Categories
Nursing

The evolving role of nurses during Covid19 thoughts on International Nurses Day

Today we are in the midst of one of the largest epidemics that the modern world has seen. As we write this India has been under lockdown for the last 60 days. Covid19 has put healthcare back on the main agenda for most public policymakers. While doctors and hospitals being recognized in this fight, the real soldiers in this war are the nurses. In any healthcare set up, its the nurses who are in the trenches, fighting day in and day out against known and unknown elements. Some time ago we had written about how the nursing services were at the cusp of change. Today we focus on how the role of nurses evolves during pandemics.

Nurses today are leading from front. They are the managers at forefront at bedside of the patients, keeping them on the path to recovery. Therefore it is importatn that we keep nurses motivated and inspired to stay on with enthusiasm in the Covid Era. On this international Nurses Days, we spoke to Col Binu Sharma, Vice President for Nursing Services at Columbia Asia Hospital. Col Sharma entered the nursing profession almost 40 years ago in 1977. She has been in charge of nursing at Columbia Asia since 2007. Today her organization has more than 2000 nurses and technicians in hospitals across the country. Below are some excerpts from the interview

Healthcare India: Nurses are the backbone for our healthcare system, how does their day to day role change during epidemics?

Col Binu Sharma: Articulating the changes in the nurses’ role during a global health crisis is helpful for communicating a plan to decrease the spread of disease and for implementing improved policies, procedures, and supplies. The nurses are not only the backbone of the health care team but they are the most important link in the health care delivery system.

During epidemics, the nurses become the “role models “rather than merely playing various day to day roles. The role of the nurse changes to adapt to the needs of the patient, their families, the hospital, and the community. During such crises nurses take up leadership roles at the forefront like this time in the fight against Covid19. They not only add to the development of policies to fight epidemics or pandemics but they also prepare for, identify, respond to, and direct recovery efforts from global epidemics that require an informed, coordinated response.

Healthcare India: What kind of training is provided by the nursing colleges to handle these situations as part of the curriculum?

Col Binu Sharma: In the revised basic nursing curriculum the Indian Nursing Council has included 100 hours of theory & 160 hours of practical to teach budding nurses on the various aspects of epidemiology & standard treatment protocols.  For community health practical the nurses are put in clinical areas in the remotest villages  & they are introduced to nursing care services in resource limited setting and they are given ample opportunities to link theory to practice in these sort of situations.

In fact the entire nursing curriculum and training is about learning to face the most complex and adverse situation with positivity & humility.

Healthcare India: What measures and steps have you initiated in your career to help nurses deal with epidemics?  

Col Binu Sharma: We have initiated many steps including

·        Improved engagement and networking

·        Providing job security and reassurance, Flexi hours, psychological counseling and support to relieve anxiety

·        Encouraging fun activities, quiz and other relaxation measures

·        Focus on their health screening, regular meals, hydration, power breaks, resting zones in hospital. Transport to pick up and drop

·        Provided with digital platforms, webinars to connect for training, live demos and team communication

·        Provided scope for continual training & development. Formulate revised SOPs based on protocols from various authorized national and international resources. Training on Infection control procedures, employee safety, and patient-related revised disease protocols

·        Supporting with adequate resources, manpower, medical disposables. Ensuring quality and quantity of personal protective equipment and other safety attire

·        Encouraging team spirit by listening to their needs, regularly talking to them, helping them, guiding & mentoring them and most importantly leading the way

Healthcare India: What are your recommendations that we are better prepared for the future?

Col Binu Sharma: No amount of preparedness can predict success or failure in the future but being prepared always helps us to develop a positive outlook.

  • Factors like creating awareness among the community, development of infrastructure of the health care system especially in rural areas , educating the population at the rural sectors, providing safety & security to health care workers may help us deal with future occurrences of epidemics & pandemics in a much more coordinated manner.
  • Keeping our nursing workforce well trained with mock drills on disaster preparedness
  • Keeping database of ready nurses to be hired in case of such emergencies
  • Developing mentors for taking higher responsibility
  • Engaging and education society in some of the recommended measures of hand washing, social distancing, respiratory hygiene, sharing right information with hospitals  are some of the regular improved measures.

It’s good to see nurses leading the fight, but as Col Sharma says in her interview, a lot of care and thought has to be given to keep the nurses encouraged and prepared to deal with the ever-changing complex scenario that has become Healthcare in India.

Categories
Healthcare Delivery

Regular patients are severely affected as India battled Corona Virus

In the last week of April 2020, a septuagenarian in the state of J&K who was a renal dialysis patient for 2 years, was asked to get his next round of dialysis from a private nursing home as the hospital where he normally went for treatment refused the dialysis procedure since the entire hospital was converted into a COVID care center. The nursing home neither had the apt infrastructure nor the skilled personnel to handle any kind of complications that is common during a dialysis. Unfortunately, the patient died in less than a week. Another dialysis patient in Mumbai had to wait for 7 hours for treatment as he was not carrying his covid test result report. Around 1,30,000 patients are on dialysis in India and most of them depend on private dialysis centers.

In another caustic case, last week, a 25 yr old pregnant woman in Delhi, visited 2 of the leading government hospitals in Delhi for antenatal care. Both the hospitals denied her admission as she was not Covid-19 positive. As a result, she visited 6 hospitals and maternity clinics in next 48hrs before giving birth outside AIIMS. Many hospitals and nursing homes are completely shut even if one case comes up in them.

There are a plethora of such cases rising across the country as our healthcare system is under stress from managing the contagion outbreak. This is despite the fact that the Government of India has asked state chief secretaries to ensure that hospitals and clinics do not ask for a Covid test report from every patient who requires medical treatment. This raises red-flags and serious questions on the local authorities and regulatory bodies who have also threatened to cancel the operating license of hospitals and clinics if they turn away any non-Covid patient. Patients also fear the escalated economic cost if their treatment cost is not claimed or reimbursed as not all nursing homes and clinics fall under health insurance policies.

Similar danger mounts on Cancer and TB patients. India has the world’s largest TB load of 25%. In Mumbai, due to COVID, lack of adherence to TB drug regimen has risen to 40% from 15%. A significant decrease in TB notification has been witnessed which indicated that access to a TB center and subsequent diagnosis and reporting has been severely hit. These are dangerous signs which are being ignored. A TB patient can infect 10-15 more, and such patient can become a breeding-ground of new Coronavirus cases as Covid hits hard on low immunity patients. Many senior oncologists have claimed that due to difficulty in travelling during lockdown, many hospitals not providing regular treatment, hospitals shutting down and fear of contracting covid, have resulted in a delayed diagnosis of cancer patients which can push them to an advanced stage of cancer.

There has to be clear and stringent guidelines by MoH to each state health authorities highlighting the delirious effect of not providing critical care to non-Covid cases. State should ensure that no patient is denied treatment for any ailment by a hospital (government or private). Instead of shutting down the entire hospital even for one covid case, a wiser approach of creating zones within the hospital can be implemented. Online, phone consultation and Tele-medicine modules should be made widespread thorough proper communication channels.

Our healthcare infrastructure is one of the weakest in the world with a lack of adequately qualified health care professionals adding to the woes. We certainly can’t afford to inflict more burden on the already fragile healthcare services by denying treatment to those who are in need.

About the author

Dr Sumeet Kad is a Healthcare and Artificial Intelligence Leader, focusing on leveraging technology to create a model for affordable care

Categories
Public Health

Covid19 – Data shows happy days will have to wait…

Lockdown 2.0 was supposed to get over today. Unfortunately, Lockdown 3.0 has been announced and we are now sitting at the cusp of 40K cases. We have gone from 20K cases to 40K cases in less than 2weeks, whereas the first 20K cases came in 2.5 months. Various states are showing a spike in cases, while new states are showing some disturbing trends. Is this the explosion that we were waiting for? Are we on the path of the US and Europe?

We look at the data and try to form a picture of the situation of India. We also take a look at the Indian States in clusters of the Encouraging States, the Worry States and the Emerging Bad. We also use CPM19 to see if we can predict how 17th May 2020 may look like for India.

Recovery Rate Update

We had introduced the recovery rate as a new parameter in our last article. In the 10 days that have passed since our last article, let us look at the recovery rates now. Green means improved from the last article and red means deterioration from the last article. Yellow means no significant change.

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Except for Spain all countries have either improved their recovery rates or stayed the same. France continues to recover poorly.

India With the World

India is on its 49th day after the 100th case. The 7 day rolling average of the growth rate for the country is 5.95%. When, compared with other countries studied it is the highest among all countries on their 49th day (See table)

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India, has clearly not followed the 42 day theory. To counter this we hypothesized that India should be treated as an amalgamation of several different countries. Hence, we broke India in 7 different parts basis cases reported. Maharashtra, Delhi, Gujarat, Madhya Pradesh, Uttar Pradesh, Rajasthan, and Tamil Nadu were taken separately and assumed to be a separate country. The remaining states were considered as ROI. When we look at it in this format, most of the states with a high number of cases are still at least 9-10 days away from the 42-day mark, except Maharashtra.

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As, it can be observed by the above table, most of the states are considerably slower than the other countries in the study as on that day. Even Maharashtra is slower than USA on the 40th day. ROI which is on its 45th day is also on the cusp of crossing below the 5% threshold. ROI had crossed the 5% threshold on the 42nd day but due to emergence of cases in Punjab it has gone above the 5% threshold again today.

India and Its States

In previous articles we had identified clusters of the state as

  • The Worry States – These were the states that had shown high growth in lockdown 1.0. These states were Delhi, Gujarat, Madhya Pradesh, Maharashtra, Rajashtan, Uttar Pradesh and West Bengal
  • The Encouraging States – These states were those that had shown signs of slowness in lockdown 1.0. These states are Andhra Pradesh, Harayana, Karnataka, Kerala, Tamil Nadu and Telengana

In this article we introduce a new category

  • The Emerging Bad – These states have shown sudden spurt of cases in lockdown 2.0. These states are Bihar and Punjab.

The Worry States

The Good news is that all the “Worry States”, 7 day rolling average of growth rates has now come below 10% (See Graph). The bad news is that even at this rate these states will continue to add somewhere between 1500 to 2000 cases daily.

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As you can see in the graph, states are showing trends of slowing down with UP and Rajasthan seemingly going below 5%, but until states like Maharashtra, Gujarat and Delhi come well below 5% there is little hope of a slowdown in these “Worry States”

These states are characterized by

  • High Positive% – The Positive%, which is total cases upon total tests is very high for these states. Except for UP and Rajasthan, the positive% is higher than 4% (the national average). Maharashtra and Delhi have a positive% higher than 7%
  • Low Outcome % – Only 26% of the cases have seen an outcome in these states. Outcome means that either a recovery or death has happened in that particular case. This is lower than the national average of 30%
  • Low Recovery Rate – The recovery rate is 86% which means in these states out of 100 outcomes, 86 people recovered. For states like Gujarat, Maharashtra and West Bengal it is lower than 80% which means that for every 4 people who recover there is one death.
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We will keep a watch on these three parameters to see if they improve over time.

The Encouraging States

Most of the states are now well settled under 5% growth rate except for Andhra Pradesh and Tamil Nadu. Andhra Pradesh also seems to be moving towards the 5% mark. Tamil Nadu is one blip on these states as after being well below 5% for a while it has now started moving up and has broken the 5% threshold. Tamil Nadu will be the state to watch

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These States are Characterized by

  • Low Positive% – Most of the states are well below 2% except Telangana and Tamil Nadu. Telangana also might be an aberration as the state has not updated its test numbers since 29th April.
  • High Outcome% – Almost 50% of the cases have seen an outcome in these states. Except for Andhra Pradesh, almost all states have an outcome% higher than 50%
  • High Recovery Rate – All the states have a recovery rate in excess of 90%. This means for every death in these states there are 9 people who recover. Kerala and Harayana infact are almost at 100% recovery rate.
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The Emerging Bad

Bihar and Punjab have shown growth trends in the past seven days that has motivated us to look at these states closely

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These states have a poor outcome%(this is because recency of cases) , although they seem to be doing okay with respect to recovery rate and positive%. These states will be monitored closely

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17th May 2020 – Where will we be?

The lockdown continues till 17th May 2020 albeit with some ease in restrictions. With economic activity starting again, the situation does not look like improving in the next two weeks. Using CPM19 we have tried to make some predictions as to where we might be on 17th May.

Although our daily growth rate will go down below 5%, but in terms of cases reported we will be hitting a peak by 17th May.

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Total cases according to the CPM19 Model will hit 75K. Our exponential growth curve would have started flattening but as of now it seems it will flatten only after reaching 100K cases.

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We have been in lockdown now for 40 days. In these 40 days we have ensured that we dont have a situation that overwhelms our medical system. But we have also failed to flatten the curve. At this juncture, if we see another exponential growth then Indian numbers will be very high and will probably end up going well past Europe by end of May. Instead of easing lockdown, the need of the hour is for a more stricter lockdown. Easing will just increase cases. Also as temperature is not playing any role in stopping this pandemic, India faces some tough days ahead.

On a brighter note, India seems to recovering well from the Covid19 with high recovery rates. If this trend continues then we may have a situation like Germany, high infections but low mortality rates. All we can now do is to try to stay as safe as possible because the next few days are going to be very risky.

About the Author

Sanjeev Prakash is an Analytics and Marketing professional with more than 12 years of experience in Analytics, Data Management, Sales, Brand Management, Corporate Communications, Market Research and Customer Relationship Management. Sanjeev has an MBA from IMT Ghaziabad and a degree in economics.

Categories
Public Health

Good, Bad and Ugly of COVID 19

By Kiten Meena

Change is difficult for all not only human. If you look back in human evolution you will find survival of the fittest. Change is never easy whether it is at work or at life specially when it is thrown at us without our buy-in. Many of us did not see COVID 19 coming. Hence, the resistance to accept the change it brought in our lives.

You have two choices – accept the change and find peace with it or rebel and go through the consequences.

Let’s start with good. The lockdown has brought us closer to our loved ones. I for sure have thought, what if these were my last 30 days of my life? What kind of legacy I want to leave behind? I want to be remembered as the perfect mother, a decent housewife, a great daughter, a helpful colleague and a best friend. Now, I have more time to spend with my family and loved ones. No more running Monday to Friday and then Saturday and Sunday to check off the list. COVID has taught me and reminded me of Mother Teresa and Mahatma Gandhi, Can I live a simple and peaceful life with bare minimum? Probably, we all could. Hence my request to look around and find happiness in what you have, what you have achieved and how you can help the needy or next-door neighbor. Once you accept the change you will find the ways to make best of it. Though it’s not easy, it is doable.

During such times, we are tested for our patience, endurance and adaptability quotient. At work, I have been asked to do more and better. As a working mom at home, it is quite challenging, when I feel, I am on the verge of breakdown. I look at my sister or friend who work at hospital. When we are locked down, she still had to go to work, risk her life and her loved ones to make life better for someone else. I find myself ashamed of not able to take this on. When my fellow nurses and healthcare staff going to much more than any of us are doing at home in our own comfort and away from sick and unhealthy. Imagine yourself in their shoes and you will find yourself – wearing masks and taking precaution, not only for you but all those brave souls who are risking their lives.

That’s not all, if you look closely you will find the worst affected ones – the small shopkeeper or hourly wages folks who barely had ends meet before COVID 19 and now struggling to survive each day. If you could just see past your uncomfortable zone, someone who lost family member to COVID 19 with no fault of their own. The anguish, pain of the young fellow who lost his job to COVID 19. Small business owners with loads of loan to pay and no hope of getting anywhere in near future. The mental state of such a human being at the verge of suicidal.

I found myself blessed and I want to share the joy I have with my kids, my family, friends and you readers. Reach out to your old friends whom you always thought of calling and never had time to make that call. Locked down in your own house is not easy for any of us but we can still do meditation, yoga, stretching to make ourselves ready for what’s coming next. Keep that hope alive, pass that unused food and items to the next-door neighbor.

Each drop of water counts – makes a difference. When you will look back after 10 years from now and recall COVID 19 – you should have a smile on your face and be proud of yourself.  Until we find cure or vaccine to control COVID 19, my fellow friends I plead you to do your best to beat this – by keeping social distancing, wash hands, cover your face with mask and avoid gatherings. COVID 19 makes me find myself and taught me to accept today and enjoy it to the fullest as future is unknown for a short while.

About the author

Kiten Meena

A result-driven, enthusiastic healthcare professional with years of experience in healthcare information technology in the successful delivery of critical and strategic projects. The initial few years spent honing my analysis skills and building healthcare products.

Kiten has extensive experience in working with healthcare delivery, clinical optimization, health plans along with healthcare regulatory and compliance projects. With a Master’s in Healthcare Administration from the University of Southern California Sol Price School of Public Policy – I am interested in taking up challenges and work in patient care settings to improve the overall healthcare experience for all.

Categories
Public Health

Covid19 the real path to recovery

Since our last article, new Covid19 cases have started showing a declining trend in the countries most affected by the virus. India, on the other hand, has started showing a disturbing trend. The ‘42 day theory’ has held true for all the countries under study (except S.Korea, an outlier). Will it hold true for India or will India also be an outlier to this theory?

With declining new cases, the recovery rates and the mortality rates start to come in play. Countries that we studied are all exhibiting different recovery rates. What factors influence recovery rates? Do some countries have an advantage over the other?

India has also crossed 20K cases. Are the same states still contributing to Indian cases or are there new states with high growth? 

These are some of the questions we will try to answer in this article with the data that is available with us. And finally we will look at this week’s performance of states that we had identified as “Encouraging” states and “Worry” states in our last article.

But first we look at the CPM19 model Performance

CPM19 – On the Mark

The model has now caught the trend of all the 9 countries in study and for the last 3 days it has been predicting with almost 0% error.

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The significance of this is that now we are able to predict daily growth rate and extrapolate the growth rate for the next 10 days with little error. We used this to look at the next 7 days for the countries in study and it definitely looks like all of them are on the path to recovery, except India.

The 42 day Theory – Update

In our last article, we had postulated the 42 day theory. (Read it again) All but the USA, India and Sweden had gone below the 5% threshold as on last update.

USA – US was on its 45th day and we had predicted it will go below the 5% threshold on the 48th day. It went below the threshold on 48th day

Sweden – Sweden was on its 41st day and we had predicted it will go below the 5% threshold on the 42nd day. It went below the threshold on the 42nd day.

So, for the USA and Sweden, our predictions were right on the mark. Also, we had postulated that once any country goes below the 5% threshold on a 7 day rolling average, they really slow down. That theory also seems to be holding true. (See table)

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Except for Sweden which showed a slight increase on one day, all the other countries have shown a steady decline in their daily growth rates over the last week.

Unfortunately, the theory does not seem to be holding true for India. India is on its 38th day and with the current daily growth rate of India, we do not see India going below the 5% threshold till day 50. We are unable to predict beyond the 50th day for India as India has shown erratic trends recently.

On the 38th day, India stands 3rd behind USA and France in terms of seven day rolling average of the daily growth rate. With the trend seen in the graph India might breach the max mark.(See graph)

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The Recovery Rate

Different countries are showing different rates of recovery, even though they may be on the same life cycle of the virus. We looked at various parameters to see if we could identify the reason for difference in recovery rates. 

To begin with, let’s define recovery rate.

Recovery Rate  = Total number of recoveries / Total number of outcomes (death + recoveries)

We analyzed correlations between various parameters and recovery rate. We also checked the correlation of these parameters with the average daily number of cases reported after the 100th case. 

Parameters Studied

Test/Million – We looked at test/million as the first factor that may aid recovery and also may explain the number of cases. Surprisingly, test per million parameter had very poor correlation with number of cases and negligible correlation with recovery rate

Obesity Rate – We looked at the obesity rate of the country that is percent of people in the country who are obese. This had a strong positive correlation with the number of cases. This means that higher obesity rate resulted in a higher number of daily cases. There was also a moderate to weak negative correlation with recovery rate. Higher the obesity rate, lower was the recovery rate.

Overall Population Age – Average age of the population had no correlation with either recovery rate or cases reported

Percentage of population infected over 50 – Since age had no correlation, we looked at the percentage of infected out of total infected, that were over 50 years. This showed a strong negative correlation to recovery rate. If the percentage of infected over 50 years out of total infected was less, the recovery rate was higher

T Factor – We looked at the amount of tourists that visit the country. Our hypothesis here was that a popular tourist destination would be more susceptible to the infection. We indexed the tourists basis the total tourists that visited the country in 2019 and called it the T factor, This showed a strong positive correlation to the daily number of cases reported

CD Factor – We also looked at the Chinese Diaspora. We hypothesized that a higher Chinese Diaspora would mean more travel of infected population from China to that country, both business and tourist. This also has held true as there is a huge positive correlation between CD factor and daily number of cases reported

We take a look at the impact of these factors for each country. 

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India

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India is green or light green on all the parameters except test/mil. This clearly shows in the recovery rate. India needs to take care that its %infected over 50 does not increase. 

Also India’s total outcome percentage that is total cases that have had an outcome over total reported cases is very low (23%). So the recovery rate may fluctuate.

Italy

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Italy has a medium obesity rate and high T factor along with a moderate CD factor. Italy is also a favorite destination amongst the Chinese. This was one of the factors for initial infection. The fact that 71.2% of its infected cases are above 50, it has a low recovery rate also

USA

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USA has a high T and CD factor. Combined with the high obesity rate, it has the highest number of cases. Also the high obesity rate and 50% of infected people being above 50 has led to its low recovery rates. The outcome percentage for the USA is only 16%. We still await results in 84% of the cases

Iran

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We did not have the age of infected people in Iran so could not review the recovery rate versus age. Iran has low T and CD factors, however, we know from news report that the initial infections in Iran were from closer interactions with China, that rose exponentially because of a religious event in the area of the outbreak.

South Korea

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South Korea is the anomaly in our study with respect to Per Day Cases. South Korea has both a high tourist population from China and a huge Chinese Diaspora. But proper management of people inflow from China helped control the spread in initial days, though they did not ban travel from China. The latter increase in cases were attributed to patient 31 who was a super spreader. The source of that infection has never been identified but post that Korean administration did well to control the spread with aggressive contact tracing.

Spain

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Spain also suffered a lot in the initial days of the outbreak. However it was able to stabilize the growth rate. With a high obesity rate and a high T factor it has reported moderate per day cases and its recovery rate is also moderate. This is due to a high percentage of infections being reported in those above 50. Also 49% of the cases still are awaiting outcome, so the recovery rate may fluctuate.

Germany

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Germany has had the fifth highest cases worldwide. Most factors were poor or moderate. This has meant that Germany though has reported a higher number of cases has managed the infection well amongst the elderly. Infact, Germany was lucky as the infection came in the country through youngsters holidaying in Italy. Rigorous testing ensured that the asymptomatic cases were also identified so that they were not able unknowingly to spread the infection amongst the older population.

France

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Due to a high T factor and its popularity amongst the Chinese, France has seen high per day cases. It has a low recovery rate also as the majority of infections are amongst the greater than 50. Outcome% for France is also low at 38% so there could be an impact on the recovery rate.

Sweden

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Everything was in favor of Sweden, except the fact that it has a moderate obesity rate and it has let the infection spread amongst the elderly. It has the poorest recovery rate and the outcome% is also very low so that recovery rate may further worsen. Sweden’s main concern is the spread of infection in old age homes.

With only 34% of the cases that have had an outcome, this might be a little early to be looking at recovery rates but this gives us a direction of things to come. We will continue to track recovery rates across countries.

India – 20,000 and beyond.

India has become the 17th country to go beyond the 20K mark. It has crossed that mark almost after 3 months since the first reported case. Let’s take a look at the daily growth rate of new cases after India reported its 100th case.

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Although the trend is downward, it is not a rapid downward trend which is not resulting in a slow down for growth rate. India’s problem seems to be arising from the fact that new states keep emerging as growth drivers while not enough states seem to be slowing down. 

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We looked at which states contributed the most in the first 10K cases and then in the next 10K cases. While Maharashtra remained top in terms of contribution, Gujarat, MP and UP have taken over the top 5. These states are also growing at a much faster pace than even Maharashtra.

Story of the States

The Worry States

In our last article we had identified states that were a worry or were showing worrisome signs. The graph below shows their 7 day rolling average of daily growth rate since the last update

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The good news is that Delhi has definitely slowed down and the growth rate has now gone below 5%. Rajasthan is also showing some slowing trends as the growth rate has just gone below 10%. 

Gujarat, MP, UP and WB are the major cause of concern currently. All these states are trending higher than Maharashtra. Although, Maharashtra is slowing down its not slowing down fast enough. Since a high number of cases have already been reported in Maharashtra, a 10% growth rate also means around 500 to 600 cases daily in the current scenario.

Encouraging States

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The empty space above 10% tells the story here. All these states have now come below 10% and have stayed below 10% over the last 7 days. Haryana has joined Kerala in the below 5% club of 7 day average growth rate. Tamil Nadu also seems to be following suit. Karnataka and AP are two states that also need to slow down and get below 5%.

India’s Road To Recovery 

The road to recovery is highly dependent on the UP, MP, Rajasthan, Gujarat, Maharashtra and WB. 

These are also the most populated states of India. Except Rajasthan, they are showing a growth rate in excess of 10%.

Extreme poverty in these states means that they also have a huge migrant population.Residents of UP, WB and Rajasthan travel all around the country as migrant laborers which will put all the other states which have controlled the cases during the lockdown at risk. 

Daily wage workers form an important part of our agricultural and infrastructural economy, keeping them under lockdown for a longer period will also be detrimental to our economy. 

Unless these states show dramatic improvement May 3rd does not seem enough for India.

About the Author

Sanjeev Prakash is an Analytics and Marketing professional with more than 12 years of experience in Analytics, Data Management, Sales, Brand Management, Corporate Communications, Market Research and Customer Relationship Management. Sanjeev has an MBA from IMT Ghaziabad and a degree in economics.

In Collaboration with Parinay Pande

(Also published on LinkedIn https://www.linkedin.com/pulse/covid-19-real-path-recovery-sanjeev-prakash/?trackingId=4oI3Xc4ESvOb3m%2FU%2B2jOcw%3D%3D)