Month: July 2020

A dubious distinction

The US has reached a dubious distinction of being a global leader in having 4 million cases of Coronavirus. What leads to this grim scenario? Often, outsiders wonder what is causing this vulnerability. I shared a different perspective on the factors contributing to this grim scenario. In my opinion, there are several factors that contribute to these dismal figures. Understanding the failure is as important as understanding the success, it is through failures that we get a glimpse of success as it offers us an understanding of modeling success and our collective behavior. In this article, I have made attempts to capture aspects across major democracies that offer an insight into success and failure.

The US – then 4 million coronavirus cases. The US is the global leader in Covid-19 cases, followed by Brazil, India, Russia, and South Africa. The statistics run like this –

99 days to reach 1 million
43 days to reach 2 million
28 days to reach 3 million
15 days to reach 4 million
… days to reach 5 million

https://ourworldindata.org/coronavirus-data?country=USA~BRA~IND~RUS~GBR~OWID_WRL

A global leader again (pun intended), how could a country reach such epic proportions of the disease in just 180 days. At least 143,820 people have died across the country. Where is the indiscretion? Is it that the population is vulnerable? Or are we following flawed models of prevention?

Let me cite an example – my HOA asked me to fix the turf, stating it is an essential service. Of course, I responded saying why it is not but this is a reflection of a flawed model being followed.

A confusion between essential and non-essential is the major factor. Another aspect that is scientific activism by gullible people called ‘Corona Mixer’. It is akin to a flawed model of Herd Immunity followed in the UK, Sweden, and few other countries, where COVID-19 eventually exploded.

Third, fatigue from indoor has wrongly motivated several families to stride outside. Of course, a gullible common man cannot see the 54 million viruses that were just sprayed by an unexpected asymptomatic person in the vicinity that followed that infects other innocent bystanders as it drifts along the path of air currents.

There are more factors to the proliferation of the disease. Another complex issue is Political liberalism and assertion for a cause. Subversion or a feeling of being subverted is causing people to rebel and aggregate. Incorrect policies and guidance by WHO and other policy-making bodies is another contributing aspect factor.

Policies – a bedrock for containment: Policies offer a solid fabric for control and on the converse is equally true that not having consistent machinery to execute policies is an equal deterrent. I will shy to quote an example from a major city from central India where a breakdown of communication amongst the policy executioners resulted in a flare-up of COVID across the town. Remember, if only the infected (symptomatic and asymptomatic) can strictly isolate, we can contain the virus.

Indore a success story

We have several success stories from around the globe but visit CovidRxExchange to learn about, Indore – A Success Story. You will see how a metropolitan city controlled the disease at the outset with a well-executed policy and a diligent team of doctors.

Can we change this? Possibly that’s the Midas touch that would delay and possibly deter further infection.

Shashank Heda, MD
Dallas, Texas

References:

https://ourworldindata.org/coronavirus-data?country=USA~BRA~IND~RUS~GBR~OWID_WRL

https://www.ncbi.nlm.nih.gov/research/coronavirus/publication/32691016

R(0) & The Real Numbers

The daily cases of positive SARS-CoV2 are rising in several states. Newspapers and Govt. channels are providing the total positive cases detected daily. However, a visibility on the total burden of positive cases is not available despite knowing the daily stats. Often, it is erroneously thought that the cumulative numbers are less.

In this blog, I have talked about the incidence and prevalence of the persons affected that are shedding the viruses in the community, both from the symptomatic and asymptomatic perspective. The average number a symptomatic patient sheds virus and the average number an asymptomatic person sheds the virus is based on the the referenced scientific data. The details are mentioned in this blog.

This blog provides us a perspective on the cumulative cases within a community as well as how long should we continue lock down amidst the airborne nature of the virus.

Let me explain the concept of incidence and prevalence.

Incidence is the new cases occurring in that period, whereas prevalence is the cumulative cases existing during that period. If I presume the incidence at the time of collection of the swab is 10,000, and the asymptomatic is 5x to 10x (let us call it A), the total burden of positive cases is in that proportion.

If we are to presume the disease persists for 14 -21 days in its mild form, then the prevalence now is 14x-21x the multiple of A. If I go by some researchers, the asymptomatic shed the virus for 21-28 days.

That’s the total burden of test-positive cases.

Airborne precautions are likely to be scaled up on the risk stratification. All those risk color charts floating around are likely unreliable for this simple reason. To make it simple, I will just make two categories –

Essential
Non-essential

Non-essential are all those without which we can survive.

You may naturally ask, until when should we live like this? It’s not too long, vaccines and drugs are on the horizon. Also, though the virus is still aggressive, it will likely become less aggressive in the future. So, let’s wait before taking an unrequired risk.

Shashank Heda
Dallas, Texas

Shades of Gray Nationalism

Interrelated phenomenon Shades of Gray – Gene Manipulation to establish hegemony, Drug Hoarding and Vaccine Nationalism,

It is understandable, the US started vaccine and drug hoarding, contrary to the principles of humanitarian values and ethics. Hegemony and lack of transparency from China and other power are adding towards a heady mix. This initiated a sense of self.

However, scientific pursuit falls within the realms of humanitarian traits, it is not nation-specific, or unique to any ethnicity, and definitely not the fiefdom or expertise of any ideology or religion.

Having said this, despite the attitude of select countries, we should keep humanity and altruism as our highest pursuits and avoid getting muddled in the politics of nationalism, ethnicity, ideology, or religion.

Every country should attempt in advancing science, however, we should not succumb to vaccine nationalism, drug hoarding, or manipulating the genome of the wild viruses and or bacteria for usurping our hegemony to advance our nationalistic endeavors. We all know, Science is a double-edged sword, used rightly will lead to evolution, and unlikely use to destruction.

Dr. Shashank Heda,
Dallas, Texas