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.
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
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
τ ≤
t, the transmission rate was assumed to decay exponentially at rate
k:
3
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.
www.centerforhealthsecurity.org
