic hygiene care is enough for recovery. In fact, these coaches must be stationed at every town railway station to handle the local patients. Hope there are enough doctors & nurses to attend these temporary care units.

Originally Posted by Thad E Ginathom

Has this been covered on the thread? It is important news, and it is a a thing for India to be proud of...

Yes indeed a great moment. But there is no mention anywhere of the type of testing that can be done with this test kit- rRT-PCR or PCR.

Originally Posted by doxinboy

It is for this reason the government is rapidly opening "Fever Clinics".

So far in Bangalore, these clinics are identified:

Originally Posted by karan0009

One of my friend owns a hotel in my hometown. He got a call from city collector office today stating that his hotel premises would be used as a hospital if required. So it's not just railways, government will also convert hotels into hospital in emergency situation.

In Bangalore, BBMP has shortlisted these hotels:

[doxinboy]

Originally Posted by poloman

Then why should we have a complete lock down? The idea behind complete lock down of 21 days is even if some one has virus, he won't be able to transfer to others since he is at home. Lot of people may not be symptomatic at all. How are they going to test them? Random testing at homes?

The reason why the nations across the world are embracing complete lockdown is to stop the virus from spreading. Please refer to Patient 31 in South Korea of how a single person can spread to over 5k people. That's an extreme example of an advance country.

If such things happen in Dharavi, we can't imagine the magnitude of this catastrophe. Already Dr.Fauci is predicting 200,000 deaths in US and Australia has banned meeting of more than 2 people, Italy is hovering around 1000 deaths a day.

So the sensible way to handle this in our vast country is to lock people up. If the virus shows up, it will be locked within the family and not spread to the community. I also read that in 80% of the cases people may not know they have the virus. It appears and due to strong immunity, it just goes away. I pray to God everyday that Indian immunity will triumph over this pest and not affect the poor population.

[ValarMorghulis]

Originally Posted by doxinboy

India was one country with least number of tests in the world. If we dont test, how do we know who is infected? ...

I read somewhere that the real numbers is beyond 21k, if that is true, we dont have a choice but speedup the testing to isolate the positive cases and arrest the spread. Do we have a choice?

This hysteria over "India not testing enough.." has been going on since the beginning of March now with even Nytimes and WSJ stating the same. However, had the number been 10x or 20x times the actual numbers, we would have seen those patients getting admitted to the hospitals, right? That's not the case.
Yes, these might be more cases out there and we'll get to them as and when they get uncovered (and helped by increased testing as well), but to blatantly say that there are 21k cases (or even 10x cases or 80x cases like a few of my friends say) is whimsical.
Nothing against you personally, just taking the 21k as a number

The fact is all we know is that as of now we have around ~1050 cases.
Thats it.
Do we have more? Probably.
Do we know for certain? No.
Do we have 10x more cases? No proof of that, now.

So let's avoid any speculation. We have the facts as of now and we know them what they are.
The next few weeks of lock down will bring more numbers out, if they are hiding.

PS: We haven't tested the entire country for small pox either, that doesn't mean we have thousands of such cases hiding due to insufficient tests.

[_chikku]

Originally Posted by hydraulicsteer

That is an unreasonable argument. HIV is not as contagious as this virus. Blood is the only carrier of HIV infection, for Coronavirus even air can be a carrier. HIV is low morbidity, low mortality vs the COVID’s high morbidity, low mortality.

Attaching here an interesting relation of lockdown period vs new cases.

You have mistaken me. I'm not arguing here. I am asking here. Why there is a question of infrastructure? Has anyone been denied testing ? Has anyone been not admitted to hospital saying no beds? I am asking everyone because I don't know.

[ritz3645]

Originally Posted by _chikku

.

I had similar questions & concerns, but for the USA - as flag bearer of world economy. If the US economy sneezes, world economy catches cold.

'How red tape has crippled America’s coronavirus response' - NYPost article.

Plenty of companies would love to retool factories idled or slowed by the crisis to manufacture goods that are now desperately needed, and so keep their employees working and money coming in. But they need regulators’ OK to produce this stuff — and that normally takes months.

https://nypost.com/2020/03/28/how-re...irus-response/

[vivek95]

Random testing is a distant step, atleast we should start testing everyone with flu symptoms. This is inevitable in the current scenario as we don't have a specific anti-viral or a vaccine yet. I for one, don't bother about any travel or contact history because I realize that the damage has been already done in the country. The sole aim is to protect the vulnerable population from getting infected so that they don't end up being critical and ultimately encountering hoards of deaths like Italy. Remember, we also need to cater to the routine medical emergencies in these times. Salvageable patients like MI, stroke, metabolic complications etc might also need ventilator and ICU care. As these conditions have proven treatment protocols, ideally these patients need to be prioritised over critical COVID-19 patients and that would be an unfortunate, tough heartless call for us Doctors to make :( I don't know how will this be perceived in our country. Worst case scenario is us doctors contracting the disease while treating COVID-19 patients. India's doctor to patient ratio is pathetic, imagine Doctors and nurses getting isolated due to this disease even if they are mildly symptomatic or asymptomatic. Who will attend the patients ?? This will eventually lead to the collapse of healthcare infrastructure. Italian doctors choose whom to let die, but they are helpless. One of the prime motives of this lockdown is to protect the country's healthcare from inundation.


Meanwhile, check this news from Mumbai. Chembur lady with no travel or contact history ends up being critical with COVID-19. She was initially advised not to get tested, as she did not fit the criteria. Fair enough by the Govt. Doctors, I would not blame them, poor people are reeling under their own constraints. But cases like this reiterates the need for extensive testing.

The woman first contacted Kasturba hospital’s helpline on March 19 as she had symptoms such as a fever, running nose and a cough. She called again on March 21. But both times she was told to stay put at home as she had neither travelled recently nor come into contact with anyone who had.

However, her condition soon began to worsen and she was taken to a hospital in Chembur, from where she was shifted to a private hospital, Mulund. There, she tested positive for Covid-19.

Read full news here - https://www.google.com/amp/s/mumbaim...w/74869126.cms

--Dr. Vivek