Important!

British Columbia, Canada, declared they will restrict travel between health zones: Divide and conquer strategy is key to winning.

Next step: Stop transmission by rapid identification and supported quarantine.

Here is the roadmap:

1/

covidactiongroup.net/roadmap-to-eli…
India's cases and deaths continue to reach all-time highs.

Multiple reports on double mutant variant are inconsistent about its role. Limited sequencing being done. It may well be important. Reports of a tripple mutant variant surfacing.

Vaccines at risk.

2/
"Rajeshwari Devi, 58, died on Sunday after waiting for two days to get uninterrupted oxygen, an ambulance and a bed in a Covid-19 hospital.

"She kept waiting and gasping but it was too late by the time help arrived.

3/

bbc.com/news/world-asi…
"She was taken to a hospital emergency room on 16 April after her oxygen saturation level dropped. Her CT scan showed that she had developed chronic pneumonia.

"But without her Covid report the hospital refused to admit her.

4/
"She spent around 36 hours in emergency room on oxygen support in the northern Indian district of Robertsganj. The staff there told her family they were running out of oxygen and she needed to be moved to a bigger hospital but there was no ambulance or any promise of a bed.

5/
"The desperate family took her in their car to a hospital where a bed had become available after the intervention of a politician. She had no oxygen support in the car - she died minutes before she could be admitted to hospital.

6/
"Ashish Agrahari, her son, says his mother "would have had a chance at survival if treatment was given in time".

"Heartbreaking stories such as this are coming in from across India as a second Covid wave wreaks havoc.

7/
"But the county's healthcare system is crumbling amid the surge in cases - doctors say it's hard for them to "see the light at the end of the tunnel this time".

8/
"Experts say this rapid increase shows that the second wave is spreading much faster across the country. Dr A Fathahudeen, member of Kerala state's Covid taskforce

9/
"said the rise was not entirely unexpected given that India let its guard down when daily infections in January fell to fewer than 20,000 from a peak of over 90,000 in September.

10/
"Dr Fathahudeen said there were warning signs in February but "we did not get our act together".

"I said in February that Covid had not gone anywhere and a tsunami would hit us if urgent actions were not taken. Sadly, a tsunami has indeed hit us now," he added.

11/
"A false sense of normalcy crept in and everybody, including people and officials, did not take measures to stop the second wave."

12/
"Sanjeev Gupta, a photojournalist based in the central Indian city of Bhopal, reached one of the city's crematoriums for what he thought was a usual assignment last week.

13/
"Mr Gupta says he was moved when a young man asked him to photograph the smoke coming out from the chimney of the electric crematorium.
"He said the smoke represented his mother. It's the most heartbreaking thing I have ever heard."

14/
New Zealand is barring travelers who've visited India -- including New Zealand citizens.

By comparison, the US is merely advising that Americans avoid travel to India -- while not placing any formal restrictions.

UK is denying entry to travelers who have visited India in the last 10 days, with exemptions for its own citizens, who may enter the country but must quarantine in a government-approved hotel for 10 days. Such mandatory quarantines are key in any exemptions to a travel ban.

16/
Notably, however, the UK is applying this restriction *after* letting at least 103 cases of the Indian variant enter the country. There is now community transmission of the new variant in the UK (i.e., several cases have been detected with no links to international travel).

17/
The critical time to apply travel restrictions is *before* a new variant enters your country, not after. We have known about the Indian variant -- and the country's rapid increase in cases, which may be linked -- for quite some time.

18/
We recommend all countries immediately impose travel restrictions, including mandatory quarantine, for any travelers arriving from India.

Such restrictions should also apply to other countries where the Indian variant has been found, including the UK.

19/
With 6.37% of the world partially vaccinated, and 2.6% fully vaccinated, we have barely reached any level of population immunity worldwide. We can continue to expect new variants, which will potentially be more infectious and more vaccine-evading than existing ones.

20/
Thanks to @geekblake for helping prepare today's update.

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More from @yaneerbaryam

19 Apr
How can airlines claim flights are safe when there is no record of who was infected on board.
"There is a new record for the number of coronavirus infections traced back to a single commercial airline flight. A whopping 47 passengers..from New Delhi to Hong Kong April 4 have since tested positive for Covid-19. That number represents 25% of the 188 passengers on board.

1/
"All passengers..had tested negative for the virus within 72 hours prior to departure, in keeping with Hong Kong’s travel requirements. Yet 25 travelers tested positive immediately after landing in Hong Kong, and a further 22 cases were discovered on day 12.

2/
Read 7 tweets
19 Apr
Canada’s Crazy Pandemic Response
"As the third wave built and now may drown us, our leaders keep blathering about ‘balance.’

"If you want to know how crazy the COVID-19 crisis has become in Canada, just listen for a moment..

@TheTyee thetyee.ca/Analysis/2021/…
"to Quebec Premier Francois Legault.

“We’ve had no choice but to lock down, reopen, lock down, reopen,” protested the premier last week as he acknowledged how fed up people are with Canada’s disastrous yo-yo approach to COVID-19.

2/
“The idea is to try to find a balance,” added Legault. “When we lock down, it’s to protect people’s physical health; when we reopen, it’s to help their mental health.”

3/
Read 7 tweets
19 Apr
India day after day huge increases: 160,694; 185,248; 199,569; 216,850; 233,943; 260,778; Today 275,306. Urgency of actions to stop it is apparent.

1/
Fire plot shows there are states that could be green zones even now.

Strongly suppress where it is, protect where it isn't, contract geographically.

2/
Thailand has a new outbreak with daily cases: 985; 965; 1,335; 1,543; 1,585; 1,547; today 1,767

Past three days at about 1,550 gives some hope it will be under control soon, despite increase today. Next few days we will find out.

3/
Read 4 tweets
18 Apr
More clarity on breakthrough infections (people who get infected after having been vaccinated) is available. CDC data shows that of these breakthrough infections, 7% were known to be hospitalized and 1% died.

1/

nbcnewyork.com/news/coronavir…
In other words, according to this data, when someone does get a breakthrough infection, they have a similar chance of death as someone who got infected without being vaccinated. (Of course, vaccination does a lot to prevent infection in the first place.)

2/
The effect of variants? "Some of the breakthrough infections are thought to stem from certain strains of the virus that may be more resistant to vaccines, experts say. They also say some highly contagious variants may pose a greater risk of reinfection from other variants"

3/
Read 7 tweets
16 Apr
Iran: Middle East's hardest-hit country Thursday reported 321 new deaths, 25,078 new cases. Widespread travel, weddings, celebrations during Iranian New Year starting March 20 cause surge in cases and deaths. Will be worse in upcoming weeks.

1/

reuters.com/world/middle-e…
Sweden: Ongoing failure

Highest European cases past week per capita: 625 new infections per million, 7-day average.

Compare 521 in Poland, 491 in France, 430 in the Netherlands, 237 in Italy, 208 in Germany.

Other Scandinavian countries much lower

2/

theguardian.com/world/2021/apr…
UK: Over the last seven days cases declined almost 7% compared with a week earlier. However, since Wednesday cases have increased somewhat.

reuters.com/world/uk/uk-re…
Read 4 tweets
16 Apr
Some steps taken today toward stronger action in Ontario.

Still needed:
1. Paid sick leave and financial support for those who have lost income as well as enforcement of stay at home measures

1/

cp24.com/news/ontario-t…
2. Internal province travel guidelines as well as inter-province travel restrictions
3. Free isolation and quarantine for people who are sick to protect family members and housemates

2/
4. Essential services with much better protection of workers and customers.
5. Better allocation of vaccination to prevent transmission

3/
Read 4 tweets

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