Case Fatality Rate (CFR) is increasing.
Why?
CFR= # Deaths / # Positive cases
- ↑ in numerator: Poor detection and treatment --> higher deaths
- Low Denominator ↓: Under-reporting of COVID Cases due to poor testing.
Higher the CFR in the city, poorer the TTT strategy.
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The review of positive Cases, active Cases, and death moving growth rate in juxtaposition will give wholistic view on the situation. #Bengaluru & #Delhi have some work to do.
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#Bengaluru: DPM tripled in 2021 when compared to 2020. (From 350 Deaths / Mn population to 1130 per million); 9612 people died in Bengaluru in 2021 due to COVID, nearly 1/3rd of total death occurred in 6 mega cities.
#Mumbai: Death MGR at below 2% for 2 consecutive weeks.
#Bengaluru continues to have the highest Death MGR amongst Mega cities; inadequate and untimely testing.
#Chennai and #Kolkata is also facing difficulty in reducing the Death MGR.
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Higher deaths during the second wave in megacities are a reminder to strengthen the pandemic preparedness for multiple waves. Test, Track and Treat (3Ts) saves lives. In the absence of effective implementation of 3T, Bengaluru is a testimony to how things can go wrong.
Not just that the technology is a barrier, this is the first time that India uses anything as a mandatory requirement for getting vaccinated. #CowinApp
Nothing can be a prerequisite for getting vaccinated or getting tested. #VaccineForAll
"It is easier to get married in India than to get vaccinated"
- @Dr_Aqsa_Shaikh , MBBS, MD Community Medicine is an Associate Professor of Community Medicine at Hamdard Institute of Medical Science and Research, Jamia Hamdard, Delhi.
This is a great question. Here are my observations regarding this.
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Dr Anthony Fauci represents a systems which have complete autonomy & are highly accountable. These are built over a long period of investment in science, public health research, evidence based priorities and goal settings. Such systems will have thousands of Fauci not seen by us.
In this article, the defiance of Dr Fauci to the attempts of the President Trump are depicted, rightly so as heroism.
Such heroes are turned out of favor when science is used as a criteria for decision making in systems that don’t have autonomy and freedom.
The key to curbing transmission is to transform the culture of data collection & review by encouraging accuracy & transparency. This can be done by incentivizing detection & not penalizing those who report.
Testing per million has remained poor in some states. This needs to be reviewed. Specifically, identify the areas with poor surveillance’s and testing and strengthen case detection in these areas. The states with better detection will isolate more cases, and will save more lives.
This is how it was done for polio eradication, in which India is a global leader. Using a syndromic approach, districts were expected to detect at least 1 non-polio AFP annually per 100 000 population in children <15 years. In endemic regions, this rate could be 2 per 100 000.
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?