Rijo M John, PhD Profile picture
Health Economist | Adj. Professor, https://t.co/3rpFbfEKfR | Guest faculty @IIMKozhikode | Consultant @WHO @TobaccoFreeKids @Tobacconomics | Former faculty @IITJ_Official
9 May
@MoHFW_INDIA is the official Twitter handle of the Ministry of Health & Family Welfare, GoI. It must a place to report accurate, realistic, & contextual info on the pandemic that is ravaging the country!

Has it done that? I do not think so!

Why?

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There's been an undue emphasis on the cumulative numbers of #COVID19 vaccine doses administered, tests done, recovered cases, etc. without a sense of reality. India is the 2nd populous country in the world. So, the cumulative numbers for anything ought to be large!

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Instead, @MoHFW_INDIA should instead answer:

What % of our population has been vaccinated so far?

What has been the pace of vaccination?

By when do you think the vaccination coverage can reach the target?

When do you think an ordinary citizen would be able to get a jab?

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Read 7 tweets
6 May
Thread on COVID testing data

It's been a month since @ICMRDELHI has been reporting at least 100K fewer tests than the tests reported by all states combined. This discrepancy has been growing & is over 3L for the past several weeks.

What does it mean? What implications?
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In the past, this difference used to get reconciled over time. But, this time, this difference is so large & not been reconciled for a long time.
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Few plausible reasons:
1) ICMR only reports tests coming from its own approved labs & states maybe adding testing numbers from unrecognized labs too
2)States inflating the testing numbers on paper for various reasons
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Read 6 tweets
5 May
Thread on #COVID19Vaccination

Daily avg jabs are now 1.8M indicating acute vaccine shortage whether GoI admits it or not.

It means 18-45 yrs who are better positioned to register on CoWIN & at lesser risk of dying are using the limited doses & depriving the more vulnerable

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Avg. daily jabs have declined from a peak of 3.7m to 1.8m (51% fall over the past month)

Many vulnerable & aged have to reschedule their visits multiple times to get jabs which increase their risk of exposure significantly

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Until the vaccine supply is increased & can be ensured at a minimum of 5m doses/day, the GoI should immediately stop the 18+ vaccination drive.

This is extremely important to reduce the risk of deaths among the most vulnerable population.

@MoHFW_INDIA @drharshvardhan
Read 4 tweets
4 May
India's reported #COVID19 cases have crossed 2cr (20M)

The daily chart suggests a peak/plateau. However, this is NOT natural.

This 'peak' has followed reduced daily testing.

From a peak of 19.5L daily tests on Apr 30, our daily testing has been on a consistent decline!
1/4
Yesterday's daily testing was only 16.6L despite being a regular Monday!

It appears that we are forcing an artificial peak with reduced testing!

The consistent reduction in testing started just as we crossed 400K cases!

2/4
Something quite similar had happened during the previous peak last year too.

The day daily new cases touched 98K & everyone was expecting India to cross 1L daily cases, the daily testing began going down

Tests did go up after a gap of few days only to see reduced cases!

3/4
Read 4 tweets
23 Apr
Some epi models predict 8L-10L daily #COVID19 cases in India in the next 2-3 weeks. In all likelihood, India is already having that many daily infections. However, will India ever report that many daily new cases?

My guess: our reported cases will not go >5L to 6L!

why?

1/4
The daily growth of tests has been much lower than that of daily cases for the past 1 month.

The avg. TPR now is 18%. Our avg. daily testing now is 16L.

At the current TPR, it'd take 33L daily tests to report 6L cases, i.e., more than double the current daily testing.

2/4 Image
TPR has also been on a steady growth path & even if we assume the TPR to reach 20%-25% in the coming weeks, it'd need 32L to 40L daily testing for us to report 8L cases. I believe, it is nearly impossible at the current level of testing & its rate of growth.

3/4
Read 4 tweets
20 Apr
It is to be noted that the policy shift in the government of India’s #COVID19 vaccination has come at a time when the daily inoculations of #COVID19 vaccines have been on a steady decline going down from a daily average of 3.7M to 2.7M in the past two weeks.
1/5
Domestic supply constraints & the Union government’s failure to ensure vaccine supply commensurate with demand from different states were evident on vaccine delivery so far.
2/5
This new liberalized policy could shift the onus of vaccine procurement to meet the demand onto the state governments, something the Union government itself has not been quite successful in the past as reflected in the slow pace of vaccination.
3/5
Read 5 tweets
23 Jan
#Kerala is seeing a steady increase of new #COVID19 cases & Test +ve rates.
👉It accounts for >40% of all new cases in India
👉Testing is pretty stagnated
👉Vaccination has been at a very low pace too. Only 47K Beneficiaries so far, while neighboring Karnataka did 1.83L
1/
The only solace has been a relatively low mortality rate compared to the rest of the country. This mortality rate has also seen a marginal increase in recent times. There are also discrepancies in reported deaths between some district administrations and the state.
2/
Districts like #Ernakulam, #Alappuzha, and #Pathanamthitta are seeing the maximum increase of new cases in recent days!
3/
Read 6 tweets
20 Nov 20
19 Nov: #India crossed 9M reported #COVID19 cases & 132202 deaths. 4.4L active cases
👉1M new cases & 12.1K deaths added in the past 23 days. The previous 1L cases were added in 18 days.

*⃣Follow this data thread to know important trends national, state & district level*⃣
1/ Image
👉Cases growing at 0.44% (it was 0.57% at 8M)
👉Steady fall in 7-day avg. daily new cases seem to have halted for now
👉Daily active cases still in -ve territory
👉Daily tests averaged 9.3L past 7 days (down from 10.5 at 8M)
👉Daily deaths ~500 (It was 511 at 8M)
2/ Image
👉Growth of tests slightly above that of cases now
👉Daily TPR at 4.2% and has been <5% level for 30 days now.
👉only 5.88 (45.4%) of the 12.96 crores tests so far are RT-PCR
👉Testing (whether RT-PCR or Rapid Antigen) need to increase significantly
3/ Image
Read 13 tweets
28 Sep 20
27 Sep: India crossed 6M reported #COVID19 cases & 95574 deaths. Only 9.6L active cases
👉Beyond the rosy recovery rates, follow this thread to know important trends upto dist. level that matters
👉1M new cases & 12K deaths were added in the past 11 days

(1/n)
👉Cases growth (1.5%) has decreased considerably over a week
👉7-day avg. daily cases showed some decline & is beginning to look up again
👉Daily active cases rebounding after being in -ve territory for few days
👉Daily tests average 10.8L last week
👉Daily deaths ~1095 (2/n)
👉Growth of tests barely above that of cases now
👉Daily TPR at 8.2% and has shown a marginal decline over the past 2 weeks
👉52% of all tests so far are Rapid antigen
👉Most states do not report test results by type of tests
(3/n)
Read 13 tweets
24 Sep 20
➡️The discrepancy between the daily testing numbers reported by ICMR & states have been growing steadily & has reached very high levels (2L+) of late!
➡️National TPR needn't be an avg of TPRs across states, as a result
➡️Lot of questions remain unanswered
@ICMRDELHI
(1/n) Image
Follow this thread here which gives plausible reasons but, none conclusive. A summary of important questions below:
1) Are states & ICMR including/excluding certain types of tests & not following a uniform standard in reporting?
(2/n)
2) Are states adding duplicates/retests to its total while ICMR doesn’t?
3) Is ICMR withholding certain tests/test types which states report?
4) Are states ‘deliberately’ inflating reported numbers in the interest of showing low TPR?
5) Only @ICMRDELHI can clarify these

(3/n)
Read 4 tweets
16 Sep 20
👉15 Sep: India reported 50 lakh+ #COVID19 cases & 82091 deaths
👉Read this detailed thread for important trends national, state & district level that matters
👉10 lakh new cases & 12456 deaths were added in the past 11 days
👉The next 10 lakh cases expected in ~10 days!
(1/n) Image
👉Cases growing at the rate of 2%
👉7-day avg. daily new cases shows a minor decline
👉Daily active cases falling (growth 1.5%)
👉Tests growing at 1.98% & 50% tests are Rapid antigen
👉Daily tests averaged 10.9L past 7 days
👉Daily deaths ~1150 level (2/n) Image
👉Growth of tests keeping at or below that of cases which means tests aren't adequate
👉Avg. daily TPR 8.5% despite using ~50% rapid antigen tests
👉Clearly, this means a lot of undetected cases out there
👉Most states don't report test results by test types
(3/n) Image
Read 11 tweets
11 Sep 20
👉10 Sep: India crossed 4.5M reported #COVID19 cases & 76304 deaths
👉This thread shows important trends national, state & district level
6.3 lakh new cases & 7735 deaths were added in the past one weeks
About 7.4M tests were done during this period (TPR 8.6%)
(1/n) Image
👉Cases growing at the rate of 2.1% & remained steady over a week
👉Average growth of active cases increased to 1.9%
👉Daily tests averaged 10.6L past 7 days
👉Daily deaths ~1100 level (2/n) Image
👉Tests & cases growing almost at the same rate
👉Of the 5.4 crore tests done so far only about 2.7 crores are RT-PCR
👉Most state daily bulletins do not provide break-up of test results by test type
(3/n) Image
Read 9 tweets
5 Sep 20
👉India crossed 4M reported #COVID19 cases & 69635 deaths
👉How India got here? Follow this thread for important trends national, state & district level
👉10 lakh new cases & 13707 deaths were added in the past 2 weeks
👉About 13M tests during this period (TPR 7.7%)
(1/n)
👉Cases growing at 2.2% & remained steady over a week
👉7-day avg. daily new cases shows no sign of slowing
👉Daily active cases rebounding (growth 1.7%).
👉Tests growing at 2.4%
👉Daily tests averaged 10.5L past 7 days (47% tests are now RADT)
👉Daily deaths ~1000 level (2/n)
👉Growth of tests > that of cases
👉Daily TPR trending down again
👉Rapid antigen tests constitute approx 47% of daily tests
👉In some states like Delhi & Kerala it's ~70%
👉state should report both tests & +ves by test types in their daily bulletin which most don't do
(3/n)
Read 13 tweets
30 Aug 20
👉29 Aug: India crossed 3.5M reported #COVID19 cases & 63657 deaths
👉About 5 lac new cases & 6811 deaths added in the past 7 days
👉Daily TPR 8.2%
👉Follow this thread to understand important trends national, state & district level
(1/n)
My👍to #Mann_Ki_Nahi_Students_Ki_Baat Image
👉Cases growing at 2.2% compared to 2.4% a week back
👉7-day avg. daily new cases shows no sign of slowing
👉Daily active cases rebounding (growth 1.2%)
👉Tests growing at 2.3%.
👉Daily tests averaged 9L past 7 days
👉Daily deaths ~1000 level (2/n) Image
👉Growth of tests keeping above that of cases
👉Daily TPR beginning to go up again
👉Rapid antigen tests take >50% of testing in many states including Delhi, Kerala, Andhra, Karnataka etc.
👉Some are not utilizing their full RT-PCR capacity
(3/n) Image
Read 13 tweets
24 Aug 20
#COVID19 projections for India:
👉Total cases to cross 4 Million by Sept 4
👉5M - Sept 15-16
👉6M - Sept 25-26
👉6.5M - Sept 30
PS: Projection is conservative & is based on trends in growth. The intent is only to spread awareness & not to create panic @ICMRDELHI @MoHFW_INDIA 1/3 Image
👉About 1Lakh+ cases per day expected by Sept 20-22 for this projection to materialize
👉At the current level of test positivity rate, it would translate to some 1.4 Million tests per day
👉That's definitely possible for India as it has already crossed 1M daily test mark
(2/3)
The earlier projections are below for reference. They were on the mark as you can see. (3/3)
Read 4 tweets
23 Aug 20
👉22 Aug: India crossed 3M reported #COVID19 cases & 56846 deaths
👉How India got here? Follow this thread for important trends national, state & district level
👉50% of total cases (15M) were added in the past 25 days
👉One crore tests done in past 12 days (TPR 7.6%)
👉 (1/n)
👉Cases growing at the rate of 2.4%
👉Active cases are now going up (growth 1.1%). It's important as it can stress our infrastructure
👉Tests growing at 2.7%. Close to 45% tests are now Rapid antigen
👉Daily tests close to 9L avg.
👉Daily fatalities now at 1000 levels (2/n)
👉Good to see growth of tests keeping above that of cases
👉Daily TPR beginning to go up again
👉Rapid antigen tests take >50% of testing in many states now including Delhi, Kerala, Andhra, Karnataka etc. 👉Some are not utilizing their full RT-PCR capacity
(3/n)
Read 13 tweets
15 Aug 20
👉14 Aug: India crossed 2.5M reported #COVID19 cases & 49134 deaths
👉Last 8 days added 5L cases & 7500 deaths
👉One crore tests done in past 16 days
👉India did 28.6M tests so far (TPR 7.9%)
👉Thread shows important trends national, state & district level. (1/n) Image
The 7-day avg. daily growth of cases now at 2.7%. At this rate, the next 1M should take only ~13 days (i.e., ~27 Aug.) Growth of cases is still more in NE states, BR, JH, AP & KL. The daily test positive rate now at 7.9% but very high in MH, KA, AP & WB. (2/n) Image
The mortality rate from #COVID19 is now only 1.9% at the national level. However, there is huge discrepancies across states as seen here. MH & GJ leads in terms of fatalities from COVID19. (3/n) Image
Read 8 tweets
7 Aug 20
👉6 Aug: India crossed 2M reported #COVID19 cases & 41638 deaths.
👉The last 1M cases came in 21 days compared to 168 days for first 1M. ▶️Next 1M expected in 14 days.
👉India did 22.7M tests (TPR 8.8%).
👉Thread shows important trends national, state & district level. (1/6) Image
The 7-day avg. daily growth of cases now at 2.9%. At this rate, the next 1M should take only ~14 days (i.e., ~20 Aug.) Growth of cases is now more in NE states, JH, AP, & A&N islands. The daily test positive rate now at 8.8% but very high in MH, KA, AP, MZ & NL. (2/6) Image
India reported the highest daily number of cases y'day at 62170 new cases and 899 deaths. A&N Islands & Nagaland leads in the rate of growth of cases while MH & AP continues to report the highest number of daily cases. MH continues to clock the highest @COVID19 casualties.(3/6) Image
Read 6 tweets
17 Jul 20
Jul 16: India crossed 1M #COVID19 cases & 25K deaths. 35468 cases & 680 deaths y'day alone. Days to reach each 1 lakh case: 1L-109; 2L-15; 3L-10; 4L-8; 5L-6; 6L-5; 7L-5; 8L-4; 9L-3; & 10L-3. Both confirmed & active cases grow daily 3.5% (doubling ≈ 20 days) & deaths 2.7%. 1/n Image
Ranking of Indian states/UTs in terms of #COVID19 cases, deaths and tests all normalized per million population. The chart also shows the cumulative test positivity rate. 2/n Image
Top 20 Indian districts for #COVID19 cases. About 60% of confirmed cases, 63% of active cases and 75% of deceased are from top 20 districts. Also note there are districts in top deceased which are not in top confirmed, indicating under reporting in those districts. 3/n Image
Read 5 tweets
3 Jun 20
Thread: A closer look at 4 high burden states in past 2 weeks: MH TN DL & GJ together contributing 66% of cases:

Maharashtra:
Test +ve rate steadily increasing, yet daily tests decreased & you see cases falling! That ain't flattening #COVID19 @CMOMaharashtra Image
Tamil Nadu:
A steady increase in test +ve rate indicative of state losing the grip on the situation. Daily cases steadily increasing, but more tests are sure to bring out much higher number of cases @CMOTamilNadu Image
Delhi:
Significant increase in test +ve rate over past 2 weeks suggestive of @COVID19 being ahead of state's efforts to contain it. Instead of increasing testing, the state seems to have decreased it & yet, the cases increasing. This is quite an alarming situation. @CMODelhi Image
Read 6 tweets
13 May 20
Close to 75,000 cases taking India to #12 among countries. Doubling time of cases (average over past 5 days) is close to two weeks now which is good. 67% of all cases are from MH, GJ, TN & DL alone. KL started a 3rd wave of cases! TS, WB & MP needs to do more tests. #COVID19 Image
TN, Odisha and Bihar have lower doubling time of cases compared to rest of India #COVID19 Image
Once normalized for the population, DL, MH and CH are at the top for per capita cases which indicate the true severity. #COVID19. Image
Read 4 tweets