Thread by @roshankar

For friends in media, academia, state, market and civil society, here's a thread on #coronavirusindia #CoronavirusReachesDelhi #Covid_19, here's a thread on the complexity, science, public health issues and city governance and capacity that will help inform your work/actions.

The Coronavirus outbreak originating in Wuhan has about 20% severe cases and 2% deaths. This is a heuristic average based on data from different countries. Reports on the incubation period are anywhere from 14-24-28 days. Citizen, community, city, state and national actions reqd.

The most interesting state response (from a public outreach and guidelines perspective) has been Singapore. Not too well to begin with but is seizing the moment with some great work.

PM address: youtube.com/watch?v=ZyZwtK…
Guidelines: moh.gov.sg/covid-19

The two most important links to keep your literate and educated from an individual and technical perspective that most countries across the world are following are:

Detail: who.int/news-room/q-a-…
Guidance: who.int/emergencies/di…

This is the base minimum to do and know.

Many think >20% or more of humanity will be infected due to a lack of baseline immunity and therefore herd immunity. However, as an example, the 2009 H1N1 flu infected 16% of all humans. It may not be so bad, it may be. We are still trying to know more about strains and travel.

Most cases are mild. Most estimates suggest 80% of COVID-19 cases are mild and feel roughly like a flu. That's why it is dangerous.

The most important individual response:

1. WASH HANDS
2. STAY HOME IF ILL
3. COVER COUGHS/SNEEZES
4. KEEP AWAY FROM UNSANITARY/OUTSIDE FOOD

10-15% cases will require hospital visits and 1-3% will require ICUs. These estimates and percentages are global heuristic averages once again that attempt to incorporate testing rates and spatial density. Budgeting state finances and capacity around this is paramount.

Some datasets and visualizations that are useful to play with and incorporate/integrate city/state/national datasets are with the WHO and here:

arcgis.com/apps/opsdashbo…

github.com/CSSEGISandData…

coronavirus.scientificanimations.com

twitter.com/yaneerbaryam

Better to err on the side of caution as an individual and paranoia as a state. Using underlying dynamics, probability, exponential/multiplier growth seen through regular testing with stringent action is the path forward. Reduction in connectivity key as are local communities.

Countries to be careful with as of now: Italy, Iran, Germany, France, Spain and the US. China is now showing decline. Much to learn from them and Singapore.

https://twitter.com/yaneerbaryam/status/1234615026335600642

How states could respond:

https://twitter.com/noahmp/status/1233588173197852681

On response to pandemics:

https://twitter.com/nntaleb/status/1221486205847646208

Response of businesses, usage of color zones and individual/community/government response on this thread.

https://twitter.com/yaneerbaryam/status/1234500411970723841

For all the academic research on CoVid:

ncbi.nlm.nih.gov/research/coron…

For the best current solution for treatment (trials still on): ncbi.nlm.nih.gov/pubmed/32074550

Indian paper from IIT Delhi's Biological sciences school has been redacted.

Like SARS in receptors. Close to H1N1 in scale.

Any national, state or city government's response should be based on 7 verticals:

1. Health
2. Transport/Mobility
3. Data and IT
4. Public Communication and advocacy
5. Outreach and Coordination with Market and Society
6. Strategy
7. Infrastructure

Without causing panic, there should public communication and advocacy on components of individual/state response on IVR, news (print/electronic), TV stations, radio stations, social media platforms, digital broadcasts, apps on Google app store and highly ranked Alexa websites.

Masks are usually not very useful but should be utilized. More important is not touching the face and using gloves if infected.

Hospitals (private and public) need offline and online retraining to live and fight this disease.

Large-scale testing and kits with protocols needed.

Maintaining clear command and control of hospitals is necessary but not sufficient. Hospitals could explore consultations on Whatsapp with a dedicated helpline and team of doctors. This would reduce anxiety and allow for social distancing or panic travel.

Paying people to report could be good. If society, ASHA, Anganwadi and DSHM staff can be used properly in coordination, we can pre-emptively intervene before cavalier patients cause much damage. List of citizens who have travelled to at-risk countries over 60 days is needed.

State capacity in no Indian city will be enough. There will need to be coordination between national, state and private medical institutions like hospitals, health centers, nursing home and doctors. MCI, DMC, private hospitals, Delhi Government and GoI will have to work together.

It may be prudent to consider finishing off quickly wings of large hospital projects to add additional capacity on ground as separate CoVID hospitals. Given reduction in growth in China cases today, it may seem like a relief but it'll probably have at least two waves to hit us.

Compartmentalizing, augmenting and retraining/refurbishing critical private/public hospital human and physical infrastructure is the most critical issue at hand of all states, municipal corporations and districts. As also streamlining of medical and pharmaceutical supply chains.

A partnership with @Facebook, @Twitter, @TikTok_IN and Whatsapp as well as cell phone operators and regulators like @TRAI, NIC, @reliancejio, @VodafoneIN, @Idea and @airtelindia that restrict fake and unscientific news and promotes public interest messages is massively important.

@Facebook @Twitter @TikTok_IN @TRAI @reliancejio @VodafoneIN @Idea @airtelindia Important to ensure that waste, water and energy infrastructure is well maintained and operationalized to ensure that any lockdown or reduction in connectivity or mobility doesn't have side effects on quality of life.

@Facebook @Twitter @TikTok_IN @TRAI @reliancejio @VodafoneIN @Idea @airtelindia Time to be innovatively technocratic, effectively bureaucratic and open-sourced democratic. It is better to have clear command and control with decision making, be informed to action by the world's best data and insights and open-source it with communication in local languages.

@Facebook @Twitter @TikTok_IN @TRAI @reliancejio @VodafoneIN @Idea @airtelindia Creation of central, district, assembly and ward control room must be done with locally elected representatives who must play their role in this pandemic. It's a few tens of thousands of people in India who are given prestige and power by the people. Time to put it to good use.

@Facebook @Twitter @TikTok_IN @TRAI @reliancejio @VodafoneIN @Idea @airtelindia Outreach and standardization in data/strategy is needed across state and city boundaries. The police, paramilitary, non-profit sector, civil society organizations and military might be required for citizen and community action of different kinds. They must be on standby prepared.

@Facebook @Twitter @TikTok_IN @TRAI @reliancejio @VodafoneIN @Idea @airtelindia If I had to sum all of this, the best response for Corona Virus is:

1. Country: China
2. City/State: Singapore
3. Individual: One who doesn't panic, communicates and self-reports.

Good luck fellow citizens. Hope we scrape through this.

Focus on health/education not war.