Categories
Public Health

Covid19 Test. Trace. Treat… Are We Doing Enough?

We have been hearing this advice from many sources for the management of Covid19 effectively. For understanding more about Covid19, I went on to check for a simple metric i.e. percentage of confirmed Covid19 cases vis-a-vis a total number of tests conducted by various countries affected with Covid19. My data sources are shared at the end of the article. I have used a different data source for the month of May; the reason being comparable dataset was not available with the earlier source.

March Numbers

CountryDateTotal TestsTotal Confirmed Cases%Confirmed
SpainMar 18, 2020300001117837.26
ItalyMar 20, 20202068864103519.83
IranMar 14, 2020800001136414.21
United StatesMar 19, 202010394594159.06
IndiaMar 20, 2020145411911.32

May Numbers

CountryDateTotal TestsTotal Confirmed Cases%Confirmed
SpainMay 24, 202035565672823707.93
ItalyMay 24, 202033911882293276.76
IranMay 24, 202078128613352117.08
United StatesMay 24, 202014357969166682911.60
IndiaMay 24, 202029434211326744.50

Just to mention, the source which I used earlier did not have the data for China so I could not include the same. Apart from China, I have shown the data for the countries which have got the maximum number of confirmed cases to date (in March) for illustration purpose and I also included our own country to put this in perspective. Now, if we compare the data for two instances; it shows different positivity rate (i.e. percentage of total confirmed cases / total test)

As we all know that lockdown was imposed in our country for preparing ourselves for fighting this long battle against Covid19 and a very important aspect in this battle is to increase our daily testing capacity as it’s the only way available to us to understand the spread of the virus in any particular community.

We have come close to daily testing capacity of 1 lakh+ tests a day which is almost 100 times increase from the initial days but still we are way behind when we see tests per million vis-à-vis other developed countries. Just to put this in perspective; India is doing 2135 tests / million population whereas Iran which has almost similar number of confirmed cases has been doing 9544 tests/ million population. And if we compare this with developed countries this number is in the range of 20000 – 75000 tests/ million population.

At the same time; we should not forget that various studies world over suggest that actual number of infected individuals are always higher than number of confirmed cases the reason being each country depending upon their testing strategies are able to identify the confirmed cases. Also, we should not forget that number of confirmed cases is a lagging indicator to understand the spread as the symptoms start to emerge only after 2 to 14 days from the day an individual got infected with the virus.

I am writing this article at a time when we are in lockdown 4.0 and have got relaxation in many parts of the country. This would be the real test of our healthcare infrastructure which we have managed to build during the national lockdown.

Key Points:

  1. Positivity rate for India is less vis-à-vis other nations which also got impacted with Covid19 (which is a good sign)
  2. We need to improve our testing capabilities to understand the level of community spread (as it is done in other countries); the reason being based on the historical evidence and current developments globally pandemic strikes in waves so we should not discard the possibility in our case as well.
  3. We should also increase the use of rapid antibody test to ascertain the level of community spread.
  4. We should be more concerned about deaths happening due to Covid19 as it is believed that 80% of the cases would be mild in nature; 15% would need hospital support and 5% would need ventilator support.

In our country, one can also debate the number of deaths happening because many of deaths happening in our country are not certified medically. But that is something we should discuss separately.

Again as always, questions and clarifications are welcome.

About the author

Yatindra Jha is a healthcare consultant with a focus on public health policy.

Sources

Data Source: https://ourworldindata.org/covid-testing – March Data

Data Source: https://www.worldometers.info/coronavirus/ – May Data

Categories
Public Health

We might be seeing the end of the #Covid19 pandemic in India.

On 15th March 2020, India had just crossed 100 cases. Italy was at 24.7k cases, US at 3.6k cases, Brazil had just gone past 200 cases, Germany had crossed 5.8k cases and Russia at just 63 cases. In the last two months even with varying amount of restrictions, COVID19 has still wrecked havoc in these countries and the world.

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With India now sitting at the threshold of 100K cases, we look at the effect various lockdowns has had on the Covid19 situation in India. We also take a look at how the countries continue to recover from COVID19.

We dig further in to our classification of Indian States with a new methodology that scores the states basis various parameters.

Note: We have removed Korea and Sweden from the study to Include Brazil and Russia. This gives us a better representation of the top countries with respect to no of cases reported

India and The world

On the 62nd day after crossing 100 cases India has the second highest daily growth rate (7 Day Rolling Average). If we look at the table only Brazil is ahead of India

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India has had 3 Lockdowns and we will start Lockdown 4.0 from tomorrow. These lockdowns have ensured that we have done much better in the number of reported cases than other countries in the study. But has the curve really flattened out? When we look at the other countries, we see that most of the countries have nearly managed to flatten the curve albeit at a very high number of reported cases. Currently on a logarithmic scale India, Russia and Brazil are showing strong signs of growing while other countries have a flat curve.USA, Italy and Iran have all flattened their curve. (Spain and France also show a flat curve though not included in the below graph)

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For India, the lockdown has ensured that we miss the steep growth path of other countries but we are still poised to hit a huge number, albeit at a slower rate. This means we have just prolonged our battle with the disease.

Although, India may seem to be trending towards a higher number of cases all may not be lost. India is doing well in terms of its recovery rate and outcome percentage.

Recovery Rate

Recovery Rate, i.e. no of people recovered by total outcomes continues to improve for the world and for India. India’s recovery rate has now crossed 90%. For the world it stands at 85%. The other countries in the study have also improved their recovery rate

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Outcome Percentage

Recovery rate should be studied along with the outcome curve, i.e. how many cases have had an outcome with respect to active cases. For e.g Russia has a 96% recovery rate but 76% of the cases still await an outcome. Similarly Iran has a 93% recovery rate at a 85% outcome rate which more or less signifies the actual recovery rate for the country.

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India has a good recovery rate with a decent outcome%.

Net Active Cases

Definitions

Net Active Cases = Total Cases – (Cases Recovered+Total Deaths)

India’s Net Active cases are at just a little above 53K. Except for Iran and Germany, all the other countries are much ahead of India. With India’s high recovery rate, it clearly shows that India is also recovering at a much higher pace than the other countries.

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India has also seen a declining trend in the net active case added each day. In the past seven days we have added around 1700 net active cases per day compared to higher than 1900 net active cases in the week before.

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This is a positive sign for the Indian Medical Fraternity as the reducing number of new active cases added does prevent the medical system from getting overwhelmed.

Lockdown Effect on India

When we take a look at the effect lockdown had on our growth rates, it can be observed that lockdown 1 certainly slowed us down, but lockdown 2 and lockdown 3 failed to have the desired effect of flattening the curve.

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If we look at the Indian States, Maharashtra has had no effect in the lockdown. Its contribution to the cases in fact has grown during the three lockdowns.

Similarly Delhi is another state that has been contributing heavily during the lockdowns showing minimal effect of the lockdown.

States Classification

We have changed the methodology of classification of states (Good, States to be Watched and Worry States) from May onwards. We were classifying the states on the basis of their 7DAGR only. Now we have also included the following to arrive at a weighted score

  • Total Cases Reported
  • Cases/Mil
  • Test/Mil
  • Growth Rate
  • Positive%
  • Outcome%
  • Recovery Rate

Basis these parameters we have arrived at a group of 

  1. Good States
  2. States to be Watched
  3. Worry States

The Good States

As on 16th May 2020, the following states qualify as the Good States. These states are characterized by low growth rates, low cases/million, higher Outcome% and high recovery rates.

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Haryana – Haryana has seen a recent spike in cases most of which are related to Delhi. Haryana, despite being surrounded by Delhi, UP, Punjab and Rajasthan (All these states have high number of cases) has done very well in terms of new cases. The Growth rate is below 4% and with aggressive testing it has maintained a low positive percentage also.

Jammu And Kashmir – This state saw a huge spurt in cases during the first lockdown. Most of the cases here were either linked to the religious event in Delhi or pilgrims returning from Iran. The state was once a worry state and now has come in the good states

Karnataka – There has been spurts seen in state but overall the state has maintained its low positive percentage and cases/million. The recovery rate is a bit lower compared to its peers but with outcome% also below 50%, the recovery rate may go up.

Kerala – This state was on its way to 100% recovery but with the return of Migrant Populations and Expats, there has been a minor spurt of cases. It will be interesting to see whether Kerala is able to control its cases as it had done previously.

Punjab – Punjab had more or less weathered the COVID19 storm in the first two lockdowns, but a sudden upsurge of cases from the last week of April saw Punjab come in the “Emerging Bad” category in my last article. But it has been an aberration due to infected pilgrims returning from Nanded and Punjab has controlled the situation well, to move in to the good states.

Jharkand – Less number of tests, but lesser cases and growth rate puts this state among the good states.

States to be watched

These states are those states that have either started showing a positive trend i.e. moving from a Worry State to a Good State or a negative trend i.e. moving from a Good State to a Worry State.

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Andhra Pradesh – This state is on the way down and will probably move towards the good states in a day or two if the trend continues.

Madhya Pradesh – Another state on the way down. This state was showing alarming trends during the month of April and was a worry state. It has still not completely slowed down but is definitely on its way down

Odisha – This was an encouraging state but recent trends show a very huge growth rate and will probably move to a Worry State soon.

Rajashtan – Another state that was showing huge growth numbers in April has slowed down very well. It had moved down to a good state but another spurt of cases moved it back to States to be watched

Telangana – We are not sure of the numbers for this state as they have stopped reporting number of tests done. Hence we are keeping this state as a state to watch

Uttar Pradesh – Like Rajashtan, UP was also supposed to burst with cases. But UP has maintained its trend, although a lot more testing needs to still happen in UP.

The Worry States

The States that add most to the growth of the Indian cases have been categorized as the worry states. These states have high number of cases, a higher penetration of cases in the population, a high positive% and low outcome%.

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Bihar – We had categorized this as an “Emerging Bad” State in our last article. It has now turned as a worry state. It has poor testing, a high growth rate and a low outcome%. This state may become a major problem especially with the migrant population traveling back.

Delhi – Delhi has tested a lot but it still has a high positive% and a high penetration rate. Delhi had slowed very well but with opening up of the wholesale market, cases have started zooming up again.

Gujarat – Gujarat was showing signs of slow down but still has a long way to go before it comes into a good state. high number of cases, poor recovery rate along with a sub 5% growth rate is making this state a huge worry for India.

Maharashtra – The state that refuses to slow down. Even after 54 days of crossing 100 cases the states growth rate of cases is still above 6%. This state has not slowed down once and daily number of cases have just shown an increasing trend. This is the most worrisome state in India, more so because of poor recovery rate also.

Tamil Nadu – A Covid19 explosion in one of its market turned this good state in to a huge worry state for India. This state is seeing a resurgence in cases after it was able to contain very well the effect of the religious event in Delhi, surge. The good part is that recovery rate is very high but still outcome% is very low.

West Bengal – Poor testing, High Growth Rate, very bad recovery rate along with questionable data sharing makes this state a time bomb. This state may explode or already has but we do not have the data for it.

In all, these worry states have to slow down. If they slow down and go below 4% India will see a reduction in cases. Also we should hope that in the coming days the list of Good States increases and worry states keeps going down.

CPM19 – The Road Ahead

On 2nd May, we predicted 75K cases for India by 17th May. There was another projection that the model made which showed more than 100K cases which was rejected as we were quite hopeful that growth trend would stabilize and we will not cross 3000 cases added per day.

This has not really happened and India has infact overshot our number by at least 18k cases. Nevertheless we will still try to predict the number for 31st May using this model.

We have used the CPM model to predict the growth trend for the states basis their classification as The Good State, States to be Watched and The Worry States. The prediction shows that by end of May we may very well be close to 150K cases. That’s another 60K cases in the next 15 days. The good news is that we may start showing a slow down in new cases reported after reaching a peak of close to 4900 cases per day. This may mean that we might start flattening the curve by end of this month.

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If our prediction holds true we may see a step towards the end of this pandemic in India although as we said before the road to recovery is a very long one. Also as India continues to ease the lockdown the road ahead may still be very bumpy.

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.

(Article also published on LinkedIn: https://www.linkedin.com/pulse/covid19-india-fights-back-sanjeev-prakash/?trackingId=D3q6XmsjQ%2B%2BWS1bIqQe8ow%3D%3D)

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

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)

Categories
Public Health

Covid19:A few myths about the virus

The world is grappling with the stark implications stemming out of the uncontrolled coronavirus pandemic. Healthcare infrastructure is under severe stress. Precious lives are being lost in large numbers (over 143k fatalities so far). Economic fragility is peaking, unemployment rate is mounting, and supply chain breakdown is hurting millions across the globe. With no sign of cure or vaccine being available in foreseeable future, nations are deploying strict and discrete measures to arrest the impact of this unprecedented crisis.

In this digital age, populations are benefitting from the constant flow of information related to covid19. Social media and instant messaging platforms are buzzing with videos, memes and trending hashtags, print media is being flooded with opined articles and by-liners from pundits, and news channels inundated with harried correspondents trying to bring every piece of information at your fingertips is quite common.

However, it becomes an arduous task for an individual to sift authentic and trustable information from the copious stream of content. As a result, a myriad of myths related to coronavirus has surrounded all of us. These myths incorporate multitudes of aspects connected to coronavirus – etiology, symptoms, vulnerability, treatment by home remedies, drugs/vaccines available, food habits, immunity boosters, effect of weather on virus potency etc. – which could be equally dangerous as the coronavirus itself. In a recent incident in Iran, more than 600 people died from the consumption of high-concentrated alcohol based on a rumour that it could prevent infection from coronavirus. The severity of these misplaced myths/fake news about the hazardous cures and viral hoaxes can be judged from such unfortunate episodes.

Based on my expertise and knowledge in medicine and healthcare, I have made an earnest attempt to dissect many of these myths in a 2-part video series (links below). The realities busting these fallacies that you see in the videos have been factchecked and corroborated through reliable and bona fide resources like WHO. I firmly believe that we as individuals need to play a much bigger role in this fight against the coronavirus and we can begin by putting a stop to misinformation about the contagion being circulated online.

Links to the ‘Coronavirus-Myths vs Reality’ video series:

Part 1: https://www.youtube.com/watch?v=TJOaScJ_3ic&t=19s

Part 2: https://www.youtube.com/watch?v=F5R7ta3o-5I&t=13s

About the Author

Dr. Anuj Chawla is one of the leading Orthopedics and Foot & Ankle Surgeon in India. He can be contacted at dranujchawla@gmail.com. For consultation with Dr. Anuj, book an appointment by visiting the website: http://dranujchawla.com/.

Twitter: @dranujortho

Facebook: https://www.facebook.com/doctoranujchawla/