'India Probably Has Tens of Millions of COVID-19 Infections Already'

[Vanguard One]

New Delhi: Citing numbers that could come as a shock to many people, Ramanan Laxminarayan, director of the Washington-based Center for Disease Dynamics, Economics & Policy has said that India probably already has tens of millions of COVID-19 infected people. He says the nationwide part of the ICMR’s recent serological survey which suggests that 0.73% of the population has been exposed to the virus corroborates this. Laxminarayan says he believes India could have 200 million COVID infected people by September.

In an interview to The Wire, Laxminarayan said there is no real difference between COVID-19 infections and COVID-19 cases except for the fact that what we call ‘cases’ are officially recorded infections whereas other infections have either not been detected or recorded. The majority of these will be asymptomatic people although a few might have mild infections which they have not bothered about.

However, Laxminarayan refused to relate his forecast of 200 million infections by September to a corresponding figure for the number of deaths.

He said that whilst the phrase ‘community transmission’ may not be a technical phrase, its meaning in common parlance is clearly understood. It means that people are getting infected from within the community without knowing from whom or how. In other words, the source of the infection cannot be traced to someone who has come from abroad or been in touch with such a person. In that sense, he said, there was no doubt that community transmission was happening in India.

Laxminarayan said he was certain that the return of millions of migrants to villages in Bengal, UP, Bihar, Orissa, Chhattisgarh, Jharkhand, etc. will lead to a surge of infections in these rural hinterlands. However, he was reluctant to accept reports in several newspapers that India would see its peak only in mid-November. Instead, he said India would see several regional peaks as individual states hit their peak at different times. He said in overall terms, the picture or graph is of a high plateau stretching for several weeks or months with different states or regions peaking at different times.

Questioned about the second part of the ICMR serological survey – which has not been officially released but has been widely leaked – which suggests that in hotspots and containment zones up to 30% of the population could be infected, Laxminarayan said it seems difficult to believe the percentage could be so large because such a sizeable number have not been infected so quickly in any other country. However, if true, it would certainly be good news because it would take these containment zones and hotspots a lot closer to achieving herd immunity which, at an R-O of 2, needs 50% infection levels.

However, Laxminarayan pointed out that even if the leaked percentage figure of 30% is correct, a lot depends upon the size of these hotspots and containment zones. It would be meaningful if a containment zone comprises an entire city of the size of Delhi or Mumbai. It would be a lot less significant if containment zones are just a few streets or a small locality in a city.

Laxminarayan was dismissive of attempts to compare India’s mortality rate, whether per thousand or as a percentage, with that of other countries to suggest that we are doing better. Not only are mortality rates calculated differently in different countries and thus not comparable but, furthermore, he illustrated his scepticism by citing the example of setting fire to two forests, one of which is 10 acres and the other 100 acres. He said both will burn at the same rate and the destruction in the burnt areas will be equivalent but, obviously, the bigger forest will take longer because of its size.

Laxminarayan also seemed to suggest that there are many questions that can be asked about the accuracy and reliability of India’s mortality rate. Are all COVID-19 deaths being counted as COVID deaths? The recent controversy in Delhi and, now, in Mumbai as well suggests that a fair number of COVID deaths are not being taken into account.

He said the biggest challenge facing the government as it gears up to handle a possible 200 million infections by September is organising the healthcare system to respond adequately. He said the answer is to move medical staff and facilities from an area where the virus is under relative control to another where it is peaking. There is no way that in the limited time available, India can actually build up a sufficient number of doctors or trained medical staff. He was particularly dismissive of government plans to rapidly train doctors to become intensivists and to adopt telemedicine handling of ICUs.

Asked whether the decision of the Tamil Nadu government to impose a stringent lockdown on Chennai and three other districts from June 19 is correct, Laxminarayan said it is not necessary. He said the situation in Chennai was under control and this second lockdown is not needed.

Finally, Laxminarayan explained that the fact nearly 50% of COVID-19 deaths in India are of people under 60 compared to just 4% in Italy and 5% in the whole of Europe does not refute the belief that India’s strength against the virus is the fact that it has a young population where 90% are under 60. He said there are many more people in India under the age of 60 than in Italy, which is why it is to be expected that more people of this age group would die in India than in Italy. But, he forcefully argued, that does not undermine the argument that with a young population, India’s ability to withstand the virus is greater.

https://thewire.in/health/india-probably-has-tens-of-millions-of-covid-19-infections-already

 

[Imran Khan]

India is sick of corona we should close borders ASAP

 

[Feng Leng]

Even people who don't die from covid-19 suffer permanent nervous system damage.

COVID-19: Severe brain damage possible even with mild symptoms

 

[KediKesenFare3]

Same goes for every overpopulated country.

 

[HAIDER]

Same goes for every overpopulated country.

exactly, non 3rd world or anyother nation has enough resources to test every individual.

 

[Bengal71]

It does no doubt. So do BD And Pak.

 

[atan651]

I have no doubt the numbers are in the hundreds of millions, given India bad healthcare system and the total lack of control and prevention.

 

[Feng Leng]

I have no doubt the numbers are in the hundreds of millions, given India bad healthcare system and the total lack of control and prevention.

NYT writer is absolutely right: Delhi is literally a shithole; but so is all of India

When the South Asia correspondent of New York Times, Gardiner Harris, wrote on 29 May (Holding Your Breath in India) — that Delhi is an unliveable place because of pollution and that he left the city to safeguard his son’s health, the outrage was similar. There was no possibility of banning an article on the Internet, but angry Indians took to social media and slammed Harris for being an elitist expat. Some said while he was over-protective over his child, he had scant regard for the Indian children in Delhi who had no option but to live there, little realising that his voice was that of a frustrated father, who doesn’t have to put his family through the perils of living in a dirty city.

Harris wrote: “Foreigners have lived in Delhi for centuries, of course, but the air and the mounting research into its effects have become so frightening that some feel it is unethical for those who have a choice to willingly raise children here. Similar discussions are doubtless underway in Beijing and other Asian megacities, but it is in Delhi — among the most populous, polluted, unsanitary and bacterially unsafe cities on earth — where the new calculus seems most urgent.”

He hits where it hurts. The capital of a super power aspirant, a country which is projected to become the world’s third biggest economy in 2020, has been described as “among the most populous, polluted, unsanitary and bacterially unsafe cities on earth”. He also goes on to add that out of the 25 worst polluted cities in the world, 13 are in India.

It’s remarkable that even after 50 years since Koestler and Naipaul refused to hold back their revulsion to the all-pervading filth in India, it still remains a humiliating truth that visitors find out the moment they set their foot in the country.

In his recent overseas tour, Prime Minister Narendra Modi claimed that earlier Indians felt ashamed of being born in India, but now they feel proud. Do they? His point was political. He thought that the change of government in India makes its people proud. But in reality, Indians should still be ashamed because outsiders find their country too filthy to live in; the filth that has permeated every state of matter — solid, liquid, gas and perhaps even plasma. It doesn’t befit a modern nation that’s apparently raring to go.

What Koestler and Naipaul wrote in the sixties and what Harris wrote in 2015 are not anecdotal, but are borne out by facts. According to WHO, India accounts for 90 percent of open defecation in South Asia and 59 percent of the practice in the world. It also accounts for more than twice the number of open defecations of the 18 countries that come after it in the WHO list.

WHO also says that close to 100 million Indians don’t have access to improved sources of water, which is not surprising because our waterways are filled with filth. According to Central Pollution Control Board’s (CPCB) 2011-12 annual report, about 60 percent of India’s water-sources (which are routinely monitored) have poor “bio-chemical oxygen demand”, an indicator of organic pollution, and about 68 percent have faecal coliform — bacteria from shit.

In other words, more than 60 percent of our water sources are polluted with organic waste and faecal matter. This happens because untreated sewage, faeces and other organic wastes are led into rivers and ponds that Indians draw their water from. Industrial waste and toxic substances that are dumped into them on an hourly basis make them lethal. All major Indian rivers are polluted by industrial effluents and untreated sewage. In its report, the Pollution Control Board even specifically mentions how under-capacity sewage treatment plants let out raw filth into the rivers at various places.

In terms of air quality, the principal concern of Harris in Delhi, 79 percent of metropolitan cities have very high levels of particulate matter and nitrogen dioxide, both of which are the main causes of air pollution. Among the four metros, the presence of particulate matter in Delhi is a well-known story and is obviously rising compared to others. But Delhi is not alone, many other cities, including small towns are asphyxiating in their own emissions.

Delhiites can be peeved because Harris picked on their city while the rest of urban India is no different. It’s only a matter of degree of criticality (air pollution levels are classified as low, medium, hight and critical). The fact of the matter is that urban India is rotting and is sinking in its own filth.

Can the Prime Minister’s boutique project of “Swatch Bharat” change this?

Absolutely not, because the socio-economic determinants of this environmental degradation are far deeper than what’s apparent. With more than 42 percent of its population living in 53 cities, India’s urbanisation is so skewed that it’s hard to provide a matching civic infrastructure and therefore untreated sewage will continue to flow into rivers, lakes, and open places. If the agriculture and rural employment continue to fail, it will get worse.

Without stopping open defecation, the spread of coliform and other parasites cannot be stopped. Without cracking down on crony-capitalists, including big corporates, the dumping of effluents into rivers and toxic gases into air will not stop. Without providing reliable public transport, the ambient air can never get clean.

And more importantly, all these are to be handled at the local level by the state governments and local bodies. Given the pathetic standards of governance and political priorities in some states, it’s a daunting task.

In the end, India’s filth is a metaphor for its overall ills that include poverty, inequality, castes, corruption, poor development policies and greed. It’s not a question of aesthetics, but a question of fundamental social change.

 

[Han Patriot]

New Delhi: Citing numbers that could come as a shock to many people, Ramanan Laxminarayan, director of the Washington-based Center for Disease Dynamics, Economics & Policy has said that India probably already has tens of millions of COVID-19 infected people. He says the nationwide part of the ICMR’s recent serological survey which suggests that 0.73% of the population has been exposed to the virus corroborates this. Laxminarayan says he believes India could have 200 million COVID infected people by September.

In an interview to The Wire, Laxminarayan said there is no real difference between COVID-19 infections and COVID-19 cases except for the fact that what we call ‘cases’ are officially recorded infections whereas other infections have either not been detected or recorded. The majority of these will be asymptomatic people although a few might have mild infections which they have not bothered about.

However, Laxminarayan refused to relate his forecast of 200 million infections by September to a corresponding figure for the number of deaths.

He said that whilst the phrase ‘community transmission’ may not be a technical phrase, its meaning in common parlance is clearly understood. It means that people are getting infected from within the community without knowing from whom or how. In other words, the source of the infection cannot be traced to someone who has come from abroad or been in touch with such a person. In that sense, he said, there was no doubt that community transmission was happening in India.

Laxminarayan said he was certain that the return of millions of migrants to villages in Bengal, UP, Bihar, Orissa, Chhattisgarh, Jharkhand, etc. will lead to a surge of infections in these rural hinterlands. However, he was reluctant to accept reports in several newspapers that India would see its peak only in mid-November. Instead, he said India would see several regional peaks as individual states hit their peak at different times. He said in overall terms, the picture or graph is of a high plateau stretching for several weeks or months with different states or regions peaking at different times.

Questioned about the second part of the ICMR serological survey – which has not been officially released but has been widely leaked – which suggests that in hotspots and containment zones up to 30% of the population could be infected, Laxminarayan said it seems difficult to believe the percentage could be so large because such a sizeable number have not been infected so quickly in any other country. However, if true, it would certainly be good news because it would take these containment zones and hotspots a lot closer to achieving herd immunity which, at an R-O of 2, needs 50% infection levels.

However, Laxminarayan pointed out that even if the leaked percentage figure of 30% is correct, a lot depends upon the size of these hotspots and containment zones. It would be meaningful if a containment zone comprises an entire city of the size of Delhi or Mumbai. It would be a lot less significant if containment zones are just a few streets or a small locality in a city.

Laxminarayan was dismissive of attempts to compare India’s mortality rate, whether per thousand or as a percentage, with that of other countries to suggest that we are doing better. Not only are mortality rates calculated differently in different countries and thus not comparable but, furthermore, he illustrated his scepticism by citing the example of setting fire to two forests, one of which is 10 acres and the other 100 acres. He said both will burn at the same rate and the destruction in the burnt areas will be equivalent but, obviously, the bigger forest will take longer because of its size.

Laxminarayan also seemed to suggest that there are many questions that can be asked about the accuracy and reliability of India’s mortality rate. Are all COVID-19 deaths being counted as COVID deaths? The recent controversy in Delhi and, now, in Mumbai as well suggests that a fair number of COVID deaths are not being taken into account.

He said the biggest challenge facing the government as it gears up to handle a possible 200 million infections by September is organising the healthcare system to respond adequately. He said the answer is to move medical staff and facilities from an area where the virus is under relative control to another where it is peaking. There is no way that in the limited time available, India can actually build up a sufficient number of doctors or trained medical staff. He was particularly dismissive of government plans to rapidly train doctors to become intensivists and to adopt telemedicine handling of ICUs.

Asked whether the decision of the Tamil Nadu government to impose a stringent lockdown on Chennai and three other districts from June 19 is correct, Laxminarayan said it is not necessary. He said the situation in Chennai was under control and this second lockdown is not needed.

Finally, Laxminarayan explained that the fact nearly 50% of COVID-19 deaths in India are of people under 60 compared to just 4% in Italy and 5% in the whole of Europe does not refute the belief that India’s strength against the virus is the fact that it has a young population where 90% are under 60. He said there are many more people in India under the age of 60 than in Italy, which is why it is to be expected that more people of this age group would die in India than in Italy. But, he forcefully argued, that does not undermine the argument that with a young population, India’s ability to withstand the virus is greater.

https://thewire.in/health/india-probably-has-tens-of-millions-of-covid-19-infections-already

Even he doesn't believe the death rates. Its classified as diarrhea deaths apparently or starvation. Makes no difference since alot of jobs were lost and they are starving anyway. So it's a question of what is killing them first, starvation or pneumonia.