What is needed now?
Multiple Temporary hospitals providing TIMELY oxygen supplementation to as many people with mild respiratory distress (poor oxygen saturation) to save many lives. Otherwise, most of them go into severe distress and it becomes that much difficult to help.
1ofN
-Use any building to place beds or rapidly construct.
- Have the facilities for triage, isolation
- Oxygen saves lives, have lots of it
- Engage as many health care workers, students & volunteers. Provide them honorarium
- Have many ambulances ready to refer immediately

2 of N
Most people with severe distress will occupy ICU beds for many days. ICU beds are limited, More people with mild oxygen insufficiency will deteriorate further due to lack of oxygen & are at risk of dying. This vicious cycle has to be broken by temporary hospitals + oxygen.
3 of N
There is some evidence from scaling up of temporary scaling up of institutional or home-based oxygen support showing benefit from
China dx.doi.org/10.2471/BLT.20…
Singapore doi:10.7326/M20-4746
Los Angeles: doi:10.1001/jamanetworkopen.2021.3990
4 of N
Dedicated oxygen war rooms in Kerala can be a good model to help people to find oxygen at the nearest place.
It is important to collaborate and onboard volunteers and IT platforms to offer help nearer to homes.


5 of N
This tweet thread is based on the literature references for responding to COVID-19 crisis in India: notion.so/Literature-ref…

For more details,
contact: hqli@stanford.edu

N of N

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More from @epigiri

4 May
Each mohalla clinic, UPHC or any building belonging to the urban local bodies can be turned into Jeevavayu centres to provide oxygen for the needy. People should be able to undergo triage here; those with distress can receive O2 till they get admission or get well & return home.
Many states are saying there is no shortage of oxygen. Why not have more outlets to serve. It is heartbreaking to see people gasping for breath because we are failing to solve the logistics of oxygen distribution.

Fix it, take oxygen nearer to homes and communities.
In a country where ice creams, chilled coke & chips reach every Galli and village, it is simply astonishing to believe that the industry cannot help in solving the logistic crisis of oxygen distribution.

How many Govts have reached out to the industry for help or partnership?
Read 4 tweets
4 May
India’s reproductive number is 1.32.
Assam: RT >2
Eleven(11) states have RT between 1.5 and 2.

1 of N
Highest number of positive cases was reported on 30th April 2021 with 4,020,14 cases, 293 Cases per million. Highest number of deaths was recorded on 1st May 2021 with 3684 deaths reported, 2.6 deaths per million; a test positivity rate of 21% has been reported in India.
2 of N
Epi-curve and RT for India
3 of N
Read 11 tweets
1 May
INSACOG researchers first detected B.1.617, which is now known as the Indian variant of the virus, as early as February, Ajay Parida, director of the state-run Institute of Life Sciences and a member of INSACOG, told Reuters.

reuters.com/world/asia-pac…
1 of N
INSACOG shared its findings with the health ministry’s @Director_NCDC before March 10, warning that infections could quickly increase in parts of the country. The findings were then passed on to the Indian health ministry, this person said.
2 of N
INSACOG's initial draft media statement for the health ministry included that the new Indian variant had two significant mutations, and it had been traced in 15% to 20% of samples from Maharashtra, India's worst-affected state.
3 of N
Read 8 tweets
20 Dec 20
What’s the need for external validation?
There’s no external validity without internal validity. 2 of N
Internal validity is absence or minimization of influence of any types/sources of systematic error.
3 of N
Read 5 tweets
19 Dec 20
It changes everything about what we understand, this virus is bit too much for mankind. Challenges aplenty but #Science will take us through !
Read 9 tweets
14 Dec 20
At this stage, Universal vaccination is a double edged strategy, promoted for protecting against #SARS_CoV_2 infection under EUA.

Many reasons

1. Fewer approved vaccines in stockpile, universal coverage is a myth in short term. It will induce & worsen inequities

1 of N
2. The countries will have to reserve significant $$$$ to buy vaccines for universal coverage, often more than their annual health budget.

Resources will have to be spent justifiably: it doesn’t make sense not paying salaries of health care workers but buy vaccines. 2 of N
3. (A)Safety , (B)efficacy are prerequisites. (C) Feasibility and (D) effectiveness are next steps. Having worked for polio eradication, I love vaccines. They do wonders when they pass the critical septs (A to D). For Covid19, we do not have many options with vaccines, yet 3 of N
Read 5 tweets

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