Rajeev Jayadevan Profile picture
May 2, 2021 11 tweets 4 min read Read on X
Did elections contribute to the COVID-19 surge? We are always tempted to say yes. I decided to do a comparison. Surprisingly, the graphs I obtained from election & non election states are near-identical. This suggests that the wave is a seasonal surge in a geographic region.
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The two images represent election states (where big outdoor gatherings occurred) on the right, and comparable non election states on the left. I have included two sets of pictures. The names of the states are on the graph. If you compare the timelines, it is near-identical.

2/9
The question is whether the surge would have occurred anyway, by pattern, and maybe the large election rallies amplified it to an extent.

This virus behaves in a wave-like pattern in most nations. The reason for the steep upward slope is exponential increase.

3/9
Exponential curves are gentle at first, when numbers are small.

As they increase by geometric progression, the time taken for a large number to double is the same as for a small number to double.

Hence it turns steep after a long and gentle rise.

(See pics)

4/9
As the surge breaks, the downtrend that follows also is exponential. That is an exponential DECLINE.

After the peak, the transmission apparently stops suddenly; the graph shows a steep downward slope (reason is unclear: definitely not “herd immunity”, weather or lockdown)

5/9
The same pattern is seen in multiple nations and might reflect the behaviour of the virus in a region. Human intervention is not enough to explain the sudden drop, as not all nations have done the same measures such as “lockdowns”. See my graph below that compares 6 nations.
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I am writing this thread just to show that our understanding of repeating waves of the pandemic are far from perfect.

Why the virus only “hangs around” in a region only for about 3.5-4 months, and returns 2-3 times a year is a mystery.

7/9
Solving this mystery might give us the key to outwit the virus & the pandemic.

e.g. Do a swarm of viruses have an genetic activation key that turns itself off at a particular time point?

Do they reactivate themselves into hyper mode after a period of quiet endemic spread?

8/9
Finding solutions requires out-of-the-box thinking.

My instinct is that there is something very important about viral behaviour that we are missing altogether. It might be the elephant in the room.

9/9

@PeterHotez @VirusesImmunity @doctorsoumya
@GKangInd @angie_rasmussen
Graphs obtained from covidindia. org
One can see that states like Maharashtra and Kerala (which have high numbers of overseas travel) have shown a sight endemic tendency between waves, the edge being rather jagged. Could be multiple separate introductions of the virus into the region, each with its own programming. ImageImageImage

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More from @RajeevJayadevan

Apr 30
Need to add “category 4” for severe dog bites @WHO

Children get bitten on their face, head & neck by rabid dogs due to their small size. As wounds are close to brain, there is higher risk of rabies than bites elsewhere.

This category requires special attention, see thread👇 Image
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Rabies is ~100% fatal. Once the virus enters the brain or spinal cord no medication can stop it. Areas of the body like fingertips and face are rich in nerve supply, and wounds in these parts enable more viruses to enter the nerves to travel upstream towards the CNS.

2/
Bites to these areas require special attention and extra care: thorough washing to get rid of all the dog saliva which has the virus in it. Once the saliva with the virus is washed away, there are far fewer viruses left in the wound for vaccine & serum (antibody) to tackle.

3/
Read 8 tweets
Jul 16, 2024
Defects in immune system at 10 months following COVID: research from Medical University Vienna

🔹Innate immunity diminished: ⬇️Natural Killer cells, neutrophils
🔹T cells, B cells diminished: ?Bone marrow effect
🔹TH1 to Th2 switch (shift towards allergic type of response)

1/5


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They compared people who were initially infected (before vaccines) versus uninfected controls. See paper for profile at 10 weeks and 10 months

Anti N declined slower than Anti Spike (also noted by Sarah Beale from London recently among people with Long COVID)

2/
The decline pattern in antibodies was age dependent, younger people showed more steep decline

Those with Long COVID had inverted Ifn gamma/IL-4 ratio, shift from Th1 to Th2 immune response, linked with ‘diminished ability to fight intracellular infection’ and allergies.

3/
Read 5 tweets
Apr 17, 2024
Tuesday meeting highlights 17 April

COVID returns sooner than expected.

This week, 6.7 - 7.3% of COVID tests turned positive, compared to nil the month prior.

Cases mild or asymptomatic (screening), severe disease not yet reported

(The last wave collapsed December 21)

1/6
While the return of COVID is only expected (cyclical), the short duration (3 months) of case-free gap is surprising.

This coincides with Bangalore waste water surveillance @TIGS_India showing viral load in all samples tested.

This means COVID is in circulation.

2/ Image
However, in most instances COVID tests are not done (multiple reasons, discussed earlier) and hence there might be a feeling that it has gone away.

Will monitor for more detailed clinical profile, this being only the first week or so.

3/
Read 7 tweets
Mar 6, 2024
Even among sedentary people, as little as ~4000 steps per day can reduce death / heart disease risk. Maximum benefit at ~9000.

There are many studies on step count, see thread. This paper also looked at how step count helped in a sedentary lifestyle.

1/5
bjsm.bmj.com/content/early/…
There is no such thing as a 10,000 steps requirement for health.

Benefits start at much lower levels.

This study received wide attention, attaching my earlier tweet

2/
In this study among older women, benefits (reduced mortality) were found at 4400 steps per day and maxed out at 7500.

3/

pubmed.ncbi.nlm.nih.gov/31141585/
Read 5 tweets
Mar 2, 2024
“Bed Rest” leads to loss of muscle

In healthy people over 60, just ten days of bed rest led to 1 kg muscle loss from the lower limbs.

Worse in people with illnesses.

In fact, there are very few real indications for “bed rest” now.
Exercise and early mobilisation is key.

1/6
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Also called sarcopenia, this is a serious problem especially in the elderly, who might suffer an abrupt decline in their health as a result. Frailty creeps in, and once they lose their muscle/bone strength, falls and other complications occur.

Also affects younger people.

2/6
How to prevent muscle loss

1. Do not do bed rest unless absolutely indicated. It is often needlessly prescribed.

2. If rest is needed, one can do exercises while still lying in bed, preferably with expert help from a physiotherapist.

3. Moving the joints gently helps.

3/6
Read 5 tweets
Feb 17, 2024
Long COVID study from Japan, published in Nature answers many questions

🔹At 1 year, 20.7% had it, higher in adults.

🔹Most initial infections (89%) were mild, 60% had Omicron

🔹Vaccine has no preventive effect

1/3


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🔹Risk higher in adults than children

🔹Adults 30-60 at high risk, women 2 x likely to get it

🔹Smokers, diabetics at higher risk

🔹If symptoms last more than 3 months, 60% continue to have it for over a year

🔹At 1 year, 13.4% had symptoms interfering with daily life

3/3


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Read 4 tweets

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