Why are numbers in Kerala an anomaly ?
Here is my take on these numbers
No. of cases are not directly comparable across states, due to the large disparity in testing capacities. It is most likely that the high nos are just representative of the testing nos. Here is a comparison of some states. Data from covid19india.org
So are the COVID-19 deaths for the states. Of note and contrast would be Kerala and Bihar - see closely the no of tests and deaths
There are also concerns on veracity of these nos theprint.in/opinion/benfor…

Therefore people have used an indirect measure called "excess deaths". The basic assumption is that any "excess" compared to previous year estimates could be suggestive of "missing" COVID-19 deaths
@Rukmini has a wonderful compilation of the "excess deaths" for these states
Therefore what we need to compare is whether the case nos could be effectively managed.

There is now evidence to suggest overloading hospitals could significantly contribute to the mortality rates nature.com/articles/s4146…
The need of the day is therefore to discuss on how to create public health systems to appropriately identify (test) and manage cases and get early warning from systematic genomic surveillance , rather than comparisons of uncomparable numbers.
The full article is here scroll.in/article/998620… @Rukmini

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More from @vinodscaria

13 Jun
As delta continues to evolve acquiring new mutations, there is a lot if interest in understanding these mutations. This tweetorial summarizes the emerging lineages of delta, otherwise named delta+

Data and analysis : @bani_jolly and @mercy_rophina
Understanding this continued evolution is of great importance in mapping the evolutionary landscape of emerging variants. Largely the virus has tried to optmise for transmission and immune escape by step-wise acquisition of new mutations.
One of the emerging variants is B.1.617.2.1 also known as AY.1 characterized by the acquisition of K417N mutation.

Thanks @bani_jolly for pointing out the mutation and lineage assignment.
Read 10 tweets
6 Jun
Interesting preprint on the antibody response after ChAdOx1-nCOV (Covishield) and BBV-152 (Covaxin) among Health Care Workers. (N=552 Covishield =456; Covaxin=96)
Both vaccines elicited👍immune response after 2nd dose. Seropositivity Covishield >Covaxin
medrxiv.org/content/10.110… Image
A number of factors include Age, Sex. Comorbidity including T2DM and Hypertension influence the antibody titres (Day 21-36 after 2nd dose) Image
More reasons why we should be eagerly looking forward to the Phase 3 data for Covaxin
Read 9 tweets
20 Apr
B.1.618 - a new lineage of SARS-CoV-2 predominnatly found in India and characterized by a distinct set of genetic variants including E484K , a major immune escape variant.
Initial sequences in the B.1.618 lineage were found in West Bengal, India.

Members of this lineage is also found in other parts of the world, cov-lineages.org/lineages/linea… but do not have the full complement of variants as found in India
This lineage is characterized by a 6 nt deletion (H146del &Y145del) , apart from E484K and D614G in spike protein
Other variants are in the ORF1ab, ORF3a, ORF7a, ORF7b and N genes
Read 9 tweets
10 Apr
B.1.617 is the name
Find more information on the lineage at cov-lineages.org/lineages/linea… Image
This lineage is defined by 15 genetic variants including 6 Spike protein variants.
Two variants of these 6 (E484Q and L452R) are involved in immune escape as well as increased infectivity. More about these variants and immune escape can be found at ESC clingen.igib.res.in/esc Image
This lineage is also now found in a number of countries including UK, USA, Australia, Singapore and Germany Image
Read 9 tweets
23 Sep 20
First report of #COVID19 #reinfection from #India - two #asymptomatic health workers identified on routine #surveillance
academic.oup.com/cid/advance-ar…

#CSIRfightsCOVID19
#Genome sequencing of the #SARSCoV2 isolates from both the episodes suggest distinctly different virus , confirming reinfection.
Since the individuals were #asymptomatic during both episodes, and identified on regular #surveillance suggest asymptomatic #reinfections could be an under-reported entity. 2/2
Read 5 tweets
24 Aug 20
Image
Facebook live in #Malayalam at facebook.com/INDIA.CSIR on 28th August 2020 from 3.00PM to 4.00PM
Facebook live in #Malayalam at facebook.com/INDIA.CSIR on 28th August 2020 from 5.00PM to 6.30PM (please note the change in time)
Read 4 tweets

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