What exactly is Government of India doing?

red dragon

Justiceforall
Skilled
Finally managed to watch PM Modi's address to the nation before declaring lockdown for 21 days.
Few observations:
1. Unlike his previous speeches, it was concise. Mostly without beating around the bush.
2. Adequate emphasis on the global danger of Corona virus ( not going to write novel/ serotypes etc.every time, we all know that)
3. Practically trying to scare the entire nation with the danger of going back 21 years if the lockdown in not taken with utmost sincerity.
4. Completely ignoring the failures of a government in power since 2014
a. Practically non existent testing protocols in place ( not talking about kits etc. even a proper protocol in place, the AIIMS one is garbage, a first year medical student can come up with something like that)
b. Not a single word about building infrastructure rapidly ( the same guy boasted about 3 trillion economy, I'm sure neither he, nor his mantris including our FM can tell how many zeroes are there in 3 trillion)
5. Finally not a single word of reassurance about maintenance of a sustainable delivery chain of essentials.

Now what happened over next 72 hours:
1.FM briefing about things on reduced penalties on late tax payments etc.
2.Some promised life insurance policies for HCPs
3. 1-6 thousand INR promised to registered labourers, factory workers, farmers etc.etc.

Now time to ask a few questions:
1. Life insurance for the most exposed population is a good gesture. But it is there in place in every non banana republics. It's nothing to cheer for. Isn't it a country's responsibility.
2. The life insurance total amount sounds pretty good but statistically less than 5% family will have to apply for it and God knows how many would actually get it. What about some real relief measures?
3. I may be wrong, but this step was more for the optics, less for anything else. As the government don't have to pay anything now and they can delay the actual payment indefinitely. Is this only optics?
4.BJP is the biggest and possibly the richest political party in the entire world, however can they not spare a penny to buy PPE?
5. Government can clamp down the huge corporates operating in India and force them to cough up money for the nation. Why it's not happening? Answer to this is easy.
They possibly can't, as the same party has milked them dry to win the elections. And next election is the bigger priority for our PM.
So basically PM Modi and his team mates have given us a 21 days of lock down to hide their weakness and incapabilities and Corona kind of helped them. Nehru will soon be replaced by Corona and soldiers at Siachen by doctors, nurses etc.
Sure, it is not a time for politics. And I do not know anything about politics.
These are views of a common Indian with average education who left India 5 years ago.
Now I know, no other country would tolerate demonitization, the GST circus, 2g hoax etc. and still believe in what Modi says.
 
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Finally managed to watch PM Modi's address to the nation before declaring lockdown for 21 days.
Next listen to the Nrmala's speech

So basically PM Modi and his team mates have given us a 21 days of lock down to hide their weakness and incapabilities and Corona kind of helped them. Nehru will soon be replaced by Corona and soldiers at Siachen by doctors, nurses etc.
The man has acted in a proactive manner. Which is not what i can say for many western govts.

In 72h the Finmin has announced measures to cater to two thirds of the country. This was a big question after the lock down speech

Double rations, double benefits for those that need it. For three months.

We're not going hungry. FCI is sitting on three times the amount of grains & pulses it usually holds thanks the super bumper crops we've had from the rains last year.

Supply chain is the question. That will be worked out for essential services in the coming days.


These are views of a common Indian with average education who left India 5 years ago.
Exactly, left, not here any more. Sees Europe in a mess and concludes India is in the same mess as well. Or even worse. How ?

We will deal with whatever comes. Why do you conclude this is the last of anything on the subject by the govt.

4.BJP is the biggest and possibly the richest political party in the entire world, however can they not spare a penny to buy PPE?
She said something about a "mineral reserve" fund which each state has, to the tune of 25 cr.

a. Practically non existent testing protocols in place ( not talking about kits etc. even a proper protocol in place, the AIIMS one is garbage, a first year medical student can come up with something like that)
What form of answer are you looking for here ? positives are double checked. We do the nose & throat swab like every other country is doing presently.

I've already pointed out to you we've got our own kits now and able to ramp up their production to meet the needs here.

The private sector has been preparing to step up. Earlier it was just govt hospitals.
 
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Oh God.... Don't trigger the bhakts man.....
To be honest, I found that speech disgusting. PM trying to terrify the entire nation during a pandemic.
Even worse was FM's series of speeches.
How many of you have a ration card?
Health insurance for people wearing raincoats and woollen/ cotton masks !!
Has anyone here seen any Indian HCP wearing the full hazmat suite? India under normal circumstances, make the absolute bottom of the barrel medical equipment. A RTPCR kit is not equivalent to preg colour card. Be real.
People need proper PPE immediately. Any decent politician doesn't talk about life insurance for people in the foreground ( it's their right, and government's duty to provide it silently, not making it look like a big relief measure)
A proper protocol in epidemic/ endemic includes detailed description of each and every operational step.
Eg. Mr.X living in place Y develops symptoms
1. Where does X go immediately
2. At the HCF- a. Collects sample or b. Keeps under observation
If a, when and where to send the sample ( including detailed sample transportation instructions)......
It's a very exhaustive guide ( and relatively rare and unknown pathogens)and has to be reviewed every year. Every civilized countries have it. Even Italy had it.
Please don't believe in the bubble Modi is trying to create... lockdown will only partially reduce and delay the catastrophe. But Modi has his reply ready already....people didn't follow lockdown.
The lockdown fatigue will start just before second week, number of cases will rise, the hospitals will start breaking down. Unless the government starts pumping real money ( they stole from Corporates) immediately, things will fall apart.
Time for Modi and co.to start telling truth to the nation and get some real jobs done. If they spend one tenth of the funds they accumulated by their fraudulent schemes before elections, India will escape a great tragedy.
 
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To be honest, I found that speech disgusting. PM trying to terrify the entire nation during a pandemic.
I thought the tone was appropriate for the crisis at hand. Unless people take this seriously it will only get worse. instilling fear in people is a common tactic to get compliance. Old, tried & tested.

Even worse was FM's series of speeches.
How many of you have a ration card?
Health insurance for people wearing raincoats and woollen/ cotton masks !!
Those masks aren't effective until all have to wear them.

FM was not addressing people here. She was referring to the two third that are poor.

Has anyone here seen any Indian HCP wearing the full hazmat suite? India under normal circumstances, make the absolute bottom of the barrel medical equipment. A RTPCR kit is not equivalent to preg colour card. Be real.
Any worse than wearing garbage bag as PPE in NYC ? i thought the garbage bag idea was good. Making do with what you can.

People need proper PPE immediately. Any decent politician doesn't talk about life insurance for people in the foreground ( it's their right, and government's duty to provide it silently, not making it look like a big relief measure)
We can make those if necessary.

A proper protocol in epidemic/ endemic includes detailed description of each and every operational step.
Eg. Mr.X living in place Y develops symptoms
1. Where does X go immediately
2. At the HCF- a. Collects sample or b. Keeps under observation
If a, when and where to send the sample ( including detailed sample transportation instructions)......
It's a very exhaustive guide ( and relatively rare and unknown pathogens)and has to be reviewed every year. Every civilized countries have it. Even Italy had it.

He talks to a doctor over the phone if he can. If its mild he will be told to get OTC drugs like every else in the world.

If its more he then goes to a hospital that is setup to deal with covid suspects. The hospital takes samples and sends them to the testing centre.

If he comes up positive they go into isolation wards.


Please don't believe in the bubble Modi is trying to create... lockdown will only partially reduce and delay the catastrophe. But Modi has his reply ready already....people didn't follow lockdown.
The lockdown fatigue will start just before second week, number of cases will rise, the hospitals will start breaking down. Unless the government starts pumping real money ( they stole from Corporates) immediately, things will fall apart.
Time for Modi and co.to start telling truth to the nation and get some real jobs done. If they spend one tenth of the funds they accumulated by their fraudulent schemes before elections, India will escape a great tragedy.
They put in $22 bn in the first slew of measures. The only time the lock down breaks is if people cannot get essentials. There will be hiccups in the first few days as kinks get removed.

At one point you say he is terrifying us and next its a bubble. So which is it ??

What truth are you referring to here ?
 
Nope, I don't hate Europe a bit. They have tested me more than once as I work for WHO and part of a 6 member team taking care of East and Central Europe for now. But yes, some Indians may face problems, it's a shame really
The bubble of being safe in a lockdown without adequate testing.
A classmate is working for NICED Kolkata. People have to jump too many hoops for a test, even today. There is no structured plan in place.
On a personal note, my wife has fever and sore throat since mid day. She will take her 4th test today and I'm scared for her. 12 people
( paramedics and nurses) got infected with whom we came to Poland.
Next week I may have to go to Spain ( if remain negative)
I'm angry at the insensitive government of India and this ****ing virus.
 
This just in :)

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The bubble of being safe in a lockdown without adequate testing.
There is no substitute for more testing. How else to identify clusters. We are working at it.

A classmate is working for NICED Kolkata. People have to jump too many hoops for a test, even today. There is no structured plan in place.
They are being picky with who they test. Unless the symptoms are there and the doctor suspects it then you won't get the test.

For now sentinel testing is where they are focusing efforts.

On a personal note, my wife has fever and sore throat since mid day. She will take her 4th test today and I'm scared for her. 12 people
( paramedics and nurses) got infected with whom we came to Poland.
Next week I may have to go to Spain ( if remain negative)
I'm angry at the insensitive government of India and this ****ing virus.
Every govt is getting called the same thing. The exact same things said about the CCP are being said about govts worldwide.
 
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Serology tests has been started in US 2 days ago. Hopefully the kit test will be replaced by it. It's far more comprehensive.
 
Here's how one doctor described the difference between the two tests

One is using real-time PCR — RT-PCR. You’re actually measuring the presence of the [ribonucleic acid, or RNA] of the virus in the host of the human sample. It’s telling you this person in front of you is infected at this moment. That’s useful for a diagnosis. But it’s not useful for very much more than that. On Tuesday the test might come up negative, but the person might be positive on Thursday.
This is vexing if you get different results two days later from the same patient for no good reason.

The second kind of test would be an antibody test. What that’s measuring is: “Has your body ever seen the virus?” That’s useful in two ways. As a diagnostic, it gives the refined information: “Yes, you have this in you at the moment.” It also can guide the activities of the physician, who might say, “Gee, I’ve got a pneumonia patient, I wonder if they’ve ever had COVID?” But the most important thing is that that test can be a public-health tool. If we had this antibody test, we can go around randomly selecting people in New York City and find out how many New Yorkers, including right now, have had this virus in their bodies. Since we know the virus has never been in human beings before, anybody who has antibodies against it has been exposed since January.

If we can get this antibody test mass-produced — and I know they’re working on it right now — and put it into commercialization really quickly, this could be a game-changer for the whole pandemic. One of the things we would love to know right now is how many people who have had pneumonia since January were actually COVID cases? Having answers to that question would make a difference on a policy level.

If we were suddenly seeing a surge in hidden pneumonia cases since mid-February, that would tell us we’re in deep, deep doo-doo; that this thing is like Italy; that we’re going to suddenly skyrocket and our hospitals are going to be overwhelmed. But if, by contrast, the same number of cases are found in the historic samples going back to the first of January, that would tell us, “Okay, it’s gradually unfolding, we don’t have to go down to lockdown every single person in New York, we may be able to flatten the curve.”

And that makes a big difference in terms of how drastic our policies need to be. There’s a reason that the governor and the mayor and the mayor’s own department advisers are arguing. We just don’t have good, solid data to work with. We’re flying blind in New York City. They’re even blinder outside the city because the population’s more scattered.

The problem with testing with the first kit presently

I’m hearing from doctors all over New York, frankly all over the country, that they and their nurses and the whole medical team are scared to death. They have no way of telling who is carrying COVID. Only a minority of COVID patients or carriers who walk in the ER have the full-blown list of symptoms: the dry cough, the high fever, the loss of appetite, muscle aches and weakness, brain fog. The vast majority of COVID people never show that constellation of symptoms. They may show one or two. And many never show symptoms that are diagnostic at all.

How the hell do you fight this if you cannot even reliably identify the suspect. This is another important reason it is spreading. False negatives.

One is that the virus is actually lurking, never really gone, and you’ve had false claims of being cured.

The other is that in fact the immune system is not making an effective neutralizing antibody response, so some percentage of these people are not truly immune and they can get reinfected. We don’t know which is true.
Two possibilities for re-infection.
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Back to India

The problem with India's initial testing was we had a generic test kit. Tests for ANY corona virus. It was not specialised only for COVID. So it would create many false positives. That is why we went slow initially. But we do we have more specific tests now.

He brings up the mitigation vs suppression question. Suppression he says cannot work. He wants better targeting. This is what Singapore is doing. They have not locked down the country there. I would see this 3 week lock down as an experiment. They will assess pros & cons and what to do next.
 
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Do these coubt as proper PPE's?

What I think is you are judging based on what you have seen or heard. You may need to check with your friends in India who are working at good government hospitals. I have seen interviews of people who were quarantine and tested negative and also positives under going treatement. In both the cases the individual was calm and appreciative of how the situation was being handled.

I too believe that we are testing too less. Our low numbers do not mean we have less infected, it just means we may or may not have infected. In both the cases, infected as well as non infected, if people stay indoors, the non infected will stay non infected and infected will get cured if they have a decent immune system. Ones with severe symptoms will need to be admitted.

We thank you for your service and all the best for you and your wife's tests. J hope she comes out negative
 
We can make those if necessary.
When does it become "necessary"? Isn't it already the need of the hour? Most government hospitals have zero PPE. A single three-ply mask does not make a full PPE.
The hospital takes samples and sends them to the testing centre.
This is the part where it is all going wrong. As red-dragon mentioned, there is no proper protocol at all. I know through personal experience that many samples are either not being tested at all, or being inordinately delayed due to lack of protocol. People I know are waiting for more than 4 days for test results.
What I think is you are judging based on what you have seen or heard. You may need to check with your friends in India who are working at good government hospitals.
Check the ground reality. There may be a few "good" government hospitals and many private hospitals that are well equipped, but there are a huge number of government facilities that lack even the basic needs. I stay in a relatively small town, and my institute has been identified as a quarantine facility. Through my interactions with the district health department officials, I found that they are rationing their essential supplies like masks, and hand sanitizers. They don't even have a single hazmat suite. Doctors and nurses are expected to work with just a mask.
I have seen interviews of people who were quarantine and tested negative and also positives under going treatement. In both the cases the individual was calm and appreciative of how the situation was being handled.
These are the people who were among the first ones to be infected in our country. As of now, the facilities for these few number of patients are really good (even though some are still whining about lack of AC or internet, etc..). When the numbers increase exponentially, and that will happen for sure, thousands and thousands will be competing for the limited resources at hand. Things won't be so rosy then, unless the government intervenes quickly.
 
When does it become "necessary"? Isn't it already the need of the hour? Most government hospitals have zero PPE. A single three-ply mask does not make a full PPE.
They're working on it.


This is the part where it is all going wrong. As red-dragon mentioned, there is no proper protocol at all. I know through personal experience that many samples are either not being tested at all, or being inordinately delayed due to lack of protocol. People I know are waiting for more than 4 days for test results.
Testing and more reliable is the need of the hour. We have our own kits, roll them out and we will figure it out. The issue as i see it isn't a problem with protocol but reliability and specificity of the tests.

Check the ground reality. There may be a few "good" government hospitals and many private hospitals that are well equipped, but there are a huge number of government facilities that lack even the basic needs. I stay in a relatively small town, and my institute has been identified as a quarantine facility. Through my interactions with the district health department officials, I found that they are rationing their essential supplies like masks, and hand sanitizers. They don't even have a single hazmat suite. Doctors and nurses are expected to work with just a mask.
How many cases in your town so far

Anti-malarial drugs went from OTC to Schedule H. That is what they will treat health care workers with if they get infected.

These are the people who were among the first ones to be infected in our country. As of now, the facilities for these few number of patients are really good (even though some are still whining about lack of AC or internet, etc..). When the numbers increase exponentially, and that will happen for sure, thousands and thousands will be competing for the limited resources at hand. Things won't be so rosy then, unless the government intervenes quickly.
Things are moving behind the scenes. The response here isn't going to be uniform but varied from state to state. Orissa announced it has a 1,000 bed facility to treat patients.

We are going through a trial by fire no doubt.
 
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That's hardly reassuring. We have suspected patients and confirmed patients everywhere already. By the time they manufacture these approved PPEs in large numbers, it might be too late. You have to accept that the govt. made a blunder by allowing export of PPEs even until the end of February. Unfortunately, the doctors and paramedics can do nothing about it.
The issue as i see it isn't a problem with protocol but reliability and specificity of the tests.
What I am writing is based on personal experiences of close acquaintances of mine. One such person had been admitted with fluid accumulation in both lungs, but his Covid tests were not even processed until 4 days. When he enquired on day 4, he was told that his sample was not yet tested, and they have no idea when it will be done. If this is not a problem with protocol and SOP, I don't know what it is. The worst part, until he gets his results, he is being treated for all possible causes of pneumonia.
How many cases in your town so far
None so far, fortunately. However, it is just a matter of time. 11 cases have been diagnosed within a radius of 50 kms.
Anti-malarial drugs went from OTC to Schedule H. That is what they will treat health care workers with if they get infected.
Antimalarials are not a panacea. There are so many side-effects, including fatal side-effects to taking chloroquine. Also, wouldn't it be better and efficient to protect healthcare professionals, than saying that we have a wonder-drug to treat you if you get infected? Every state government is now trying to recruit retired physicians to add to the manpower. How will these 60+ aged doctors work confidently if they cannot be guaranteed even the basic PPE?
 
1. Serology tests take long time to perform, cannot be used as primary test during pandemic like this.
2. As far I know, India is not even testing 1% of what's required.
3.Not a single doctor I've communicated with knows the exact hoops a patient has to jump to get him/ her tested. At least in Kolkata, all the doctors are sending patient to ID/ NICED and very very few got their results back.
4. Very few doctors in India have seen a hazmat suite in life, let alone know how to use it.
5. A lock down only method IS NOT effective in controlling epidemic/ endemic.
6. An epidemic/ endemic in early stage 3, doesn't need a lot of doctors. It needs some with 100% protection.
7. We are doing this for more than 10 years and this is what we get paid for. And India still hasn't asked for a team to go there. They are pushing hapless doctors to jump in the fire.
Epidemic/ endemic is not a medical speciality/ superspeciality. It's all about intensive training, and there is no such training in India. Disaster management training for doctors in India is absolutely rudimentary.
8. Indian government is basically hoping and expecting....this too shall pass!!
9.I have been to West Africa during one Ebola epidemic, those poor countries have more proactive government.
10. Setting up railway coaches for treating infected patients can have extremely devastating and unimaginable damages.
11. I am too tired to argue with people thinking India's approach is just fine and R value is everything during epidemics ( due to the stupid movie Contagion)
12. Offer your prayers for the country because the PM is hoping locking away billions and making them watch Ramayana will solve the issue and he will be able to blame Corona for everything till the day before thrown out of the office.
13. I'm specially bitter, because my wife has been tested positive and put in quarantine and I will be going to Spain on Wednesday.
 
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Highly unlikely, 2 months will completely destroy the economy. It will kill more people than the virus itself.
Even an average middle class Western European struggles with extra expenditure of 250 EUR a month (200 USD for Americans)
More than 80% will loose jobs if the lockdown goes beyond 4 weeks.
Every country will struggle beyond a month. It will be far worse than all world wars combined.
A lock down is not sustainable. It has to be temporary and in our case acts as an experiment and a delay (we think) to faster progression.

Here's a paper that challenges contemporary thinking, came out in 2011, many uni's around the word, including Manipal


See what they found

We included 67 studies including randomised controlled trials and observational studies with a mixed risk of bias. A total number of participants is not included as the total would be made up of a heterogenous set of observations (participant people, observations on participants and countries (object of some studies)).

The risk of bias for five RCTs and most cluster‐RCTs was high. Observational studies were of mixed quality. Only case‐control data were sufficiently homogeneous to allow meta‐analysis.

The highest quality cluster‐RCTs suggest respiratory virus spread can be prevented by hygienic measures, such as handwashing, especially around younger children. Benefit from reduced transmission from children to household members is broadly supported also in other study designs where the potential for confounding is greater.

Nine case‐control studies suggested implementing transmission barriers, isolation and hygienic measures are effective at containing respiratory virus epidemics.

Surgical masks or N95 respirators were the most consistent and comprehensive supportive measures. N95 respirators were non‐inferior to simple surgical masks but more expensive, uncomfortable and irritating to skin.

Adding virucidals or antiseptics to normal handwashing to decrease respiratory disease transmission remains uncertain. Global measures, such as screening at entry ports, led to a non‐significant marginal delay in spread.

There was limited evidence that social distancing was effective, especially if related to the risk of exposure.

This next article takes a good swipe at fear mongering. It fires off several broadsides at present approaches as well.


How can policymakers tell if they are doing more good than harm? that is the thread title articulated in another way

The one situation where an entire, closed population was tested was the Diamond Princess cruise ship and its quarantine passengers. The case fatality rate there was 1.0%, but this was a largely elderly population, in which the death rate from Covid-19 is much higher.

Projecting the Diamond Princess mortality rate onto the age structure of the U.S. population, the death rate among people infected with Covid-19 would be 0.125%. But since this estimate is based on extremely thin data — there were just seven deaths among the 700 infected passengers and crew — the real death rate could stretch from five times lower (0.025%) to five times higher (0.625%). It is also possible that some of the passengers who were infected might die later, and that tourists may have different frequencies of chronic diseases — a risk factor for worse outcomes with SARS-CoV-2 infection — than the general population. Adding these extra sources of uncertainty, reasonable estimates for the case fatality ratio in the general U.S. population vary from 0.05% to 1%.

That huge range markedly affects how severe the pandemic is and what should be done. A population-wide case fatality rate of 0.05% is lower than seasonal influenza. If that is the true rate, locking down the world with potentially tremendous social and financial consequences may be totally irrational.

It’s like an elephant being attacked by a house cat. Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies.

One of the bottom lines is that we don’t know how long social distancing measures and lockdowns can be maintained without major consequences to the economy, society, and mental health. Unpredictable evolutions may ensue, including financial crisis, unrest, civil strife, war, and a meltdown of the social fabric. At a minimum, we need unbiased prevalence and incidence data for the evolving infectious load to guide decision-making.

One can only hope that, much like in 1918, life will continue. Conversely, with lockdowns of months, if not years, life largely stops, short-term and long-term consequences are entirely unknown, and billions, not just millions, of lives may be eventually at stake.

If we decide to jump off the cliff, we need some data to inform us about the rationale of such an action and the chances of landing somewhere safe.
We need better data. We're flying blind right now. All of us.
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The total deaths caused in a month by dengue, malaria, cholera and diarrhoea in India are probably twenty times higher than this Corona Extra.
In the last ten years itself I've seen massively hyped up diseases like SARS, H5N1, swine flu, Ebola, Zika, etc that disappeared without a trace. This outbreak too will be gone and forgotten by the end of the year just like the others, it'll cause some short term problems but it'll be gone nonetheless.
The dilemma with your post is if you're right we save the economy, if you're wrong we end up with a catastrophe.

What we need is better data to distinguish between the two.

Read the article above by Ionadis

Present data is unreliable.

We are making policy on the basis of this unreliable data.

We are currently flying blind.

Both sides can make arguments and there is no clincher available.
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That's hardly reassuring. We have suspected patients and confirmed patients everywhere already. By the time they manufacture these approved PPEs in large numbers, it might be too late. You have to accept that the govt. made a blunder by allowing export of PPEs even until the end of February. Unfortunately, the doctors and paramedics can do nothing about it.
Are you giving into hysteria here ?

A shortage of PPE's will be dealt with. The shortage now will be a minor footnote in the bigger story i think.

What I am writing is based on personal experiences of close acquaintances of mine. One such person had been admitted with fluid accumulation in both lungs, but his Covid tests were not even processed until 4 days. When he enquired on day 4, he was told that his sample was not yet tested, and they have no idea when it will be done. If this is not a problem with protocol and SOP, I don't know what it is. The worst part, until he gets his results, he is being treated for all possible causes of pneumonia.
You say its protocol to me it sounds like
  • they don't have enough test kits available. The ones they do have an expiry of a couple of days once opened so need to process a batch otherwise its not VFM
  • how specific are their tests. A generic coronavirus test means, corona virus but don't know which one so let's treat for all kinds of pneumonia.
  • Are they sensitive enough to prevent false positives or negatives. In this case they make the patient wait until symptoms become more pronounced (patient must become more sick before they will even test) so the probability of a positive test if suspected can be confirmed.
  • they are stringing several suspect patients along like this
All of the above points to the quality of the test kit. Testing kit issues. Present test kits ain't great right now.

None so far, fortunately. However, it is just a matter of time. 11 cases have been diagnosed within a radius of 50 kms.
Are people complying with the lockdown. Do you see people wearing masks. What is the awareness of this outbreak in your town like.

As to whether cases show up it depends on the flow of people. If you suddenly get a mass of people showing up because they have no work in the big city then that is one thing.

The idea of stopping bus & train services was to precisely prevent the anticipated exodus of out of work service sector people back to the smaller towns & villages.

Antimalarials are not a panacea. There are so many side-effects, including fatal side-effects to taking chloroquine. Also, wouldn't it be better and efficient to protect healthcare professionals, than saying that we have a wonder-drug to treat you if you get infected? Every state government is now trying to recruit retired physicians to add to the manpower. How will these 60+ aged doctors work confidently if they cannot be guaranteed even the basic PPE?
Right, was reading the article by Ionadis and he mentions when the swine flu came out that is H1N1, Tamiflu was the wonder drug the WHO was recommending to govts to stockpile and that is without anything more than anecdotal evidence. No RCT's to back the recommendation.
 
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Oseltamavir was recommended by everyone in 2009 ( CDC, NICE, ECDC) along with WHO.
Nobody told to stockpile it.
Even atorvastatin is under fire now, saturated fat possibly has nothing to do with atherosclerotic diseases.
Modern medicine was never an exact science entirely. But taking HCQS and azithromycin without testing is plain stupid.
 
What exactly is Government of India is doing?

Playing with public mind by increasing lock downs every few days by 15 days in installments rather than announcing it altogether to avoid panic.
People already know this is going to be like this till june or beyond.
 
Are you giving into hysteria here ?
No. My observations are based on my colleagues' fears who are right now managing the pandemic. Almost none of them has ever seen a hazmat suit, let alone worn one.
BTW, full body PPE suits have their own limitations. The doctor or paramedic cannot use the restroom while wearing it, so breaks have to be given once every 4 hrs or 6 hrs to the person wearing it. That means it has to be discarded once every 4 to 6 hours. Now do the calculations for how many such full body PPEs will be required. To compensate for deficiency of full body coveralls, the MOHFW has given guidelines saying that only doctors in ICU and those collecting samples for testing require these coveralls. I don't know what to say about this.
Are people complying with the lockdown. Do you see people wearing masks. What is the awareness of this outbreak in your town like.
Around 75% of the population is complying with the guidelines, by maintaining distance and wearing masks or kerchiefs. But there are people who keep going around like nothing is happening.
The idea of stopping bus & train services was to precisely prevent the anticipated exodus of out of work service sector people back to the smaller towns & villages.
Clearly, many governments did not anticipate or chose to ignore the extent of movement that would happen when a lockdown is announced. It happened in Chennai after Modi's announcement of 21 day curfew. Huge crowds gathering in bus stands and railway stations to try and catch a trip to their hometown. Even worse was what happened yesterday at Anand Vihar, New Delhi. :(
 
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