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Thread: Will SARS make a come back?

  1. #601
    Senior Contributor Oracle's Avatar
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    Politicians are elected to serve...far too many don't see it that way - Albany Rifles! || Loyalty to country always. Loyalty to government, when it deserves it - Mark Twain! || I am a far left millennial!

  2. #602
    Senior Contributor DOR's Avatar
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    How many lives were saved?
    Trust me?
    I'm an economist!

  3. #603
    Turbanator Senior Contributor Double Edge's Avatar
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    Couple from Shamika

    Covid-19: Fight uncertainty with data| Analysis | HT | May 24 2020

    In the early days of the pandemic, limited data availability led the first generation epidemiological models to predict that hundreds of millions would be infected with the virus, and millions of lives lost. Fortunately, the reality so far has turned out to be very different. However, the situation is still worrisome. From 657 cases on March 25, India has more than 125,000 cases today. Even more troubling is that active cases continue to grow, despite a significant slowdown since the national lockdown.

    To understand the future trajectory of the pandemic and to frame appropriate policy responses, we need granular data based on contact tracing at the level of a city or district to provide information on three important epidemiological parameters.

    One, incubation period, which is the interval between infection and symptoms. The distribution of this parameter helps the government and experts understand the nature, extent and possible future scenarios of the outbreak. It also informs in the evaluation of the disease-control strategy.

    Two, the serial interval, which is the time between the onset of the illness in the primary case (infector) and illness onset in the secondary case (infectee). If the estimated average of the serial interval is shorter than the estimated average incubation period, then pre-symptomatic transmission is more likely to happen than symptomatic transmission. Research from Japan has indicated that the median serial interval for Covid-19 is 4.1 days, which is less than the mean incubation period of approximately five days. The public policy implication of this is that containment via case isolation might be a challenging task. Containment would, therefore, require to be guided by an aggressive testing and rapid contact tracing strategy.

    Three, the basic reproduction ratio (also popularly known as R0), which is the average number of secondary cases per primary case. There has been a great deal of focus on this parameter, because if the R0 is greater than one, then the probability that there will be an outbreak is extremely high.
    Given the importance of the parameter R0, one has to exercise great caution in interpreting and estimating it. Most models that estimate this parameter assume that all individuals have a homogenous transmission and constant recovery rate. Therefore, a population-based R0 is estimated with the implication that if this is greater than one, then outbreaks from a single infected person is highly likely to happen.

    However, research based on the previous Severe Acute Respiratory Syndrome (Sars) epidemic in 2003 has shown that there is a great deal of variability in individual infectiousness. For example, research on Sars epidemic from Singapore revealed that the majority (approximately 73%) of the cases were mildly infectious; in other words, they had an R0 of less than one, while a small proportion of them (approximately 6%) was highly infectious or “super-spreaders” with an R0 > eight.

    The variability of R0 plays an important role in the dynamics of an outbreak. Models that account for individual variability show that even if the population-based R0 is greater than one, an outbreak could still be a low-probability event. Introducing individual-level variability in the model thus explains why during the Sars epidemic in 2003, several cities did not witness explosive outbreaks despite undetected exposures to infectious cases. In these models, outbreaks are typically caused by super-spreader events (SSEs).

    In the Indian context, this might explain why Mumbai is experiencing an explosive outbreak, while many other large, highly-dense cities with significant populations dwelling in slums, are not experiencing such an outbreak.
    We assume the degree of infectiousness is constant everywhere. It isn't. This is why only some places are doing worse than others.
    Last edited by Double Edge; 25 May 20, at 21:56.

  4. #604
    Turbanator Senior Contributor Double Edge's Avatar
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    Imperative to instil confidence, COVID policy must remove fear around health & economy | IE | May 25 2020

    Despite repeated assurances from governments, the unabated reverse exodus of migrants to their homes in the eastern states signals the fear and uncertainty that has gripped the nation.
    If we had the universal ration card scheme in place less would feel the need to return to their home states. There will always be those that want to return but the exodus would have been less.

    The immediate reaction of the government, an extended national lockdown, has been extremely successful in slowing the growth of the virus. However, we are yet to “flatten the curve” — that is reach the peak beyond which active cases decline steadily and total number of cases flatten with strong recoveries.

    It is also important to note that “flattening the curve”, doesn’t make the virus go away. There remain high chances of resurgence, as seen in Germany, South Korea and, more ominously, in Iran.
    India is yet to peak, we don't know when that will happen.

    We must, therefore, now shift to a plan that balances the need to protect our health and reopen our economy by locking down only those who are infectious.

    This article presents a simple, scalable, and credible solution.

    One, introduce a comprehensive “test and isolate” policy across the country.

    Two, build testing laboratories in all 7,000 blocks across the country and three, build dedicated infectious diseases wards in every district hospital across the country. This will make it safe for Indians to return to work and help in keeping the infection rate below 0.5 per cent of the population (currently it is 0.007 per cent). Until a vaccine is developed and deployed, the simplest and safest path to this outcome is a national COVID management strategy of isolation combined with contact tracing and testing.

    This strategy is far less disruptive and cost-effective than our current policy. It does not rely on any technological breakthroughs and will work even in the worst-case scenario. This provides a roadmap for a future in which Indian citizens are confident that their health and the economy’s future are protected against the virus, and from future pandemics. It is the fastest path to an economic revival because it is the simplest and safest path. A strong commitment from the Centre to provide resources has already been signalled by the finance minister in her last stimulus announcement.

    Easing containment policies without a viable alternative like “test and isolate” in place would resume the exponential growth of the virus and very likely bring us back to our current situation. The strategy, once implemented, must continue for the next 18-24 months or until a vaccine is widely available.
    Last edited by Double Edge; 25 May 20, at 22:03.

  5. #605
    Turbanator Senior Contributor Double Edge's Avatar
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    Who is in charge of the state of Gujarat ?

    Hospital body says restricted testing giving false sense of security in Gujarat | ET | May 26 2020

    The Gujarat government's move to reduce testing as the number of Corona-positive cases are rising alarmingly in the state has come under fire from both the Gujarat High Court and the Ahmedabad Hospital and Nursing Homes Association (AHNHA).
    Last week, the Gujarat High Court had observed that “the argument that ‘more number of tests which lead to 70% of the population testing positive for Covid, thereby leading to a fear psychosis’ should not be a ground to refuse or restrict the testing.”

    “Many times, doctors are insisting on a Covid test on patients who need to undergo other treatment or surgeries, so as to avoid any post-treatment complexities. Even in such circumstances, the tests are not being permitted to be carried out,” the high court had noted.

    The state government’s reluctance to test even frontline workers had caught the attention of the high court. The court, in its order, has mentioned a letter it received from a resident doctor from Ahmedabad Civil Hospital who had tested Covid-19 positive in the line of duty.

    “Eight residents from my department and five residents of my unit were tested positive and we were criticised for getting our tests done”, the doctor wrote. “The hospital management is just concerned that if residents get tested, and if they turn out to be positive, then who will work?” he added.

    Not only doctors, several policemen ET spoke to had made similar observations and narrated stories on how they were actively discouraged from getting tested. At least in two cases, two men in uniform had got themselves tested in private laboratories and realised that they were positive.

    “The state government is directed to immediately procure maximum testing kits to enable even laboratories at private hospitals to carry out the coronavirus testing at government rates,” the high court had directed.
    I thought Gujarat's cases reducing recently was a sign of good news but it appears they are testing less.

    Insane
    Last edited by Double Edge; 26 May 20, at 23:18.

  6. #606
    Turbanator Senior Contributor Double Edge's Avatar
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    Sweden admits it DID get it wrong on coronavirus: Expert behind country's refusal to enter lockdown says he would have imposed tougher restrictions 'if we knew what we know now' | Daily Mail | Jun 03 2020

    Their foreign minister is still defending the approach. She says it can't be gauged on week by week stats.

    They aren't locking down now AFAICT.

    This is just an admission that the death rate is too high or higher than expected. It does not signal any change in policy.

    Like Giesicke said, evaluate after a year.
    Last edited by Double Edge; 05 Jun 20, at 09:40.

  7. #607
    Turbanator Senior Contributor Double Edge's Avatar
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    In conversations i've had with people in the excellent UnHerd channel some one mentioned 80% of the population might not be susceptible to the virus. This struck as stange an incomprehensible. But there is a basis to it just that people don't understand the why and can comment only on what they observe.

    Karl Friston: up to 80% not even susceptible to Covid-19 | UnHerd | Jun 04 2020

    What got Friston noticed was his comment about 'immunological dark matter'.

    Apparently Germany has more of it than the UK and that is why their mortality figures are lower than others.

    This immunity is at the T-cell level fromm other similar coronavoruses like the common cold.

    Friston is a modeller too but different to previous ones who he refers to as conventional modelers. He is a modeler using Dynamic Causal modeing. Not a medical doctor.

    Why Sweden's mortality isn't very different to the UK is becasue the UK never really 'locked down' makes sense to me. Countries that locked down less tight or later had higher mortality figures. The susceptible groups in the population were exposed sooner.

    But there are people that are immune to this disease and can beat it on their own without even knowing it. We've assumed to date that 100% of the population is suceptible. But is this true. Friston thinks its much lower, 50% maybe only 20% of the population is suceptible.

    He makes the point that huge disparitites between countries is not primarily a function of govt policy. There are other reasons that need to be researched.

    The implication of being correct here are stark. If presently we allow only a limited amount of people to assemble in a fixed space due to social distancing then we will be able to allow more than present without increasing the level of risk.
    Last edited by Double Edge; 05 Jun 20, at 10:13.

  8. #608
    Turbanator Senior Contributor Double Edge's Avatar
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    That's the state of NE India right now. The surge in cases is due to migrants returning. They will have been picked up as they arrived and quarantined so i expect the number of active cases to abate in a months time.

    Name:  Jun 13 NE Covid cases.jpg
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    Meghalya is doing the best. Mizoram's gone back into 2 week lockdown after their surge.

    Nagaland with twice the population as well as density is doing better than Mizoram with similar number of cases.

    Arunachal with twice the population but a fraction of the density of Sikkim and has the same number of cases.

    In terms of density, Manipur, Meghalaya & Nagaland are similar. But the difference in cases between Meghalaya & Manipur is quite large for similar size populations.

    Tripura has twice the density of Manipur and has twice as many cases so its doing about as well as Manipur. Which is to say not great.

    It's difficult to say more as the only states in the NE releasing test data are Assam & Tripura.

    Assam with ten times more population and similar density as Tripura does not have ten times the active cases as Tripura. Assam is doing much better than Manipur & Tripura.

    Assam has the strictest quarantine rules on the planet. Literally !!

    They test you on arrival in Assam, then its 7 days quarantine. At the end of that they test you again.

    Now, the kicker is, even if you test negative, there is an extra 14 days quarantine on top.

    So any visitor to Assam is in quarantine for 21 days before the state deems them safe to release.

    Assam has tightened rules over the centres directives which they are free to do. States cannot relax the centres directives.

    Data from ISRO's tracker

    What i like about their tracker is they plot active cases with recovered. A state is improving when number of recovered over takes active cases as can be seen in the case of Megahalya.

    Confirmed cases is useless and only of value to the media as this parameter never decreases, only increases and then remains as it was.

    Active = Confirmed - Recovered

    Active denotes the present case load the state has to bear.

    A bulk of cases in India are aysmpotmatic. The ICMR has found asymptomatic to be infectious up to 4-5 days.

    This is because people mostly contacts or arrivals from hotspot states test positive initially and after a few days test negative in many instances.

    Meaning, after 10 days they let you out and they do not even bother to test at the end of the period.
    Last edited by Double Edge; 13 Jun 20, at 16:35.

  9. #609
    Turbanator Senior Contributor Double Edge's Avatar
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    PHILIPPINES IN A NUTSHELL
    Filipinos: does not follow the rules
    COVID infected people rises
    Filipinos: blames the government
    More common than we think ; )

  10. #610
    Senior Contributor Oracle's Avatar
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    Warning: 3-4 Covid-19 victims being taken to a crematorium in a single medium sized ambulance, handling of their bodies, staff at the crematorium not having adequate body kits etc.
    Politicians are elected to serve...far too many don't see it that way - Albany Rifles! || Loyalty to country always. Loyalty to government, when it deserves it - Mark Twain! || I am a far left millennial!

  11. #611
    Senior Contributor Oracle's Avatar
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    This is what Covid-19 has done to the country, the ordinary people, the system, businesses. And no country, not even mighty USA talks about holding communist China to account, why? Why is no country, no leader holding Xi Jingping/CPC accountable? F communists.
    Politicians are elected to serve...far too many don't see it that way - Albany Rifles! || Loyalty to country always. Loyalty to government, when it deserves it - Mark Twain! || I am a far left millennial!

  12. #612
    Senior Contributor Oracle's Avatar
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    Quote Originally Posted by DOR View Post
    How many lives were saved?
    Not much. More lives have been lost, and will be lost in future due to this lockdown.
    Politicians are elected to serve...far too many don't see it that way - Albany Rifles! || Loyalty to country always. Loyalty to government, when it deserves it - Mark Twain! || I am a far left millennial!

  13. #613
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    Quote Originally Posted by Oracle View Post
    This is what Covid-19 has done to the country, the ordinary people, the system, businesses. And no country, not even mighty USA talks about holding communist China to account, why? Why is no country, no leader holding Xi Jingping/CPC accountable? F communists.
    Sorry, the CCP ain't the one to blame on this one. It's a bug and they did their best to lock it down (they quarrantine an entire province, remember). Yeah, they acted too late but hindsight is always 20/20 but seeing how the rest of the world fared, no one was going to stop it.

  14. #614
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    Quote Originally Posted by WABs_OOE View Post
    Sorry, the CCP ain't the one to blame on this one. It's a bug and they did their best to lock it down (they quarrantine an entire province, remember). Yeah, they acted too late but hindsight is always 20/20 but seeing how the rest of the world fared, no one was going to stop it.
    ^ Hmmmm, what you've said is true. Why don't you take a vacation sometime. No homes in the Canadian wild, like the ones I see on YouTube? Cut down a tree for firewood, kill a deer, roast it. Have your own YouTube channel and post videos. Sounds nice, nah?

    But who is responsible then? I don't blame Chinese who eat bats. They have been eating bats and other exotic animal for decades. China's Wildlife Act?
    Politicians are elected to serve...far too many don't see it that way - Albany Rifles! || Loyalty to country always. Loyalty to government, when it deserves it - Mark Twain! || I am a far left millennial!

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    I do go on vacation. I went fishing and I do hunt but forget about roasting a deer right after you drop it. The meat is too tough. You have to hang it for a few days. Cutting down trees for firewood has to happen in the spring for it to dry through the summer. Wet/green logs don't burn. I have a hunt camp with electricity and running water. Outhouses gets old real fast and besides, I don't go out when the musquittoes are out.

    Who is responsible? Mother Nature. It's a natural freaking virus. It found a way into a human host and that's that. There's no blame here. It is what it is.

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