1. I am going with the assumption that community transmission might have started at some location; but with that assumption this 21-day lockdown becomes an imperative and excellent step.
2. Will people obey the lockdown? (This is not a curfew, as essential services would be open.) Many people, sadly, would not. That is where the sometimes-criticized high-handed approach of police and other agencies would be useful.
3. I am optimistic about this period. At the end of it, if nothing else, we would have more data points to make thoughtful decisions about how to proceed and what other measures need to be taken.
4. Testing is being ramped up, and I hope it is an exponential ramp-up. Local test kits are also approved and beginning production today.
As a nation with 4X the population of the USA, and 1/3rd the area, the population density in India and particularly in the urban areas is off the charts. Hence, the approach suggested in some other countries, like carrying on with walks, exercises and other outdoor activities while practicing 'social distancing', gets much more difficult.
It is nearly impossible to be outdoors in urban areas and not have people nearby. As such, measures have to be very strict. I imagine the situation was similar in Wuhan in China, and they had to impose a complete lockdown as well.
Also no suspension of EMIs, loan repayments, rent collections etc announced till now.
More questions remain.
Better than losing the sole earning member of the family to an avoidable disease. :(
There is no compulsion that I know of, but most of these businesses have associations and lobbies that will be dealing with the government and trying to keep things open. I have no doubt there will be disruptions all over the country. There are no precedents of such situations, nor would I expect any kind of Standard Operating Procedures to be in place.
It's gonna be chaotic - but hopefully not deadly. And that is the important thing.
Last few days, I have been thinking how disastrous a widespread infection would be in India. I shudder thinking about the numbers if this goes out of hand. A small percentage of 1.4 billion is a huge number. To avoid that, frankly, I'd accept temporary draconian measures.
I have been preaching "Stay at home" to everyone in my circles who would listen. Hope you do the same. :pray:
The military will deliver the food to you. Only thing you need to ask yourself as an Indian is the degree of integrity, honesty, and uprightness of your ruling class. [edit: and not to forget, + authoritarian tendencies]
- Many people are making excuses of getting groceries/milk/medicine to roam.
- Some people are just treating it as picnic and roaming streets to see what a lock-down looks like. Local police was perplexed with this thought.
- People who are in essential services are having hard time to get to their workplaces. For example: my sister is a Bio-medical engineer in local hospital and she is not able to book a cab or take local public transport. Today I went to drop her off and police stopped me twice to ask why I am out. We need to somehow make this easier. So essential services and their support can function.
What a sad way of handling things.
Edit: and most of the people who loiter around do it in groups, everybody from a different household.
Edit2: source: I used to be one of those at some point in my life. Thankfully there was no pandemic at that time.
Jokes aside, this was a needed measure in India. I just hope the government gives a helping hand to the poor, even if it means I have to pay double the tax this year.
Places where you can get them : https://twitter.com/BhardwajAnanya/status/124209734947373056...
Also I am worried about support services to essential workers as well. Like just today, my sister(see GP) called a medical equipment company to come and fix an issue with their device that her team is not able to fix. The company refused and just said to talk over video call.
Also newspapers continued to publish and be distributed.
Of course the country is so huge I only have my own experiences and that of family members (I happened to be traveling alone that day so had my own experiences).
I read somewhere that there are districts in India with more people than the entire population of Norway!
Given India's geography, these nation-states would likely find equilibrium in a permanent state of war. Given India's history, this hypothesis has basis.
The client states didn't even have to cease to exist once they lost actual control.
We helped Bhutan too during the Doklam crisis. India won't and will never invade. So these small countries feel safe. The only time India failed was when India couldn't stop the invasion of Tibet by China. Subsequently, we also lost a War with China when it occupied a portion of Ladakh (Aksai Chin). That loss made us realise the importance of being a nuclear power. So India strengthened only when we acquired nuclear capabilities. That has kept both Pakistan and China in check and ensured some form of stability for the smaller countries that share borders with India.
I don't know what that would look like because I don't know India that well, but I do know that the guys at work from Tamil Nadu are very different from the guys from Northern India. It's not a Texas vs California difference, it's a "we don't even have the same mother tongue" difference.
What is wrong with that? Belgium and the Netherlands are successful peaceful multilingual countries.
Interesting. Your "solution" to the India-Pakistan conflict is to break up India. You also claim the antagonism is one-sided and coming from India.
What makes you think Pakistan will respect the sovereignty of an independent Jammu and Ladakh? What makes you think the Pakistan and Gujarat border will be peaceful?
And Pakistan has thrived on the Hindu-Muslim conflict in India. It'll be counterintuitive for Pakistan to dream of seeing India broken up. The antagonism with Pakistan is deep rooted in the psyche of Indians and is something that will never die out. No matter how you divide and subdivide the country. The reason for that is behavior of Pakistan itself. Indians don't forget atrocities done over them so easily. If Pakistan wants improved relations with India or a hypothetical 36 mini-Indias it needs to get its house in order. That will never happen because of its love for housing Islamic Terrorists (like Osama bin Laden and other outfits).
And speaking of Pakistan, it has more to prove that it is a good neighbor than India does. We have good relations with all neighbours except Pakistan. The same can't be said for Pakistan. Pakistan's only ally in the region is China. The other two are Malaysia and Turkey. India is friendly with the World. We have no problems with anyone else. So no one will buy Pakistan's premise that it is somehow the afflicted one here. It is an immature nation that has ambitions way higher than what it is actually capable of.
What makes it worse for Pakistan is its track record of keeping allies. It backstabbed USA and recently backstabbed Malaysia and Turkey too. Wasn't it Imran Khan who wanted to create a separate Islamic block from OIC with Malaysia and Turkey? Then he skipped the first ever meeting of the new Islamic block backstabbing both Malaysia and Turkey in the process. Mahathir lost his chair too because of his hatred for India. Now Malaysia is trying hard to placate India which had always been friendly with it. All because it believed Pakistan. Malaysia ended up losing a trustworthy friend like India and did not gain a friend in Pakistan. The damage it did to Malaysia-India relations is massive. It negatively impacted Malaysian economy. India never forgets insults and atrocities committed on it. Malaysia was literally begging India to restart palm oil imports after Mahathir stepped down and a new Government came into place. Building allies is a hard task that only mature countries are capable of. You can't behave like immature kids in the International community. People see through lies and deceit and will never work with you again. All these factors weigh against Pakistan unfortunately. Pakistan literally destroyed its own image. India was just a catalyst for it. Nothing more.
1. States have some level of independence in India, and that is quite messy to handle. It would be a bigger mess if it were nation-states. Think EU.
2. People won't accept - it may have been a possibility 20 years back. They have seen the consequences of allowing to create first version Pakistan. And if they were forced to chose sides - the smaller nations would be at war and civil war.
And the ungovernable part comes from the mediocrity and complexity mindset. That is more prevalent in the government. The newer generation is different and we might see sudden improvements to India overall after the next 15-20 years, as the older folks fade away
We could be United and stayed secular together, but secularism was not acceptable to the Muslim league.
And yes, creation of that theocratic state, the violence of partition, and the terrorism caused by that theocratic state is the reason most Hindus don't like Pakistan and have an inherent distrust of Muslims.
Btw, my understanding of causality is not agreement of the riots and the violence.
The riots and violence in India today is directly caused by the current government's policies. I know that before Modi, even my religious but western-educated Pakistani friends would point to India and say we should be like them. Not so any more. Something has changed in India in the last decade - blaming an event from three generations ago does Indians and their intelligence a disservice. It implies that they are not in control of their own destiny and are instead held hostage by a three-generation old event.
> blaming an event from three generations ago does Indians and their intelligence a disservice. It implies that they are not in control of their own destiny and are instead held hostage by a three-generation old event.
Great point. I have mixed feelings about this statement. We've had 4 wars with Pakistan, countless terrorist attacks, and Kashmir as a never ending problem for both nations. While that should ideally only route Indian ire towards Pakistan as a nation - the problem is that it also somehow festers mistrust towards Muslims in the country. The can of worms is somehow never really closed. The 3 generation old event continues to affect our lives.
It also doesn't help that Muslim society is fairly insular and conservative. They are seen with suspicion as being sympathetic to Pakistan. Example : Reports of celebration of Pakistan's victory over India in cricket matches (which is a very very sensitive issue if you are Indian). This isn't an attempt to blame Muslims in India, but it does contribute to a disconnect between the non Muslim and Muslim populations in India. Muslims are somehow seen as outsiders due to the historical animosity - invasion, conversions, creation of Pakistan etc. Some of the other minorities like Christians do not face such discrimination because they're seen as just being regular Indians.
I agree with you that it is downright stupid. BJP does not make it any easier to bring these communities closer either. Ultimately, it is intelligence v/s decades of animosity, emotions, propaganda, actions etc. I personally think the younger generation (millennials and younger) see through the charade and am optimistic about the future.
Good story you tell yourselves. Start a country based on religion, and then act surprised that it turned religious. This is your second prime minister "I do not agree that religion is a private affair of the individual nor do I agree that in an Islamic state every citizen has identical rights, no matter what his caste, creed or faith be ...
— Governor-General Khawaja Nazimuddin, 1948–49, "
> I know that before Modi, even my religious but western-educated Pakistani friends would point to India and say we should be like them. Not so any more.
I agree that india's going down a dark path and Pakistan should aim for better. Btw, India is still better than Pakistan for rights of its citizens.
> Something has changed in India in the last decade - blaming an event from three generations ago does Indians and their intelligence a disservice
Saying that they are well meaning and fooled by modi also does the same disservice. There is distrust of Muslims, even Indian ones. Why would there not be? They demanded a partition decades ago, and still hold on to communal Sharia laws.
Such historical events are not and should not be easily forgotten, do we forget the holocaust and not criticize white nationalism?
Add to the fact that Pakistan has constantly delved in terrorism. You said something changed in last decade, maybe because Pakistan committed the Bombay attack in 2008?
Indian Muslims and Pakistans and Bangladeshis are no less natives of the subcontinent than the Hindus or the Buddhists or the Jains are - they just happen to practice a different religion.
I'll assume for a second that you're Indian... let's say your brother were to become Muslim tomorrow. Would he be any less Indian after the fact? Or any less your brother? No he wouldn't. Muslims in India aren't Arabs who invaded and settled, they're Indians who converted. Go back far enough and you probably have a common, Indian ancestor with most of them.
>Prior to 1947, Hindus constituted between 14% to 23% of the population of what is now Pakistan, that is more than the current percentage of Muslims in India. Cities like Karachi (about 50%) and Lahore (roughly 30%) had sizeable number of Hindus. Today, as per the 1998 census, Hindus comprise a mere 1.6%.
Meanwhile the Muslim population in India has grown as a percentage.
It would be better for everybody if there was a whole lot less of that feeling going around.
It’s actually, better than anything else at making enemies for no earthly reason.
In any case, the geographical boundaries of my state in India changed thrice within a span of ~70 years. And that happened peacefully. I can't imagine that happening without wars if the individual states are nation states.
Modi is a shallow imitation of Indira Gandhi in his attempt to centralize powers.
The "Far Right" is to news papery editorial opinion written by 20 year olds.
This is just false. Every government since independence has fought tooth and nail to keep Union of India united a.k.a "one nation" policy. They have, regardless of political orientation, largely made the same moves wrt Kashmir, Naxalism, insurgencies in eastern India etc. Remember who started the unification process in 1947? The current government, right wing and divisive as they may be, isn't doing anything drastically different than any other government in the past. Seems like this is just a cheap shot against a government you don't like.
By all means criticize your government, but I suggest you also acquaint yourself with history.
The last three partitions of India led to three of the largest genocides of the 20th century, so I'm not sure that would be a great idea.
> I read somewhere that there are districts in India with more people than the entire population of Norway!
New York City has nearly twice the population of Norway. Not the metro area - the city itself.
European cities and countries are small by global standards; it doesn't make sense to use them as a point of reference.
The colonial experience basically pointed to this flaw -- that India has to be at military and economic level be a Union. Will India in future fragment, possibly.
But the history from 323 BC till today is the same -- fragmented states and weaker prince seeking bargain with foreign force.
India is imperfect will remain choatic -- top down design of making something out of it will make Syria and Holocaust look like picnic. Be careful what you wish for.
Country as a concept is relatively new. There were Empires and/or Kingdoms.
India as a country is created by British, but that's just about word. India as a big empire existed under many kings.
Ashoka Empire: https://en.wikipedia.org/wiki/Ashoka
Maurya Empire: https://en.wikipedia.org/wiki/Maurya_Empire
Note that edicts mentioned in the above wikis were found outside modern India as a current country.
It's not just the size that matters always, it's about unifying culture. In India, some kings worked in cooperative manner and did not enter wars. For example, in Southern India history, Hari Hara Bukka Raaya (of Karnataka region) did not face trouble with Tiruvankur Empire in cooperative model. At the same time, we had a continuous war between Cholas and Pandyas.
As recently as 800 years ago, Adi Shankara established four mutts in four corners of India. It would not have been possible if people/kingdoms were not united.
Just to give you another perspective, how easy it is to transfer the culture, rituals for generations in entire sub continent if it were not united in minds.
Most unfortunate issue with India is, history is convoluted on both sides. Extreme hinduists expanded original Mahabharatha to double its size, British sympathizers have masked the co-opearative India.
I also keep hearing that it's because of British that we have industry concept. India was the one of the best ship building industry, one of the best clothing industry before British or Europe even can imagine.
Please read Indian history by non-British and their company.
Another unfortunate thing about history is, Cholas and Pandyas empires are not covered much. They spread outside subcontinent, not saying it's great, but it's just the history to be knonwn.
Breaking down countries doesn't always work. Most of the African countries are smaller than India and you still have issues.
Punishments include doing situps, holding ears, rolling around in the dirt, making lines in the dirt with your nose, and light beating with batons.
While some may consider it a human rights violation, I think it's much better than burdening the poor with criminal cases. In fact, in most of the cases people prefer to get this light punishment instead of getting charged with a crime.
Instead, they are subjected to humiliating corporal punishment. This can't be good advertisement for the country.
Unfortunately, that's not likely to work in all parts of India. We cannot expect all first-world practices to work in developing countries.
A lot of rules get made with little understanding of the actual problems and circumstances of a lot of the people they are supposed to apply to.
Not so sure about the others though, but fair enough if it works for you guys.
Seriously, I'm astonished about the rise of people advocating dehumanizing authoritarian measures here.
It's rather unequal (for some people it's literally not a punishment, for others it's tortuous), and (less so if it is a voluntary alternative to a citation which has usual due process) it is also a denial of due process if it is summary punishment instituted by the police without judicial oversight.
The parent comment had one foot on each iceberg, but this is completely unmoored.
> I'd have no issues police offering that as an alternative to a fine in the UK for petty crimes
It was completly criticized even india. pretty sure its not controversial flamewar.
Anyways. I understand. won't happen again.
Edit: A better link (warning: police hitting people with a cane): https://www.youtube.com/watch?v=5wNQ_V-Ol78
I also came across this one:
To be clear, I don't think this will actually be enforced
In my opinion, Army will be called if the police is not sufficient to enforce this.
Similary some states only allowing trucks with essential commodities to enter and exit. Now trucks coming with vegetables etc, often has to go back empty, but state not allowing entry/exit of empty trucks, likewise myriad issues of logistics are needed to be resolved.
People are being too callous. They are going about the city as though everything is normal. Some are celebrating religious festivals, some are going out on vacations and 'long drives'.
We are poor country with 4x the US population, packed so tightly even 7Zip would be put to shame. We don't have money or medical infrastructure to fight this at later stages.
FYI - Essential supplies are being kept open, govt services are being kept open, food delivery is being kept open. Free groceries (rice, dal etc)are being given to people who need it.
I pray that our country survives this without too many deaths, even as an atheist, because that's the only thing I can do now.
That is OK. After a few days police and government staff will begin to fall ill as a consequence of their actions. They will, as a group, realize how foolish it is to constantly interdict people. Police interdiction numbers will be reduced due to both illness and to "street smarts".
Given that the only other option is to pile the hospitals with dead bodies, force short of killings should be used.
Since India doesn't do this regularly, they have to give a crash course to people who think that the law won't touch them
That too could be challenged, I doubt if all those quarantined, isolated etc in India has been given formal quarantine orders, considering the chaos at airports.
And additionally at this juncture government wouldn't want to overcrowd the prisons at this point of time.
These services cater only to major cities though. The govt is looking to keep supply lines of essentials open even in villages and remote towns.
But as usual with everything else, it's the poor who are going to be affected the most.
• Daily wage workers, as it implies should earn every day to feed their family. They have already faced the wrath of COVID-19 for past few weeks due to stoppage of certain work, now there will a complete halt.
•States do have public distribution schemes to distribute food ingredients at subsidised rate, certain states have announced making them free; yet there are several labourers who have travelled outside their states and they wouldn't be eligible to get it.
•Those who can stock up supplies have already did, in-spite of govt. requesting not to do so. Again, those who listened to the request (or) do not have the purchasing capacity would be the most affected in the coming days.
•Essential services personnel e.g. Garbage disposal, health workers, utilities etc. should be provided PPE; unfortunately most garbage disposal/sewage cleaners don't have gloves or masks even on normal days in most areas.
•Even if Govt. decides to send money to the poor directly, many don't have Bank Accounts.
Edit: It seems there was a need to clarify poor. For the sake of discussion, let's consider people below poverty limit($14-$17/month) as poor; i.e. 22% according to 2012 statistics but as you can see the limit itself is set very low when compared to standards of a developed country.
since there's more poor than rich, thats just statistics. if you select 1000 random people, most of them will be poor.
Each metro area and state should lock-down when they think they are going to get near their max ICU capacity (of course taking into account that hospital load lags by 2-3 weeks).
It doesn't do any good to lock down a city that doesn't have any community spread yet. It's just pure economic pain without any benefit.
In order to stop transmission, infected people need to be quarantined. If you have no idea which individuals are infected...the (incredibly painful, yes) alternative is everyone.
Also, making statements like millions of Americans will die is causing more harm than good. The country with the highest per capita infections in San Marino with 553 infections/100K pop . San Marino is a small city state. Switzerland has the highest per capita cases of "real" countries and is still 5x lower at 107/100k pop. Since the United States is a much larger country with a much lower population density, the infection rate of San Marino likely wouldn't translate. However, even if we do so that would give a total number of cases in the US of 1.8 million. That means there wouldn't even but millions infected let alone dead.
Let the experts do their work, take your precautions and everything will be fine.
Madrid has converted its largest ice rink into a morgue:
Staff are leaving senior homes and their inhabitants to their own devices. Soldiers have found deserted senior homes with bodies of victims:
Arguably, the planet isn't going to get wiped out. This isn't Hollywood. But rapidly mounting deaths, strained or collapsing health care systems and widespread fear will make these type of stories inevitably more prevalent in many countries in the next couple of weeks.
"everything will be fine" sounds nice.
But it's crystal clear that it won't be fine for many. The vast majority isn't going to die, but many will lose family members, friends, jobs, their current way of living,... And that's just horrible in itself.
It's been weeks now that people have been throwing the same line: "well wait and see in two weeks".
According to official stats, there are 17k deaths worldwide at the time of writing for 450k confirmed cases, assuming the number of cases grows exponentially, the death rate will eventually be much lower than what people are projecting.
The million dollar question here is how many cases go unnoticed. How many deaths go unnoticed. Nobody really knows.
Nobody knows how mortality is going to evolve either, since nobody knows how well health care systems around the world will be able to cope. Collapsing health care systems will yield a different outcome then those that do cope. And we don't know how they will cope.
So, I'm not accepting either "a few ten thousands" or "multiple millions" of deaths predictions at face value. The right answer is the very uncertain "we do not know".
What is clear is that people die from this, that no one is immune, and that a confusing response of authorities that aren't able to rally together doesn't really spark confidence.
Few deaths are going unnoticed. Even without this virus, there are cases every year in the US of isolated seniors dying at home because they were unable or unwilling to seek help. But it is trivial.
As far as actual cases of CV, can't we assume that the highest possible accurate infection rates would be coming from the countries with the best testing - those who are testing randomly or even those who aren't sick. And even in those countries, we're not seeing a death rate any higher than a normal flu season, apparently.
In the US, we're only testing those who show up at the hospital and are already sick. Our infected rate is missing out on all those people who don't need hospital care or don't even realize they already had and recovered from the virus.
So most countries have, in fact, a much smaller death rate than what is being published. If anything, the math here is telling us that we're overreacting, and the only question is by how much.
Extrapolating the results from one context into a different context - different parameters (i.e. hospital capacity, treatment, prevention, local culture,...) - also yields a skewed view.
Even experts don't know how ugly it's going to get:
So, I don't want to make any guesses about exact death rates. That's just a number. What we do know is that a substantial number of people who get sick will need intensive care. How bad things will get depends on how well health care and social security systems will be able to cope; and how the other domino's - companies, taxpayers,... - will cope with that reality.
Did you simply just woke up and decided to troll?
But as living standards have risen, some people have developed civic sense. Also, on the individual, family, and community level, there are many traditional practices that are similar to social distancing that, though they have some questionable origins in repressive social structures.
At least they are not in denial anymore.
Where I think it would falter is in keeping the essential supplies running. Even todays PM speech contained no indication that essential services will have to be running. Without that lockdown could turn ugly.
Not to mention the massive possibility that the cops at checkpoints will see in the bribes the can collect to let people pass.
To go out despite knowing what they know is tantamount to violating curfew with impunity. Cops are not in the streets to provide a PSA about COVID19. They are there to enforce the law. For once they are vs. taking bribes (a common topic shout Indian cops on HN). Now you have a problem with that as well? Please suggest a scalable solution. The time to coddle people into doing their part to “arrest” the spread of COVID19 has passed.
I believe that people can be allowed around for such activities as long as social distancing is followed.
The police is not that well respected by the people and rarely do the cops work for the people at least for their day to day interactions. People see them as rotten institutions there to only to collect bribe and do the bidding of the political party in power. Unless you have some clout even registering a complaint with them like a burglary or theft is a challenge. They would do everything in their capacity to prevent that from happening. Unless the commissioner is your neighbor or a buddy you will have a tough time.
This is harsh on police officers who genuinely want to make a difference, but they are a shrinking breed. Even a driving motivation to become a police officer is for the opportunity to get bribes. Lower level recruitment by the police are a complete sham riddled with corruption. A constable bribes to get the job.
Polite explanation works when there is some mutual respect.
Name another country with the population of India, level of illiteracy, lack of civic sense, and general disregard for rules. If said country exists and has implemented a scalable solution, let's propose it to the Indian authorities.
My concern though: the economic pressure of staying indoors will make a 3 week long (minimum) quarantine very tough. Based on certain sources, more than half the workforce are daily wage labors. Every day they don't work, they're not paid and they don't have insurances / safety nets to leverage.
Unless there's an influx of aid (from the government or otherwise) to help these folks pay for food / rent / pay back loans, etc. in the short term, there will be significant suffering, likely riot attempts and suicides. I'm already feeling significant panic from daily wage worker groups. There needs to be some kind of aid announcement ASAP to help them cope.
1. As an Indian why do I believe community transmission has not started or rampant: Because our hospitals are not overrun with people with breathing issues
2. Is this the right thing to do? Well, we don't have the capacity to treat the entire population, this we need to "cut the curve" rather than flatten it. Will this work? Your guess is as good as mine.
3. Will people obey the curfew: I really hope so
4. Should we test more? Sure maybe, but here is the thing we can't test someone once and be done with it, constant testing will be needed, and at our size, we can't do it, which is why I believe ICMR started with testing patients with some symptoms. Also, if people get the test, and they are negative, it might feel like a license to go back to regular life, which is a risk.
We are in uncharted waters. I really hope we can get to some scale in temperature surveillance at scale in the near future.
That is a serious, potentially fatal (literally!) mistake. One of the things that makes covid-19 so nasty is that it is transmissible long before the onset of symptoms.
"First, COVID-19 does not transmit as efficiently as influenza, from the data we have so far.
With influenza, people who are infected but not yet sick are major drivers of transmission, which does not appear to be the case for COVID-19.
Evidence from China is that only 1% of reported cases do not have symptoms, and most of those cases develop symptoms within 2 days."
This report is from March 3rd, so maybe our understanding has evolved.
I may be missing something here, but this seems like selection bias. If they're not showing symptoms, they're much less likely to get tested and, as such, reported.
A speech from the director-general. Not a report?
> With influenza, people who are infected but not yet sick are major drivers of transmission, which does not appear to be the case for COVID-19.
This is the same WHO that claimed "no evidence of human to human transmission" not long ago. Regardless, iirc, the R0 for SARS-CoV-2 is estimated at 2.5 to 3.5, much higher than Influenza's, which is at 1.8. It doesn't matter if SARS-CoV-2 is spread by the infected yet not sick, because the R0 is significantly higher, plus the incubation period is too damn long and there's no therapeutic treatment nor a vaccine.
When the dust settles, and more conclusive and complete research is done to learn about the virus, we will have all the answers, but given the current state of affairs, imo, it is highly unlikely that SARS-CoV-2 is any less infectious than Influenza.
Does WHO reference any studies that prove asymptomatic folks don't infect others?
If you happen to know, what explains the higher R0 and higher rate of infection world-wide?
> ...for example people having their temperature checked outside public buildings.
That isn't bullet-proof, tbh. India saw instances of people popping paracetamols to work around temperature checks.
I am not aware of any studies but on the other hand it would be incredibly easy for cases of asymptomatic spread to actually have been infected by a symptomatic person, in a chaotic environment it's difficult to get good data.
That may well be, but "not the main driver" != "not a driver". Do you really want to roll those dice?
Like, I get that you start shedding the virus, but if you don't cough or sneeze and practice generally good hygene it should not spread, right?
People cough and sneeze all the time even if they are healthy. Also, when you talk, you expel droplets of saliva when you make sounds like "P" or "B" or "K". The virus travels in those droplets. They float through the air, someone else breathes them in, and voila.
1. Mucus. Cold weather can trigger a brief runny nose, which in turn is easy to wipe on sleeves, arms, or the back of the hand without much/any thought.
2. Saliva. Spittle from speaking is just about impossible to stop.
Labourer travelling in train (usually it's general class, cheapest ticket) have contracted COVID-19 a week back.
Person who has not travelled much outside his home and has no known contact with anyone from foreign travel has contracted COVID-19.
How many poor people in India visit doctor for systems similar to common cold/flu? Even if they visit Govt. hospital and die from it, How many deaths of people with such symptoms in Govt. hospitals published?
>Is this the right thing to do? Well, we don't have the capacity to treat the entire population, this we need to "cut the curve" rather than flatten it. Will this work? Your guess is as good as mine.
Yes, should have done 2 weeks back. Unfortunately with any poor country with large inequality; it's the poorest who would be affected by this as well.
>3. Will people obey the curfew: I really hope so
It is lockdown, no curfew. Curfew (144) in India denies people not to gather in groups; now during lockdown every single person outside their house is liable to be questioned by the authorities.
>4. Should we test more?
Yes. But I'm not sure how many would take the effort to visit testing center. Again, it's poor who would not have the mechanism to even get tested.
Oh stop it! There have been confirmed cases of folks who do not have travel history but are infected with SARS-CoV-2 . Plus, we aren't even testing enough to know the extent of the spread.
> Is this the right thing to do?
It is absolutely the right thing to do. Should have happened sooner.
> ...we can't test someone once and be done with it, constant testing will be needed, and at our size, we can't do it
This is not even a good excuse. The only way to get out of a quarantine or lockdown before a vaccine is ready is to extensively test anyone that wants to be tested, and if positive, contact-trace everyone else and have them tested too. There's no other way anyone is getting ahead of the spread otherwise. Repeat after me: Testing isn't sufficient by all in itself, but it is absolutely necessary.
> I really hope we can get to some scale in temperature surveillance at scale
Temperature surveillance? Jesus Christ, you do not think tests are enough but want checks for symptoms that close to 80% infected people do not display for days on end, if ever?
> why do I believe community transmission has not started or rampant
We already have many unexplained cases of local transmission. So yes it has already begun.
Nothing you or me say will change this fact.
This is the best we can do in India. If you have anything else feel free to share.
Right now I can't think of anything else with the current already crumbling medical infrastructure we have in India.
> Will people obey the curfew:
Is there a problem with how India is doing it?
Is there a problem with Indians?
This is human nature. People will panic.
But this is no reason to not apply a curfew.
> they are negative, it might feel like a license to go back to regular life
Finally, I see someone who thinks logically.
Otherwise, people either support whatever Modi says or oppose whatever he says. No common sense applied to understand what is right or what is wrong.
> We are in uncharted waters.
You want to stay in a comfort zone. I am sorry to disappoint you.
Corona virus is not the last pandemic you would see in your life time.
And this is yet far away from the worst humanity has seen.
Search Spanish flew. Just think about medical understanding doctors have back in those days. Yet they fought and we survived.
We would survive this also. Long live Humanity.
This govt was callous in its approach.
I pray the medical infrastructure is able to handle the upcoming deluge. Peak infection rates are known 14 days after a complete lock down, IF THERE IS COMPREHENSIVE TESTING alongside the lock down. Our testing is woefully inadequate at the moment.
If we had a lock down in beginning of March it would be over in a week or 2. Now the lock down is 21 days. It may get worse.
It is a sad state when the police is beating up and arresting journalists, and those delivering or out to buy medicines/food.
Overall the government trying to be extremely paternal and the language used is lacking a humane touch.
All the essentital service are avaialable.
While I don't support police beating those who break curfew, it should be understood that India is severely underpoliced and Police do have a difficult job ahead.
The upper middle class increasingly have insurance like people in the US, and the very wealthy pay for treatment directly. Both groups seek care at private hospitals that have equipment and staff that would rival those in wealthy countries - often set up and funded by Indian physicians abroad.
My family have to invested in such hospitals and I have toured them. No doubt they do charitable work on the margins, but they likely can't scale to a pandemic.
"It covers 3 days of hospitalisation and 15 days of post hospitalisation, including diagnostic care and expenses on medicines."
3 days of hospitalization even with the best facilities is probably nowhere near enough for a serious COVID19 case.
Then again, health insurance providers in the US also recently balked quite strongly at the US administration's suggestion that they cover the full cost of COVID19 treatment, including co-pays:
How this all is paid for - and the delicate question about who has the right to the best treatment (those who can pay?) - are big issues that will soon be faced by health services and governments in all societies, whether wealthy or developing.
There are government hospitals and they are average. They are better avoided by people who can afford private clinics.
But for epidemic causing diseases the government is very active and proactive when they understand the protocol. If you are in quarantine, they will give your free medicines for you and the people you contacted, free and hygienic food, will sanitize your house and neighborhoods if needed. If you hospitalized yourself to a private hospital, the cost is yours. But otherwise the government will take care of hospitalization. Their quarantine beds are nothing less than world-class.
However, things can be drastically different and painful for your care taker once out of quarantine. ICUs (non-quarantine) in government hospitals have a higher rate of passing on a secondary infection.
Even at the costly private hospitals, cost of healthcare is quite low in India compared to the western countries and quality is similar. But they are not adequate for the pandemic of Covid19 scale
Public healthcare is abysmal unless you are in a tier 1 city or higher. Central government does little and most responsibilities is on the state government so you would see varied healthcare in different states.
I don't see many people using insurance to pay their bills. Most of it is paid by their pockets. It's changing but I don't want a situation where majority of the people have health insurance and companies start abusing the lowest section of the population who wouldn't be able to afford it. It's already happening. If you let clinics know that you are covered by insurance, they will do more quite a lot more tests and make you sit there.
The private hospital sector is better though. But not everyone can afford it.
Perhaps a lockdown might prevent those sorts of things ?
However milk, vegetables and other essential goods will be supplied to them at their home door to door by milkman, vendors and rehries etc. we are taking help of best price shop, swiggy, zomoto and other online companies and they will also be supplying grocery items door to door.
but when they reach in your locality , people should not crowd the vendor vehicle and should wait for it to come to their home. they should maintain the distancing norm of 5 feet while making purchase from them. all of them must wear mask and only one person should come out of the home to purchase from the cart. try to make payment online as far as possible.
General public is not allowed to come out of their homes during curfew. if anybody requires any pass to move in the curfew he should apply in the DC or CP office onlone.
However following persons can come out without passes during curfewbut some ID card of the Individual is Mandatory.
1. Doctors & other Hospital Staff of Govt and Private Hospitals.
2. Electricity and water supply Department Employees.
3. Municipal Corporation Staff.
5. Private Security Guards going to duty in uniform.
6. Patients having Medical Emergency cases.
7. Telecom Company Employees on duty during office hours.
8. All types of Goods/Fodder/Supplies carrying vehicles including Interstate goods vehilces.
9. Patrol Pumps (06:00 AM to 08:00 PM)
10. Hawkers of Recognised News papers (05:00 AM to 08:00 AM)
11. LPG delivery vehicles for door to door supply (06:00 AM to 08:00 PM)
12. Milk Plant vehicles and their Employees on duty.
1. Vegetable vendors will be open from 6 am to 10 am.
2. Grocery shops will be open from 5pm to 7pm
3. Hospitals/clinics/chemist shops will remain open as usual.
#SocialDistancing is not different/difficult http://archive.vn/bEMTt
Also the quarantine legal framework is also no clear. In US people in federal quarantine are issued a quarantine form, indicating the duration, location and terms of medical review with automatic reviews every 72 hours. I have not heard of similar formalized quarantine scheme in India, rather much confusion abounds.
Some time ago I read that Walt Disney (the person) was obsessed with washing his hands. He allegedly washed his hands every few minutes. I never gave this much attention, but if you consider that he was sixteen years old at the time of the Spanish Flu, and if you take a look at us now, this behavior suddenly becomes much more understandable. Let's all try to keep sane during in these strange times.
As an example, should I expect support from, say, Cisco or Verizon (two companies that I know from recent experience are running their support orgs out of India), to simply up and cease to exist? Will it somehow get more frustratingly difficult than it is already Or should I expect business as usual?
How's India's internet access at homes? I lived in S. India about a decade ago, and the internet was okay at the various IT offices, but it seemed a lot of office workers used their work PCs for a lot of personal business like banking and media (i.e. after hours), and I assumed this was because access was poor in home residences.
But maybe it has improved in the last decade.
India, like other warmer regions, has not been very active in the diagnostic. This is also what explains the low numbers you in Africa, Middle-East, and part of Asia.
Right now there is only one way that we currently have to stop this, and it is to do it Wuhan-style. Full lockdown for 8 weeks.
And forget about chloroquinone, studies published over the past 2 days are showing that it doesn't make a dent if you are already infected.
The virus they have to alive to be killed by sun rays(Yeah UV rays can destroy virus but in that case, we already be having skin cancer by now.)