Corona virus


psyph3r

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Lot of conspiracies surrounding this pandemic going on, especially one related to this "Event 201" that was held in Oct of 2019, an exercise covering scenarios we are going through now.


"In recent years, the world has seen a growing number of epidemic events, amounting to approximately 200 events annually. These events are increasing, and they are disruptive to health, economies, and society. Managing these events already strains global capacity, even absent a pandemic threat. Experts agree that it is only a matter of time before one of these epidemics becomes global—a pandemic with potentially catastrophic consequences. A severe pandemic, which becomes “Event 201,” would require reliable cooperation among several industries, national governments, and key international institutions. "


 

blr_p

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India is in stage 3. No matter whatever the government is saying. I am pretty sure that we are more knowledgeable than politicians. I was infact shocked to see cardio-thoracic surgeons giving advice in indian national channels. It is like epidemiologists giving lectures on CABG!!
Stage 3 implies community spread. We're not there yet.

If cases double every week there is NO community spread. R0 is around 2. When R0 jumps higher you get more cases coming in.

Now India's low testing numbers means we don't know the true number yet. The way this was handled was explained in the interview i posted in the other thread.

We'd be seeing more cases showing up with symptoms. This btw has become the default way of handling this in many countries now. Only those with symptoms will be tested.

Sneezing is unlikely in Corona infection, but many of the infected won`t have any/minimal fever.
They are asymptomatic spreaders then. We along with many countries are absolutely fine with this.


neighbours.png


Notice how Japan & Vietnam have not conducted much tests yet.

This question was put to the former AMA head, KK Aggarwal in an interview on Mar 16

Q. Numbers in India are low, is this because we have not tested enough people or the virus just has not spread very far ?

A. At the start of this interview we have just over a 100 cases with 2 deaths. The doubling time of this virus is 7.1 days so we expect to see cases double each week. By next week it should be 200. If our total number of cases does not exceed a thousand it means we have won the battle.

China has 50 per million population
Italy has 250 per million population. Total population of Italy is 60 million. If 250 per million is infected there then it is very, very high.
USA has 4 per million population
NZ has 10 per million population
India has 0.1 per million population

At the moment we have it under control but mistakes have been made which should not have happened eg. Hinduja hospital. In Delhi, one patient was referred to a govt hospital by a private one and its unknown what precautions the private hospital took before sending him over. Then in Karnataka a patient died, was shifted to another hospital and back again to the first. If these mistakes happen again we will lose the game. Otherwise, clearly we are under control. 0.1 per million population is the best we can expect.
Q. Indian health officials frequently say there is no community transmission in India. Can you explain further what that means ?

A. Three C's. Case, Cluster & Community

First case entered India which resulted today in 100 patients in clusters around the country. 30 in Maharashtra is a cluster.

How do we look for community spread ?

- In Bombay every 20th H1N1 acute respiratory illness case is checked for COVID-19. All were found to be negative. This is one way to test for community spread.

- The next indicator of community spread is if the doubling time shortens to one or two days from seven. In Korea the doubling time reduced to a day. Same happened in Italy & Iran. Getting 700 - 800 cases a day is community transmission.

If the doubling time remains seven days it implies there is no community transmission.

If in India today we have a 100 cases and the day after another 100 show up. We're not seeing this in India as of yet.

- The DG of ICMR has said it is inevitable that community transmission has to occur in India. So either its already occurring which we're unable to detect. Reason being, our current policy is, if i'm positive i will be tested twice, now and after treatment and all my contacts will be kept under observation and testing them only if they're symptomatic. So we're not using all our resources to check all the contacts so maybe we might be missing a number of cases in the community. If this was true then the number of cases we've found so far should have been higher by now. At least 300 and not 100. The people we're missing likely are mild cases because we're only testing people with symptoms.
Listen to the second interview i posted in the other thread as well.

HCQS AND azithromycin is showing some progress by increasing zinc in the cellular compartment and hindering first stage of reverse transcription. Wont go into details. But unless someone in zinc deficient, zinc supplement wont help.
Remember one thing (no Indian media is talking about this)
How about quinine ? same as used for malaria
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Some friends from India just sent me weird videos of people making noise with pots and pans. Modi requested the nation to do so. These guys are crazy.
MOdi requested a people's curfew for Sunday which was followed. This was a good idea as it prepares people for such in the future should it become necessary in cluster areas.

Now as for the pots and pans people came out to celebrate after the curfew ended. Which kinda defeats the purpose of social distancing. I'd seen some video from Indore.
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Lot of conspiracies surrounding this pandemic going on, especially one related to this "Event 201" that was held in Oct of 2019, an exercise covering scenarios we are going through now.


"In recent years, the world has seen a growing number of epidemic events, amounting to approximately 200 events annually. These events are increasing, and they are disruptive to health, economies, and society. Managing these events already strains global capacity, even absent a pandemic threat. Experts agree that it is only a matter of time before one of these epidemics becomes global—a pandemic with potentially catastrophic consequences. A severe pandemic, which becomes “Event 201,” would require reliable cooperation among several industries, national governments, and key international institutions. "


I watched the one to do with communications and its exactly what we did in J&K :)


Event 201 is Bill Gates effort to spread awareness about pandemics around the world. The problem is govts did not want to listen.

They will now though.
 
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psyph3r

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Event 201 is Bill Gates effort to spread awareness about pandemics around the world. The problem is govts did not want to listen.

They will now though.
Yea right, the same Bill Gates who keeps conducting illegal vaccine trials (Gardasil, Cervarix, etc) in third world countries for big pharma under the guise of philantropy, apart from his other questionable actions favouring big corporations.




 
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blr_p

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Yea right, the same Bill Gates who keeps conducting illegal vaccine trials (Gardasil, Cervarix, etc) in third world countries for big pharma under the guise of philantropy, apart from his other questionable actions favouring big corporations.




It wasn't illegal if they got licenses to conduct the trial was it ?

Look we have problems to solve, when there are interested parties looking to provide solutions.

Are you to going to let them in or shut the doors and let your people die.

Answer that

Its' clear that the AP govt moved quick. I see that as a good thing.

There's definitely some grey area activities taking place there.

If the potential payoff outweighs the cons then it takes a decisive leadership to go for it. Not surprised to see Gujarat in there. This is something Modi would do.

I'm surprised you'd slam Bill gates over this. The man's done a lot of good for the world with his foundation.
 
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psyph3r

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It wasn't illegal if they got licenses to conduct the trial was it ?
Just like all the mining that goes on in Jharkhand, no one's there to stop it either.
In our country it's too easy to grease palms and get permissions for anything, those clinical trials would've been carried on but it got too hot to handle after the deaths of girls.
 

blr_p

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Just like all the mining that goes on in Jharkhand, no one's there to stop it either.
In our country it's too easy to grease palms and get permissions for anything
Maybe remove the onerous rules put in place and it won't be necessary ? its called deregulation, usually spurs investment as gains become visible.

I've heard that those rules are put in place for one sole purpose.

To extract revenue.

those clinical trials would've been carried on but it got too hot to handle after the deaths of girls.
Same will happen with Corona. Trump already allows drugs under 'right to try'

Potential gains outweighing cons.

More lives saved/enhanced vs those lost and continuing to be lost.

What do you do ? you bite the bullet and go ahead.
 

psyph3r

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To extract revenue.
Straight into the corrupt individuals pockets not into the state coffers, the likes of Jaganmohan Reddy for example.

Same will happen with Corona. Trump already allows drugs under 'right to try'

Potential gains outweighing cons.

More lives saved/enhanced vs those lost and continuing to be lost.

What do you do ? you bite the bullet and go ahead.
Apples and oranges, 'right to try' applies to person administered medicines targeting afflictions affecting them, not conducting trials on healthy individuals in rural, poorly governed districts that aren't even affected by the disease like in the case of Gardasil.
 

blr_p

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Straight into the corrupt individuals pockets not into the state coffers, the likes of Jaganmohan Reddy for example.
For any & every govt that enters office.

The rules are difficult to comply with so the result is there are violations and the bribes are paid to overlook them.

Change the rules and make them serve the people and corruption reduces.

No party or leader will do that.

Apples and oranges, 'right to try' applies to person administered medicines targeting afflictions affecting them, not conducting trials on healthy individuals in rural, poorly governed districts that aren't even affected by the disease like in the case of Gardasil.
Fine but what about pros outweighing the cos as a general principle here.

It's a risky move for any govt to allow for the very reason what you linked to could happen.
 

psyph3r

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Witcher 3 on sale. If you've not played it before I'm sure it will outlast the duration of lockdown.
I've played the entire trilogy twice but yea a normal WT with the DLC will take up 150 hours easy, guess I'll clear my Steam backlog in the meantime until some of the titles in my wishlist drop in price.
Everyone seems to be playing Warzone atm, it would've been great if CP2077 hadn't been delayed.
 

Marcus Fenix

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I've played the entire trilogy twice but yea a normal WT with the DLC will take up 150 hours easy, guess I'll clear my Steam backlog in the meantime until some of the titles in my wishlist drop in price.
Everyone seems to be playing Warzone atm, it would've been great if CP2077 hadn't been delayed.
And here I am working way longer hours with stupid WFH. :(
 

red dragon

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Please do not get fooled by the stage 2 epidemic. In huge country like India with absolutely broken health system with 500-600 tests per day, stage 2 is long gone. My friends, PLEASE TAKE THIS SERIOUSLY, WE ARE IN STAGE 3 AND STAGE DOES NOT MATTER NOW.
Lockdown only wont help much, India needs lot more testing. I am an epidemiologist and not in any any social media. Please be careful, follow whatever Modi or whatever is saying about lock down, but do not let them get away without testing and hiding facts.
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Stage 3 implies community spread. We're not there yet.

If cases double every week there is NO community spread. R0 is around 2. When R0 jumps higher you get more cases coming in.

Now India's low testing numbers means we don't know the true number yet. The way this was handled was explained in the interview i posted in the other thread.

We'd be seeing more cases showing up with symptoms. This btw has become the default way of handling this in many countries now. Only those with symptoms will be tested.


They are asymptomatic spreaders then. We along with many countries are absolutely fine with this.
I studied epidemiology for 3 years mate and know these things. In India, under normal circumstances data collection is sketchy. Do you really believe in the numbers you are getting? R value is basically reproduction rate of the virus in a very loose way. Sure in movies it plays a great part, but not so much and ground level.
If you wanna go deep,
SEIR (susceptible-exposed-infectious-recovered) dynamics and can be described by the following set of ordinary differential equations (ODEs)
After transmission of the virus, susceptible individuals S enter the exposed class E before they become infectious individuals I that either recover and survive (R) or die. 1/σ and 1/γ are the average durations of incubation and infectiousness. The case fatality rate is given by f. The transmission rate in absence of control interventions is constant, i.e., β(t) = β. After control measures are introduced at time τt, the transmission rate was assumed to decay exponentially at rate k:3
equation M2

i.e., the time until the transmission rate is at 50% of its initial level is t 1/2 = ln(2)/k
I can go on...this is what I do everyday.
Forget R, consider it as stage 3 and please be safe. India is absolutely not fine. You feel safe as you have not seen a full blown viral rampage yet....we still have nightmares of Sierra Leone and Liberia. PLEASE BE SAFE.
 
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blr_p

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Please do not get fooled by the stage 2 epidemic. In huge country like India with absolutely broken health system with 500-600 tests per day, stage 2 is long gone.
It's funny the number of times i've heard how bad India could be by numerous commentators and then i see how the western world has handled it.

Know what ? i would NOT feel any safer in NY, London or Paris or god forbid MIlan than i presently am in Bangalore or any where else in India for that matter.

I WOULD feel safer if i was in Singapore, HK, Taiwan, Vietnam or Japan. Those countries have got a handle on this crisis.

What scared me was the the way the UK govt was handling this and then i learnt British PM & Indian PM made same speech, on the same day for same lock down duration with same conditions.

Modi has taken it seriously which all these western govts did not when they had the time to do something. Including China because every one worries what will happen to the economy.

Economy is secondary against an enemy that is unseen, non negotiable and merciless. I never saw a situation where every citizens action matters to such an extent. Just one woman accounts for 60% of the infections of S.Korea !!! One lawyer ends up getting a town in NY into quarantine.

We lack experience with SARS which east Asian countries have so I would place us in between the west & these east asian countries.

The numbers in a few months will bear this out. How well India did compared to the best vice the worst. We can make judgements after.

My friends, PLEASE TAKE THIS SERIOUSLY, WE ARE IN STAGE 3 AND STAGE DOES NOT MATTER NOW.
Let's get the definition of stage here. You've asserted but not defined it. So I will. And ignore the number of tests mentioned here the graphic of this article is a week old.

4 stages.jpg


What does it say for stage 3. The word LARGE areas is mentioned. Where is that happening in India atm ?

Also the article talks about II - III as in we don't know when we are in stage 3. Perhaps. But i was referring to people making statements that we are in 3 without any evidence.

The evidence is people with symptoms show up at hospitals. They have breathing difficulties. They NEED help. That is not happening yet over a large area or in numbers indicative of it.

The disease surveillance network does random sampling and found nothing in villages. And we want to keep it that way, hence why buses & trains were stopped. So people in the cities do not go back to their native and infect them. That is when things get hard.

The disease seems to be mostly in cities. Admittedly the number of tests is low but we get a feel. ten tests x 50 disease centers is around 500 for the entire country on a weekly basis. The govt labs capacity is under utilised, they are capable of 6,000 per day. But the testing was kept low initially so people did not panic.


Lockdown only wont help much, India needs lot more testing. I am an epidemiologist and not in any any social media. Please be careful, follow whatever Modi or whatever is saying about lock down, but do not let them get away without testing and hiding facts.
Lockdown does not help ONLY when people disobey. When all the stupid things Italian mayors point out people should not be doing. Please do listen to them and understand why Italy is so fcuked up. If we do the same and ignore our govt begging us to stay indoors then we will end up like that also.

As for testing, i noticed that countries in the far east did not do much either. Japan & Vietnam. Yet their infection numbers are low. S.Korea gets touted as some example but the reality is S.Korea got unlucky with a super spreader. Now the point about testing comes into perspective and you see the following

covid19-tests-per-million-people.png


Japan & Vietnam have tested ten times more per million than we have. This gap must be rectified. And it will be and soon. We now have our own test kit now. Works out a quarter the price of the Roche one. We no longer have to depend on Korea, Japan or US for test kits. Let them help others. The Pune company can roll out kits that allow 100k tests per week which can be ramped up to 400k. This will greatly improve our sentinel testing. People should keep in mind that 100k tests does not equal 100k people. At most 25k and frequently lower as more tests can be performed per patient. If a positive is found it will then be double checked at another lab. So that's a minimum of 4 tests per patient already.

I studied epidemiology for 3 years mate and know these things. In India, under normal circumstances data collection is sketchy. Do you really believe in the numbers you are getting?
The disease surveillance network was setup in 2000. It presently tracks 32 diseases across the country. This is one more in the list.

As to whether to believe that depends on how transmission goes. It will not be as bad as Wuhan where that city alone accounted for 62% of China's entire total. I did the math. Wuhan had an R0 of 3. 3 to the power of twelve gets you 50k and then things flat line two weeks after the lock down occurs. Hubei alone accounts for 80% of China's total.

20% is the rest of China that did not have as strict lock down as in you cannot leave your housing complex. So just on that basis i can confidently say lock downs DO work. Many countries prove social distancing has its merits.

Know what works even better ? a policy that makes wearing masks mandatory. As i recently learned surgeons wear masks to avoid infecting patients they operate on instead of the other way around.

Every one wearing a mask prevents the sick infecting the healthy. Outside of the far east such a policy isn't in force because govts cannot provide the supply.



R value is basically reproduction rate of the virus in a very loose way. Sure in movies it plays a great part, but not so much and ground level.

If you wanna go deep, SEIR (susceptible-exposed-infectious-recovered) dynamics and can be described by the following set of ordinary differential equations (ODEs)

After transmission of the virus, susceptible individuals S enter the exposed class E before they become infectious individuals I that either recover and survive (R) or die.

1/σ and 1/γ are the average durations of incubation and infectiousness. The case fatality rate is given by f.
any calculators to look at and plug numbers in ?

The transmission rate in absence of control interventions is constant, i.e., β(t) = β. After control measures are introduced at time τt, the transmission rate was assumed to decay exponentially at rate k:3

equation M2

i.e., the time until the transmission rate is at 50% of its initial level is t 1/2 = ln(2)/k
I can go on...this is what I do everyday.

Forget R, consider it as stage 3 and please be safe. India is absolutely not fine. You feel safe as you have not seen a full blown viral rampage yet....we still have nightmares of Sierra Leone and Liberia. PLEASE BE SAFE.
There is a simple formula i learnt to estimate true cases based on deaths.

India is presently at 657 recorded infected and 12 deaths

Assume a fatality rate of 1% that means 1200 were infected of which 12 died.

It takes 17 days to die for the vulnerable

The virus doubles infected in 6 days

So In the time it takes to die there are at least three doublings

That means present number of cases in India isn't 657 but approaching 10k.

Reply by doctors here is if there really were that many our hospitals would be seeing much more complaints than at present.

ICMR has said its inevitable we will get to stage 3 so its only a matter of when not if.

Note i hope this post gives you an idea of where India stands at the moment.