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Giridhar Profile picture
@epigiri
Aug 26, 2020 • 5 tweets • 5 min read • Read on X
#covid19 #deaths in India & other nations, here I explain several ways to have reliable estimates. Of all range of estimates, the probability of deaths being actually lower should not be ignored. In the absence of data, if undercounting is possible, so is over-attribution 1 of N
First, deaths due to #COVID19 are far lower compared to other reasons. @DMavalankar and Dr Divya Nair explain why we should not focus too much on India’s COVID-19 #Mortality and not loose focus on deaths due to other Diseases. science.thewire.in/health/indias-… 2 of N
Second , as Prof K Srinath Reddy of @thePHFI explained here, a sharp spike in home deaths over a long period is also not likely to go unnoticed. bbc.com/news/world-asi… 3 of N
Young age, cross-immunity and genetics might have had a role to play why India and other countries have low mortality. We need more studies to understand the mechanisms.

thewire.in/health/intervi…


dsprdpub.cc.ic.ac.uk:8443/handle/10044/1… 4 of N
In the short term, comprehensive death audits will be of use. Here is by Kerala. health.kerala.gov.in/wp-content/upl…

Medium term: Verbal autopsies can guide to understand comprehensive causes of #death. @countthedead

Long term: Improve #MCCD and link to #EHR. N ofN

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More from @epigiri

Giridhar Profile picture
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
Giridhar Profile picture
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
Giridhar Profile picture
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
Giridhar Profile picture
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
Giridhar Profile picture
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
Giridhar Profile picture
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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