Friday, April 17, 2020

Coronavirus News (44)



Why does India have so few Covid-19 cases and deaths? India is four times more populous than the US, but has just 2% the number of cases and only 1.5% of the number of Covid-19 deaths. How has the country, whose per capita income is just tenth of the US, avoided being flattened by the pandemic? ......... The epidemic may have struck later than in other countries. ... India’s 21-day lockdown may have successfully suppressed the epidemic. Physical distancing is one of the best ways to slow the epidemic ...... India has not been able to test enough to count all cases and deaths. ..... India may have protective characteristics against Covid-19. ........

the low share of elderly in the population, the high temperatures and humidity in India, widespread BCG vaccination for tuberculosis, or resistance to malaria have helped India escape the brunt of the pandemic.

....... A Covid-19 death typically is confirmed by a Covid RT-PCR test. Those tests are in short supply and cost INR 4500 ($60) in India. Moreover, if an individual with Covid-like symptoms dies, but a test is not performed before his death, it does not make sense to waste scarce resources on the cadaver. Nor do officials report unconfirmed, Covid-like deaths, because there are many reasons that one may die from flu-like symptoms, and officials do not want to create panic. ....... By shutting down travel and factories, it has eliminated transport-linked deaths and deaths triggered by air pollution. Physical distancing measures may also lower deaths from influenza, just as they reduce Covid-19 deaths. So it is theoretically possible that Covid-19 has had a substantial mortality impact, but that total deaths have not risen because the lockdown reduced non-Covid deaths. .......... Its reproductive rate in India is around 1.8, which implies that approximately 65% percent of the population will be infected without a lockdown or vaccine.

Even if India has a death rate as low as Germany’s 0.3%, two million people could die.

........... the mortality rate from Covid-19 infection is much higher among the elderly: it is

14.8% for those above 80, but just 0.2% for individuals below 39.

In India, only 0.8% of the population is above 80 and nearly 75% are below the age of 40. .......... The fatality rate rises by roughly 30% if a person has cardiovascular disease, diabetes, chronic respiratory disease, or hypertension. India has roughly double the rate of heart disease as Italy, and among the highest prevalence of respiratory diseases in the world. In addition, India is home to one in six people with diabetes. ......... hotter temperatures in India may slow the virus. ....... Countries with latitudes between 30-50 degrees above or below the equator, and average temperatures between 5 and 11 degrees celsius have, thus far, borne a higher burden from Covid. ...... India may face higher transmission rates during the monsoon, which is India’s flu season ......... Covid-19 may not go away in warm weather as colds do, because significant parts of the population remain vulnerable to the virus. The weather alone is insufficient to protect India......... universal BCG vaccination in India, or domestic hydroxychloroquine use to combat malaria. ......... India’s relatively light exposure to Covid-19 remains a puzzle. It may have certain characteristics that protect it from the deadliest impact, but they do not suggest that it will escape the pandemic unscathed. Great care and vigilance are still necessary.


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As COVID-19 cases mount in nursing homes, exact locations remain a mystery
Cautionary Tale Spurs 'World's First' COVID-19 Psychiatric Ward There was no hand sanitizer on the hospital's psychiatric ward for fear patients would drink it; they slept together on futons in communal rooms and the windows were sealed shut to prevent suicide attempts — all conditions that created the perfect environment for the rapid spread of a potentially deadly virus. ...... it was the reality in the psychiatric ward of South Korea's Daenam Hospital after COVID-19 struck. Eventually health officials put the ward on lockdown, but it wasn't long before all but two of the unit's 103 patients were positive for the virus....... "because how many inpatient general medical units are going to want to take a significantly symptomatic COVID-19 patient who was in the hospital for being acutely suicidal? There are no easy solutions."
Coronavirus in a psychiatric hospital: 'It's the worst of all worlds' Social distancing in a psychiatric facility is easier said than done. So far 34 people at Western State Hospital have tested positive for coronavirus......... It's not unusual to hear patients screaming and crying at Western State Hospital, workers say. But lately, they say it's been worse than normal at the massive psychiatric facility just south of Tacoma, Washington........Since COVID-19 hit the hospital a month ago, its Victorian-era buildings have felt "eerie" and "strange," according to workers......... The art room is empty, group therapy is canceled and patients eat alone in the cafeteria. A skeleton staff cares for more than 700 patients battling illnesses that range from schizophrenia to suicidal depression. Older patients are not so much quarantined as stranded, unwilling or unable to get up from their hard plastic beds without help ..... younger patients are free to roam the halls with no masks. ......

"We have people who are sick, and we have people who are absolutely scared."

........... Western State, one of the oldest and largest state psychiatric hospitals west of the Mississippi, was the first in the U.S. to report a coronavirus case. At least 62 other state facilities have followed to date. An outbreak at a Louisiana facility has infected 99 patients and 34 staff members; in New Jersey, all four state psychiatric hospitals have outbreaks and six patients have died....... "You get one case in these institutions, and you've got 10 in the next few days." ......... "These are almost invariably very high-risk patients. They're elderly, they have chronic medical conditions, they're on medications. It's a mess." ......... "It's sad to think about how many staff members are going to be positive, how that is going to trickle down to their families

Prisoners in New York City jails sound alarm as coronavirus spreads: 'I fear for my life' American jails are "ticking time bombs" for COVID-19, a retired sheriff said............ New York‘s notoriously brutal and unsanitary jail system ...... So far, 167 inmates and 114 Department of Correction staff members have tested positive for COVID-19 ...... Jails may act as COVID-19 incubators, sickening and killing inmates and workers and spreading the disease to the broader public. ........ “County jails will suffer the most because they’re the ones that cycle people in and out the quickest.” ...... There are indications that COVID-19 is beginning to spread in lockups around the country. Jail inmates have tested positive in Illinois, New Jersey, California, Texas, Louisiana, Georgia, South Dakota and Washington, D.C. Inmates or staff members have tested positive at state prisons in California, Louisiana, Michigan, Texas, New York and Georgia.......... “We’re at the epicenter of the epicenter,” Skelly said. “You want to talk about social distancing, but you have housing areas in jails that are 50 inmates to one officer, or almost 100 to one.”



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