World COVID Meter 19th April, 2020

India doubling time 8 days (National), 7 days Maharashtra and 19 days Kerala

India

healthysoch

New Delhi, April 19, 2020 :

210 Countries, over 2.33 M cases, Deaths crosses 175,000, with minimum expected deaths over 169045, around 6000 deaths per day, 20.6 deaths per million population

US:

9,282 health care workers

723 Hospitalisation

27 deaths

1^st 100,000 in 67 days, 2^nd in 11 days, 3^rd in 4 days, 4^th in 3-day, 5^th in 2.5 Days, 6^th in 2 days, 7^th in 2 days, and subsequent in 1.5 days

First reported Case: 10^th January

Situation Around the Globe

Likely minimum deaths (160755 + 55265 x 15 = 8290) = 169045

Cases: 2,330,937 (81287 yesterday)

Deaths: 160,755 (6505 yesterday)

Recovered: 596,537

ACTIVE CASES: 1,573,645

Currently Infected Patients

Mild 1,518,380 (96%)

Serious: 55,265 (4%)

CLOSED CASES: 757,292

Recovered: 596,537 (79%)

Deaths: 160755

Cases per million population (global) 299

Deaths per million population (global) 20.6

India

Confirmed 15,722

Deaths: 521

Recovered: 2,463

CLOSED CASES: 2,984

Cases which had an outcome:

2,463 (83%) Recovered / Discharged

521 (17%) Deaths

Cases: 11 per million population

0.4 deaths per million population

243 tests per million population

India Cases on 18^th 15722 Case on 10^th April 7600,11^th April 8446 Doubling time: 8.5 days

Lower doubling times needs more attention MP, Gujarat

Growth factor > 1

GF = every day’s new cases / new cases on the previous day. For example, a quantity growing by 7% every period (in this case daily) has a growth factor of 1.07. A growth factor above 1 indicates an increase, whereas one which remains between 0 and 1 it is a sign of decline, with the quantity eventually becoming zero, whereas a growth factor constantly above 1 could signal exponential growth.

Death Rate :

Europe 10% [100,000 deaths with 1 million cases]

Asia 3.89% [ 370166 cases and 14401 deaths)

Oceania 1.05% [8105 cases and 85 deaths]

North America: 5.26% [792066 cases and 41641 deaths]

Africa: 4.98% [21741 cases with 1082 deaths]

South America: 4.7% [78042 cases with 3661 deaths]

India 3.31% [15722 cases with 521 deaths]

World 6.9% [2330937 cases with 160755 deaths]

Updates :

1. 30% of India cases are from Tablighi Jamaat
2. Youngest casualty in India: 45 days old admitted at Delhi’s Kalawati Saran Children’s hospital (total 10 cases)
3. In one containment zone, in one family in Jahangirpuri 26 people testes positive
4. Pandemic is National Health Emergency
5. If you are a healthcare worker and on HCQS prophylaxis fill the form https://www.surveymonkey.com/r/6KPW8CR
6. India doubling time is > 8 days
7. Open health care establishments all across now
8. Treat every surface and asymptomatic person as virus carrier
9. COVID 19 may assume a seasonal nature.
10. BCG may be protecting Indians to some extent. ICMR has started a study. Cases 11 per million population against 299 global
11. Diagnose early (antibodies test will take 7 days to detect) and treat early (reduce viral load and prevent cytokine storm)
12. The WHO issued a warning that there’s no evidence that serological tests can show whether a person has immunity or is no longer at risk of becoming reinfected.Nobody is sure whether someone with antibodies is fully protected against having the disease or being exposed again. Tests also may give a false negative result.
13. WHO said not all people who recover from the coronavirus have the antibodies to fight a second infection? With regards to recovery and then reinfection we do not have the answer yet.
14. A preliminary study of patients in Shanghai found that some patients had “no detectable antibody response” while others had a very high response. Whether the patients who had a strong antibody response were immune to a second infection is “a separate unknown question”.
15. Both ARDS and silent hypoxia requires specific non ventilatory and ventilatory prone settings with standby ECMO. tPA, heparin, ACE inhibitors, early treatment, plasma therapy, blood/ cord blood transfusion, timely air lift of critical patients may help.
16. Post @ https://mobile.twitter.com/ChestImaging?s=08: Post COVID positive X rays, CT images. Normal chest X ray does not rule out COVID.
17. Collateral benefits: Reduction in air pollution, Clear Ganges, reduction in overall deaths (low pollution, less stress, more hygiene, no traffic accident deaths).
18. ZIKA Brazil Model: Army used for the crisis. Keep Army at standby
19. Quarantine models

India: Early lock down for forty days

Wuhan: Selective sealing of epicentre

Vietnam: Sealing of a village with most cases

Bhilwara CLUSTER: Seal 2 km all around, fumigate each house, house to house survey for ALI and SARI, isolate infected cases, test all close contacts

Bird flu model: April 20, 2016, the Lebanonese Ministry of Agriculture found H5N1 in 2 poultry farms in the border of Lebanon with Syria. 20,000 domestic birds died. The ministry culled all (60K) domestic birds within a 3-km radius. All farms were disinfected, and organic remains were disposed safely.

Germany, Sweden and Japan model: Selective isolation of elderly and high-risk comorbid patients

S Korea: Intensify testing amongst all or high-risk group

Italy: Deploy younger health care workers and women as front-line fighters (2 hospitals posted young doctors < 40 years, 60% women on duties with no mortality in healthcare workers)

Singapore: Make available surgical masks at reception to be worn by all patients entering the hospital. Give N 95 masks to all health care providers and use AII rooms for all procedures on infected cases

20. Convalescent plasm therapy: India, USA started it. Reduces viral load
21. Protect healthcare workers:Delhi HCW model: Keep all the healthcare workers on duty in hotels
22. Significant exposure to Covid-19: face-to-face contact within 6 feet with a patient with symptomatic Covid-19 that is sustained for at least a few minutes (and some say more than 10 minutes or even 30 minutes). The chance of catching Covid-19 from a passing interaction in a public space is minimal.
23. Mask Policy: All health workers in health care setting should wear N 95/ surgical and general public should wear cloth mask when on the roads.
24. Market: The cost of API used in hydroxychloroquine has touched around Rs 70,000 per kg, from around Rs 6,500 per kg in February. The cost of API for azithromycin, the other drug used in combination with hydroxychloroquine for treating coronavirus, have doubled to Rs 16,000 a kg. China is a major supplier of APIs.
25. A six-day delay by China costed the whole world:On January 14, top Chinese officials sensed a pandemic. The head of China’s National Health Commission, Ma Xiaowei, in a confidential teleconference with provincial health officials, said: “The epidemic situation is still severe and complex, the most severe challenge since SARS in 2003, and is likely to develop into a major public health event.” Yet in the six days that followed, Wuhan hosted a banquet attended by thousands and millions of Chinese migrated within the country for the Lunar New Year celebrations. On January 20, President Xi Jinping warned the public, saying the outbreak “must be taken seriously”. The same day, a leading Chinese epidemiologist, Zhong Nanshan, announced for the first time that the virus was transmissible from person to person on national television. But by then, more than 3,000 people had been infected.
26. 12 days of silence added to the fuel:From Jan. 5 to Jan. 17, China’s Center for Disease Control did not register any case of pneumonia-like disease from local officials. Yet during that time, hundreds of patients were appearing in hospitals not just in Wuhan but across the country. On January 2, local officials of the Chinese Communist Party punished eight doctors for “rumour mongering” for warning friends on social media about the emerging SARS-like threat. One of the doctors, Dr. Li Wenliang, later died on Feb. 7.
27. The two Chinese companies sold UK 2 M home test kits said to detect antibodies for the coronavirus for $20 million paid upfront on take it or leave it terms. The simple pregnancy test like option was a potential game changer but the tests did not work.
28. Rota virus, polio and measles should not be ignored in this season

 

Country, Other	Total Cases	New Cases	Total Deaths	New Deaths	Total Recovered	Active Cases	Serious, Critical	Tot Cases/ 1M pop	Deaths/ 1M pop	Total Tests	Tests/ 1M pop
World	2,330,937	+787	160,755	+112	596,537	1,573,645	55,265	299	20.6
USA	738,830	+38	39,014		68,285	631,531	13,551	2,232	118	3,722,209	11,245
Spain	194,416		20,639		74,797	98,980	7,371	4,158	441	930,230	19,896
Italy	175,925		23,227		44,927	107,771	2,733	2,910	384	1,305,833	21,598
France	151,793		19,323		35,983	96,487	5,833	2,325	296	463,662	7,103
Germany	143,724		4,538		85,400	53,786	2,922	1,715	54	1,728,357	20,629
UK	114,217		15,464		N/A	98,409	1,559	1,682	228	460,437	6,783
China	82,735	+16	4,632		77,062	1,041	85	57	3
Turkey	82,329		1,890		10,453	69,986	1,894	976	22	598,933	7,101
Iran	80,868		5,031		55,987	19,850	3,513	963	60	330,137	3,931
Belgium	37,183		5,453		8,348	23,382	1,119	3,208	471	145,997	12,597
Russia	36,793		313		3,057	33,423	8	252	2	1,831,892	12,553
Brazil	36,760	+38	2,368	+7	14,026	20,366	6,634	173	11	62,985	296
Canada	33,383		1,470		11,207	20,706	557	885	39	516,216	13,677
Netherlands	31,589		3,601		250	27,738	1,279	1,844	210	154,911	9,041
Switzerland	27,404		1,368		17,100	8,936	386	3,166	158	216,400	25,004
Portugal	19,685		687		610	18,388	228	1,931	67	235,878	23,133
India	15,722		521		2,463	12,738		11	0.4	335,123	243
Ireland	14,758		571		77	14,110	294	2,989	116	90,646	18,358
Austria	14,671		443		10,214	4,014	208	1,629	49	175,932	19,534
Peru	14,420		348		6,684	7,388	117	437	11	135,895	4,122
Sweden	13,822		1,511		550	11,761	1,054	1,369	150	74,600	7,387
Israel	13,265		164		3,456	9,645	164	1,533	19	187,250	21,634
S. Korea	10,653		232		7,937	2,484	55	208	5	546,463	10,659

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