However mild #Omicron is, it is not a vaccine. There are deaths and hospitalizations due to this variant.

Stay away from misinformation. Compared to Vaccination, natural infection could not protect population (against death or hospitalization) against any variant (Alpha, Beta, Gamma or Delta).

Proponents of Herd immunity are saying it again; #Omicron would provide herd immunity.

Evidence matters, not opinions

More actions points can be following :-
1. Since day of 1st case of #Omicron #B.1.1.529, establish travel history & identify secondary transmission throughout world. If primary case was in early November, not difficult to miss areas of circulation.
1ofn who.int/news/item/26-1… 2. Botswana, South Africa & Hong Kong cannot be the only areas where #Omicron has travelled. These areas are the ones that have probably better surveillance and genomic sequencing and hence have reported in timely manner. Absence of reporting is not absence of circulation.
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Brilliant study done in China, If scaled up, blood pressure reduction (-26.3 mmHg) achieved by training lay health workers can reduce significant mortality in LMICs.

abstractsonline.com/pp8/?_ga=2.141… -Globally, >17.9 million people die each year CVDs.
-Hypertension related CVDs contribute a significant proportion
-Chinese study shows some of these deaths & disability are preventable.
-Train lay village workers in BP measurement, counseling & provide affordable drugs.

Sudden cardiac arrest & Sudden cardiac death (SCD) refer to the sudden cessation of cardiac activity with hemodynamic collapse, typically due to sustained ventricular tachycardia/ventricular fibrillation; mostly occur in patients with previously undiagnosed diseaes.
1 of N Results from Framingham heart study suggests that more men are affected with increasing age.
Not rare, 15 percent of the total mortality in the United States & other developed nations is due to SCD. (pubmed.ncbi.nlm.nih.gov/11684624/)

2 of N

This tweet thread is about the results from the second serosurvey done in the #Karnataka state. Ahead of sharing the link, some caveats first.
1. The @DHFWKA has used the data from this round of serosurvey in late March to update testing and surveillance strategies.

1 of N 2. The study found Lower levels of IgG seroprevalence, mostly due to antibody waning.
3. A substudy was done to confirm the antibody waning. This study was delayed due to rapid surge of cases in April.
4. We found near 0 prevalence of active cases during mid-February 2021.
2/n

Polio anywhere could be a threat to countries that had eradicated it. It took decades to eradicate polio in most parts while some are yet to eradicate. Not just this necessity, it was possible mostly due to a collaborative approach & strong leadership at the global level.
1/N Lessons from Polio Eradiation, Cochi S et al
-Strong political & social support in each country
-Strategic planning & policy development
-Partnership management & donor coordination
-Program operations & tactics
-Oversight and independent monitoring.

polioeradication.org/wp-content/upl…

2/N

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…

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:

https://twitter.com/epigiri/status/1401469425836978183?s=20

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

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.

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

This is a great question. Here are my observations regarding this.
1 of N 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.

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-… 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.

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

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.

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

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

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

What’s the need for external validation? There’s no external validity without internal validity. 2 of N

It changes everything about what we understand, this virus is bit too much for mankind. Challenges aplenty but #Science will take us through !

https://twitter.com/jeremyfarrar/status/1340244494105649152

Much needed Update From @mvankerkhove

https://twitter.com/mvankerkhove/status/1340020594188890113

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

#NFHS5 report released by @MoHFW_INDIA . Here are some snippets
-% women having a mobile phone that they themselves use has increased from 47 to 62 in #Karnataka compared to previous survey.
-Women who are overweight or obese (BMI ≥25) has increased from 23.3 to 30.1

1 of N Ever-married women age 18-49 years who have ever experienced spousal violence has increased from 20.6 to 44.4 %. It either means that reporting has improved or we are becoming more regressing societies. 2 of N