What is going to be our exit strategy?


red dragon

Justiceforall
Veteran
Almost the entire planet is under some sort of lockdown under the Corona threat, however some countries are slowly trying to come back to life. Of course it should be phased. This is not a plan ( even a 5 year old can understand that much). Pour in with your ideas. Epidemiology textbooks do not talk much about exit plans and like the lockdown was never a medical decision ( AFAIK Andrej is the only PM to have discussed with only public health experts before declaring lockdown on 11th March in Czech Republic. We were in that panel and spoke to him directly over video conference and other than Interior Minister Jan Hamáček, not a single political leader / minister were present. And believe it or not, we had an exit strategy in place a full day before the lockdown was announced and everything was made public by Andrej himself well in advance. Despite all the preparedness we Czechs are having a difficult time to implement the exit strategy effectively.
Unlike the lockdown, the exit has to be somewhat in sync with the rest of Europe for us, as Czechia and Slovakia are relatively poor and weak and we are dependent heavily on Poland and Germany and most importantly our country is not brave enough to shock the nation with sudden announcements.
What is going to be the Indian exit strategy? I asked some ICMR officials, understandably, they have no clue whatsoever, as like the lockdown, the exit will be completely political decision. What is it going to be Modi`s approach? I have no clue myself as I have been baffled every time by his office`s decisions ( some were indeed good, which I realized later)
Please share your thoughts as bright young Indians. I may add some medical perspective on how an epidemic ends in between.
 

6pack

Well-Known Member
ex-Mod
I was trying to imagine this happening in a space ship in space.

Would a lockdown work? No. Just imagine all the various departments told to stop work and stay in their bunks to avoid an air borne disease that even the air filter cannot remove! How long do you think before people start revolting and asking for removal of the captain? How long before the engine stops? How long before the medical supplies run out? How long before everyone is infected and what do you do after that? Do you wait it out? Do you self destruct?
 

nRiTeCh

Well-Known Member
Veteran
They are simply going to rely on and keep imposing god knows how many multiple lockdowns and they wont mind going through the extremes of doing it till December or till next year as well. And this is the only strategy they can think off.
They dont care about economy at all & eod it will be imposed on tax payers ultimately and the common man will feel all the heat and flames.
 
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red dragon

Justiceforall
Veteran
^^^ THIS, THIS....this is exactly what I think about lockdown against a ****ing strand of RNA!!
The lockdown in Spain/ Italy/ USA was to indeed flattening the curve.
The lockdown in Czechia was imposed to increase testing and we did test more than 90 thousand people rapidly to understand the disease load ( from day 1 we assumed community spread and told it to the citizens) and we have a fair idea of how much time and human sacrifice ( in form of infection) will be needed to achieve a reasonable herd immunity.
Despite what happened to Britain's PM, no one can deny, herd immunity seems to be the only favourable logical ending to this pandemic.
I still can not justify India's lockdown, specially the timing. PM's speech sounded like he is trying primordial intervention ( that was impossible medically as India had over 900 cases at that time) for the sake of argument , this decision would have been palatable, if he said they are in very early stages of community transmission, and he planned to seal off the borders, trace the 900 something contact fully and eradicate the virus completely.
However the reality was different, there was full fledged community transmission. Now the real wastage of time began. They could identify some hotspots but couldn't plan anything other than enforcing stricter lockdown ( the plan should involve very streamlined approach of identification, isolation treatment PLUS clearing and declaring safe zones inside the hotspots, this way gradually when these safe zones crosses a threshold, declare the hotspot clean and move on) enforcing lockdown and notch it up every time you find a new case is surefire way of creating chaos ( that's the situation India is in, millions in isolation, yet nothing has been cleared yet, resulting in a complete chaos and no roadmap in sight)
Identification of hotspots is just the first baby step in the right direction. Clearing it by half incubation period is the real challenge.
But you need a failproof plan, strict implementation ( not punishing or criminalisation of the infected, by strict I mean to be strict on the enforcers not the population) and most importantly not moving round and round the same circle...MOVING ON
It is insane how health ministry formed a planning committee with cardiovascular surgeons, very few community medicine experts. Didn't they know that the entire country doesn't have a single epidemiologist with experience of epidemic?
Now I know they did, however they thought it is a very easy job and anyone can do it.
It is as difficult as doing a coronary bypass surgery. If I was put in charge of a CABG what the hell could I do? India did the exact same thing.
Now they have hired 7 people who worked with epidemics , but most of the valuable time is gone. Chances of a success ( getting to some acceptable herd immunity without infecting the most vulnerables ) is lower now, meaning some more lives will be lost.
 

sauravghosh

Active Member
Disciple
There can be no exit strategy for a contagious disease like this, other than hoping for a vaccine. Lockdown is a must, that's what even US is doing, who put economy first, human lives after.

What needs to be done though, that it should be made strictly illegal more than one child per family from now on. In fact I wonder why this was not done at least few decades back. In this way, when the next pandemic comes, whenever that is, India's population doesn't reach 3 billion.
 

adder

Well-Known Member
Veteran
There can be no exit strategy for a contagious disease like this, other than hoping for a vaccine. Lockdown is a must, that's what even US is doing, who put economy first, human lives after.

What needs to be done though, that it should be made strictly illegal more than one child per family from now on. In fact I wonder why this was not done at least few decades back. In this way, when the next pandemic comes, whenever that is, India's population doesn't reach 3 billion.
For the size of India, we should probably have half the current population. But imagine the oppostion from all quarters if the one child policy is put. There will be 1000x jump in illegal abortions.
We will have food shortage if our populations keeps on increasing.
 

sauravghosh

Active Member
Disciple
For the size of India, we should probably have half the current population. But imagine the oppostion from all quarters if the one child policy is put. There will be 1000x jump in illegal abortions.
We will have food shortage if our populations keeps on increasing.
Yes, there will be a lot of consequences ranging from protests to human rights getting involved to abortions etc., but in long term those will prove to be extremely petty matters. We are a couple of decades late as it stands, I sincerely hope they consider doing it without any further ado.
 

red dragon

Justiceforall
Veteran
There can be no exit strategy for a contagious disease like this, other than hoping for a vaccine. Lockdown is a must, that's what even US is doing, who put economy first, human lives after.

What needs to be done though, that it should be made strictly illegal more than one child per family from now on. In fact I wonder why this was not done at least few decades back. In this way, when the next pandemic comes, whenever that is, India's population doesn't reach 3 billion.
It is not that simple mate.
What US is having today, Spain and Italy went through yesterday. Despite the destruction, US is doing a great favour to the mankind. Their data system is open for everyone to see and interpret.
Lockdown was absolutely necessary for those countries, it's a very common containment measure for infectious disease epidemics.
You may think US has put economy in front of lives ( given their death toll, however US is one of those countries who is not into hiding deaths, Trump was right when he said China is still no 1 as far as death toll goes and that too by a very large margin) Despite the deaths, NY city is the only place where they tested practically every adult ( either with serology and RT PCR) For native US citizens serology possibly has far more sensitivity ( though specificity will remain low worldwide- explanation is slightly complicated, can go there if anybody wants) now NYC has a much clearer idea of how many more lives will be lost and MOST importantly the disease load ( symptomatic and asymptomatic) what else do you need to calculate the herd immunity ( worst case scenario : 27 days of incubation period, best : 15 days).
Now they can calculate pretty accurately the herd immunity percentage within next 30- 54 days.
It may sound cruel and inhuman but if they lift lockdown completely they will reach the downward curve between 1 and 1.5 months.
For them with or without lockdown, it is only about damage control. However they can see the exit point clearly much clearly now.
Czechia on the other hand have tested more than 90 percent of population at Prague. The declared lockdown on 11 th March and has started lifting the lockdown already. Since their caseload is minimal, with low fatality rate ( Prague can calculate gen fatality rate, not CFR )they can now enforce border lockdown but ease intra state travel, which they are starting. However we are heavily dependent on Germans and Poles, we may have to go to smaller lockdowns again in parts, however our national exit strategy will remain same.
Italy and Spain are still in some damage control mode, however at least the northern Italy and Spain must be way down the descending limb and will resume everything ( however some parts with low tests will see few small secondary waves)
Now India is in a very interesting situation, where unlike the US and Europe, common public seems ok with lockdown, and government is happy to play along. Their plan is to push it as far as possible ( and now finally implement some strategical steps in red zones) This approach has an inherent flaw. This is just widening the curve further hoping the height should decrease ( as the infection burden at onset and during lockdown remained low) This sounds very logical. But in practice it may not hold true, as the national viral load might have increased considerably ( given the number of asymptomatic positives and inadequate testing across the nation, not a single group of randomly sampled population outside red zone has been tested yet), in that case, widening the curve is not going to decrease the height, in simple word, every day of lockdown will cause more deaths in future. And there won't be any exit point in near future.
The lockdown to flatten the curve defies all logic in India ( if anyone can prove it mathematically, I will agree, but showing the increasing doubling time won't, it will take less than a minute to explain that this information is absolutely useless)
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I'm sorry for such a long winding post.
TLDR
India with lockdown is
1)just widening the curve, hoping the height should come down ( as the national viral load is slowing down, given the increased doubling number)
2) However with this many asymptomatic cases and practically no test for a single asymptomatic, the national viral load may be rising, in that case there's going to be a wider curve with same height
Meaning more infections and death with every extension of lockdown ( when it is lifted eventually)
 
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r19

Active Member
Disciple
Not sure total corona count can be so low. 15 lac people came from outside, and partly were given a simple temp test which many seem to 'bypassed', and govt only somewhat cared about enforcing voluntary self quarantine later on. Don't know city like Bangalore can have so low, or even Chennai if you remove later Jamaat cases
 

nRiTeCh

Well-Known Member
Veteran
Well India acted too late and the IMF over confidence f**d it even more.
I was expecting India to act by mid Feb to ban all In/Out International flights and to act on medical measures and be prepared.
But seems they all believed on this crap "corona virus doesn't survive in hot and humid Indian tropical climatic conditions" and now we are to suffer on such baseless claims.
And someone said about 1 child per family, due this is India where religions comes first and such important measures are only in farting air.
 

red dragon

Justiceforall
Veteran
Not sure total corona count can be so low. 15 lac people came from outside, and partly were given a simple temp test which many seem to 'bypassed', and govt only somewhat cared about enforcing voluntary self quarantine later on. Don't know city like Bangalore can have so low, or even Chennai if you remove later Jamaat cases
Everything in India has to be political/ religious.
Not having adequate kit is understandable for such a huge country with insane population density. Many wealthier countries failed to import kits on time / took late measures.
But hiding cases and thinking US is over reporting cases is insane.
One of the golden rules of epidemiology is, when you do not have adequate testing ( lack of kits, poor sensitivity of kits, very expensive tests etc) use your clinical skills and include ALL symptomatic cases ( exclude other common similar ailments for which tests are available , i.e exclude as many differential diagnosis as possible with other tests) as positives in calculations.
This is where Indian politicians are playing a big role in the extent of exerting pressure on doctors to change death certificates.
This is plain unacceptable.
However to divert people's attention to real issues, media is being involved into spreading state sponsored half truths.
Presently it is the vaccine, specially the ChAdOxin ( that Oxford university bullshit) , it has only gone to human trial on Thursday and mysteriously there is no official data on pre human trial.
This is ****ing insane how ICMR scientists are getting sidetracked with these useless reports ( of all people, they should know how much time it takes to make an effective vaccine)
Pune office of ICMR is literally having a collective hard on about Serum institute's plan of mass producing a cheap vaccine.
Even that rubbish dengue monoclonal vaccine that institute made is getting mentioned as a success!!
 

blr_p

Well-Known Member
Veteran
If you're going to go through fire you try to get through as fast as you can. The exit strategy is the smaller states get out sooner, hotspot districts remain locked down while others recover and relax restrictions


See how they did it, strict and got their R0 to 0.48

The NE is clear, Goa only had 7 cases and has not registered one in over two weeks. Those are NZ like size states that benefited from a strict lock down.

Imagine the same for districts.
 

red dragon

Justiceforall
Veteran
^^ You can not just mention countries at your convenience mate.
Do you know how much have they tested ( let's just say almost double per million of South Korea)
They announced lockdown with cases less than 100 with zero deaths.
Their geographical position is so unique that they can go for "complete elimination" method.
They had exit plans before they announced lockdown.
You can not test the lowest number and expect to get away unscathed like countries which planned and worked hard.
Stop mentioning R0 of other countries, IT DOESN'T MAKE ANY SENSE.
India couldn't even plan properly for a single small city, yet you are dreaming like New Zealanders, beautiful!!
 

nRiTeCh

Well-Known Member
Veteran
Someone posted a meme on whatsapp but its truly logical...

India's population is 135cr.
Everyday even if we somehow manage to do 1 lac tests, the last persons turn for test will come only after 37 years + count the newborns during this period. so it might be extended by 5 years.
So is India going to do lockdown for 40 damn years then? :oops:
China, Pakistan and even Sri lanka and Bangladesh will tear us freely effortlessly!
 

red dragon

Justiceforall
Veteran
No one is suggesting to test everyone. Set a target like we will test 1000 per 10 lakhs by end of this month. ICMR "scientists" do not know how to take random samples properly during epidemic. To them it means something completely random, like same birthday.
How about diabetics with h/ o any diabetes related complication ( neuropathy/ nephropathy/ retinopathy) in major cities?
Anyone can understand the implications, but the " scientists" will argue relentlessly unless they are shown some real data.
Even India had some studies in the past with targeted random samples, yet they have forgotten everything!! It's so difficult to work with these clowns.
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Wow!! Something unexpected happened!! Received a call from the most powerful lady of Bengal.
She was upset that I've accepted ICMR's offer without discussing with her!!
I don't know her personally, never spoken to her and somewhat scared of her because my "commy" past.
Anyway, she sounded very agitated about possible further extension of lockdown as I warned about in one article @ Lancet.
Someone called Rajiv ( must be some biggie in West Bengal politics) asked permission to include the article in some letter or email or something.
She may call again and I plan to ghost her.
No interest in Indian politics or influence in my job.
 
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adder

Well-Known Member
Veteran
Testing can get you stats to hypothesize the spread. But unless the damn public follow the rules, we will be back to square one.
India should put a fine of Rs1000 on spitting or blowing your nose in public.

Today a newspaper delivery guy to bank in front of my house, blowed is nose on the street right where thr ATM is, he had no tissue/kercheif and delivered the newspaper, such disgusting people. I waited for the security person of the bank to open up and informed him about this, I told him to tell the mangement to stop getting newspapers and throwaway the existig newspaper.
This is how any virus spreads by such disgusting people.

In my life I have not even once spat on the road. What are todays parents/teachers teaching kids?
 

nRiTeCh

Well-Known Member
Veteran
India should put a fine of Rs1000 on spitting or blowing your nose in public.
What are todays parents/teachers teaching kids?
Dude in which era are you? Fines are already there but who collects them, heck who even observes who is spitting or peeing etc?
Todays not much quality is taught in schools, its just for formalities everyone has to go through a factory process.
Educaton is tutions and friends.
Parents? Both of them are earners and doubt they find time to teach their kids or even take their homework
On weekends they simply muhc on kfc mc pizzas and hotels or go outside.
 

Renegade

The Outlaw
Super Mod
Yes, there will be a lot of consequences ranging from protests to human rights getting involved to abortions etc., but in long term those will prove to be extremely petty matters. We are a couple of decades late as it stands, I sincerely hope they consider doing it without any further ado.
You know when the pandemic was just an epidemic, I thought to myself, maybe the Chinese have deliberately devised and released a virus to thin out their weak population, alleviate the strain on resources and forge the next generation.

This is a right time to seize a lot of initiatives by the government, one being limiting the children to one/two. They can spin a nice narrative to force this change through and the public will support them in the name of nationalism and self sacrifice.
 

Marcus Fenix

Well-Known Member
Veteran
You know when the pandemic was just an epidemic, I thought to myself, maybe the Chinese have deliberately devised and released a virus to thin out their weak population, alleviate the strain on resources and forge the next generation.

This is a right time to seize a lot of initiatives by the government, one being limiting the children to one/two. They can spin a nice narrative to force this change through and the public will support them in the name of nationalism and self sacrifice.
Seems like the tinfoil hat brigade got to you eh?

This was something that was flying around a lot on whatsapp but I googled a bit and found all this.



1587999181862.png


The receptors of the COVID virus are not something anyone except for Mother Nature can do and China's bio-engineering skill is simply not at a level where this is even plausible. Hell there's no one in the world who can do this.

I would trust Nature magazine where Nobel laureates' papers are published a lot more than any whackjob spouting off on social media.

Always do a fact check on Google after receiving this kind of stuff on social media/YT as the social media algorithms put us in bias bubbles but Google search is not personalized to that extent to feed our biases.

As for raw numbes 17.3 percent i.e. 24 crore Chinese are in the senior citizen age range.

As of now China has had 4.6k deceased(which no one is buying). Even if I multiply that number by a factor of 100 it comes to 46 lakhs.

So ask yourself this-
1) If the virus was developed by the Chinese govt for thinning out the herd then its really inefficient as a bio-weapon(4.6k out of 24 crores).

2) Why would China enact harsh containment policies if they had planned this as a population control mechanism. Do they have some beef with the Wuhan oldies only?

3) If the virus spreads to the world and starts killing off seniors everywhere and then China gets caught then they will be the international pariah with only maybe North Korea as its ally.
US has a strict policy where any bio/chemical weapon attack is treated the same as a strategic nuclear attack and it sparks off WW3.

If not that then at least China's progress gets rolled back 50 years as US already has a hard-on for China now.

4) Every sane person does a cost-benefit analysis before they do anything major in their own lives. The risks to such an operation far outweigh the benefits for Winnie the Pooh.
 

booo

BA BA BA BABANANA
Veteran
for USA the reason for shutdown was to stop the overrun of hospital capacity until they fix the supply chain. few things that USA did in the shutdown time
1. declare defense production act to force all the car manufacturers to start producing ventilators.
2. Honeywell and 3M to start manufacturing PPE and masks in US. They were force to start facilities.
3. liquor manufacturers to start producing hand sanitizers.
4. reorg FDA to remove all the barriers for approvals for new tests. and also ramp up testing. If you see the testing rampup it was an exponential curve.
They expected over 100000 deaths intially but they managed to squash it below that effectively due to the above actions. Now that they achieved the objectives, they are planning to lift up the shutdown. not because the virus went away but because they are confident that they can handle the surges.

Now, compare that to India.
1. Where are the ventilator production numbers?
2. Still importing chinese made ppe. getting ripped off for sub standard goods.
3. not sure where India is w.r.t testing large scale. still importing chinese test kits. havnt made our own tests yet.
4. General trend is that the virus will go away after some time. without taking any actions.

To be honest, I dont have any faith in Indian govt controlling the spread or minimizing the deaths. the things that scare me the most are... population density and the over worked lungs due to the amount of pollution in India. think of these two factors before comparing india to US or any other European country.
 

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