May 07, 2020

A New SARS-CoV-2? 

A study has found that a new highly potent, ‘more contagious’ strain of Covid-19, named A2a, has become dominant world over.

Why is this worrisome? Not only does this version spread faster, but unlike many other viruses, this one could make you more susceptible to a second infection as the mutation allows the coronavirus to enter human respiratory cells more effectively.

Most scientists developing vaccines against Covid-19 are working on the assumption that the virus is stable and less likely to mutate as rapidly as the seasonal influenza virus. This discovery could change that. Vaccines developed must be effective against this particular strain as it is the most prevalent and can take us closer to reaching herd immunity. However, if mutations in the virus continue, effectiveness of such vaccines would be limited.

We don’t know if this new strain is more dangerous than the original, but it has a much higher rate of transmission, making social distancing all the more important.

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May 06, 2020

This Is Why The World Is Wondering About Heat And Immunity

A COVIDIndia.org analysis reveals that there is a zone of lower COVID density in hotter Africa, Southern Asia, Oceania region. Multiple reasons for why this might be have been proposed.  

One hypothesis is that countries with existing BCG vaccination programs have higher conferred immunity. Another points to lower transmission due to heat. A third is that widescale testing does not exist in some areas. Countries with widespread malaria have also been offered as a hypothesis. There is even a theory that widespread use of the flu vaccine may reduce the immunity of people in some of the developed countries. None of the theories have been proven, but many believe there’s something different going on in this region.

 

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May 05, 2020

Will We Ever Get A COVID-19 Vaccine?

Vaccines, a long term innoculation against infection, normally take more than years, if not decades, to develop. Some viral diseases, such as dengue and HIV, still don’t have one. Currently, there are over 100 vaccine candidates in preclinical trials for Covid-19 and around 5 have progressed to the clinical evaluation stage. The first human trials began in Seattle, USA and Oxford, UK last month. Scientists have fast-tracked the process by not conducting animal trials (preclinical evaluation) to test its safety. Even with human trials, optimistically, we could have a successful vaccine only by mid-2021. Assuming that there will be a limited supply initially, only risk groups will be vaccinated first, including healthcare workers, children and older adults. So, it’s better that we get accustomed sooner rather than later to this new normal because no magic drug is going to revamp the situation anytime soon.

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May 04, 2020

Global Curve Signalling End Of Phase One?

Global COVID-19 cases have risen to about 3.5 million on day 156 since the day of the first case. However, the good news is that the rate of increase is not increasing and the doubling time has doubled as well. This is taking us closer to the flattening of the global curve, which is a situation in which each day sees a reduced number of new cases.

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May 03, 2020

Neutrophils – Fighters Of Infections, Aggravators Of COVID-19?

Neutrophils are white blood cells that protect us from infections. Amongst their functions, they sometimes form Neutrophil Extracellular Traps (NETs) to destroy microbes outside the cell. When NETs are not well-regulated they can cause an abnormal inflammatory response and blood clotting. Researchers have found that severe COVID-19 patients have increased NET blood levels. It is believed that blood clots and respiratory failure in COVID-19 patients could, in fact, be promoted by excess NET formation.

It is well understood that the cause of death by COVID-19 is often a result of the massive, immune response in some patients. Now, NETs are believed to be part of this response both directly, and indirectly by promoting the infamous ‘cytokine storms’, a massive inflammatory reaction in the body.

If true, treatment that inhibits development of NETs could dampen the body’s response and prevent it from losing control. The good news is that many drug candidates for this already exist and are in various stages of clinical trials for use in COVID patients.

Source: NCBI

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May 2, 2020

Bemcentinib, Cancer Drug – A Cure For COVID 19?

Bemcentinib, traditionally a cancer drug given along with chemotherapy, has been fast-tracked into human coronavirus trials in the UK. The medication, which comes as a once-a-day pill, has previously prevented immune invasion, drug resistance, and growth of cancers. The hope is to see it boost an immune response in COVID 19 patients and keep the virus from entering and multiplying in the lung cells by turning off the AXL receptors.

If the testing is successful, we can hope to see suitable treatment for COVID 19 soon.

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April 30, 2020

COULD The Cure To COVID Be COVID itself? – A Radical Idea And A Call For Data

At this point there are over 3600 genomes of the SARS-COV-2 virus. This in itself is not more newsworthy than saying people have different eye colors. At some point though, it calls for a thorough understanding: Is there one strain or more? What’s driving the pandemic? And more importantly, are there strains that are not driving the pandemic, and why not?

According to Indian scientists, there are up to 11 strains and only one driving the pandemic in India, which is the original strain from Wuhan. However, why are the other strains not driving the pandemic. This could be a lower transmitability, a lower infectivity, or much higher levels of asymptomatic infection. The last two, bring forth a radical notion. Is it possible to vaccinate an individual using a milder strain of the active infection – analogous to what we used to do with kids and chicken pox, knowing that childhood infection is much milder than adult infection.

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Image Source: Nextstrain.org

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April 29, 2020

PCR Vs Antibody – What Is What And What Is Better?

Two different types of COVID tests are being referred to in media, the PCR and the antibody. But what are they and how are they different, and why do we even need two?

One is the PCR test (polymerase chain reaction test), in which an oral or nasal swab is taken. This tells us whether a patient is currently infected by looking for genetic material of the virus.

The antibody test, however, looks for the the antibodies that the human body forms in response to the infection. If the antibodies are there, that means we are currently or have previously been infected. If not , it means we have never been infected, or it is too early in the disease and our immune system reactions have not kicked in.

So really, PCR test for infection, while antibodies test for immunity, or more accurately, immune response.

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April 28, 2020

What is R0 And Why Should We Care About It?

Basic Reproductive Number or R0 (pronounced R-Naught) is essentially the average number of people who will contract a disease from someone who already has the disease. Covid 19’s R0 is estimated to be between 2-4, implying that every sick person will spread the disease to another 2 to 4 people. This cycle of reproduction will continue until there is some sort of intervention. If R0 is less than 1, the infection will eventually peter out. But if R0 is greater than 1, it will keep spreading exponentially and cause an epidemic. Thus, only when the R0 will go below 1 can we hope to see the eradication of the virus.
Read more about this here!

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April 27, 2020

Modeling Projections Based On Initial 21-day Lockdown: Is This How It Will Unravel In India?

On 25th March 2020, India announced a nationwide 21-day lockdown till 14th April 2020. A study, conducted by researchers at the Center For Disease Dynamics, Economics & Policy (CDDEP), Johns Hopkins University, and Princeton University, has modeled the impact of the 21-day lockdown on the spread of COVID-19 in India before, during, and after the lockdown is lifted. See the full study.

Source: CDDEP

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April 26, 2020

Remdesivir Flops, But Was It Ever Designed To Succeed?

The best hope for a near term vaccine apparently showed in clinical trials that “it did not improve patients’ condition or reduce the pathogen’s presence in the bloodstream” causing an 8+ billion dollar drop in the market cap of its maker Gilead Sciences. But was it ever designed to succeed. Remdesivir is an antiviral designed to stop the virus from replicating (see our 3D animation). But the first set of trials were all late stage trials in very severe cases. In severe cases it is the massive immune response that kills the patient not the virus itself. Therefore, reducing the viral load at that point is most likely the proverbial ‘too little too late’. Stopping the pathogenesis, or progression, of the disease with antivirals usually requires intervention in the early stages when the viral load is building. Indeed, Oseltamivir, or tamiflu, used as a prophylactic against swine flu is required to be taken within 48 hours of symptoms.

Thus by requiring that trials be conducted on severe patients first, remdesivir was potentially due to the fail from the beginning. However, the possibility that remdesivir still can be used as a prevention or early stage treatment can not be ruled out.

Source: BBC

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April 25, 2020

Modi’s Lockdown Strategy Dates Back Nearly 700 Years

Recently , a loyal visitor asked CIO for a map of quarantine centers. Our first thought was every house in the country is a QC. We didn’t know how right we were until we came across the origin of the word quarantine. During the mega pandemic of the bubonic plague in the middle ages, one city in the then Venetian empire (now Dubrovnik) instituted an embargo on arriving ships for thirty, and subsequently 40 days (in Latin quarantino). Similar to what happened with the Diamond Princess in Japan. Modi’s lockdown from March 25 to May 3rd is similarly a 40 day period. In effect, the whole country is a quarantine center. A strategy that was invented in the 1300s and still used today.

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April 23, 2020

Projections Show That Pandemic Could Peak In India By Mid-May

A study has predicted that the pandemic could peak in India by the middle of May, after which there will be a gradual decline. The report estimates that India could see the number of coronavirus cases crossing 75,000 around May 22 and gives an indication of when it might be safe to lift the lockdown. See the full study.

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April 22, 2020

Can The Curve Be Flattening Even Though Cases Are Spiking?

India has reported over 20,000 confirmed cases. Today, Maharashtra, Rajasthan, and West Bengal reported their largest single-day rise in cases. However, the doubling rate tells a different story. At CIO, we have tracked the doubling rate in real-time since mid-march. The doubling rate has slowed to over 7 days in the last week compared to 3 days before the lockdown. At present, we calculate a doubling rate of approx 8 days, indicating a progressive slowing. The recent spike in daily cases per day, means that the curve flattening could also be a lower but constant exponential growth rate after lockdown rather than a progressive decrease in the rate.

Confirmed COVID-19 Cases in India

* 3 initial cases in Kerala recovered; This chart shows from the resumption of cases on March 2nd.

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April 21, 2020

Widespread Asymptomatic Data Means Testing Needs Ramping Up?

As testing is being scaled globally, asymptomatic positive cases are emerging in significant numbers. In some Indian states, including Maharashtra, UP, Punjab, Odisha, and Assam, asymptomatic infections are higher than symptomatic infections. In Jharkhand, 35 out of 36 cases (see the chart) were asymptomatic at the time of testing. The section of the population showing mild to no symptoms are in the 20-45 age group. Concerns are increasing of asymptomatic transmission. However, the ICMR has stated that the testing strategy has adequate provisions for suspected asymptomatic people, with travel or contact history, and those with influenza-like illness, and severe acute respiratory illness in high-risk areas. In a previous key insight, CIO showed that successful countries have early Mega Scale Testing.

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April 15, 2020

COVID-19 cases grown 20x in India during lockdown; see how other countries compare with India

In his speech on April 14th, The Prime Minister said that thanks to the lockdown, the growth of Indian cases after 550 cases was less than in other countries. We compared the 21-day growth all world countries post the 500 case mark to validate or dispute this. See our interactive chart.

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April 13, 2020

Convalescent therapy – does it in fact work?

Kerala is set to become the first state in the country to commence clinical trials of convalescent plasma therapy. This therapy uses antibodies from the blood of cured patients, to treat critically ill COVID-19 cases. Convalescent plasma has been around for over a hundred years. If it works, why didn’t countries start using it immediately? Why do we need clinical trials for a century old procedure? Read more about the muddied history of this technique.

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April 10, 2020

Why India Should Mega-Scale its testing program

Countries that test more, catch infections early and can mobilize contact tracing faster; thereby managing the outbreak better. The hardest hit countries, like the US and Italy have not tested enough and so have a high percentage of positive tests. Germany, however, has fared better and its vigilance is reflected in widespread testing. South Korea has lead the way with massive testing without a prescription, and has been a success story in managing the COVID outbreak so far. Indian positive test percentages started low, but are now rising. India needs to step up its testing program to stay ahead of the pandemic.

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April 9, 2020

Rajasthan strong in testing

A low number of test with a low number of infections sometimes indicates that the state is not testing enough. A high number of tests with high infections also can indicate that more testing needs to be done. But Rajasthan has a high number of tests with a low case positive rate, indicating that it is strong in tracking the spread of COVID.

Data indicates Rajasthan treatment protocol effective

Studies show that the average time to death for a fatal COVID case is approximately two weeks. But Rajasthan has 430+ COVID infections, with some of the oldest cases. and still has a very low number of deaths. How is Rajasthan treating patients? To know more see treatment section.

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April 8, 2020

76% Of Positive Cases In Maharashtra Have No Symptoms

Two days ago, covidindia.org concluded that only severe cases worldwide were being tested. Now, Maharashtra released data shows that most (76%) cases are asymptomatic. It stands to reason that many more asymptomatic people would never have been tested. This would indicate a far lower mortality rate than can be calculated from confirmed cases.

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Maharashtra Data Confirms Community Transmission

An analysis of travelers vs. non-travelers shows that no growth in travelers in the past 11 days vs more than 5x growth in non-travelers.

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April 7, 2020

India is not immune to COVID-19

While we suspect there are many mild unreported cases in India (see only severe cases reported) as has been the claim for other countries. the data of the first 4067 cases released by MoHFW shows very similar patterns to the WHO joint study in China of the first 72,314 patients. The severity of cases with age and even the Case Fatality Rate reported thus far are similar. Though the sample size is low, Indian’s show no sign of immunity to COVID-19

Source: PIB

April 6, 2020

Worldwide, only very severe cases are being reported

CONTEXT: Numerous studies have described the pathogenesis of the disease. As a result, we know that the time to death for mortality cases mostly ranges between 9-20 days, with 14-15 days from detection as a reasonable average.

METHOD: We looked at the number of deaths in countries with over 1000 cases on April 3rd. We then compared them to the number of reported cases two weeks prior, as these cases would on average be part of the reported cases at that time.

CONCLUSION: The number of deaths as of April 3rd was a very high percent of the cases reported on March 19, with the world average at 27% ! Since we know by all accounts that the mortality is anywhere from <1 to 4% , this indicates that in most countries in the world only very severe cases that are much more likely to be fatal are currently being reported.

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April 3, 2020

Are we testing the right people?

Only a low percentage of tests come positive, meanwhile the curve is not flattening. Stories are emerging of people who have symptoms being turned away from testing because they didn’t have travel history. We have missed the start of community transmission, by prohibiting potential community transmission cases from being tested.

Confirmed COVID-19 Cases in India

3% Of Tests Come Positive

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April 3, 2020

Join Us! Help Us Combat COVID-19

The COVIDIndia.org project is not just a website.  It is a movement, supported by 250+ volunteers.  Besides the timely, actionable, credibly sourced, and verified content on the site, we are engaged in numerous offline activities to help increase ventilator production, introduce rapid testing kits, build contact tracing tech and much more.  

If you want to help, please fill this form.  This is your chance to be part of the human response. No one will forget 2020 !

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