India’s Covid 19 Moment of Truth
mindthismagazine.com
mindthismagazine.com
source: https://www.thehindu.com/news/national/coronavirus-supreme-c...
Given the emergency situation it is much better have a greater degree of control. This is similar to the war time (WW-II) control on news agencies. The situation is similar.
https://web.archive.org/web/20200401075505/https://www.mindt...
[1] https://www.msn.com/en-in/news/in-depth/with-just-18-tests-p...
In short, infections may well go unnoticed because of limited testing. But deaths will be recorded.
Having said that, we do have incidents of groups who hide/protect people who are potentially infected. There are ongoing efforts to persuade communities (especially in identified hotspots) to come for testing and tracking but then these are the challenges of a large and diverse country.
It pains me to say this but there will be. It can take up to 14 days for symptoms to show up. A lot of people don't even show any symptoms but keep spreading it. I hope the lock down helps India but we've not yet seen how much it had spread before the lock down. We'll see that in the next 1-2 weeks. BTW 10 people died since this morning in India of covid-19.
This doesn't cease all transmission of SARS-CoV-2, it considerably reduces the rate of infections. The virus does not do well in higher temps (ideally with high humidity; which is why it's doing so very poorly in both Hawaii and Singapore, despite entirely different approaches to dealing with the virus). Singapore gets up to 32-33 degrees this time of year and Hawaii is at 25, which is enough.
There is overwhelming evidence at this point that SARS-CoV-2 is slowed by temperatures over ~18 degrees. China and the US have both seen the same thing. Prior studies on influenza indicate that its transmission rate plunges over roughly 17-18 degrees. Which also matches what the MIT study (below) found looking at the infection data for this virus. There are two other recent studies mentioned below, that reach a similar conclusion.
Here's China seeing the same thing:
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3551767
Here's the US:
"The results: In the most recent analysis, which used data compiled by Johns Hopkins University, two MIT post-docs in the civil engineering and cognitive science departments found that the maximum number of coronavirus transmissions has occurred in regions that had temperatures between 3 and 13 °C during the outbreak. In contrast, countries with mean temperatures above 18 °C have seen fewer than 5% of total cases. This pattern also shows up within the US, where southern states like Texas, Florida, and Arizona have seen a slower growth rate than northern states like Washington, New York, and Colorado. California, which spans north and south, has a growth rate that falls in between."
"Two other preprint papers have drawn similar conclusions. The first, posted on Monday by two researchers from Spain and Finland, found that 95% of positive cases globally have thus far occurred at temperatures between -2 and 10 °C"
https://www.technologyreview.com/s/615381/coronavirus-spread...
Note: that publish date for the article is from March 19. The predicted results have not only continued to hold well globally, they have unfortunately proven to be a future forecast for what happened in NYC due to its climate.
My opinion is that combined with faster & widespread testing, better small outbreak tracking combined with more rapid quarantining (trained behavior), taking advantage of the inbound Spring/Summer temps (in the northern hemisphere that is), and getting an eventual vaccine, that is how we'll deal with the virus. It may also moderate over time, as viruses usually do (with few exceptions).
I was listening to a podcast that was breaking down one study that thought humidity + heat might be more of a barrier. But it was a really early test too.
I am a little wary that there’s a climate connection being made which could also be explained by other things - for example while Singapore and Hawaii are both warm regions, Singapore were also quick to impose restrictions, and Hawaii is a pretty isolated archipelago that has not seen widespread testing yet (the same has been said of India re testing).
We won’t and can’t know yet, but I would suggest not to buy too much into the idea of temperature being able to regulate the virus’ spread and to instead just maintain the usual, sensible distancing precautions.
It's not well explained by other things in all regions when taken comprehensively, that's the far larger issue. Your premise doesn't hold when you include the large number of other cities and areas that are seeing a similar pattern due to higher temps. Which is why multiple studies are reaching this conclusion.
Las Vegas should have an enormous number of cases, given its international traffic, or general traffic from within the US, along with its large casinos & large number of casino workers. It reacted slow to the virus, shutting the city and casinos down late. It should be a super spreader metro. Instead, it has two dozen deaths and a thousand cases, with no indication of a big surge happening as in NYC.
Check out Reno NV (425k population metro). It's practically barren of cases.
California and Texas should have dramatically larger numbers. California was hit earlier than NY was. Neither of those states were effectively approaching the virus like South Korea and Singapore did. That isn't down to lack of enough testing, the proof is in the lack of dead bodies and hospitalizations (which are both being reported; and we have enough testing now to know more definitely what's going on state by state).
Look at New Mexico's numbers: 315 cases (against 12,925 negative tests, an extreme +/- ratio), 24 hospitalized, 4 deaths. That's broadly what Mexico is seeing as well.
At a time when New York is seeing hundreds of daily deaths. Texas has 41 total and that's maybe rising by 5 to 7 daily.
Look at Virginia Beach. 65 cases, 1 death. The Virginia Beach metro has 1.7 million people. Look at Norfolk VA, similarly very low. Richmond Virginia, 1.2 million people in the metro with ~100 cases and only a few deaths. Now, assume these numbers are off by 5-10x, they're still low.
Virginia with 8.5 million people has had a total of 165 hospitalizations and 27 deaths (the latest figures from the state). It's seeing no great surge in cases. That's not due to a hyper effective program they put into place like South Korea. It has a climate that the virus likes less than states like Pennsylvania, New York, New Jersey and Massachusetts.
Look at Raleigh North Carolina (1.21 million people in the metro). ~200 cases, zero deaths. Charlotte (2.5m people) is fairing a bit worse, with ... 420 cases and a few deaths. No surge is going on. North Carolina as a state has 1,500 cases, 157 hospitalizations, 8 deaths, with 10m people. Similar to Virginia in outcome.
Look at Augusta Georgia, metro population of 600k and Savannah Georgia, metro population of 400k. Very few cases or hospitalizations.
The Charleston South Carolina metro has 715,000 people. One death, 150-200 cases for the area.
The Atlanta metro has six million people. It has around a thousand cases (aggressively counting the wider area), two dozen deaths, and isn't seeing the NYC type surge.
Several of the major cities in Florida (eg Tampa, Jacksonville, Orlando) are seeing very low per capita rates of infection, hospitalization and death.
And so on.
I am not optimistic
[1] See here for many countries (some data a day behind): https://www.visualcapitalist.com/infection-trajectory-flatte...
Saudi Arabia is asking Muslims to defer Hajj due to coronavirus. Today's high in Mecca is estimated 99F (37C).
Today's high in Porto Alegre, a little bit to the south of Sao Paolo in a state with hundreds of cases, is 89F (32C). That's just about the same temperature as you might find today in Kerala.
All three places -- Brazil, Saudi Arabia, India -- get hot.
The point is that there is no evidence of a magic threshold temperature above which we are safe. We can't assume that summer temperatures decrease contagion. I hope it is true that the virus abates in warm weather, but hope isn't a basis for decision-making.
People in squalid Indian slums are exposed to much sickness and death that would be easily eradicated by access to good medical care, sanitation infrastructure, and reliable pharmaceuticals. Child mortality is alarmingly high in these slums. These poor people are vulnerable. It does them a disservice for government administrators to convince themselves that there may be a simple, inexpensive solution in the form of natural weather patterns. It's an insidious thing, this suggestion. On the one hand, it feels hopeful to think that the climate will interfere with contagion. On the other hand, the idea is harmful because it counteracts the fear of outbreak that should be motivating governments to listen to their public health officials and be proactive and aggressive in mitigating the outbreak.
I have no idea if temp makes a difference of not. Number of tests are very low to determine that.
And one more thing not all people live in slums in India. India is too big and varied. Visiting Mumbai slums does not mean we are filled with it.
Guayaquil in Ecuador is another outbreak zone. 245km south of the Equator, 32C today. Dead bodies rest in the streets for days, people are dying in front of hospitals, morgues are full, and even the mayor has tested positive. The official death count is above 60 but is considered by many to be a fraction of the true toll, since testing capacity is scarce and deaths of the untested do not contribute to the count.
https://thecitypaperbogota.com/news/the-impossibility-of-bur...
https://www.sandiegouniontribune.com/en-espanol/noticias/sto...
I don't think all people live in slums in India. I've never been there. I've been all over Latin America and have seen the good and the bad. The problem with the developing countries here in the Americas isn't poverty; it's disparity. The urban poor are truly destitute, face challenges that never affect the rich, and are locked out of certain strata of economic and political life. Yet, you can walk two blocks down the street from a slum and find yourself in front of a luxury high-rise where life is totally different and residents feel a mix of fear and pity for their less-fortunate neighbors. I imagine that India has a similar combination of extremely developed and extremely destitute areas. My personal view is that the ruling classes tolerate this arrangement when crime can be contained, because slums are a source of cheap labor.
Destitute areas are a risk when it comes to contagion management.
Tens of millions of people live in slums in India, and those places could be a breeding ground among individuals who then carry their illness to work or to hospitals. Annual childhood mortality has been counted in the millions in India's slums, and COVID-19 wouldn't be the only disease making the rounds there. The risk of secondary infection would increase mortality among a population that already lacks good access to health care.
It doesn't really matter if heat is slowing it in India (relative to e.g. USA) or something else is, the growth is still currently exponential.
We are not gambling on the fact that given all our advantages we MAY NOT have an outbreak. BTW, while the Govt. has called for the lockdown it is largely community driven and community implemented.
Its quite possible they have flu related deaths thanks to incoming/ outgoing travel, but it's low/hidden amongst all the other respiratory related deaths they have every year.
If this pans out...India will be an interesting case study in our hyperconnected world of what happens when people react to a threat (on some other part of the network) at population scales and the threat fizzles.
- we seem to be naturally far more resistant to the flu than the US (for example).
- those getting flu seem to be very mildly affected by it. It's a bit like a bad cold.
- We haven't seen any deaths by flu.
Thanks for this reference, hadn't seen it yet.
One important limitation - they estimate R0 based on serial interval and time course of number infected. Due to undercounting of cases this underestimates R0. Compare ICL report 13 (Flaxman et al., [0]), where based on doing the same thing using deaths, they get 3.87.
So even if the magnitude of seasonal forcing is as that paper claims, it may well not be enough to stop exponential spread in the absence of additional mitigation measures.
[0] http://www.imperial.ac.uk/media/imperial-college/medicine/sp...
https://www.bloomberg.com/news/articles/2020-03-30/century-o...
See map as to who else might: http://www.bcgatlas.org/
I've read India also gives hydroxychloroquine to their frontline medical staff as a prophylaxis, which could be helping as well.
India makes a ton of pharmaceuticals, so at least they should be OK on the drugs side.
Their healthcare is piss poor otherwise, however, so drugs are probably their only hope, with a population as high, and healthcare spending as low as they've got.
https://www.medrxiv.org/content/10.1101/2020.03.24.20042937v...
Having given this link, it can be proven to be (tragically) wrong...
Can the author provide any relevant sources that proves the above fact. If you write a column, you should be able to prove what you said. This hurts sentiments of Hindu's, a religion which consists of majority of Indian population.
The important aspect of the outbreak is not the fact that there is loss of human lives, but most importantly loosing the things that makes us human.
https://www.reuters.com/article/us-health-coronavirus-india-...