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Demographic breakdown by Age for India and Italy, and Death Rate by Age for #COVID19.
#CoVID19

Global Case Fatality Rate (CFR): 3.5%
[(3800 deaths / 110,000 confirmed cases) X 100]

1. CFR will come down as more people are tested.
2. Unlike flu, CoVID19 has to be tested. Millions may have it but recover without having gotten tested, i.e. CFR may be inflated.
As PM @narendramodi said: "Say no to panic, say yes to precaution".

My views on #CoronavirusPandemic, on @TimesNow with @PadmajaJoshi. Please do watch. #IndiaQuarantinesCorona
South Korea is just a league apart. In addition to containment and health measures, the more testing you do, the more confirmed cases you will find, the lower would be your death ratio (defined as deaths by confirmed cases). Lower death ratio means less panic. #COVIDー19
The UK Chief Scientific Adviser Sir Patrick [ex R&D Chief GSK] wants 36 million Brits to get infected with CoVID-19. This 'Herd Immunity' plan - to stave off subsequent CoVID waves - is opposite to what every other exposed nation is pursuing and is fraught with danger. RETHINK.
Fantastic breakthrough by German scientists, just published in Cell (cell.com/action/showPdf…) and today corroborated in PNASc (pnas.org/content/pnas/e…) that CoVID19 employs human TMPRSS2 protein for entry.

Existing anti-TMPRSS2 drug Camostat (+E-64d) blocked CoVID19 infection.
Camostat Mesylate, the drug shown by German scientists to effectively block corona virus CoVID-19 infection of lung cells, is apparently made by Sun Pharma in India and sold as Camopan. It is approved for human use in Japan but is not FDA-approved.
Update on approved drugs that effectively block Corona virus entry into human cells:

1. Excellent study showing entry of SARS corona virus is blocked by combination of two drugs: Camostat + Bafilomycin A1. This was 8 years before the current German study. jvi.asm.org/content/jvi/86…
2. A 2016 study showing the FDA-approved drug Nafamostat able to block MERS-Corona virus entry into host cells ten times more effectively than Camostat.

#CoVID19, as shown by the Germans, uses the same mechanisms as SARS & MERS for host cell-entry. aac.asm.org/content/aac/60…
3. A 2016 study showing FDA-approved drug Teicoplanin able to block MERS-and SARS- Corona virus entry into human cells.

Given its low toxicity, the scientists proposed its use in the clinic for MERS- and SARS-CoV infections in an emergency. jbc.org/content/291/17…
4. A 2015 study showing a combination of drug K11777*/SMDC256160 (currently undergoing clinical trials against hookworm disease), and Camostat blocks Corona virus entry in a lethal SARS-CoV animal model.

Both serine- and cysteine proteases were targeted. reader.elsevier.com/reader/sd/pii/…
5. Summary: Drugs already in use, that block entry of SARS-, MERS-, and #CoVID19 in human cells (in vitro + 1 animal study), and whose combinations inhibit TMPRSS2 & Cathepsin-mediated pathways, crucial for Corona entry.

A. Camostat
B. Bafilomycin A1
C. Nafamostat
D. Teicoplanin
Note: Although these drugs are approved for human use, none of them have been tried for their potency in Corona-infected humans. But given the choice doctors are having to make in Italy - who to save: young or the elderly - their use could be an option.
EXCELLENT advice. Even though the PSV23 vaccine is ineffective against virus, it will help protect the elderly against 23 pneumococcal bacterial strains, so that when they do get CoVID19, their bodies will not succumb to opportunistic bacterial infections.
Sobering paper just out, on Chloroquine as a drug against #CoVID19. It's anti-viral nature has been known since the 1960s; and it works really well against CoVID19 as well, but only in cell culture (in vitro). In animals and humans, not so well. @elonmusk sciencedirect.com/science/articl…
Contd /- A 2006 study showing Chloroquine to be totally ineffective against SARS Corona virus-infected animals. The scientists believed Chloroquine was useful only for ameliorating hyper-inflammatory response. journals.sagepub.com/doi/pdf/10.117…
As India reaches a decisive stage in her battle with Corona virus, my views on the issue and why we need to proactively protect the elderly as they are most vulnerable to CoVID19 infection among all age-groups. #IndiaFightsCoronavirus
Interesting paper just out [non-peer-reviewed]: SARS-CoV2, that causes CoVID19, may use a second mode of entry into human cells through CD147 or Basigin, also used by Malaria parasite for entry.

Approved anti-CD147 antibody Meplazumab blocks corona entry. biorxiv.org/content/10.110…
Well-done, NIV, Pune. CoVID-19 cell-culture facility must be established immediately to allow Indian scientists and pharma companies to test approved drugs and small molecules against CoVID-19 ASAP. We are already more than a month behind others in this. zeenews.india.com/india/india-fi…
As Italy struggles, and as @realDonaldTrump mentions Chloroquine and HydroxyChloroquine as treatments for SARS-CoV, I think of an Italian who proposed this first. 17 years ago.

Grazie, Dr Andrea Savarino (@istsupsan). The world owes you a debt. thelancet.com/journals/lanin…
In the 2016-17 Flu season an estimated 24,981 Italians aged 65 and above died from Flu (143 per 100,000 population).

4,200 deaths per month. Not because of #CoVID19 but Seasonal Flu.

Did you know of this back then? ijidonline.com/action/showPdf…
In a (non-peer-reviewed) paper published today, scientists from Hong Kong report on stability of the corona virus that causes CoVID-19.

Strikingly, a significant level of infectious virus could be detected on the outer layer of a mask even after a week. medrxiv.org/content/10.110…
Interesting study published (non-peer-reviewed) today by Prof @alexlachmann, that estimates CoVID-19 cases in China could be as high as 702,000 and not 80,000 as reported. medrxiv.org/content/10.110…
Two (non-peer-reviewed) studies published today with non-Human primates infected with SARS-CoV-2 disclose that the virus is intermediate in its severity between MERS and SARS-CoV-1, and that reinfection DOES NOT occur once the monkey is cured of CoVID-19. biorxiv.org/content/10.110…
Live @10DowningStreet: The UK is planning to totally isolate its 1.5 million vulnerable population for 3 months.

This is what one of its top scientific advisors had said a week ago: Ideally I'd like to isolate all the vulnerable and expose everyone else to a "nice big epidemic".
A great resource of all the CoVID-19 tests currently available or awaiting approval.

The simple Antibody test - that detects antibodies against SARS-CoV2 in blood using a SARS-CoV2 protein (probably the Spike protein) as bait - would greatly help India. finddx.org/covid-19/pipel…
Why is it VITAL for India to procure Antibody test?

1. Will increase testing speed, allowing more of the infected to be isolated.
2. Will give us, and this is CRUCIAL, an estimate of the population already cured of CoVID-19 (i.e. has antibodies but no disease). @drharshvardhan
10% of Human genome is made up of viral DNA. It is vital for our survival and, among other things, fetal development.

Humans already have parts of SARS-CoV-2 (CoVID19) Spike protein [prefect N-terminal match with Human Ephrin Receptor. Analysis predicts it to be a signal.]
India must procure CoVID antibody test IMMEDIATELY. It will not only greatly aid the social distancing effort, but also give VITAL epidemiological data necessary to quell panic.

This and other points, on @TimesNow with @RShivshankar. #StayHomeIndia
Excellent (non-peer-reviewed) study published today by Indian scientists reveals a unique mutation in the Indian SARS-CoVID-2 strain, and also that the potently anti-viral human microRNA (miRNA) hsa-miR-27b has a target ONLY in the Indian strain. biorxiv.org/content/10.110…
#CoVID19 March 24 status:

Italy.
Tested: 206,886
Confirmed cases: 69,176
Deaths: 6820
Death rate: 9.8%

Germany.
Tested: 167,000
Confirmed cases: 32,781
Deaths: 156
Death rate: 0.4%
Dear @drharshvardhan, FYI Berlin-based company Pharmact (pharmact-health.com/en/sars-cov-2-…) has now begun shipping its CoVID-19 Antibody detection test, based on 3 SARS-CoV-2 proteins. 100% specificity; upto 92% IgM & 98.6% IgG sensitivity.

India NEEDS this kit at once. Millions of them.
Brilliant idea, dada. @drharshvardhan, please have a look.

In fact, if I may - why not construct an MIP (Mycobacterium Indicus Prani) strain expressing a SARS-CoV-2 protein, e.g. N or the S1 protein? Wouldn't that vaccine elicit stronger immune response?
This is an ESSENTIAL read, by @samirsaran, on how day by day, decision by decision, the @WHO and its Chief @DrTedros sold us out.

Samir tallies the reaction of WHO to SARS-CoV-1 back in 2003, and to SARS-CoV-2 now. The difference is stark, and SCARY. orfonline.org/expert-speak/c…
An NPR study published by @neelbs identifies CoA of the freely available anti-epilepsy drug Epilex binding to SARS-CoV2 RDRP. Another study just identified this drug as binding to Human HDAC2 that is used by SARS-CoV2.

Two birds with one stone. BRILLIANT. osf.io/b8jv4/?view_on…
Interesting paper (non-peer-reviewed) just out from Oxford suggests that by March 19, 68% of the UK population was ALREADY infected with CoVID-19 (R0=2.25).

This translates to the death rate because of CoVID-19 in the UK to be 0.16%, SAME as seasonal flu. medrxiv.org/content/10.110…
A non-peer-reviewed paper published today proposes Theaflavins, found in large quantities in Black Tea, as inhibitors of SARS-Cov-2 (biorxiv.org/content/10.110…).

A 2005 peer-reviewed study found Theaflavins potently inhibiting SARS-CoV-1 protease (ncbi.nlm.nih.gov/pmc/articles/P…).
Unrelated, a team of French & Indian scientists report today (non-peer-reviewed) that Theaflavins, found in very high quantities in CTC Assam Tea not only potently block Hepatitis C Virus entry into human cells, they also prevent cell-to-cell virus spread. biorxiv.org/content/10.110…
Had said this two weeks ago, and I repeat: the only way to quell panic is through true estimation of CoVID death rate (CFR); and that is why it is VITAL to test millions with the antibody test kit [RT-PCR can't tell you if you had CoVID but recovered].
The prolonging or curtailing of the lockdown is inextricably linked to the antibody test.

ONLY the antibody test can give us a true estimate of the extent of spread, or danger, the CoVID epidemic poses for India.

My views on @TimesNow. #StayHomeIndia
Preliminary evidence but I congratulate @dasgobardhan dada, India's top immunologist. He told me the exact same TWO weeks ago.

Paper just out today (non-peer-reviewed) establishes a correlation between CoVID19 cases/deaths and BCG vaccination. MUST-READ. medrxiv.org/content/10.110…
Australia has fast-tracked BCG vaccination trial for CoVID-19. Germany is going to try a boosted BCG variant that has its urease C gene replaced with the listeriolysin gene from Listeria monocytogenes. cc @dasgobardhan bloomberg.com/news/articles/… spiegel.de/wissenschaft/m…
What do our numbers mean, and what should be our plan, as we move in to the next crucial week of the lockdown. My views on @TimesNow with @RShivshankar. #BharatWillDefeatCorona
BRILLIANT. Germany to use the Antibody test to screen 100,000 people at a time and then issue all-clear certificates to them so they can re-enter the workforce. Way to go.

WE NEED TO DO THIS. telegraph.co.uk/news/2020/03/2…
Detailed SNP and dN/dS study of 95 SARS-CoV-2 genomes by Indian scientists published today (non-peer-reviewed) points to a rapidly evolving viral replicative machinery so as to evade host response. [2 of the 95 genomes were from Indian CoVID-19 patients.] biorxiv.org/content/10.110…
A study (non-peer-reviewed) just published, of 133 patients with moderate, severe, and critical cases of CoVID-19 finds the Antibody test superior to RT-PCR detection of SARS-CoV-2. medrxiv.org/content/10.110…
In silico analysis published today (non-peer-reviewed) throws light on the increased infectivity of SARS-CoV-2 compared to SARS-CoV-1.

In binding to human ACE2 to gain entry, SARS-CoV-2 S protein out-competes even the natural ACE2 binder ATR1 by 64% (BA). biorxiv.org/content/10.110…
Fascinating. Always wondered why SARS-CoV-2 infects lungs more than intestines. Turns out intestines have a molecule α-Defensin-5 (HD5) that binds ACE2 receptor and stops the virus from binding to it first, says a study published today (non-peer-reviewed). biorxiv.org/content/10.110…
Like humans, monkeys also produce Defensins, small peptide molecules that are anti-microbial in nature. Here, a 2009 study reports how a monkey Defensin (RTD-1) prevented death in SARS-infected mice.
jvi.asm.org/content/jvi/83…
21% of all Indian CoVID-19 cases attended the Tablighi Jamaat congregation at Delhi. 434 out of 2034 cases.

32% of all Indian CoVID-19 deaths are linked to the Tablighi Jamaat. 19 out of 58.

That's a super-spreader if ever there was one.
“Courage isn’t a matter of not being frightened. It’s being afraid, but doing what you have to do anyway.”

How to Protect the Protectors. A MUST-READ guide for doctors fighting CoVID-19, by Dr Zarir Udwadia, one of India's top chest physicians. reader.elsevier.com/reader/sd/pii/…
Stunning capture at 2000 frames per second by an MIT scientist shows that a human sneeze can travel upto 26 feet.

Each sneeze contains 40,000 droplets and millions of virus particles. This work has direct implications for WHO social distancing guideline. jamanetwork.com/journals/jama/…
Research published today (non-peer-reviewed) by Swedish scientists raises questions regarding the role of ACE2 - human receptor used by SARS-CoV-2 to gain entry - for infection of lungs. The scientists checked for the presence of ACE2 in all human tissues. biorxiv.org/content/10.110…
Anti-SARS-CoV2 antibodies detected in cats. Cats can be infected with CoVID-19 according to a just published (non-peer-reviewed) study. biorxiv.org/content/10.110…
French scientists report today (non-peer-reviewed) of hitting a library of FDA-approved drugs against SARS-CoV-2. AZ and CLQ analogues dominate but another promising drug (EC50 of 5) crops up - Alprostadil, a vasodilator used against erectile dysfunction. biorxiv.org/content/10.110…
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