rdst_1
Juggernaut
They can get back to work, can't they, after a mandatory quarantine. It also helps those people themselves as they can stop living in fear and return to normal lives.
What exactly is Government of India doing?
- Thread starter red dragon
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blr_p
Oracle
What is the right number of testing ? people say test more.
As far as i can see whoever gets prescribed a test should get one. That is how it works in Germany. All symptomatic get tested is the right number of tests.
timesofindia.indiatimes.com
And once they clear that all 7 NE states are C19 free
As far as i can see whoever gets prescribed a test should get one. That is how it works in Germany. All symptomatic get tested is the right number of tests.
Assam: ‘All active patients may be discharged by April 28’ | Guwahati News - Times of India
Assam health minister Himanta Biswa Sarma on Monday said the state expects to ‘wrap up’ Covid-19 active cases in the state by April 28 as the number o
timesofindia.indiatimes.com
And once they clear that all 7 NE states are C19 free
rdst_1
Juggernaut
Do you think every symptomatic is getting tested in India at the moment?What is the right number of testing ? people say test more.
As far as i can see whoever gets prescribed a test should get one. That is how it works in Germany. All symptomatic get tested is the right number of tests.
Assam: ‘All active patients may be discharged by April 28’ | Guwahati News - Times of India
Assam health minister Himanta Biswa Sarma on Monday said the state expects to ‘wrap up’ Covid-19 active cases in the state by April 28 as the number o
And once they clear that all 7 NE states are C19 free
I don't believe it. Even I had CoVID 19 symptoms in early March. I had even visited a local tourist hub which is frequented both by foreign tourists as well as Tibetans who frequently travel to China. I wouldn't have been tested unless I had contact history. Many people have Flu symptoms this time of the year and all are definitely not being tested.
Hell, my BiL being a govt employee in Food department is out on duty every single day and even they aren't being tested or even being provided an accomodation separate from family.
blr_p
Oracle
If you see number of infected rising then they are getting tested. Definitely the case in Maha.
Who qualifies is up to the doctor that prescribes the test.
You are saying you got tested because of your travel history ? Unless you're in a hotpot you won't get tested for flu like symptoms.
Does you bil have any symptoms ?
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I am not sure, that press release doesn't get into the details of the tests. Isolating covid 19 RNA directly in samples is going to be really really difficult.
AFAIK, Siemens already have a viral panel of some 20 plus common pathogenic virus earlier (similar machines are used widely in India, it includes previous Corona serotypes, possibly they are developing a module with covid 19 RT PCR to integrate with the previous panels.
In any case very few Indian labs have those very expensive Siemens easy mag extraction systems ( most lab in India use cheaper EMES)
I meant quantitative analysis ( similar to hepatitis B/ C genome load detectors) , that will probably never come for mass use. There are undisclosed documents of Germany/ China developing it. Crazy Trump is providing serious cash flow to certain companies ( can't name them) to develop something similar.
Germany is silently testing a lot of asymptomatics ( they are the champions of effective random sampling. Random sampling is a very unique and valuable tool and some statisticians working in Germany are exceptionally good, to be clear the randomness of the sampling is not really random, rather extremely well thought selective sampling)
To treat this thing scientifically at least 60 percent of the asymptomatics need to be tested ( 73.3 percent if we consider the sensitivity of RT PCR, specificity is not a concern for this calculation)
If there is any mathematician here, I can PM him/ her the detailed method of calculation. It's complicated for us, but should be nothing for them.
tech.monk
Herald
See this bragging about testing - , this will answer your questions
No body from authorities can tell/answer about incubation period of Corona in India. Nobody wants to comment on it
I can not really understand some of the ICMR / health ministry's statements.
1. This doubling time they are bragging about.
2. The hype around the R0 values ( I bet very few doctors actually understand it, it's just a mathematical calculation. It doesn't represent the the infective potential of the virus ( as far as I know R0 value for measles, chicken pox and mumps are the top 3)
3.ICMR doesn't talk about Survival function, values from Jacobian matrix etc. ( Highly doubt if they have ever calculated those)
4. What's the point of introducing serology at a point when RT- PCR tests are way below the numbers required ( 30 thousands per day is about one third of minimal requirement)
5. What about publishing some important findings
a. Is elevated zinc level is still inhibiting reverse transcriptase ( with HCQS) ? It is not in Brazil!!
b. What's the guideline for intubation and specially weaning?
c. What exactly are Indian clinicians should look for chest CT in Indian context? ( As the CT pattern is changing slowly and lobar consolidation and or necrosis is getting common)
6. Indian government tried to fool the people with cheap ventilators. Please stop it immediately. If they are really concerned about curing critical patients, try to import/ develop some ECMO machines and train the doctors to use those ( less than 0.1 percent of chest physicians in India have seen those, let alone use) Use the CTVS people to teach the intensivists, chest physicians etc.
Ventilator is not the last answer. ECMO can theoretically save all ARDS patients when used timely.
From now on, I will go technical with this ( and related) threads, since I have time now.
In doing that, have to go hard on ICMR, health ministry and some Indian doctors spreading rubbish on media and of course WHO.
There's nothing personal against any of them, we all make mistakes. I have made many clinical errors ( but my understanding of epidemiological aspects is not superficial) I am a very average clinician but pretty good with public health.
1. This doubling time they are bragging about.
2. The hype around the R0 values ( I bet very few doctors actually understand it, it's just a mathematical calculation. It doesn't represent the the infective potential of the virus ( as far as I know R0 value for measles, chicken pox and mumps are the top 3)
3.ICMR doesn't talk about Survival function, values from Jacobian matrix etc. ( Highly doubt if they have ever calculated those)
4. What's the point of introducing serology at a point when RT- PCR tests are way below the numbers required ( 30 thousands per day is about one third of minimal requirement)
5. What about publishing some important findings
a. Is elevated zinc level is still inhibiting reverse transcriptase ( with HCQS) ? It is not in Brazil!!
b. What's the guideline for intubation and specially weaning?
c. What exactly are Indian clinicians should look for chest CT in Indian context? ( As the CT pattern is changing slowly and lobar consolidation and or necrosis is getting common)
6. Indian government tried to fool the people with cheap ventilators. Please stop it immediately. If they are really concerned about curing critical patients, try to import/ develop some ECMO machines and train the doctors to use those ( less than 0.1 percent of chest physicians in India have seen those, let alone use) Use the CTVS people to teach the intensivists, chest physicians etc.
Ventilator is not the last answer. ECMO can theoretically save all ARDS patients when used timely.
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From now on, I will go technical with this ( and related) threads, since I have time now.
In doing that, have to go hard on ICMR, health ministry and some Indian doctors spreading rubbish on media and of course WHO.
There's nothing personal against any of them, we all make mistakes. I have made many clinical errors ( but my understanding of epidemiological aspects is not superficial) I am a very average clinician but pretty good with public health.
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rdst_1
Juggernaut
From what I saw in the local market in my village today, our people deserve a govt like this. In fact, I would say, our govt is doing much better than the morons out on the roads and markets. There was no social distancing and no masks were being worn despite the local sarpanch distributing free masks and a small bottle of hand sanitizer to all households just yesterday. I am guessing the limit of how long our people can stay disciplined has been reached. Our people only follow protocol when a policeman is around. We are taking all this economic distress and it will be for nothing in the end, thanks to our indisciplined public.
I was literally scared for myself today because no matter how much I tried to keep my distance, my efforts were rendered futile due to others. I swear, I would have punched someone today.
I was literally scared for myself today because no matter how much I tried to keep my distance, my efforts were rendered futile due to others. I swear, I would have punched someone today.
^^ The pictures are same here brother, these lockdowns have become an excellent excuse for the governments and research institutions to wash their hands off. Can't blame common people. Lockdown for more than a month is extremely harsh on everyone ( specially the police force, it is toughest test for them)
Anyone with experience with infectious disease epidemics would tell you, complete lockdown for more than 2 weeks causes more harm than good.
And no one in India working presently has any first hand experience of epidemic ( other than cholera outbreaks, which is a complete different beast)
Had a Skype interview with someone from ICMR ( Dr. Bhargava) He is a professor of cardiology ( possibly AIIMS) very honest, no nonsense gentleman. Told me pretty bluntly that the epidemiology wing of ICMR ( possibly in Pune) is practically useless and that's the reason why he is after people who did PhD in public health under ICMR and working elsewhere.
I would love to contribute, and can work for any country unless on active WHO assignment.
But can't sell my services for peanuts even remotely( he could offer me 400k INR for 30 days!!) Sure working from home seems a nice idea and don't have to deal with any HR people/ managers etc.
But once I reduce the rate this low, everyone will come with similar offers as nothing remains secret for long.
If I was living in India, this money is more than enough, but here ( specially when we are planning to move to Sweden) this is barely sustainable.
For India I'm ready to work for free , but then can't work under any deadline.
He will call me after midnight (in India) from his phone directly. This good guy is under lot of pressure, and I really want to help my country. But I have a family with kid. They are my first priority. Let's see what happens. BTW Bhilwara never had any epidemiological map, no proper planning is documented. He mailed me whatever he had, those documents could be planned by anyone. India should stop this propagandas immediately.
These will harm the country in long run. They didn't even have any microplans, only a blank paper with some random names and places, really pathetic.
Now I know, why WHO pays us so much. You get what you pay for. I sent him our plan for Krakow, he immediately understood the difference and promised to call back!!
Anyone with experience with infectious disease epidemics would tell you, complete lockdown for more than 2 weeks causes more harm than good.
And no one in India working presently has any first hand experience of epidemic ( other than cholera outbreaks, which is a complete different beast)
Had a Skype interview with someone from ICMR ( Dr. Bhargava) He is a professor of cardiology ( possibly AIIMS) very honest, no nonsense gentleman. Told me pretty bluntly that the epidemiology wing of ICMR ( possibly in Pune) is practically useless and that's the reason why he is after people who did PhD in public health under ICMR and working elsewhere.
I would love to contribute, and can work for any country unless on active WHO assignment.
But can't sell my services for peanuts even remotely( he could offer me 400k INR for 30 days!!) Sure working from home seems a nice idea and don't have to deal with any HR people/ managers etc.
But once I reduce the rate this low, everyone will come with similar offers as nothing remains secret for long.
If I was living in India, this money is more than enough, but here ( specially when we are planning to move to Sweden) this is barely sustainable.
For India I'm ready to work for free , but then can't work under any deadline.
He will call me after midnight (in India) from his phone directly. This good guy is under lot of pressure, and I really want to help my country. But I have a family with kid. They are my first priority. Let's see what happens. BTW Bhilwara never had any epidemiological map, no proper planning is documented. He mailed me whatever he had, those documents could be planned by anyone. India should stop this propagandas immediately.
These will harm the country in long run. They didn't even have any microplans, only a blank paper with some random names and places, really pathetic.
Now I know, why WHO pays us so much. You get what you pay for. I sent him our plan for Krakow, he immediately understood the difference and promised to call back!!
blr_p
Oracle
What did i tell you. We too wasted our money
Tell me how are we supposed to increase the rate of testing with junk like this. As it is the positivity rate is quite low in India.
It does not change whether in Maha or Assam, same rate. How is that ? if there are more cases in Maha.
We need 25 tests to find one positive. Does not matter where in the country. This is what we are discovering.
Obviously we are going to use testing only when there are symptoms and not otherwise as it isn't cost effective.
This simple point mentioned by the Niti Ayog chairman is missed by those advocating more testing.
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chiron
Innovator
Without lockdown and with easy access to groceries and I am still not doing ok mentally, in Canada. I can't imagine what my friends and family in India are going through in this times.
N
India wasted more than a month on nothing. Czech Republic had one batch of bad kits, yet they used it and didn't make it an excuse.
Lesson no.1 for epidemic management:
No excuse is good enough. Faulty kits, no problem, treat every SARI as covid 19, no CT machine- every SARI IS COVID
Faulty ABG machine- test your own blood and compare it in a colorimeter.
No Ventilator: Intubate and keep on pumping the ambu bag till you pass out.
Lesson no.2 : Throw away all the faint of hearts, replace sensitive doctors with hardcore critical care/ ER nurses. They are far more effective. IT IS WAR ( India hasn't seen it yet, 10 patients with severe SOB every 15/30 minutes. You write more death certificates overnight compared to all in your lifetime.
You cry alone, you cry silently night after night so that NO ONE SEES IT. And you go back to work before sunrise next day.
Lesson no 3: Anybody under you made a mistake, it's your mistake, deal with it, blast him/ her later in your office not in presence of anyone.
Lesson no 4: You WILL BE INFECTED , and will possibly die alone in one of these beds, you are lucky if you don't. If someone in your team dies, it's your responsibility to inform the family, take all the blames silently.
Now this will be the national excuse for next 4 weeks. You get what you pay for. Where are the my lab kits?
India wasted more than a month on nothing. Czech Republic had one batch of bad kits, yet they used it and didn't make it an excuse.
Lesson no.1 for epidemic management:
No excuse is good enough. Faulty kits, no problem, treat every SARI as covid 19, no CT machine- every SARI IS COVID
Faulty ABG machine- test your own blood and compare it in a colorimeter.
No Ventilator: Intubate and keep on pumping the ambu bag till you pass out.
Lesson no.2 : Throw away all the faint of hearts, replace sensitive doctors with hardcore critical care/ ER nurses. They are far more effective. IT IS WAR ( India hasn't seen it yet, 10 patients with severe SOB every 15/30 minutes. You write more death certificates overnight compared to all in your lifetime.
You cry alone, you cry silently night after night so that NO ONE SEES IT. And you go back to work before sunrise next day.
Lesson no 3: Anybody under you made a mistake, it's your mistake, deal with it, blast him/ her later in your office not in presence of anyone.
Lesson no 4: You WILL BE INFECTED , and will possibly die alone in one of these beds, you are lucky if you don't. If someone in your team dies, it's your responsibility to inform the family, take all the blames silently.
blr_p
Oracle
This test, test mantra gets a good beating in this talk. Interesting to see a left winger like SG falling in the line with the govt's position because even he realises we're on the right path.
I like the comparison between Bolivia & Belgium. One with lots of deaths and testing and another with very few tests as well as deaths,
Is R0 the same here ? obviously not.
So assuming just because it is so in one country and then applying every where is the foolishness we are being told to do.
Indian government is not in the right/ wrong path. It's completely oblivious to the situation.
However some people @ ICMR have finally got their heads out of their a£sholes.
India is not even close to the top of the ascending limb of the curve.
The real deal will start in late May. Hopefully by then you will be able to wrap your head around the basics of epidemiological calculations and realize this R0 value works great in movies, but useless in real life situation. Just like those half assed ventilators.
If you look closely at the proposed ventilator design, you will realise that people who made it, have not even seen how the endotracheal tube connects with a ventilator in a real patient.
Incredible India!!
So this is the latest propaganda from PMO!! We don't need tests now!! Brilliant brother..
1. We can't test because we don't have kits.
2. We have developed kits which will cost less than half a dollar, it will come between March 23rd and 27th
3.Once we have those kits, we will test 1lakh/ day
4. We have Chinese kits now ( however the evil Chinese people have mixed preg colour kits with RT-PCR)
5. Chinese kits are faulty, we will detect IgG/ IgM now, and call it rapid test, and we have invented the idea of pooled samples...our gift to the world!!
6. Oh! Those are not for diagnosis, the whole world will make fun of us.
7. We will abandon tests now, as Bolivians are getting away without testing and Belgians are dying!! Must be the evil kits!! RT-PCR go to Pakistan!!
The story has not yet started!!
Highlights of my interview with some lady (the email from someone @ ICMR.... very high up in the central government and Central health ministry!!)
A Skype call from India ( 8pm @ Praha)
1. Hi, I'm ################# ( the most powerful person you have ever interacted with)
Me: ok mam, I'm already scared.
2. So you are an Indian, completed your studies here yet working in EU, why?
Me: Err.. don't know mam, got better job here.
3. So money is everything to you, you won't work for your country!!??
Me: no mam, I will, but my consultation fee is fixed, I've a family to feed, living cost is 10 times here.
4. So you don't understand the situation "your country is in"? Haven't you heard about the epidemic?
Me: yes mam, I have. Epidemics are not new to me. I worked in the busiest hospital in Spain. I have 7 papers on Ebola. I'm not Indian anymore.
5. Gets furious...you can work in Africa / Spain for free, not India!! You should be ashamed.
Me: err..Spain was not free, neither was Africa. WHO pays me for all the services.
6. You know WHO is responsible for everything.
Me: no mam, not for everything. But yes, we made mistakes.
7. Don't you feel that you should share the blame and work for free .
Me: getting irritated..mam, it's going nowhere, ICMR requested me, if you find my fees too high, please stop wasting time. I have things to do.
8. I am way more busy doc!! Unlike you, we love our country and live here.
Me: ok mam, good night and thanks for calling.
9. No, no!! You can't hang up like that, I have to brief 50 people in health ministry. We will pay your fees. But you should be ashamed of yourself.
Me: ok mam, I'm really ashamed. Shall we get to work now? Please email me the contract papers/ any other paperworks.
10. I don't do those petty things myself. My secretary will do everything.
Me: ok mam.
11. You should be ashamed of yourself ( with a deep sigh...you disappointed me son!!)
Me: disconnects.
My wife: ( who watched the entire thing silently standing behind me, almost the entire conversation was in hindi, she didn't understand a word): Was this Banerjee aunty's sister from Kolkata? ( her notion of entire India has been somehow constricted to Kolkata and Indians to Banerjee aunty and her family, she sometimes forgets her husband is an Indian!)
Me: God!! Why me!!??
However some people @ ICMR have finally got their heads out of their a£sholes.
India is not even close to the top of the ascending limb of the curve.
The real deal will start in late May. Hopefully by then you will be able to wrap your head around the basics of epidemiological calculations and realize this R0 value works great in movies, but useless in real life situation. Just like those half assed ventilators.
If you look closely at the proposed ventilator design, you will realise that people who made it, have not even seen how the endotracheal tube connects with a ventilator in a real patient.
Incredible India!!
So this is the latest propaganda from PMO!! We don't need tests now!! Brilliant brother..
1. We can't test because we don't have kits.
2. We have developed kits which will cost less than half a dollar, it will come between March 23rd and 27th
3.Once we have those kits, we will test 1lakh/ day
4. We have Chinese kits now ( however the evil Chinese people have mixed preg colour kits with RT-PCR)
5. Chinese kits are faulty, we will detect IgG/ IgM now, and call it rapid test, and we have invented the idea of pooled samples...our gift to the world!!
6. Oh! Those are not for diagnosis, the whole world will make fun of us.
7. We will abandon tests now, as Bolivians are getting away without testing and Belgians are dying!! Must be the evil kits!! RT-PCR go to Pakistan!!
The story has not yet started!!
Post automatically merged:
Highlights of my interview with some lady (the email from someone @ ICMR.... very high up in the central government and Central health ministry!!)
A Skype call from India ( 8pm @ Praha)
1. Hi, I'm ################# ( the most powerful person you have ever interacted with)
Me: ok mam, I'm already scared.
2. So you are an Indian, completed your studies here yet working in EU, why?
Me: Err.. don't know mam, got better job here.
3. So money is everything to you, you won't work for your country!!??
Me: no mam, I will, but my consultation fee is fixed, I've a family to feed, living cost is 10 times here.
4. So you don't understand the situation "your country is in"? Haven't you heard about the epidemic?
Me: yes mam, I have. Epidemics are not new to me. I worked in the busiest hospital in Spain. I have 7 papers on Ebola. I'm not Indian anymore.
5. Gets furious...you can work in Africa / Spain for free, not India!! You should be ashamed.
Me: err..Spain was not free, neither was Africa. WHO pays me for all the services.
6. You know WHO is responsible for everything.
Me: no mam, not for everything. But yes, we made mistakes.
7. Don't you feel that you should share the blame and work for free .
Me: getting irritated..mam, it's going nowhere, ICMR requested me, if you find my fees too high, please stop wasting time. I have things to do.
8. I am way more busy doc!! Unlike you, we love our country and live here.
Me: ok mam, good night and thanks for calling.
9. No, no!! You can't hang up like that, I have to brief 50 people in health ministry. We will pay your fees. But you should be ashamed of yourself.
Me: ok mam, I'm really ashamed. Shall we get to work now? Please email me the contract papers/ any other paperworks.
10. I don't do those petty things myself. My secretary will do everything.
Me: ok mam.
11. You should be ashamed of yourself ( with a deep sigh...you disappointed me son!!)
Me: disconnects.
My wife: ( who watched the entire thing silently standing behind me, almost the entire conversation was in hindi, she didn't understand a word): Was this Banerjee aunty's sister from Kolkata? ( her notion of entire India has been somehow constricted to Kolkata and Indians to Banerjee aunty and her family, she sometimes forgets her husband is an Indian!)
Me: God!! Why me!!??
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tech.monk
Herald
Agreed but the tonality of the call and the way of expressing things
Also, did Indian (read Modi) Govt. gonna mention that they're taking help from someone (here its our friend @red dragon), no way, thats never going to happen.
They will tell - Modiji found out the way ahead - if I will be in case of @red dragon I would have charged double fee and donated the rest to the needy anonymously. They will have to accept their failures/mistakes - which they are not doing and in place blaming others. Someday once this pandemic ends - they will even tell this story on Mann (read Modiji Mann) ki Baat but never accept their mistakes.
We all remember one thing - if we fail and accept our mistakes - everyone will stand behind us even if we failed (will have to ensure our intent is still honest, even while accepting the mistake) but if we blame and wash our hands from responsibilities - I better don't write this (as Bhakt's will get irritated).
Did the call sound professional at all? That lady sounded more like an angry kakima/ jethima/ ma, than some highly ranked official.
I really don't care about media exposure in India. It's true, people of India helped me immensely with my education ( most of it from MBBS and thereafter was practically free or scholarship) My parents could never afford ( even the textbooks were borrowed from seniors) those expenses. And someday I will have to pay back.
I'm not involved in any way other than making a fail proof plan. 100 percent of the credit should go to the poor people who will be risking their lives to implement it. I can't go back to India for personal reasons under any circumstances.
I didn't disclose any names from health ministry, but you all probably have seen her on daily media briefings.
I'm a free spirited individual who is not one bit scared of political pressure. But the lady evoked some strange lost emotions inside me ( which my wife/ any other European family/ friends can never understand) No matter how far I am/ will be physically from India, the fact that it's impossible to return to India,my son will never have another chance to know the great country his father was from, I will always remain an Indian and support my nation.
Everything I work on ( for India, in this epidemic and beyond) after first 4 weeks will be completely free. They have promised to appoint 6 other epidemiologists I suggested, if they can do that, we do know how to fight the worst, we will work 24*7 till 3rd May ( it's huuuuuge work, the country is vast) and will come up with something fail proof.
We have done it in West Africa, in Spain. We can do it in India too. Jai Hind!!
Well after waiting for 10 hours, received a map...a ****ing screenshot of Google map!! Neuvěřitelné lidi!!!
I really don't care about media exposure in India. It's true, people of India helped me immensely with my education ( most of it from MBBS and thereafter was practically free or scholarship) My parents could never afford ( even the textbooks were borrowed from seniors) those expenses. And someday I will have to pay back.
I'm not involved in any way other than making a fail proof plan. 100 percent of the credit should go to the poor people who will be risking their lives to implement it. I can't go back to India for personal reasons under any circumstances.
I didn't disclose any names from health ministry, but you all probably have seen her on daily media briefings.
I'm a free spirited individual who is not one bit scared of political pressure. But the lady evoked some strange lost emotions inside me ( which my wife/ any other European family/ friends can never understand) No matter how far I am/ will be physically from India, the fact that it's impossible to return to India,my son will never have another chance to know the great country his father was from, I will always remain an Indian and support my nation.
Everything I work on ( for India, in this epidemic and beyond) after first 4 weeks will be completely free. They have promised to appoint 6 other epidemiologists I suggested, if they can do that, we do know how to fight the worst, we will work 24*7 till 3rd May ( it's huuuuuge work, the country is vast) and will come up with something fail proof.
We have done it in West Africa, in Spain. We can do it in India too. Jai Hind!!
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Well after waiting for 10 hours, received a map...a ****ing screenshot of Google map!! Neuvěřitelné lidi!!!
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rdst_1
Juggernaut
Nah! Never in my life!! It was beyond my wildest dreams. Though somebody sent an apology mail, yet to receive the map from local corporation. I thought every civilized nation has some form of detailed map for every town/ district etc. Even African countries do!!
rdst_1
Juggernaut
Looks like you guys will have to be very clear and detailed with your instructions as well as impress the urgency of your demands on the people you will be dealing with.
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