
India Could Be Next Virus Hotspot with an ‘Avalanche’ of Cases - JumpCrisscross
https://www.bloomberg.com/news/articles/2020-03-17/india-could-be-next-virus-hotspot-with-an-avalanche-of-cases
======
sumgame
Fellow Indian here who's been tracking this since Feb.

Highlights of what I think are the biggest risk: The number of tests being
performed in India are 20x less than most other countries, though it has
ramped up in the past few weeks, there was a free flow of international travel
till then.

My fear is that because the virus is asymptomatic, there are a lot of active
carriers freely moving around. Most companies in India also find WFH an alien
concept, even in tech, so it seems like most people still have to go to work.

I believe that the urban density in India is too high to stop something like
this even from a lockdown. Also the lockdown would only help the middle class,
there is a large section of urban poor that depend on daily wage that can't
stop working. They depend on this money for food and shelter.

Overall, the avalanche is imminent, and I believe that the situation could be
dire in the cities.

As tests ramp up the true impact will be seen but I fear that we'll always be
behind the curve on this because of the difficulty of mobilizing testing at
such scales.

The only way we can avoid large scale impact is if the virus finds it hard to
survive in the heat, now that summer is in. Temperatures are rising but there
is no consensus on whether that hinders the spread.

~~~
bilbo0s
> _The only way we can avoid large scale impact is if the virus finds it hard
> to survive in the heat_

Personally, I'm hoping against hope that the heat really does slow this virus
down. I don't really have much faith in the policies that the various
developed nations have enacted to deal with this particular threat. Not really
the fault of the leaders, This situation's just something that has not been
seen previously. No experience with it at all. I do think governments are
emphasizing the wrong things and not being comprehensive. But so are the
people. We're buying toilet paper, but leaving soap on the shelves? But
overall, governments at least seem to concede it is a threat at this point.

If the heat won't help us? We're in trouble. If India's heat doesn't slow it
down, we're gonna be living with this virus for a good long time. Everyone
should be rooting for India and Africa at this point. Cut off the rest of the
world from those two places so that we can see if the spread is, at least,
impaired a little by the heat or the humidity.

~~~
robocat
> Not really the fault of the leaders, This situation's just something that
> has not been seen previously.

This is the fault of the majority of our past or present leaders that ignored
history and ignored the warnings (recently SARS, MERS, Ebola), and have left
everyone unprepared. Not all countries were unprepared.

A civilised, well run country, deals with risks proactively (and ideally
develops techniques to decisively act reactively as well).

~~~
tinuviel
How did India Handle Nipah?

------
superasn
To add to this the UP govt is planning an "Ayodhya Ram Navami Mela"(1) where
millons of people will be gathering soon. They plan to tackle this by using
100k masks, 4,000 litres of sanitiser.

(1) [https://theprint.in/india/governance/despite-coronavirus-
lak...](https://theprint.in/india/governance/despite-coronavirus-lakhs-to-
gather-in-ayodhya-because-this-ram-navami-is-different/381972/)

~~~
Osmium
> On Monday, the CMO cited the chief minister’s advice against large
> gatherings to say they didn’t have “infrastructure to screen and hand out
> masks to 5 lakh people”.

For anyone interested, I did some quick math and it seems like it'd be about
two tablespoons of hand sanitizer per person (500k people / 4000 litres).

~~~
compressedgas
Not 2 but 1/2\. You did the division backwards and got the reciprocal. It is
0.5 tablespoons per person. What you got is 2 persons per tablespoon.

Google states that for: "(4000 litres / 500000) in tablespoons": the result is
"0.541024363 US tablespoons"

~~~
gramakri
This of course assumes zero waste. And also availability of water

------
ISL
The underappreciated risk is Russia. They claim only 63 cases, all "imported
only". That number has been very slow to rise.

[https://www.who.int/docs/default-
source/coronaviruse/situati...](https://www.who.int/docs/default-
source/coronaviruse/situation-
reports/20200316-sitrep-56-covid-19.pdf?sfvrsn=9fda7db2_6)

It is very hard to believe that there is no local transmission, and very easy
to believe that any covid-19 news there is suppressed.

~~~
high_pathetic
That's because they had only tested people who came from abroad and had
symptoms.

Today's numbers are 114 total. They have started testing people with symptoms
who had immediate contact with the infected..

------
dr_
It’s somewhat hard to believe that a country with a population of almost 1.4
billion, has only 137 cases and 3 deaths. It’s more likely they have not been
diagnosing and tracking the actual cases out there.

~~~
mcsb4
As the article states, India is currently doing 500 tests per day. Germany is
doing 160.000 tests per day.

~~~
pmlnr
160k a day? No way. Citation needed. So far total tests in UK are ~30k.

~~~
mcsb4
I can't find the source anymore, but the latest Roche AG systems are capable
of doing 4000 tests per day. The last generation was 1000 tests per day.
Germany also is doubling the capacity of intensive care beds from 28000 to
56000. There is enough money for the machines. Also look at the ratio of
infected to dead: 7000->20, while Italy 30000->2000\. Just more tests.

------
Bhilai
One of the key challenges for India will also be to fight the spread of
misinformation through WhatsApp and Facebook. There is false information and
unproven remedies being circulated on WhatsApp and people blindly believe what
gets forwarded to them giving them a false sense of security.

~~~
KorematsuFred
People using unproven remedies is not really a problem. It does not help but
it mostly does not hurt either. I am moderator for super large fb groups and
over dozens of whataspp groups and I find them to be a boon in the moments of
crisis. We have been able ot convince people of its seriouseness, got
marriages to be cancelled and religious ceremonies to be postponed.

~~~
jimmux
It can absolutely hurt. I have a relative who uses this particular snake-oil
despite everyone pleading for him to stop. Now he's using the pandemic to push
it on the rest of us again.

Prepare to be horrified: [https://jimhumble.co/blog/a-word-on-
coronavirus](https://jimhumble.co/blog/a-word-on-coronavirus)

~~~
StrictDabbler
Oddly, chlorine dioxide gas isn't a bad idea for this outbreak... but only for
disinfecting buildings while empty, not for taking as an internal treatment.

------
dageshi
Do we know if the virus does worse in warmer climates? I ask because I'm still
amazed that the numbers in south east asia are so low, Thailand and Vietnam
had huge amounts of Chinese tourists over Chinese new year and yet case wise
they seem really low. Whereas europe which has a much colder climate right now
is doing much worse.

~~~
Leary
It's probable that the virus transmits less readily in warmer and wetter
places. By how much however, is a key question. Unless the R0 becomes less
than zero, then countries still should take precautions to control their
outbreaks, especially in densely populated cities.

~~~
rrrazdan
R0 cannot be less than zero, unless a patient can actually cure other
patients.

------
robertpelloni
Chloroquine being OTC there may be beneficial, I am eager to see more data on
its efficacy.

~~~
bushido
I spoke to a few folks in India, and seems like the majority are on some form
of maintenance dose of chroloquine from a getting malaria in the last 6-8
months. I hear this is pretty common practice there.

And not just OTC, but handed out for free and in large quantities at govt
hospitals.

I am eager to see this data as well.

~~~
rrrazdan
I am living in India right now and have never heard about this. It is
interesting that you would gather that the majority of us are on some dose of
Chloroquinine. Nobody I know, is.

~~~
stickfigure
I had the same doubletake at first reading, but I suspect GP meant the
majority _of the folks s /he talked to_.

~~~
bushido
Yes, that's what I meant. I can't possibly assume that the handful of people I
spoke with are a representation of the whole country.

------
thorwasdfasdf
worldwide number of new cases appear to be leveling off:
[https://www.buzzfeednews.com/article/peteraldhous/coronaviru...](https://www.buzzfeednews.com/article/peteraldhous/coronavirus-
updating-charts-maps)

that's pretty darn encouraging, considering most places haven't gotten serious
until recently.

~~~
Tomminn
Wait, are you saying that based on the very last data point? That is, based on
the data point related to a day that hasn't finished updating?

~~~
thorwasdfasdf
look at the last 4 or 5 days, the midpoint is about flat.

------
sandGorgon
Unless of course the HIV medicines and chloroquine do work to cure COVID-19.

India is after all the generics manufacturing capital of the world. We can
churn this stuff out by the billions.

Fingers crossed.

~~~
ignoramous
It is my understanding that chloroquine isn't exactly elixir to the already
ailing elders. So, the section of population that's the most vulnerable is the
one that simply can't take in doses of chloroquine without worrying about
grave side-effects.

------
hiyer
If there were really a lot of hidden cases I would have expected a lot more
deaths - especially considering Corona mostly affects people in urban areas
where hospital access is decent. That being not the case, either there is not
too much spread or Indians are somehow immune to most COVID19 effects.

------
yumraj
India's _Patient 31_

[https://timesofindia.indiatimes.com/city/agra/techie-had-
not...](https://timesofindia.indiatimes.com/city/agra/techie-had-not-tested-
positive-when-his-wife-left-bengaluru-google/articleshow/74618637.cms)

In addition India has a huge population with hypertension, who are on ACE
inhibitors or ARBs, and diabetes.

~~~
RHSeeger
> After the medical team reached the house of the woman’s parents, her father,
> a railway engineer, refused to cooperate with us and lied that his daughter
> had left for Bengaluru. But after the district magistrate’s intervention, we
> were able to gain access to their house and took all the nine family members
> to the district hospital for screening."

Wow. Just wow. What do you have to be thinking to come to the conclusion that
"screw everybody, we'll just spread the illness" is your decision? At some
point, isn't it attempted murder?

Also, shame on that site for hijacking the copy functionality.

~~~
robocat
> What do you have to be thinking to come to the conclusion that "screw
> everybody, we'll just spread the illness" is your decision?

Give the guy the benefit of the doubt: then the question becomes “why would a
sensible person act that way towards authority?”... Perhaps someone local
could answer whether he was acting sensibly, or whether most local people
would act the same way?

------
vuln
A rather large MSSP enacted WFH for their employees last week. India will be
very interesting for sure.

------
redpillor
i will call it bullshit. western media is just pulling up conspiracies against
india so that they can divert their problem towards india. this is the same
trick pakistan uses when army over there gains extra power or does some shady
shit.

