[INJAXN]

Originally Posted by sunilch

Sorry for your loss but you must be aware of the social fabric of the general populace at Indore I suppose. Not saying your relatives fall in the same bracket but in general the attitude of the population at the start of this Pandemic was very casual. Remember the 'Juluce' they took out on Janta curfew day? Or the stoning and brick-bats beating of the healthcare workers who were contact tracing in some locality? The city took it very lightly with 'Our Immune system is superior to handle this Virus' attitude in March/April. The Tashan baji there is only second to Delhi I suppose.

I agree that there have been few unfortunate instances which you have mentioned, but such similar incidents are every where in the country.
This is a very difficult and never seen scenario for everyone, and everyone it trying their best to cope with it.

Indore and its residents have proven their ability to be extremely disciplined by making Indore the cleanest city. That too 3 years in a row. It is really very clean.

So, lets not generalize on whole city .

[Miyata]

Originally Posted by The Rationalist

The genetic variation in SARS-Cov-2 isolated from different parts of India.

It would appear, among the 6 clusters, the A2a clade is the deadliest in India? This has been responsible for most infections and most deaths. While there are mutations that can make the virus "less deadly" these specific mutations in A2a clade (P314L and D614G) has somehow made it more dangerous.

While I don't yet know much about P314L, I am bit surprised about D614G - replacing an aspartate (negative charge) with glycine (neutral) - I would have imagined it is less specific in binding to cells and therefore ought to have been less infectious.

Guess there might be some other missing mutations on this.

[The Rationalist]

Originally Posted by aaggoswami

If someone get Coronavirus now, it means they must have interacted in last 14 days with someone with Coronavirus. Wasnt isolation the sole purpose of lockdown ? Why still are we getting close to 4000 cases on daily basis ?
Never knew that a virus can be so damn adaptive that it can survive heat wave of India and thrive in colder regions.

Once you get infection, you can be isolated. The issue is we have very large number of asymptomatic infected people. I have mentioned that here before, but there are few who question whatever I say, so had stopped drilling sense. The asymptomatic maybe doctors, police personnel, essential shop staff etc. There will be less than 1% of these people who know how to remove the mask properly without contaminating and even less who will never inadvertently touch the face (including we doctors) and other areas, you can’t prevent that happening. So if lockdown had to work, ideally all except medical staff, nobody should have been coming out of their houses, was it possible, absolutely impossible. There ends the ratioanality of lockdown!

Now about the virus getting killed in hot climates, this was mostly propagated by many politicians and by WhatsApp and Facebook scientists and by some doctors also. I was ridiculed by few fellow intensivists when I told to think a type of Corona virus to behave unlike other similar viruses will be foolish. Education as it is imparted in our country is good to get some 9-5 jobs, not intended to make anyone think and apply scientific temper in life. You need to teach your kids only one word “Why”, asking that single world will change one’s life dramatically.

[kiku007]

Originally Posted by rakesh_r

I made my dad download and learn how to use Google Pay and Paytm. Since him being an old school, he use to shun away from using any payment apps. Now he is comfortable using them, be it medicines or groceries, he finds it more convenient now.

Yeah, he started using Google Pay on the phone. I guess the tendor-coconut vendor on street hasn't joined the digital bandwagon yet.

[DCEite]

Originally Posted by The Rationalist

Now about the virus getting killed in hot climates, this was mostly propagated by many politicians and by WhatsApp and Facebook scientists and by some doctors also. I was ridiculed by few fellow intensivists when I told to think a type of Corona virus to behave unlike other similar viruses will be foolish. Education as it is imparted in our country is good to get some 9-5 jobs, not intended to make anyone think and apply scientific temper in life. You need to teach your kids only one word “Why”, asking that single world will change one’s life dramatically.

While i agree that there seems to be no general relationship between hot climate and COVID-19 transmission rate, i came across some studies which state otherwise.

Note that i am neither advocating that Climate has a positive nor advocating there is no affect.

Its just that these studies point out that hotter climate has inverse relationship between COVID-19 transmission rate:

https://www.medrxiv.org/content/10.1....23.20040501v3

https://www.medrxiv.org/content/10.1....27.20045658v2

https://www.thelancet.com/journals/l...003-3/fulltext

https://www.medrxiv.org/content/10.1....30.20044099v1

https://www.annualreviews.org/doi/10...-012420-022445

[Miyata]

Originally Posted by The Rationalist

Education as it is imparted in our country is good to get some 9-5 jobs, not intended to make anyone think and apply scientific temper in life. You need to teach your kids only one word “Why”, asking that single world will change one’s life dramatically.

You could say that again....and again (at least 5 times, I guess!). May be asking 'why' once will make one good, asking it five time will make one great - Toyota would have us believe so -

5 Whys method as “the basis of Toyota’s scientific approach by repeating why five times to find the nature of the problem, as well as its solution,

[am1m]

Originally Posted by The Rationalist

I have mentioned that here before, but there are few who question whatever I say, so had stopped drilling sense.

Aiyoo sir, please don't let that stop you from posting your points!

The posts from you and the other medical professionals have been the MOST useful on this and the other covid-related threads. We've all learned a lot from them.

There will always be people who will try to pick apart arguments to try and support their position. Unfortunately most of the pro-and anti positions almost all of us take on this (and several other issues) are politically, upbringing, sociology-economically and otherwise influenced. So it's good that the medical professionals bring the scientific facts which are really all that count since this is basically a medical situation and will finally be solved medically, not politically!

In fact, instead of politicians and screaming TV anchors, imagine if there was a rotating panel of a few epidemiologists and virologists on TV each day answering common questions, translated into all major Indian languages, how much more useful that would have been. I think people would have panicked less and followed protocol better if they knew the facts.

[vivek95]

Originally Posted by aaggoswami

Somehow, am not able to understand the trend of Coronavirus. How can we be recording cases now ? If one catches coronavirus, then the symptoms show up in 14 days or so, hence the quarntine timeline of 14 days. Now, we are in lockdown for over 50 days. So shouldnt the cases be over by now ? Or at the most in 30 days, there should be no cases. If someone get Coronavirus now, it means they must have interacted in last 14 days with someone with Coronavirus. Wasnt isolation the sole purpose of lockdown ? Why still are we getting close to 4000 cases on daily basis ?

On another note, I have lost two distant relatives in Indore due to Coronavirus, and 10 of my maternal relatives in Indore are Corona Positive while results for two are pending. Some other relatives have survived and tested negative as of now. Never knew that a virus can be so damn adaptive that it can survive heat wave of India and thrive in colder regions.

First of all, really sorry to hear about your loss. Highly unfortunate and may their souls rest in peace.

14 days is a "median" incubation period and there are many outliers. I have had personal account of two patients reporting "positive" after 28 days. As Dr./ intensivist @The_Rationalist has pointed out, subset of large asymptomatic carriers is one reason for all the recent spike and this coupled with widescale testing as compared to earlier.

1.36 years Male lands in Mumbai on 9th March from Dubai and duly gets quarantined at home like a strict law abiding citizen. He lives with his wife,son, parents, brother and brother's wife. He never developed any symptoms, did not ventre out even once and locked himself up for more than 20 days at home. Media aroused a lot of curiosity in him and he got himself tested on day 29th just for the sake of it. He had no symptoms but it was curiosity alone that he convinced a known doc for a prescription and got himself tested. Turns "positive". I began talking to him regarding the WHO guidelines on home isolation measures for positive individuals back then, 2 months ago, before I quickly realised "why to take a risk on my medical license" and backed off and asked him to call up the state helpline immediately. Had I shared this before on team-bhp ?? Sorry, if this is a repeat.

2. Elderly person aged 75 male lives with his wife and was indoors since two months ever since the 22nd March curfew in Mumbai. Only wife stepped out to nearby shops for groceries. Wife gets admitted at a huge prominent hospital in Mumbai for entirely different reason ( non-covid). The said hospital has declared themselves non-covid centre, so as a protocol, the attendants need to compulsory undergo covid-19 testing to get a visitor pass. Wife who is admitted also underwent mandatory testing but she is negative. You guessed it right, poor uncle tested "positive". No symptoms, nothing.

I personally take an interest to talk to positive patients and understand their symptoms and the chain of events in the background. This is sort of a personal small scale study I do it for myself. We cannot keep harping on "nothing is yet known about this virus" slogans and imprison ourselves endlessly. We can atleast act based on whatever we know so far. And yes we "may" fail, sorry !

All that aside, we in the frontline could be spreading the disease too, let me be honest on that. But, blame the contagion, it's practically impossible to act foolproof all the time. Challenges faced by healthcare and allied administration are enormous but that is more so logistically. The virus be damned, we don't really bother about it anymore. Most of the frontline personnel are already positive ( not lab confirmed, but by applying a certain scientific logic ), but if we test and isolate all of them, the entire system will collapse. The intersectorial functioning will go for a toss and there will be complete disaster and all this for a virus which is passing down as a mild to no illness in 80% patients.

[Nalin1]

Originally Posted by vivek95

All that aside, we in the frontline could be spreading the disease too, let me be honest on that. But, blame the contagion, it's practically impossible to act foolproof all the time. Challenges faced by healthcare and allied administration are enormous but that is more so logistically. The virus be damned, we don't really bother about it anymore. Most of the frontline personnel are already positive ( not lab confirmed, but by applying a certain scientific logic ), but if we test and isolate all of them, the entire system will collapse. The intersectorial functioning will go for a toss and there will be complete disaster and all this for a virus which is passing down as a mild to no illness in 80% patients.

I have had this feeling for quite some time. Was wondering if it was making sense though.

I think this virus has spread its tentacles far and wide almost throughout the country and maybe the whole world !.

In other words, almost all of us are already carrying the virus without having a clue.

I could be completely wrong too!. Time will tell.

[The Rationalist]

Please go through the largest and best study done yet to find out the prevalence of Corona virus in Spain. While my arguments of asymptomatic infection turned out true, I have to admit my assumption of deaths is way off by a mile.

Major findings, 90% of infections gone undetected by the health care system! Only 5% of Spaniards are infected, for herd immunity to develop 60% needs to get infected. Fatality rate is 1%. If herd immunity is tried Spain will lose 2,00,000 to 3,00,000 people. These are scary findings to be honest, so the epidemiologists believe Vaccine is the only option as the human cost is unacceptable and follow social distancing. But to vaccinate the whole world it would take couple of years. It’s really like being between the devil and the sea.

https://english.elpais.com/society/2...Qu40GYi51vobJY

[mohansrides]

Originally Posted by The Rationalist

WHO experts are experts indeed. First, they were not sure Covid-19 was a pandemic, then they said lockdown was the magic bullet, now they are not sure whether the lockdown will work. The joke is on the poor people.

https://www.bbc.com/news/world-52643682

If I can think of one clear loser in all of this, it is the WHO. They have been nothing of short of schizophrenic during this crisis. -

"It is not a pandemic." "No wait, it is a pandemic." "Lockdown is the answer." "Lockown may not help all that much." "So proud of the fact that some vaccines have reached clinical trial stage in record time." "A vaccine may take years or may even never materialize." "Wear masks." "Masks may not help that much." "We will overcome this disease." "Disease is here to stay."

I mean, how do these guys even have a freaking job? They called for a massive shutdown of society inflicting enormous pain and suffering on the most vulnerable, which is the majority of the people in the world. They urged governments to push people and businesses to bankruptsy and ruin, all based on notions that they cannot properly justify. Now we are stuck in a lockdown that no one knows how to exit. (Wait, actually everyone knows how to exit it. They just don't have the courage to walk back their statements and to take Covid casualties.)

In short, the WHO has made an excellent case for its own dissolution and dismissal. Which is a shame really; because the WHO is responsible for so many public health triumphs in the past. Think eradication of Polio and Smallpox. For those who don't know, WHO doctors are regularly hunted down in places like Afghanistan and Pakistan under the notion that the vaccines are a western conspiracy to indoctrinate people.

In fact, the clear winners from this crisis are the religious nut jobs. Those guys are going to come out looking like rockstars at the end of this. Their goal has always been to undermine democracies and civilized society. If ever they needed an example of a situation where science and rationality didn't provide answers, this is that time. Whats more, these morons preach the gospel of courage; even if it is to do the wrong things. Now, with our run-and-hide response to Covid, we have given them a great platform from which to make the case that they are the chosen ones filled with courage and a sense of self-sacrifice, while people in general society are inferior, unworthy, and completely oblivious to the pain of the common man. These radicalists are going to have a field day gathering new recruits and brainwashing people.

Seriously, we caught the $h*t end of every stick out there.

Originally Posted by The Rationalist

Please go through the largest and best study done yet to find out the prevalence of Corona virus in Spain. While my arguments of asymptomatic infection turned out true, I have to admit my assumption of deaths is way off by a mile.

Major findings, 90% of infections gone undetected by the health care system! Only 5% of Spaniards are infected, for herd immunity to develop 60% needs to get infected. Fatality rate is 1%. If herd immunity is tried Spain will lose 2,00,000 to 3,00,000 people. These are scary findings to be honest, so the epidemiologists believe Vaccine is the only option as the human cost is unacceptable and follow social distancing. But to vaccinate the whole world it would take couple of years. It’s really like being between the devil and the sea.

https://english.elpais.com/society/2...Qu40GYi51vobJY

This death rate is even less than what was originally quoted (3%). And the conclusions mentioned in the article may be appropriate for Spain. But seriously, in most parts of the world and especially in India, if we implement social distancing measures to protect 1% of the infected population from death, then we will rain ruin on the majority of our countrymen. The loss of life due to such measures will far exceed the 1% fatality rate of the infection. The vast majority of our people in our cities do not live in places that allow social distancing; and will not be able to find work that will accommodate social distancing in all aspects, including in the actual commute to work, in the work itself and in places where they feed, recreate and worship. Simply illogical to the core.

[poloman]

Originally Posted by mohansrides

If I can think of one clear loser in all of this, it is the WHO. They have been nothing of short of schizophrenic during this crisis. "It is not a pandemic." "No wait, it is a pandemic." "Lockdown is the answer". "Lockown may not help all that much." "So proud of the fact that some vaccines have reached clinical trial stage in record time." "A vaccine may take years or may even never materialize." "Wear masks." "Masks may not help that much." "We will overcome this disease." "Disease is here to stay."

Not only WHO, a whole bunch of medical advisory bodies and epidemiologists have been behaving in this manner. WHO even told initially that this virus wont spread from one person to another. That is why I have always maintained that this mess is created by these bunch of lunatics. If you have to live with the virus means why the hell you recommended the lockdown?

You may be able to survive lock down even if this sucked out around 10T USD. But these guys have damaged the social behavior of general public by doomsday mongering. They injected paranoia in to people's minds and they are running scared. Not in the near future people are going back to being social beings. This will inflict more damage to the global economy than the lockdown itself.

[mvadg]

Originally Posted by Nalin1

Time will tell.

Originally Posted by mvadg

no choice but to lift the lock down. ... the brilliance of our masters sooner than you think.

Originally Posted by vivek95

All that aside, we in the frontline could be spreading the disease too, let me be honest on that. But, blame the contagion, it's practically impossible to act foolproof all the time. .

Realization about the inevitable spread of the virus dawned on me quite early when I observed my own failings. I expected others to catch on too; in fact, I was sure the lockdown would be lifted much before May 15th. In my earlier post on 16th April and I had urged other members who were against the lockdown like me to be patient, expecting a quick end to this fiasco.

I'm not good at reading the general public's mind it seems Now I'm trying to understand the reason why almost 50% of our members still favor the lockdown. I've read their points of view, but I was expecting a change as the situation progressed. Oh, well!

[mohansrides]

Originally Posted by poloman

Not only WHO a whole bunch of medical advisory bodies and epidemiologists have been behaving in this manner. WHO even told initially that this virus wont spread from one person to another. That is why I am always maintained that this mess is created by these bunch of lunatics. If you have to live with the virus means why the hell you recommended the lockdown? ....

I agree that it was started by WHO. But, at some point, it falls on our government to take a more studied stand; even if that means rolling back what they said earlier about the disease.

Seeing what we are seeing every day for the last few weeks, I will certainly hold the government accountable for not taking responsibility. The WHO may have provided the recommendations. But, they don't run our country. Our government does.

Here are some snippets from my own family.

1.) Someone we know is an only child. His mom had a brain tumor operation last week. So, the man had to attend to her at the hospital. But, his dad himself needs help as a geriatric patient. Now normally, the person in question would have all kinds of help available. He has lots of cousins and aunts and uncles who would have helped him with his dad while he attended to his mom at the hospital. But, due to the lockdown, he had no help. No relatives, no friends, not even paid help could be organised quickly as the tumor situation with his mom developed quickly into a complication.

Result? He was forced to drop his dad in an old age home and rush to the hospital. The next day, the dad promptly died at the old age home due to a massive heart attack. The old age home refused to release the body saying that it was a Covid death when the old man had not even been tested for Covid and had shown no symptoms.

Next result? They refused to release the body. That's when my family got involved. My father's sister is a much-awarded social worker who has a lot of connections. Over 50 years of work, she has cultivated enough goodwill for her word to carry a lot of weight.

(Being a spinster she doesn't have immediate family to worry about; and she has remained working and is out and about servicing people during the lockdown. She is 77 and has been a diabetes patient for 30 straight years. But, you would not know it if you looked at her.)

She called up the people she knew and got the police to instruct the old age home to release the body of the dad. Even at the point, everyone in the home kept insisting that it was Covid despite there being no proof of it being Covid.

The cremation was carried out by some stranger in a PPE in the presence of my aunt and with the son standing far away. The wife is yet to even know that her husband of 50 years is gone.

So, bottom line - one parent dead apparently due to Covid even though there isn't any proof of that (the man had never been tested, and when he simply clutched his heart and collapsed dead); and another parent recovering from cancer in the hospital in a situation where care-giving resources are scarce.

My aunt came home and cried for an hour. Not out of misery. But out of gratitude for her parents (my paternal grandparents) having had the good sense to depart a decade earlier, and for having spared her the misery that that poor man is experiencing right now.

Respect for our elders and for the departed? Human decency? I don't think so. We can't be bothered with all of that now. Not because people are bad. But, because we shoved ourselves into an untenable situation with our fear.

My aunt says that if you show up at KEM hospital with a cough, you are automatically termed a Covid person even before an actual test. She doesn't blame anyone. With this fear prevalent in society, what else can we expect?



2.) That same aunt is out organizing food packets and water for the migrants walking on the highway. She says, while food is a problem, the migrants somehow manage to get something to eat. People help. Truck drivers help, and so on. But, the vast stretch of highway offers no shelter for other things.

Result? The highways are reeking of human waste. People are simply doing their business where they can. As to washing themselves or their hands?! Well, use your imagination. What would poor people who are trudging home in the hot sun do with the precious little water that they can carry?

My aunt says that if I took my usual route on EEH to visit her, I would not be able to enter her back road from the highway. She says that I would probably faint from the stench. She says that the general risk of infections from a thousand other diseases is now more real than Covid.

Just this week, she spent three whole days arranging for a place for people to wash themselves and take a bath. She says that the City is a mess. Lots of garbage lying around, as is human waste in places where it normally would not be. While water and sewage services are working for the middle class, the lower income areas are struggling. BMC needs money to send workers. Money that is not available so easily at this point.



3.) A close friend of mine here had driven back to Hyderabad in January to meet his parents. Father is 87 and a dementia patient with quite a few other health issues. Mother is 80 something. Neither of them has Covid. No one in the family does either. But, these are people with some means. So, his sister and himself took their parents and isolated them at a farmhouse 50 kms from Hyderabad.

Earlier last week, his dad's condition quickly started going south. No, not due to Covid. But, in general. So, they needed access to some special medications for which they needed to take the patient to the hospital in Hyderabad. They piled into my friend's car and drove to town.

They promptly got stopped and turned around by the police. What's worse, the police went absolutely ballistic seeing the MH registration on the car. The whole stand-off took 3 hours; all the while the dementia patient is not doing so well inside the car. It was all they could do to get released by the police, and get back to the farm house that day.

Finally, after some intervention from somewhere, I understand that they have made it back to their flat in Hyderabad. But, without access to medications for 10 days, the dad has slipped into a quasi-coma. He doesn't speak. Can't eat or drink. Can't recognize anyone or even acknowledge anyone's presence. Pulse is erratic and all vitals crashing fast. Their doc finally told them to prepare themselves.

Their next battle is about the procedures if the inevitable happens. How many agencies do they have to run to? To get what certificate? To present to whom? To do what to finally be able to lay the man to rest?.

Lockdown? My foot. I am so waiting for the elections. This time, I am not making the mistake that I made the last two times.

[Thad E Ginathom]

Originally Posted by mohansrides

If I can think of one clear loser in all of this, it is the WHO. They have been nothing of short of schizophrenic during this crisis. -

Right at the beginning, couldn't understand this waffle about whether it should be called a pandemic or not. It was obviously serious, bad and spreading by then. However, isn't the responsibility about what to do when with each individual country? It is not as if the WHO gave out some formula which everybody followed.

In fact, the clear winners from this crisis are the religious nut jobs. Those guys are going to come out looking like rockstars at the end of this. ...

Interesting point, and I'm sure you are right on this one. Haven't we already seen it? Pick a god: it is in your god's hands whether you live or die, so don't worry about it. Of course: those who do live will be the new chosen ones.

I don't know how much that will spread. Maybe the same percentage of people who thought like that before will go on thinking like it. And the same percentage who don't, won't.

Anyway, this line of conversation offends too many people, so we'd better stop. But thanks for the thought.