Building a new set of social norms and culture

Author : Dr KK Aggarwal : President CMAAO, HCFI and Past National President IMA

India

healthysoch

New Delhi, May 12, 2020 :

Let us end the social pandemic before the medical pandemic. Let us live with it.

We must learn to live with corona now: Simple living. No show sha,  walk ro cycle shorter distances, prefer stairs than lifts, do not allow to smoke cigarette – bidi- of hooka in front of you; Wear long sleeve shirt; Carry hand sanitiser; do not shake hands or touch anyone; carry currency and coins in a plastic pouch; handle tickets in metro with care; wear gloves; maintain 3 feet social distance and do not meet strangers for more than  3 minutes.

212 Countries, Crosses 4.25M, Nearly 75,000 cases per day, Minimum Likely Deaths 294198, Deaths to Cross 300,000 this Week

Ground Zero Wuhan 1^st Case: 10th January.  Total cases are based on RT PCR which has only 67% sensitivity. Does not include clinical cases.

GOOD NEWS : 

Nearly controlled in China, S Korea, Hong Kong, Australia & New Zealand. Remdesivir approved in US for emergency compassionate use. Learn to live with Corona. Restructure (Reaction, adjustment and liking) your life and economics with Social Distancing and Cleanliness.

Patients with prostate cancer being treated with androgen deprivation therapy (ADT) are less likely to become infected with COVID-19 and die from the disease than other groups, including other patients with cancer. [May 7 in Annals of Oncology.] Pandemics have two endings: a medical one, when death rates plummet; and a social one, when the wave of fear over the disease wanes.

Bad News :

UK PM Boris Johnson, Russia PM Mikhail V. Mishustin suffered with Covid-19; Out-of-hospital cardiac arrests increased 58% during the peak in Lombardy, Italy, compared with last year.

JAMA: COVID virus present in the semen of patients both those recovering and those with acute disease Antibody test is not reliable: For test to work in a disease that affects 2%-3% of the population, we need a test with at least 99.7% specificity. ICN: Over 90,000 health-care workers worldwide are infected with COVID-19. Over 260 have died.

India: ‘Hotspot (Red zone) classification’

Highest case load districts contributing to more than 80% of cases in India or Highest case load districts contributing to more than 80% of cases for each state in India or Districts with doubling rate less than 4 days (calculated every Monday for last 7 days, to be determined by the state government. Subject to: No new confirmed cases for last 28 days (Green zone)
Situation Around the Globe

 Likely minimum deaths (287250 + 46963  x 15 = 6948) = 294198     

Cases: 4,253,802 (+74,228)

Deaths: 287,250 (+3403)

Recovered: 1,527,029

ACTIVE CASES 2,439,523

Currently Infected Patients 2,392,587 (98%) in Mild Condition

46,936 (2%) Serious or Critical

CLOSED CASES 1,814,279

Cases which had an outcome: 1,527,029 (84%) Recovered / Discharged

287,250 (16%) Deaths

Deaths 546cases per million population (India 49)

36.8 deaths per million population (India 2)

India :

India predictions :

1. Death Rates as on Today: India: 3.25 %
2. Corrected Death Rate = Number of deaths today/ Number of cases 14 days back: 2212/ 29451= 7.5%
3. Estimated cases in India: Number of deaths on a given day x 85 = number of serious patients 14 days before

With 175 new deaths on 4th May, On 20^th April we should have had 666 serious cases. Expected cases on 20th should have been 4440 as against 1239 reported (Undiagnosed cases 3201 > 75%)

4. Formula: >90% of people are symptomatic within 2 weeks of infection, with fatalities occurring on average 2 weeks after
5.  3.29 % of people tested in the iceberg tip have died. The question is, how much iceberg is under the water?

Assumption: Iceland: 1: 2; Roughly two undocumented cases of COVID-19 for each documented case.

German: 1: 5; 70 out of 500 (14%) people tested in a hard-hit area had coronavirus antibodies.

New York City grocery store shoppers: 1: 10; 20 % seroprevalence rate.

California seroprevalence study of 3300 individuals: 1:85; 1.5% positive

So, numbers will vary from zone to zone.

healthysoch