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Dr Giridhara R Babu Profile picture
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31 Jul, 5 tweets, 2 min read
One and half years without school is a great toll on the children. The difficult part is to answer how to reopen schools with strict enforcement of #COVID appropriate behaviours. How can schools be made safe and protected bubbles for children?
School transmission varies according to student age and incidence in the local areas. The outbreaks in the school settings are substantially reduced with mitigation measures. Regular testing, teacher and staff vaccination can help reduce transmission.
acpjournals.org/doi/full/10.73…
As per the ECDC, there is very little possibility that schools are not associated with accelerating community transmission.
ecdc.europa.eu/en/publication…

However, large outbreaks can occur within 2 weeks of school reopening as per this Israel study.
eurosurveillance.org/content/10.280…
Mitigation measures need in schools:
1. Universal face mask use
2, Increasing physical distance by decreasing crowded classrooms and common areas
3. Using hybrid attendance models to prevent crowding, 4. increasing room air ventilation
Mitigation measures needed in schools:
5. Expanding screening testing to rapidly identify & isolate asymptomatic infected individuals.
6. Staff & students should continue to have options for online education.
7. Mandatory vaccination of staff & teachers.
jamanetwork.com/journals/jama/…

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More from @epigiri

Dr Giridhara R Babu Profile picture
6 Jun
Source: @jeevanrakshaa @Mysore_Sanjeev

The 7-Day Moving Growth Rate
-#Mumbai: < 2% for over 4 weeks, city ready phase 4?

-#Delhi & #Ahmedabad: <2% for 2 weeks.Phase 2 or 3?

-#Bengaluru, #Chennai & #Kolkata: little over 2% Phase 1?

Phases 1-4:

1ofN
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.

2ofN
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.

3 of N
Read 7 tweets
Dr Giridhara R Babu Profile picture
6 Jun
Once test positivity is under 5 over a week, what's safe to #unlock in the first phase ?
In Phase-2, what's safe to #unlock?
No more than 10 people in the following settings.
In Phase-3, what is safe to #unlock?
Not more than 50% of the capacity
Read 4 tweets
Dr Giridhara R Babu Profile picture
4 Jun
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.

Read 4 tweets
Dr Giridhara R Babu Profile picture
29 May
This is a great question. Here are my observations regarding this.
1 of N Image
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.
Read 4 tweets
Dr Giridhara R Babu Profile picture
29 May
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.

I explain to @nidhi_sharma of @EconomicTimes m.economictimes.com/news/india/55-… Image
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.
Read 5 tweets
Dr Giridhara R Babu Profile picture
17 May
SMALLER DISTRICTS NEED MORE ATTENTION & RESOURCES:

Current actions are inadequate in smaller districts.

-100% surge in over 50+ Districts in 30 days

Monthly Growth rate

-TAPI (GJ): 180%
-Kodagu (KA): 204%,
-Mansa (PJ) 211%

Adequate & Timely Testing is the ONLY solution
1/n
Cost of Poor Testing

In Kodagu, there is 100% increase in mortality. It had 73 deaths on 14th April.

Mahendragarh had only 22 death, in a matter of 4 weeks, it has gone up 78. 3.5 fold increase.

2 of N
In 1 month, COVID cases has surged by 70%, last week it has grown by Kodagu, 80% of India's Coffee is grown here.

It has less population of 7 Lakh.

It had active cases of 164 last month, today it has 5178.

3 of N
Read 8 tweets

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