novel-Coronavirus and Covid-19

Thursday, August 5, 2021

COVID Surge in India - Third Wave

WION-Gravitas YouTube Channel - Aug 2, 2021

Saturday, May 16, 2020

Facemasks and Social Distancing
Zach Zachariah, Ph. D., M.B.A., Associate Professor Emeritus, Ohio University
May 15, 2020

On Monday April 27th, when Ohio Governor Mike DeWine rolled out Phase 1 of his plan to reopen businesses, he said, “no mask, no work, no service, no exception.” The next day, DeWine who required facemasks for everyone, reversed his decision by making it mandatory for employees only and not for customers. He said, "We heard from a lot of different people who felt that 'I may wear a mask, but the government should not be telling me what to do.'” I wish he had not reversed his decision.

Surgical masks and other face coverings do not offer full protection against a heavy load of Coronavirus. However, they will prevent aerosol droplets released when a person sneezes, coughs or even talks loud from spreading to the surroundings. Coronaviruses are denser than other pathogens and they drop to the ground within six feet, a distance considered safe to be away from the next person. Assuming that most store-goers do not sneeze or cough, there is only a slight chance that a person who does not cover the face may breathe viruses from the air, if a safe distance is maintained. Coronaviruses stay on hard surfaces for several hours. That is the reason why stores are thoroughly cleaned and carts, checkout counters and conveyer belts are frequently wiped down. It is still possible that one will touch surfaces that may have virus droplets. When we touch our nose and face with our hands, the virus can enter the body. The advantage of having a facemask is mainly to protect you from the virus rather than protect fellow customers from you.

During the time the stay-at-home order was in place, I noticed about 90% of the shoppers covered their face. Two days ago, I went to Walmart at a less busy time and counted eight people in the 20-50 age group without any face covering. This is about 30-35% of the shoppers I encountered. It is quite possible that some of them have touched their face or nose with their hands. What if one or two of them touched a surface that harbored Coronavirus from an asymptomatic person. These people would be going home to an elderly relative or someone with an underlying condition. Such a behavior is enough for the disease to spread in the community.

Later that day I watched on YouTube, a clip of the PBS program, Amanpour & Co in which Hari Sreenivasan interviews Dr. F. Perry Wilson, a researcher from the Yale University School of Medicine. The video can be viewed by clicking here[1].

Dr. Wilson Interview on PBS

Even if you are unable to watch the whole video, watch at least the last two minutes beginning at about 15:30 minutes. This is a synopsis of the doctor’s message:

Americans cherish individual liberty and do not like to be told what to do.
They have embraced shared sacrifice during times of war.
Wearing a mask and keeping a safe distance in public are behavioral changes that everyone should be able to make.
Leaders must lead by example. Challenge the people to be patriotic and tell them that ‘we need to work together to save this country from this pandemic.’ President Trump has declared that he will not wear a facemask. Many state governors and mayors have been seen wearing masks. If these leaders will demonstrate by example and talk about shared sacrifices, then people will come together.

The doctor also explained how misinformation related to medical research is carried on air and on social media. In the four months since the pandemic, so much data has been collected. Pre-prints of several studies have been published without adequate peer review. Data can be interpreted in multiple ways. What media initially reports is usually one interpretation of the data by a set of researchers. When other experts look at the published data, they may come up with an alternate interpretation. Further research may even disprove the findings. These new results may not even be publicized.

In another segment, Dr. Wilson talks about the rate of false positive results from the antibody tests on a limited number of persons, which when adjusted for the population may be as high as one third. Since it is not feasible to administer the PCR test for the entire population, the most viable option, in the absence of treatment and vaccination, is for the CDC and other public health agencies to test a representative sample of the population using “Seroprevalence Surveys.”[2]

A Raleigh, North Carolina native hired an airplane to display this message over the city, which I thought was poignant:

“Fewer graves if we reopen in waves.”

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[1] Dr. Wilson Interview on PBS, https://www.youtube.com/watch?v=m8EBHXrum-M
[2] Seroprevalance Surveys, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1580051/

Saturday, May 9, 2020

The Kerala Model – Testing, Isolation and Contact Tracing

How the model compares to Vietnam and California

Zach Zachariah, Ph.D., M.B.A., Associate Professor Emeritus, Ohio University

May 9, 2020

Kerala, the state where I was born lies on the Southwest coast of India on the Arabian Sea near the equator. It is the twenty-first of the twenty-eight Indian states in land area and has one of the highest population densities.

Two other areas of the world chosen to compare Kerala’s success in mitigating the Covid-19 pandemic are Vietnam and California. Vietnam that borders China, where the novel-Coronavirus originated, was able to contain the spread of he virus and not a single person has died from the disease. California is ten times larger than Kerala in land area; but has only six million more people living there. Both Kerala and California encountered the first novel coronavirus case by the end of January 2018. While Kerala has only 504 reported cases and just 4 deaths so far, California has reported 63,700 cases and over 2600 deaths.

Experience: The deadly Nipah virus infection was first detected in the Kozhikode district of Kerala in May 2018. The state government responded quickly, within days traced, and isolated everybody who had contact with the infected. The outbreak was contained in just two districts. It claimed seventeen lives and by the end of June 2018, Kerala was declared Nipah-free.[1] Virus is a Malayalam movie set against the backdrop of the 2018 Nipah virus outbreak in Kerala and is available on Amazon Prime.

Preparedness: Based on the lessons learned during the Nipah outbreak, Kerala government has strengthened the disease response infrastructure by putting in place a 24-member task force coordinating with police and public officials around the state. Operating procedures and protocols were set in place in anticipation for the next epidemic. When the state became aware of the new Coronavirus disease spreading in China, the health minister, K.K. Shailaja, a former science teacher set in motion the government machinery as the first person, a student from Wuhan, China arrived. She was immediately isolated and when tested was found to be Covid-19 positive becoming India’s first Coronavirus case (K. K. Shailaja interview on NDTV)[2]. On February 2, 2020, the government of India issued a travel advisory asking people not to travel to China and said that anyone with travel history in China could be quarantined.

Investment: Kerala has been ruled by left and center-left parties. The left-leaning governments maintained its focus on social welfare. RT America TV interviewed the historian and author, Vijay Prasad about Kerala’s response to Covid-19 and the video on YouTube [3] can be viewed from this link. The state has also invested heavily in education and public health initiatives. It has a 94% literacy rate, the highest in India. Its government run health-care system consisting of primary health centers in rural parts of the state, specialty district hospitals and a number of medical colleges and teaching hospitals is ranked the best in India. Kerala has a vibrant local media that disseminated Covid-19 information without regard to political affiliation. Most people in the state realized the seriousness of the situation, followed government guidelines on social distancing, personal sanitization and sheltered in place during the lockdown.

Response to Covid-19: A family of three, who arrived from Italy on February 29, skipped the voluntary screening for Covid-19 at the airport and traveled to their hometown. They developed the disease and infected two elderly grandparents.The District Collector, a career public servant who belongs to the prestigious Indian Administrative Service (IAS), resorted to the WHO recommended plan of contact tracing, isolation, and surveillance. He mobilized a team of law enforcement and public health officials, paramedics, and volunteers to retrace the family’s movements through cellphone data and interviews, tracked down the contacts, and isolated them. He also set up a call center in his office, bringing in more than 60 medical students and staff from the district’s health department, whose job was to call everyone isolating, every day[4]. All the five persons survived including the two

elderly relatives. One child and three adults died in Kerala of the disease; two of the adults were in their sixties and one was 71. More than 50% of the deaths in the United States and Western Europe occurred in the nursing or eldercare homes. A recent headline in the Washington Post says, “America doesn’t care about old people.”[5] Unlike the more developed countries, Kerala cared about the old.

When an outbreak of new cases occurs, thousands of state-employed health workers and volunteers equipped with maps and flowcharts conducted aggressive contact tracing and brought the situation under control. As the number of Covid-19 cases grew to 15, the state chief minister, Pinarayi Vijayan, ordered a lockdown, sealed state borders, restricted public and private transportation, closed schools, and banned gatherings larger than ten including religious services. The government also quarantined hundreds of thousands of migrant workers in camps and provided them with free food.

Kerala promulgated an Epidemic Disease Ordinance on March 29, 2020, days before the central government instituted a harsh lockdown. It included an economic package worth $2.6 million (₹20,000 crores) to fight the pandemic. The government entrusted the task of implementing the economic package to the nationally acclaimed poverty eradication and women empowerment program known as Kudumbashree[6]. This organization that is spread throughout the state has over 5 million members in 430,000 ward level units. They organized community kitchens to cook and deliver food to the needy, especially to the families of schoolchildren. Kudumbashree volunteers also assemble grocery kits and deliver them to 8.7 million families. It formed 200,000 WhatsApp groups to provide Government instructions regarding Covid-19 to dispel fake news. Mental health helplines were also established across the state[7]. The state liaised with service providers to increase network capacity for Internet and promised two months of advance pension.

In an interview with TimesNow [8], the chief minister of Kerala detailed how the government harnessed the resources of the state’s Innovators and entrepreneurs to design and manufacture PPFs, respirators and ventilators. According to him, hotel rooms, hostels, and additional buildings were being identified to accommodate a surge if that happens. As the Indian government is easing travel restrictions, Kerala expects tens of thousands of Keralites to return from overseas. While still keeping the social distancing guidelines in place, the state is preparing to quarantine returnees for seven days after which they will be tested for the disease and only those found negative will be released for an additional week of quarantine at home.

Update (May 11, 2020):
On May 10, 2020, the government of Kerala has issued new guidelines on quarantining the returnees[1]. Every returnee will be screened on arrival for Covid-19, asymptomatic persons will be required to adhere to strict home quarantine rules for 14 days and those who show symptoms will be admitted to specially designated Covid hospitals. Those under home quarantine show symptoms, they will be tested and if found to be positive to the virus, will be transferred to a hospital for treatment.

[1] Lessons from Kerala’s bold fight with Nipah https://www.orfonline.org/expert-speak/42270-lessons-from-keralas-bold-fight-with-nipah/

[2] Health Minister K. K. Shailaja Interview on NDTV, https://youtu.be/q9xQljHg21c

[3] RT America, the Model State, https://youtu.be/7AGI6qVVmpo

[4] MIT Technology Review, MIT Technology Review, https://www.technologyreview.com/2020/04/13/999313/kerala-fight-covid-19-india-coronavirus/amp/

[5] Washington Post, America doesn’t care about old people, https://tinyurl.com/y9jzk6l3

[6] Kudumbashree, http://www.kudumbashree.org/pages/171

[7] The Guardian on Kerala, https://www.theguardian.com/commentisfree/2020/apr/21/kerala-indian-state-flattened-coronavirus-curve

[*] The Guardian on Vietnam, https://www.theguardian.com/commentisfree/2020/may/01/testing-vietnam-contained-coronavirus

[8] Kerala Chief Minister’s Interview: https://www.youtube.com/watch?v=bkmBI6mHR8g&t=1s

[**] Vox.com – Contact Tracing, https://www.vox.com/2020/5/4/21242825/coronavirus-covid-19-contact-tracing-jobs-apps

Tuesday, April 28, 2020

New Covid-19 Cases in Several Countries

Zach Zachariah Ph.D., M.B.A., Associate Professor Emeritus, Ohio University

April 28, 2020

Around 2:00 PM (ET) today, the number of confirmed Covid-19 cases in the United States surpassed the 1,000,000 mark. U.S. now has one-third of the total reported cases in the world.The death toll as of today is 57,000.[1] The five-day average (April 24 thru April 28, 2020) of the number of new cases reported in the U.S. is a staggering 30,221. The rate of new cases has plateaued so also the number of deaths reported. Even though the number of new cases reported is not increasing exponentially, it has not yet shown a downward trend.

The Financial Times [2] tracks the spread of the new Coronavirus pandemic worldwide and produces charts comparing a seven-day average of data for daily death toll, new deaths, and new cases. This International daily newspaper headquartered in London has made available for free their Coronavirus coverage. Here is the latest chart on new cases reported from several countries of the world.

Source of Chart: Financial Times

An Explanation About the Chart from Financial Times

Linear Scale vs. Log Scale (Click to Play)

The charts that most of us are familiar with are linear. The values between two points do not change. The y-axis of this chart from the Financial Times uses the logarithmic scale, which is based on exponents.
The video from Vox [3] explains the difference between a linear scare and a log scale. It is based on the number of reported Covid-19 cases, not just new cases.

Some of the highlights:

The number of new cases is on the decline for most countries of the world including Italy.
Only three countries with the highest total of new cases, the United States, U. K., and Spain, have not shown a decline in the number of new cases.
However, the new Covid-19 cases have plateaued in the three countries indicating that the measures taken by the authorities to shut down or mandate a shelter-at-home and asking everyone to cover faces and maintain physical-distancing when outside, have flattened the curve.

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[1] Worldometer https://www.worldometers.info/coronavirus/country/us/

[2] Financial Times, https://www.ft.com/coronavirus-latest
[3] Video from Vox, https://www.youtube.com/watch?v=O-3Mlj3MQ_Q&t=5s

An Updated Chart Comparing Responses to Covid-19 by U.S., India and States Within

The chart has been updated with data available as of April 25, 2020. While there is a plateauing of the number of cases in the places shown, the number of new cases and the deaths are still not declining.

Thursday, April 9, 2020

Ohio and Cuyahoga County Stats on Reported Number of Cases - Covid-19

Tuesday, April 7, 2020

Covid-19 Cases and Forecast - Cuyahoga County and Ohio

Zach Zachariah Ph.D., M.B.A., Associate Professor Emeritus, Ohio University

April 7, 2020

Reported Coronavirus Cases for Ohio and Cuyahoga County

Comments:

These are actual data from the Ohio Department of Health [1] website and Cleveland.com [2]
The number of cases for Cuyahoga County for April 3 (780) and April 4 (781), and the numbers for Ohio for the same two dates, 3312 and 3379 did not follow the general pattern.
Since then, the daily number of confirmed cases has been increasing exponentially although at a slower rate, indicating a possible flattening..

Forecasts for Cuyahoga County and Ohio