Giridhar Profile picture
Jul 26, 2020 12 tweets 8 min read Read on X
In India, the following are the latest weekly incremental increase in absolute value
• Testing / Week: 25 lacs
• Positive / Cases: 2.3 lacs
• Deaths : 4150

Data analysis: Jeeavanrakshe
For more details, send email to:
Mr Mysore Sanjeev email: jeevanrakshe1@gmail.com

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The 7 day and 30 day moving average growth rates are in this graph.

Too early to say, but we might have begun to plateau with several other conditions

1. Parts of central India is yet to peak; can alter the trajectory
2. Need to wait out for the surge in southern states

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Compared to nations having more than 100K COVID cases, the death pattern
a. Average #DPM is 151 v/s India's current DPM of 19.5
b. Highest DPM of a nation is 665 and least is 15
c. Tests per Mn Population 45760 v/s India; 9480
d. Cases / Mn Population 3478 v/s India: 740
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Several factors will influence India's future DPM

a. Test positivity directly proportionate to testing
b. Recently launched medication and plasma therapy
c. Limited health infrastructure and manpower especially medical professionals
d. Tier 2 & 3 cities yet to peak

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India’s current mortality rate is 2.5% dropped over the last few weeks there is a drop in mortality rate, primarily due to sharp increase in the denominator (number of positive cases).

Death per million is steadily increasing in several cities, towns; currently 20.

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Testing Data
India 9480 Tests per Million (TPM)
18 nations >100K COVID: 45760 TPM
India’s Test Positivity 6.9%.
Tamil Nadu has tested highest number of people in India. It has tested 1.88 Mn people, which indicates 24145 tests per million population.
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Testing Data
Andhra Pradesh is a star performer: 3.5% Positivity rate, below National rate of 6.9%, only state having more than 2,000 Positive COVID cases in all districts.
MH has highest 19.8% positivity.
WB 6925 TPM below national average. High mortality rate of 6%.
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EAG states Testing

Bihar 2951 TPM, least among all states and UTs in India. Test Positivity 6.9%,

In Uttar Pradesh, cases per million population has increased from 75 to 208 in a span of 4 weeks, 6,000 TPM

Rajasthan cases per million has increased 4 times TPM is 14800

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Mortality Trend in EAG States

Low mortality rate (1.6%) and Deaths per million population (2) compared to the national average of MR of 2.5% and DPM of 19.

Testing rates should increase drastically with improved surveillance mechanisms for improved case detection.

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#Delhi data

Highest recovery rate of over 86%: most are mild
30-day moving average growth rate of active cases is (-)6%.
Death Per Million population has increased from 106 to 182, highest among all states & UTs in India
Mortality rate of 3%, highest in the country

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Vast majority of India’s population lives in semi-urban & rural areas which has relatively weaker health infrastructure. Over last 2 weeks number of deaths in semi-urban and rural areas are higher than in mega cities. The strategy for these areas should be strengthened.

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The outbreak in micro states and union territories is not yet a major concern, small sample, sparse data bias.

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More from @epigiri

Dec 30, 2021
However mild #Omicron is, it is not a vaccine. There are deaths and hospitalizations due to this variant.

Stay away from misinformation.
Compared to Vaccination, natural infection could not protect population (against death or hospitalization) against any variant (Alpha, Beta, Gamma or Delta).

Proponents of Herd immunity are saying it again; #Omicron would provide herd immunity.

Evidence matters, not opinions
During delta wave, this is what we knew based on #Epidemiology of infectious diseases.
-This is not the last variant.
-There will be another wave.

Same would hold true for Omicron.

thehindu.com/sci-tech/scien…

newindianexpress.com/nation/2021/ap…

m.rediff.com/amp/news/inter…
Read 4 tweets
Nov 26, 2021
More actions points can be following :-
1. Since day of 1st case of #Omicron #B.1.1.529, establish travel history & identify secondary transmission throughout world. If primary case was in early November, not difficult to miss areas of circulation.
1ofn who.int/news/item/26-1…
2. Botswana, South Africa & Hong Kong cannot be the only areas where #Omicron has travelled. These areas are the ones that have probably better surveillance and genomic sequencing and hence have reported in timely manner. Absence of reporting is not absence of circulation.
2 of n
3. Imposing travel restrictions, restricting entry from few countries is NOT going to help either prevent or control the spread of #Omicron. It’s akin to closing stable door after horse has bolted. Instead, identify cluster of cases of recent origin & do genomic sequencing.
3/n
Read 11 tweets
Nov 17, 2021
Brilliant study done in China, If scaled up, blood pressure reduction (-26.3 mmHg) achieved by training lay health workers can reduce significant mortality in LMICs.

abstractsonline.com/pp8/?_ga=2.141…
-Globally, >17.9 million people die each year CVDs.
-Hypertension related CVDs contribute a significant proportion
-Chinese study shows some of these deaths & disability are preventable.
-Train lay village workers in BP measurement, counseling & provide affordable drugs.
-In India, @docraghu8 et al showed overall estimated prevalence for hypertension in India was 29.8%.
ncbi.nlm.nih.gov/pmc/articles/P

- A study showed 44.7% Indians are aware of their diagnosis, 13.3% are treated, & 7.9% have achieved control.
sciencedirect.com/science/articl
Read 5 tweets
Oct 30, 2021
Sudden cardiac arrest & Sudden cardiac death (SCD) refer to the sudden cessation of cardiac activity with hemodynamic collapse, typically due to sustained ventricular tachycardia/ventricular fibrillation; mostly occur in patients with previously undiagnosed diseaes.
1 of N
Results from Framingham heart study suggests that more men are affected with increasing age.
Not rare, 15 percent of the total mortality in the United States & other developed nations is due to SCD. (pubmed.ncbi.nlm.nih.gov/11684624/)

2 of N https://www.sciencedirect.com/science/article/pii/S000287039
-It is the initial clinical manifestation of 15% of coronary heart diseases (CHD).
-SCD is the mechanism of death in over 60% of patients with known CHD.
-Risk increases by a number of factors: Age, underlying cardiac diseases, post-menopausal women, CHD risk factors
3 of N
Read 20 tweets
Aug 12, 2021
This tweet thread is about the results from the second serosurvey done in the #Karnataka state. Ahead of sharing the link, some caveats first.
1. The @DHFWKA has used the data from this round of serosurvey in late March to update testing and surveillance strategies.

1 of N
2. The study found Lower levels of IgG seroprevalence, mostly due to antibody waning.
3. A substudy was done to confirm the antibody waning. This study was delayed due to rapid surge of cases in April.
4. We found near 0 prevalence of active cases during mid-February 2021.
2/n
5. There was a subsequent surge seen in Karnataka state due to a mix of alpha, delta which was picking up speed in April, and a large susceptible population were infected.
6. Results from the substudy on antibody waning was necessary for releasing the final report & paper.
3/n
Read 8 tweets
Aug 2, 2021
Polio anywhere could be a threat to countries that had eradicated it. It took decades to eradicate polio in most parts while some are yet to eradicate. Not just this necessity, it was possible mostly due to a collaborative approach & strong leadership at the global level.
1/N
Lessons from Polio Eradiation, Cochi S et al
-Strong political & social support in each country
-Strategic planning & policy development
-Partnership management & donor coordination
-Program operations & tactics
-Oversight and independent monitoring.

polioeradication.org/wp-content/upl…

2/N
If there was high polio circulation in one region, other countries could prevent the possibilities of its import by vaccinating the children in their countreis. Therefore, all countries are continuing polio vaccination till other regions accomplish eradication.

3/N
Read 11 tweets

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