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India coronavirus: The 'mystery' of low Covid-19 death rates (bbc.com)
240 points by happy-go-lucky 31 days ago | hide | past | web | favorite | 361 comments

This should not be a mystery at all. India locked down entire country (no state rights in Epidemics laws), despite federal structure. Very few things can be bought, even Amazon is only delivering "essentials."

But more importantly, India has been contact tracing like a greedy algorithm on steroids since case #1. There was a positive case in a condo nearby mine. The entire condominium building and adjacent locality is sealed. Not a lockdown, sealed. Nobody in, nobody out. The authorities spent over 9 hours interviewing all family members, neighbors, and friends of the infected for contact tracing. Every contact is being monitored, with police showing up randomly to make sure of no symptoms and adherence to home quarantine.

People are self policing mainly to avoid police, but they are self policing each other because nobody wants their buildings sealed. It really is working, I see people unwilling to hand over their credit cards in shops insisting to tap to avoid infections. In my state, there are only 85 active infections, only 2 are residents of my city, and even then I'm given gloves and sanitizer when I enter minimarts, with only 10 minute allowance to go and shop with maximum 4 shoppers allowed inside.

Edit: It becomes a big news when a positive case is found nearby. There is a distributed effort of volunteers to monitor infections (http://covid19india.org). There is no way government can lie about numbers.

Absolutely this: nobody wants their buildings sealed. In most apartments, people have continued to pay full salaries to their domestic help and insist that they do not show up for work. In some cases where the domestic help are young migrants from other states, the employer families have even invited them to stay over until the lockdown is over. They continue with their daily chores with full payment and the additional benefits of being taken care of by a family instead of being on their own. Whenever someone requests the HOA to allow outside workers, other residents immediately express concern about what happens if even a single person is tested positive. Nobody wants to spend a fortnight confined to their houses, and not allowed to venture out of their house for even a walk.

India going all Wuhan on the virus. The difference between India and the US particularly is that it's lockdown lite in USA while it's full on there. You can't take a walk, you can't drive farther than 3 KM, cops will kick your butt and impound your vehicle. And the population by and large listens, while we have morons here who want lockdown eased to get haircuts.

I'm in Canada (west coast). No restrictions on driving. People are still taveling to their cabins on the weekend. They get yelled at by other people but are not breaking any laws. My neighourhood is full of elderly people walking their dogs. Bicylists are everywhere. Restaurants never stopped doing takeout. But we cannot get haircuts.

Cops have stopped speed enforcement in my area, at least the dedicated speed traps.

The speeding has been happening all over the US too and it makes me sick. These people should be fined into oblivion, cars impounded, licenses revoked. Now is not the time to be creating extra problems for society.

As always, it depends on the circumstances. If you're doing 15-20 mph over the limit on a highway with very little traffic in the daytime and good weather? That's probably appropriate speed for the conditions.

If you're doing double the limit, or freeway speeds through neighborhoods, that's probably dangerous.

Typical city dwelling urbanite bugman attitude. There's never been a time when people weren't speeding at every chance, and there's never been a safer time to do it. Pretty sure if you continue to hide in your apartment you'll be safe from the bad people who are driving faster than the 1950s norm.

LICENSES REVOKED, he says, SHOULD NEVER DRIVE AGAIN. You sound like an old church lady waving an umbrella.

So you come across pandemics and traffic accident risks and your response is you want to stay drunk on adrenaline.

So you come across comments on HN and your response is that you want to blow them out of proportion

If a person can't restrain themself from driving over 100mph, they don't have the temperament to drive on public roads. They're just a sociopathic child with twisted priorities and no self control. What I find especially strange is how these people think they are somehow special and exempt from the law. They are not special, no matter how fast their vroom vroom machine can go.

100 mph is 160 kph. Yes, you lose your license for that most places. That's not "speeding", it's street racing.

Which is also fun, but I won't defend it, as I've restrained myself from doing so for quite a long time now. Stupid kids are going to do what they're going to do, though, and the threat of losing their license probably won't make much difference.

>> If a person can't restrain themself from driving over 100mph

That isn't speed. In my neck of the woods that will be called street racing. License revoked. Car impounded. Probably criminal charges. "Speeding" is doing 60 in a 50, 60 in a 30 because the "construction zone" stopped all activity a month ago but forgot to take down the signs. Or it is doing 32 in a 30 school zone ... when no student has attended a school in months. 100 is a different league.

I'm in Western Canada, too. Seeing the same thing here.

Cases keep dropping, regardless.

I suspect a late cold snap and some snow a month ago, followed by a lot of rains in the last couple weeks, have also helped.

Calgary is having trouble -- that's where most of the cases are in AB -- but case load across AB and Western provinces is stable and below projections.

edit: cases in the province, via the CBC:

Calgary zone: 3,366

South zone: 685

Edmonton zone: 486

North zone: 202

Central zone: 84

Unknown: 27


there is no evidence for that whatsoever. You have absolutely no data on what takes place in India - it is a gigantic country with gigantic variation across. Plus the families are much larger, all confined together. When the train was shut down millions traveled back home for days on packed buses, it unlikely that any lockdown could have had such a pronounced effect so quickly.

The truth probably lies elsewhere, perhaps the population is overall a lot less susceptible, perhaps the genetics is such that adverse reactions are far less common, perhaps the weather conditions make the virus less virulent etc.

There is no way in hell that India was more locked down than Spain - yet Spain, with a population that is of a tiny fraction of India is still producing many more cases per day even today, more than a month after a full lockdown.

If anything Spain compared to say Sweden shows that brutal lockdowns don't work, the disease would have taken the same course had there been much less strict measures.

India has some of the densest urban environments on the planet... Mumbai, Calcutta, Howraw, etc.

And, it has pockets of density that are mind-boggling, such as the slums at Dharavi. 9 to 10 people in a room, families taking 'shifts' in the same living areas, 100+ people per latrine in some parts.

Yet, absent a massive cover-up, no reports of mass deaths.

The same goes for many of the world's other dense cities: Manila, Caloocan, Port-au-Prince, Kathmandu, Subang Jaya, Tokyo (not to mention the dozen or so 10mill+ cities in China.)

When this is mentioned, the response is invariably that "they have an amazing lockdown system with state-of-the art contact tracing." Or, "well, THOSE people are very submissive and obedient to authority."

It's not believable.

What does it even mean to "lock-down" Dharavi?! That's absurd...

Millions of deaths were predicted. There aren't millions of deaths. Great. The lethality of the virus was grossly over-estimated. Yet, instead of happily acknowledging this, there are some bending over backwards trying to maintain that the Virus magically avoids places like Dharavi (or homeless camps in LA, or San Fran, or the elderly-populated Florida) because of government pronouncements.

I don't live in Dharavi. I've been there. And, I know there are plenty of people from India on this site. Maybe I'm wrong, but I cannot wrap my head around ANY lockdown policy that would make a rat's ass worth of a difference to virus spread in Dharavi. Ditto for Mexico City, the slums in Monterrey, Lagos, and the urban/slum sprawl in the metro areas of S. America.

this is the elephant in the room,

it is not fashionable to talk about, it does not fit the current narrative - the scientific "group think" when it comes to the virus is incredibly strong

Edit: "I don't live in Dharavi. I've never been there."

People there have been exposed to more viruses and in India specifically - BCG vaccine which protects against Tuberculosis. https://www.hindustantimes.com/india-news/nations-that-manda... Yes, am with you that expected numbers were blown out of proportion, but in a way that was needed to, because governments are complacent and people more so.

If Spain had taken strict lockdown measures before the virus took hold they would not be in the mess that they are in now.

Compare Denmark to Sweden and it gets pretty obvious that early lockdowns have an effect

They simply don't test and don't count. There is a strong incentive to show low numbers at state level. They conduct covid test on everyone who come to hospital for any reason, but not anyone outside hospital.

There are serious issues with the numbers coming out of India. For instance, some states which share huge borders with other states are showing far less numbers than the states they share the borders with even though these states didn't really implement movement restrictions at the border.


Do you think speaking the way you do is actually helpful or positively contributes to the conversation?

I found it productive.

What exactly is productive about using terms like "Trumptards?"

Thank you!

Heh, families in India have started doing haircuts at home. Some people get it right, and some people don't ... it's not even funny anymore.

I could have been the moron standing with a placard demanding a haircut, but I took the simpler route by buzzing my hair with a clipper :-)

People are largely forced to comply to the lockdown because police are often resorting to using of indiscriminate force, which isn't becoming in any modern country. Serious lack of empathy from the Police and Governments in India.

India has one of the lowest police officers to population ratio in the world, with 144 policemen to 100,000 citizens [1].Significanty, large majority of the policemen do not even carry guns or even tasers. The public trust of the police is also fairly low.

People are staying in and following the curfew because thanks to a robust media ecosystem and insane connectivity facilitated by cheap data plans and accessible smart phones, most folks are aware of the severity of the challenge confronting the country.

There are significant issues, especially with testing and the plight of the unorganised migrant labour, with how this is playing out, many due to simply the massive scale and relatively poor Indian state capacity, as well as some political football from all players involved.

Nonetheless, a large reason why people are "complying" with the lockdown is (IMO) because of a lot of awareness and a high degree of social responsibility.

It is difficult to imagine how the microscopic "blue line", or khakhi line, in India, as it were, could "force compliance" in this situation if the society at large did not accept that it was required.

This argument that the large majority of the population is complying due to fear of the police or authorities is (IMO) a disservice to the maturity demonstrated by the Indian society.

I can only hope the Indian govt and political class can step up to the plate and manage the exit and restart of the economy with the same maturity and sagacity.

[1] https://www.livemint.com/news/india/india-s-police-force-amo...

Edit: added link and clarified 2 sentences to improve readability

The level of ignorance exhibited here is breathtaking!

And then there are city level containment zones for tiny colonies (say 3-4 km^2 Radius) when even a single case is detected, where nothing is allowed, groceries are delivered by authorities.

Then there are sub - total city wide lockdowns in certain states where absolutely no travel is allowed.

Lockdown limits can be increased by the states, but limits imposed by the center can't be diluted.

Overall, the reason is very clear as the parent says - Most extreme lockdown of any country (or) at-least compared to other countries where death rates are high; subsequently the cost being paid is extraordinarily high[1].


These are interesting strategies, are there places to read more? Most of my Indian friends are the South and wealthy, they're locked down in multi generation compounds and lamenting cleaning for themselves for the first time - maids sent home. The situation doesn't sound as bad on the ground but I'm skeptical in the sense that my province in Canada has imported 16 cases from India, which is on par with Iran (19), Cuba, while it's not as high as US (393), UK (124), or other hard hit European countries (30-40), it dose seem like there as some moderate level of spread in the country for that much to be exported. For reference China only exported 5. Are there discussions about follow up strategies? Contact tracing apps etc, or is the process going to be manual.

> These are interesting strategies, are there places to read more?

Here's WEF's report on India's cluster-containment strategy[1].

>Most of my Indian friends are the South and wealthy

India of Wealthy is radically different from others, Just $77,000 is required to be at the top 1% in the country[2].

> my province in Canada has imported 16 cases from India,

That's indeed very interesting. India stopped International flights on Mar 23 and the infections as of Mar23 were < ~500[3]. Though it is possible that those 16 acquired the disease from super spreaders in India[4], the likelihood of them arriving in Canada is extremely low. May be they contracted it in their flight to Canada or did they cross land border from US?

Do note that, India's infection rate is among the highest in Asia as of writing [5].

[1] https://www.weforum.org/agenda/2020/04/india-covid19-coronav...

[2] https://www.businessinsider.in/slideshows/miscellaneous/here...

[3] https://www.worldometers.info/coronavirus/country/india/

[4] https://www.google.com/search?q=India+super+spreader

[5] https://www.thehindu.com/data/indias-coronavirus-infection-r...

Regarding [5], it says infection rate but talks about absolute number of cases. Which isn't a big surprise to be second in, India is a big country.

I'm not entirely sure what you expected from 'infection rate', it is the terminology being used every where to signify the number of infections.

If you wanted to know, 'how many people does a single person spread the infection' i.e. R0 or R-Naught; then it has come down to 1.55 on 11th April from 1.83 on 6th April[6].

[6] https://theprint.in/science/r0-data-shows-indias-coronavirus...

You can't say infection rate and not say a percentage. What the article says is the number of infections, not a rate.

And I'm not talking about the effective reproduction number.

Government of India launched an app for contact tracing weeks before Google and Apple announced making one, which relies on GPS and bluetooth to monitor.

What is the official end game? Are they hoping that it will be eliminated worldwide, will they continue in this mode indefinitely assuming it won't be, or do they plan to basically close the borders forever (i.e. anyone who enters has to be strictly quarantined so that the internal contact tracing regime could be relaxed)?

What is the official end game for all the countries that have lockdown?

Have control over new infections and resulting hospitalizations so as to not overwhelm healthcare infrastructure. This is especially required in India, where a large section of the population is uneducated, lack propee facilities and live on daily wages, with little to no savings or assets.

As in South Korea, the idea is to ramp up testing so that the country can limp back to normalcy while affected areas are isolated.

Absent the strict lockdown, I dia does not have the infrastructure to handle the surge in cases.

Hopefully, the population gets immunity and effective medicines are developed to immunize or treat the disease.

There's a painful cognitive dissonance that people seem to have about this disease. If your lockdown stops the spread of the disease, your population doesn't get immunity. No amount of infrastructure will allow the population to get immunity without all of the deaths that come with it.

Absent effective medicines being developed, which are very unlikely to appear for a long time, countries need to consider that they're choosing somewhere to fall along a spectrum of disease, or disease + poverty.

In Star Trek there's the famous unwinnable test, the kobayashi maru, and our hero Kirk says there's no such thing. This is the kind of naive arrogance that is going to amplify an already bad situation.

I don't know much about India or its particular situation but rising food prices are going to be a hell of a struggle.

Aside from the fact that the jury's still out on whether infection actually confers immunity with Covid-19, the options are not just "get everyone infected" vs "eternal lockdown", you can actually suppress the disease to a level where new infections are rare and easily enough traced, or even completely absent.

A lot of Asian countries are indeed showing that this is possible. That's good news!

Good luck trying to contain the flu that way. SARS-COV2 seems to be very virulent, but not so virulent like flu or measles that it can't be contained.

Isn't R0 for COVID supposed to be much higher than flu? That was one of the major parts of the arguments for lockdown that I've seen.

It is, but paradoxically it also seems easier to control. Perhaps because while it is infectious through the air, it is maybe not infectious over the same distance - but not as infectious inside a close distance.

I'm just guessing really. People say flu can't be controlled in the same manner. But we also haven't done that experiment like we're doing now. So maybe the people who say that are just wrong.

Thank you! Not sure why this is so difficult for people to understand.

This is what India is trying to achieve. Delay the spread (flatten the curve), ramp up health care facilities (doctors, beds and medicine), identify hot-spots and trace ruthlessly and finally hope that some medicine/vaccine would be quickly invented (the whole world is working on it).

You can do this in a closed system. India is not a closed system. At some point, someone is going to screw up. You can't shut down a city every time that happens.

Evidence shows otherwise. You're even complaining about it.

You're right, that's fair, technically India can do this if it wants to forever isolate itself from the rest of the global economy and into greater levels of poverty than ever before.

I had assumed India didn't want to be a closed system.

It's interesting that you mention cognitive dissonance while presenting a false dichotomy.

There's a painful cognitive dissonance that people seem to have about this disease - there isn't an option (unless you don't care about lots of people dying) where the economy doesn't take a big hit in order to contain the exponential phase.

It's not clear what the alternatives are?

I assume you're not advocating a no measures approach.

No lockdown even with social distancing still does huge economic damage and even then you would not get herd immunity - 60% infection rate is required.

German government declined the herd immunity strategy with the argument that for it to succseed in a year's time we have to increase the rate of new infections every day to 70k. No way our health care system can handle this. And there is also no need since we expect to have a vaccine ready in one year.

We have been told to expect a vaccine ready in about a year, but this seems to be based on wishful thinking. There's no guarantee any of these candidates will be any more successful than all the HIV and herpes simplex vaccines we've watched fail again and again for decades.

This is ignoring that disease immunity can massively vary, and if the antibodies only confer immunity for a few months, then this naive approach means we're back to step 1 relatively quickly.

This also ignores the potential for a chickenpox-like situation where the virus could reactivate itself, in which case exposing our population to the disease is just going to cause further issues down the line.

Yeah, I don't see the point of crushing the curve in developing countries where it's not feasible to elevate substantially medical capacities. Where many people's ability to support themselves is a day by day process not paycheck to paycheck. It makes no sense to shut down hard other than political optics - all the rich countries are doing it therefore there's an expectation and pressure for leaders in these countries to as well, even though the outcomes will not be the same. Cure is worse than the disease territory. Developing countries with demographics that skew young might actually do better with herd immunity approach.

The point is avoiding mass death. They care about their families lives too and not just economics.

It's not a 'political' choice or about 'optics'.

It's also not just 'old' people who are dying. It affects 50+ year olds in not insignificant numbers.

It depends whether you prioritise health or economics.

You can balance health and economics and choose to prioritise one _before_ the other.

It does however requires the political will to support the economy (and the poorest) whilst health care is prioritised to buy time during the exponential phase.

This is all theoretically true, but my inclination is that healthcare cannot be prioritized in a meaningful way within a meaningful time frame in many countries. I would love for India to succeed, but it seems incredibly unlikely that they can delay mass deaths for the time it will take to roll out a vaccine, because it does not seem possible for India to elevate medical access to comparable levels with developing countries per capita in the same time frame. So this delay is just heaping on unnecessary economic damage which in many ways is linked to health. Either way, I wish them the best.

I am pretty sure that international travel will stay banned for quite some time more, maybe the end of the year? But the current lockdown is supposed to be "eased" on May 3, and we are already seeing lists of districts with zero new case, where things will become really easy. But at the other extreme, there are "hotspots" where the lockdown will not ease at all for some more time. The lockdown won't just end on May 3. Some states intend to continue the lockdown on their own beyond that. Local shops have been allowed to open already. Some travel will become possible, probably within city limits or state limits. Restaurants and malls are unlikely to be opened any time soon. Everyone is still waiting to see what the official policy is.

I think India opted to err on the side of caution. Now where is required or possible, the lockdown can be eased. Opposite strategy would have been far worse.

This is the main question I have too. We have a disease that is pretty much guaranteed to be endemic so there will always be the ever present threat of re-importing the disease.

- guaranteed to be endemic in countries that have not taken the necessary public health measures. Consequently there will be very tough restrictions on travellers from those countries. Maybe the world will divide into green and red zones?

It's simply not realistic to keep a highly infectious disease forever out of a country like India (unless the virus just doesn't thrive there for environmental or demographic reasons). What are they going to do, shut down entire cities every time there's a lapse in security?

If the world did somehow divide into green and red zones, you would have a worse problem on your hands. The red zones are the wealthier western countries, and are more desirable than the green zones. Good luck trying to maintain global economic relevance when you don't allow immigrants from the wealthiest countries in the world. There's a similar argument to immunity passports. If people need to be immune to the disease to re enter the workforce safely, they will infect themselves with the disease to do so.

Land borders are of course harder to seal than air - but not impossible. Having to shut down entire cities if there is a breach will make their vigilance that much higher.

The green zone will prosper, perhaps those wealthier western countries finding themselves in the red zone will no longer look so desirable. Of course I'm hoping it won't come to this, but it does seem to be the direction we are heading.

You've written green and red, and somehow assumed that green is good. Green means your population is vulnerable to an infectious disease that, in this universe, is highly prevalent in all of the wealthy countries. Long term its a weakness.

You are forgetting about international trade, tourism and migrant work. The only country I'm aware of that was a "green zone" pre-COVID is North Korea; it didn't exactly prosper.

I'm in Austin. There was a confirmed case in my building and the best we got was a vague email from the management saying that someone had it and that the person had used the mailroom the Saturday before (we got the email on a Wednesday).

assuming that that person self-quarantined, it seems reasonable they informed the building but didn't do anything other than maybe wiping down the mailroom and door handles to mollify the paranoid. just having someone in the building doesn't pose appreciable added risk. would you rather they didn't tell you?

Remarkably I hear that Austin is going to be un-locking soon? Is that true?

Texas in general and especially Austin have also had a very mild version of all of this compared to some places. At peak we used something like a quarter of our available ICU beds before things started going back down, from the numbers I've seen. There basically haven't been any shortages of anything (at worst, people would buy up all the toilet paper in the morning and it'd all be restocked the next day).

Of course, one way to reverse that situation would be to start opening things back up.

Our state is going to attempt "phases" - https://www.politico.com/news/2020/04/27/texas-loosen-restri...

Management is being vague on purpose, due to HIPAA.

it's unlikely an apartment building's management is familiar at all with HIPAA. it's more likely incompetence or like most things in the u.s., a lackadaisical attitude towards the viral outbreak. i doubt HIPAA applies to a global pandemic. that's not its purpose.

HIPAA only covers health care providers, so does not apply to employers.

> But more importantly, India has been contact tracing like a greedy algorithm on steroids since case #1.

So looks like India is doing in practice what they show CDC doing in the US in the movies, such as in Outbreak.

Clips from my friend in Goa show the street scene hasn't changed. People still loitering and buying things in the open air and forming dense crowds. From the clip maybe less than half had masks. Super disappointing and concerning.

These numbers seem far to low given the flippant nature most city dwellers are appearing to have to this disease and taking necessary precautions. To me, this is the calm before the storm.

Goa was declared COVID-free when the last cases recovered and there were no new cases. That is probably the reason - the situation in other parts of India is quite different.

Source: https://m.timesofindia.com/india/goa-covid-free-but-risks-lo...

Goa doesn't have any active cases and the borders with other states are still locked: https://timesofindia.indiatimes.com/city/goa/state-govt-want....

Absolutely this. My hometown, whole hometown, home to 55k people, got sealed on just one single case. National highway is blocked. All previous passes invalidated. New passes were issued to ensure delivery of groceries. In a town where no company does grocery delivery, local vendors have started doing home delivery.

> Not a lockdown, sealed.

How does this work with essentials like food and medical care? Does the government bring supplies to people since they can't go to the store?

Really though the governments planning has been very opaque. Even now they don't seem to give any clue on what is going to happen once the declared lockdowns end.

Also government is keen on pushing a shady app for monitoring purposes, I home some one does a security audit of that app.

And the police has been acting in heavy handed manner. Instead of seeing this is a health care issue, the government seems to view this as some kind of law and order issue, and turned the whole country into a police state, putting countless people into misery, especially migrant labourers with hardly any concrete scheme put in to take care of them during this.

There has been serious lack of empathy and care towards the citizens from the government. Government seems to act to preserved face and reputation, rather than for the peoples welfare. Testing rates has been low, also testing is slow, it seems to take 2 or 3 days for people to get their test results. Projections, analyses etc has been hardly published by the government. Also many people have been testing positive more that 30 days, after they have arrived from out of country, that is still yet to be explained by the government.

Unfortunately, from what I have heard from my doctor friends, the government does lie about the numbers. Not all the state govts are doing this to the same extent but I have heard first hand information for doctors on the ground that the govt is hiding and misreporting numbers.

>India has been contact tracing like a greedy algorithm on steroids since case #1.

Care to provide source?

>People are self policing mainly to avoid police, but they are self policing each other because nobody wants their buildings sealed.

I have seen videos of people violating lockdown without fear.

>There are only 85 active infections

85 infections which were caught.

> Care to provide source?

There is some info here: https://www.nytimes.com/2020/03/17/world/asia/india-coronavi...

The US is #1 in infections for a reason: we are doing it wrong.

>The US is #1 in infections for a reason: we are doing it wrong.

It's more likely that we're testing far more than most countries than "we're doing it wrong."

No. Per capita, our testing is absolute crap--South Korea and Singapore are good examples of countries that actually have done thorough jobs in testing everybody.

South Korea's positive test rates are somewhere in the single digits, the US is around 20-30%. That's not a sign we're "testing far more than most countries."

In fact the governor of Washington said in a speech that we are limited in the amount of testing that we could do, and that we need to be substantially increasing our test capacity and turn-around in order to lift lockdown. So it's very accurate to say the US isn't testing enough.

And in fact the limiting factors for test capacity is our ability to manufacture PPE, swabs, containers, and chemicals. All the things we've been busily outsourcing overseas to China.

The US has actually been testing more people per capita than South Korea (or, indeed, most countries) for a while now - if I remember rightly, for about a month in terms of testing rate and a week or so in terms of total tests done. South Korea is running at about 6,000 tests per day right now with a peak capacity of about 20,000 last used a month or two ago. If scaled up to the US population that would correspond to about 40,000-125,000 tests per day. The US was stuck around 130,000 tests per day for a while but has been at around 200,000 per day for the last few days.

The US media has just carefully worked to convince people of the opposite without technically saying as much, probably for stupid partisan political reasons. South Korea's positive test rate is low because they have few detected cases, and it's not actually clear why - social distancing definitely played a major part, since they had to impose stricter social distancing rules to actually get the number of confirmed cases to drop to the point they are now, but they've dropped those now and even outright lockdowns haven't had the same level of effect elsewhere.

That's become true recently (we're now neck and neck with South Korea), as Korea's case rate has plummeted; South Korea has essentially weathered this storm, or at least the first wave of it. But it's nowhere close to true compared to Italy; our per-capita test rate is half that of Italy's. And Italy's test positive rate is something like half that of ours; the point 'jcranmer makes --- that you can work out whether we're undertesting from our test positive rate --- stands.

Have you looked at deaths? Or are you suggesting india's creating mass graves that media is not aware of, or doctors who aren't speaking out.

I have a lot of relatives back in India who are doctors, and our hospitals aren't overwhelmed. There are very few cases. And they test every ICU admit for coronavirus.

india doesnt have mass graves not because 'they are doing it right' or they are 'hiding the bodies', but because ITS WARM AND HUMID AND YOUNG. people are acting like idiots when it comes to this virus.

take this article: "...others talk about the possibilities of the presence of a less virulent strain of the virus in India, along with the possibility that its hot weather was diminishing the contagion. Both these claims are not backed by any evidence."

they have such a hard-lined stance, which is odd because: ""To be totally frank, I don't know and the world doesn't know the answer,""

there IS evidence warm weather makes a difference. droplet virus last longer in the air colder / dryer climates, its why we have a flu season. This has been tested. you pair that with outcomes of countries based on climate, you see a trend that matches expectation.

so "Both these claims are not backed by any evidence.", literally the opposite is true. you could argue that maybe cv19 is different than other cv, but so far that isn't true. Not to mention India is younger than most nations on the planet, you have a recipe for a low risk nation.

And for a nation that initiated its lock down 5 days after New York City and to be attributing all their low effects from the virus from their actions? thats laughable. If anything, India is probably doing worse to itself

You are comparing totally non sense timelines. Five days after NYC, but so many cases before NYC.

if you think its nonsense get your logic circuits checked. India is closer geographically speaking. Their lock-down was extremely late in the game. The 5 days after NYC puts in context just how far late it was; I'm sorry you do not have the ability to see the importance of that.

> if you think its nonsense get your logic circuits checked.

If you need to attack people to get your point across, it means your argument holds no weight.

You don't do lockdowns based on how some far away city is doing. Germany did lockdown months after Wuhan, yet they are doing fine.

> India is closer geographically speaking.

What does that even mean? Closer together? Closer together than jam packed NYC? Closer to jam packed NYC? Both of these are incorrect.

> Their lock-down was extremely late in the game.

Extremely late by what measure? Number of cases in country? Extremely late compared to which country?

> The 5 days after NYC puts in context just how far late it was; So comparing to random cities puts things in context? How many days after Wuhan/Lombardy Germany went in lockdown? How does this comparison makes any sense?

> I'm sorry you do not have the ability to see the importance of that.

I am sorry you can't reason politely.

What is that based on?

As a relatively rich country, the US has a natural advantage compared to poorer countries, but compared to other countries that have a similar per-capita GDP, that doesn't seem like an obvious conclusion. Hell, given how badly the creation of the original assays by the CDC went, and how distributed the healthcare system is, on top of the current political climate, the opposite conclusion seems warranted.

> testing far more than most countries


>India has been contact tracing like a greedy algorithm on steroids since case #1.

Some states like Kerala is doing active contact tracing. Also the first case was reported 3 months ago and not 2 months ago.


> >There are only 85 active infections

I am not sure which area the original author is talking about but less than 150 is the real active cases in some states https://dashboard.kerala.gov.in/

all my relatives in india, incl 60+ yr old folks are using contact tracing apps. In the US people are completely ignorant about these things and there's no effort from the govt to push these apps.

So what if you have seen videos where people violate the lockdown?

What are you trying to say? That there is no lockdown, or that a few people violate it or that its no use to lockdown?

Violations of lockdown are happening all over the world. If you are from the USA, better worry about the 60k+counting, avoidable deaths due to avoiding a lockdown.

Lol where does the 5% of yearly deaths from TB factor into all this? You mean the millions dead in India over the past decade is still happening, but they stopped this brand new considerably less deadly virus right away?

Do you live in Noida?

>But more importantly, India has been contact tracing like a greedy algorithm on steroids since case #1.

How is what you're describing a greedy algorithm? The behavior is based on self-interest, but that's not what a greedy algorithm is. https://en.wikipedia.org/wiki/Greedy_algorithm

I can give some ground level information. I live in a very densely populated street (total length is just two hundred meters, my guess is at least a thousand people live here). No one is dying here without others noticing. Further, there's a great amount of scrutiny into whether anyone's sick (see the reports of doctors getting beaten up even by the cops).

As far as I know, no one has died in this street in a month. The ambulance hasn't entered the street either. So unless there's a great conspiracy which most of us in the street are unaware, there really doesn't seem to be that many deaths. In fact the death rate is lower than normal, when people normally die, the first ritual is the blowing of a very loud horn in front of their house for an entire day. Haven't heard that in weeks. I live in the middle of the fifth biggest city in the country as well. It's likely many people in the street already have this but it's very unlikely that many or any have died from covid.

For reference, official disease tally for my city is now 570 cases.

My own personal experience : A close relative passed away in a large city early April (of pneumonia caused by COVID-19) complications. His entire family was interviewed for 2 hours and all contacts were screened - the family and some of the contacts were also put in quarantine and tested. The names of my relative and others who tested positive were put in the papers the next day (name, address etc) after the test, to help identify people who may be may have come in contact. This is obviously anecdotal - but i have so far seen the opposite of hiding data - some places are revealing too much rather than too little information.

But India has a federal structure, different states may have different policies. It is pointless to make one statement about the whole country, especially when the numbers are coming from states, not the center.

> Further, there's a great amount of scrutiny into whether anyone's sick (see the reports of doctors getting beaten up even by the cops).

What? Why are doctors being beaten up? I don't understand.

It's very stupid, but a (very) few people see them as potential spreaders of the disease. Public health workers going into the community to find infected people have also been attacked. Also, until recently, suspected COVID patients had to be in hospital -- no home isolation allowed -- and some of these patients (or their relatives) thought that venting their anger on doctors would help.

Unfortunately, the law of large numbers in India means that a "very few" can mean tens of thousands of people.

[1] https://www.bbc.co.uk/news/world-asia-india-52151141

[2] https://www.bloomberg.com/news/articles/2020-04-13/doctors-c...

In North American long term care facilities, this is exactly what's happening. In Canada, a ban was put in place to prevent health workers from working in multiple long term care facilities - it was found that infectious material was making its way via health workers from one home to another, all full of high risk populations.

Add in the fact that many hospitals in North America are short on PPE, and some are even preventing nurses and care personnelle from wearing PPE (or to bring their own, etc) - and you can see how much of an issue this can be.

Of course, beating up the doctors is a bad idea, but the roots of the idea that health workers are potential spreaders isn't all that far fetched.

> a (very) few people see them as potential spreaders

One problem is that although only a very few will see it this way, other people would be cautious about being caught up in it. This could affect the way they behave because if they think that somebody died in their house from this disease then they won't want to advertise that at all (eg by blowing horns) in case they were subsequently targeted. The fear is likely worse than the reality but behavior like this is driven more by fear.

However I can understand that ramraj07 says it seems unlikely on their street as it would surely be difficult in a close community to hide a van coming to take Auntie-ji away.

Few isolated incidents mostly in slum areas where rumors spread of a government conspiracy of targeting muslims. This government's anti-minority image did not help.

Source: https://www.hindustantimes.com/india-news/assam-mla-held-for...


OBL was "murdered"?

Is that your view?

"Don't feed egregious comments by replying; flag them instead."


Sorry. I should have put that in scare quotes.

And to be clear, I'm not arguing that he was murdered. I was just pointing out that some Muslims consider that he was murdered. I mean, the doctor who led the CIA to him is still in jail, and likely will be for the rest of his life. And the lawyer who defended him was murdered by the Taliban.

Forget that part, since when do doctors get abused in Pakistan (except in the brawl by lawyers recently)? What’s a basis for this speculation?

Huh. I thought that this was common knowledge.

> The Taliban began assassinating polio workers the year after the CIA used a vaccination campaign for hepatitis B, not polio, to identify Osama bin Laden's hideout in Abbottabad.


> There has been opposition to such immunisation drives from some powerful clerics while a fake CIA vaccination campaign, which helped to locate Osama Bin Laden in the Pakistani city of Abbottabad, is thought to have had a detrimental effect as well.


Yeah but it's quite a leap from polio vaccinators getting waxed and Shakil Afridi being jailed to "Doctors have a bad reputation in Pakistan" and then imply it's because it's a Muslim country. Many (even conservative) parents send their daughters to publicly financed medical colleges often to increase their marriage prospects. Does that sound like a thing they would do if doctors had a bad rap? Doctors came out and criticized the clerics for lack of adherence to social distancing, I didn't see anyone call them un-Islamic for standing their ground.

Maybe so. But I never claimed that it was mainstream in Pakistan. Just that it might account for this in ramraj07's comment:[0]

> Further, there's a great amount of scrutiny into whether anyone's sick (see the reports of doctors getting beaten up even by the cops).

Perhaps they could share a link about that.

0) https://news.ycombinator.com/item?id=23005076

> What? Why are doctors being beaten up? I don't understand.

The anti-vax crowd in India tends to be on the violent side of things.

when people normally die, the first ritual is the blowing of a very loud horn in front of their house for an entire day. Haven't heard that in weeks.

Could people be hiding deaths due to the stigma around COVID? Quietly taking their loved ones' bodies out of the neighborhood for funerals?

Never say never, but when I say crowded small street, I definitely mean it, nothing larger than a tote bag moves without gossip spreading, unless maybe at 3 am. So, perhaps? But I wouldn't bet much money on it personally! We will know in a few weeks though, if people are dying in our street, given the absolute lack of any distancing measures inside the streets (lockdown is only at a block level), more people should get very sick very soon.. hope not.

There are some numbers which simply don't make any sense.

Take today's data:

Delhi - 3,314 cases. (likely to go up as data is updated for tonight). Total population of Delhi is 19 Million.

Rajasthan - 2,438 cases. Total population: 68.9 Million

Haryana - 311 cases. Total population: 25.4 Million

Haryana has less than 10% of Delhi's covid case numbers while being a much larger state and while sharing a big border with both Delhi and Rajasthan where the covid cases are much higher. Also, huge numbers of people travel between Haryana and Delhi on a daily basis. Haryana's numbers make no sense.

Uttar Pradesh - 2,134 cases. Total population: 204 Million

About 30% less than Delhi while being much, much larger than Delhi and sharing a huge border with Delhi with vast numbers of people travelling to and from Delhi! Uttar Pradesh numbers too seem heavily under reported.

Bihar - 403 cases. Total population: 99 Million

Bihar has much, much lower covid cases than even Uttar Pradesh when Uttar Pradesh's numbers were themselves already suspiciously low. Bihar shares a huge border with Uttar Pradesh and there is simply no way Bihar with a much poorer healthcare infrastructure can have such low covid numbers.

Both UP and Bihar has huge numbers of migrants working in Delhi, Mumbai etc which makes these numbers even more dubious.

So on the face of it, there are big issues with these numbers being put out by some of the biggest states in India. If these numbers were more accurate, the overall figures for covid cases from India will be much higher.

India shares a massive border with China and is right next to China while having almost the same number of covid cases as Peru - which is halfway across the world from China and which is relatively shielded from the rest of the world in comparison to India - in terms of number of travellers coming in etc.

570 official cases in the city would mean 5-20 deaths. You most lokely wouldn’t noce those deaths on your street unless the street has 20% of the popularion of the city.

His comment is addressing thoughts about whether official numbers are off by a couple orders of magnitude

kranner 31 days ago [flagged]

I'm guessing you live in Hyderabad. Clearly your street is not a hotspot, and you really shouldn't be extrapolating from it to the rest of India. As far as people having it while being asymptomatic, that is unfalsifiable until they are tested.

Don't think I mentioned anything to generalize. Just what I observed in my city (Chennai) in my street.

What I was implying is that perhaps things did go okay in terms of slowing the spread in India: of course, there's probably more spread than is being reported, but that seems par for course everywhere.

I'm only worried that the lockdown is going to significantly affect the poorer communities worse at the expense of richer folks.

>>the lockdown is going to significantly affect the poorer communities worse at the expense of richer folks.

In such situations that is always the case. If there is a lockdown, poor will suffer financially. If no lockdown, poor will be exposed to the infection more than others since they have to be out working.

Apologies, I read that as extrapolation. Also assumed Hyderabad as that is the fifth biggest city in size, and cases are around the same in number.

uh ... India has so many cities, how can you assume any city unless the person says?

GP did say that they lived in 1) the fifth biggest city in India, and 2) the case count was currently 570 in their city.

The fifth biggest city in India population-wise is Ahmedabad but its case count is 2378.

The fifth biggest city in India area-wise is Hyderabad whose case count is 542.

Therefore I assumed OP meant Hyderabad. Both counts are from https://www.covid19india.org/

It’s not your fault. This kind of positive outcome just isn’t acceptable to a lot of people so they’re going to at best claim you’re the exception and at worst that you’re fudging the numbers.

Today’s fashion is drama and any not hysteric action must end in doom and gloom.

> I'm only worried that the lockdown is going to significantly affect the poorer communities worse at the expense of richer folks.

Sorry, what? The lockdown isn't about the rich or the poor. It is mostly about containing a deadly disease we don't fully understand yet. It is for the medics but also mostly to keep the social fabric intact. No one wants this to descent into chaos and madness without controls in-place. A deliberated and measured response is warranted despite an unprecedented loss of livelihood and absence of any real infrastructure to handle the fallout, especially to support the 500m people who live on daily-wages. Unless an effective prophylactic or a therapeutic treatment is discovered, lifting the lockdown can be disastrous for a country as dense as India and for incubation periods as long as they are for a rabidly contagious SARS-CoV-2.

Hopefully, the current situation improves in a month (most cities and states could possibly reopen in the coming weeks), but I wish the conversation around UBI (food subsidies including) and universal healthcare picks up steam rather than the pathetic pettiness around religious faultlines that seems to be in focus, all the time, aided by the ruling party's inclination to make a mockery out of democracy and India's minorities. I digress.

>> I'm only worried that the lockdown is going to significantly affect the poorer communities worse at the expense of richer folks.

> Sorry, what? The lockdown isn't about rich or poor.

I think you misunderstood the parent comment. They are worried that the poor will be more negatively effected by the lockdown than by the coronavirus, in contrast to the rich. This has been observed in other countries, where the poor have had no way to sustain themselves without work, whereas the rich can just hide inside and wait it out without a problem.

> I think you misunderstood the parent comment... the poor will be more negatively effected by the lockdown than by the coronavirus, in contrast to the rich.

GP said and I quote, "at the expense of the rich", which, to me, implies that somehow the rich are conspiring to persist with the lockdown. The families reliant on dialy-wages have always had massive problems in terms of education, healthcare, food, and shelter, and it isn't something the pandemic has birthed though it has aggravated it. There exists central and state government schemes to address these issues, but I wish there was a more systemic, consorted, and uniform approach to it with UBI and universal healthcare, instead.

It sounds like you're taking the opportunity, a grammatical error in the op's comment, to be combative and argumentative. Now you're just being dismissive of the plight of others and using your command of the language to minimize the situation.

The pandemic and quarantine haven't just aggravated an untenable situation, they're pushing it to the limits. The poor can't afford to not work, the rich can afford to remain in lock down. It's happening everywhere, not just in India.

There are those of us who can afford to be out of work for a long time, and there are those of us who can continue to work while maintaining quarantine, however there is a significant portion of the population that has run out of reserves and must work to live. These are people driving trucks, delivering packages, stocking shelves, generally putting themselves at risk while enabling the wealthy to remain quarantined.

> It sounds like you're taking the opportunity... to be combative and argumentative.

I'm sorry it comes off like that. My intention was to point out that this situation isn't of advantage to anyone regardless of their social or economic standing. Sure, a lockdown is harsher on some people than the others, but life, in general, is harsher on some people more than on the others.

The pandemic is doing a great job at ringing the alarm bells. I hope it stirs the government and the policy makers into action and not use it instead for abhorrent religious and political mileage at the expense of steering away from building a support framework for all its citizens.

> ...using your command of the language to minimize the situation.

I'm not the one mentally replacing at the expense of with in contrast to.

> The pandemic and quarantine haven't just aggravated an untenable situation, they're pushing it to the limits.

You'd find that we are in agreement. I don't understand what part of my comment made you think I'm cold to their struggles.

> I don't understand what part of my comment made you think I'm cold to their struggles.

As I said, it's the minimizing choice of language and your choice to ignore a grammatical error.

> I'm not the one mentally replacing at the expense of with in contrast to.

As I said before you're ignoring the grammatical errors in that sentence and paraphrasing to suit your argument.

> GP said and I quote, "at the expense of the rich",

That isn't what was said. The full quote:

> I'm only worried that the lockdown is going to significantly affect the poorer communities worse at the expense of richer folks.

Which is grammatically incorrect and doesn't make sense. However given the context and the structure of the sentence it's hard to draw the conclusion that you did. Rather, it's more likely the op mean to say something like:

> I'm only worried that the lockdown is going to significantly affect the poorer communities worse than richer folks.

But some how you've interpreted it to mean that the richer are willing to accept some self harm if it means harming poor communities?

Ah, gotcha. Thanks for clearing that up.

Fwiw, I didn't somehow interpret it purposefully in any sinsiter way or choose to ignore an error to start an argument. For some reason, that's just how I read it.

> Fwiw, I didn't somehow interpret it purposefully in any sinsiter way or choose to ignore an error to start an argument.

No worries, a lot of that was probably how it sounded in my head.

"can be disastrous for a country as dense as India and for incubation periods as long as they are for a rabidly contagious SARS-CoV-2."

Isn't the whole point of the article that this isn't the case?

> Isn't the whole point of the article that this isn't the case?

The author rather paints a skeptical view of the numbers coming out of India.

He didn't extrapolate - the article is about the country, his comment is about his street, "on the ground".

I’m a (foreign) American citizen staying in India and happened to arrive here a few days before lockdown started. I don’t understand how this is a mystery: India quickly locked down the entire country and going outdoors was consistently punishable by police hitting people with sticks (thankfully it seems like the brutality has eased up since the start and police are doing things like making people write sorry on the beach or do squats instead) People are taking the virus and situation seriously, without an unusual spike in fake news. You can’t even order anything outside a narrowly defined “essentials” category online. Thankfully food delivery is opened up.

To all the Indians here who are in the same situation, phew, I understand your pain. Hopefully this next extension is the last one and then it’ll be more limited to hotspots: and we will all be able to order from amazon again soon. I also hope the economy can open quickly and smoothly when the time comes.

A lockdown is not supposed to reduce the total number of cases; it is supposed to "flatten the curve" so those cases take a lot longer to develop. The intent is to drag the virus out for as long as possible so we can prepare our hospitals, develop more effective treatments, and get closer to a vaccine. A lockdown does not make the virus go away sooner; it prolongs it.

According to the Johns Hopkins dashboard[0], India has peeked. Just like most other nations, India seems to have made it through the worst of it and is now on a downward trend. That is the mystery.

The article makes a few suggestions. Maybe the virus hindered by the warmer climate. Maybe the strain in India is weaker than others. Maybe India's relatively young population is just more resilient. Unfortunately, we just don't know yet.

[0] https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594...

Nah, a stay at home order is to flatten the curve. A lockdown is to burnout the virus. If you lockdown for about 2x the time the virus incubates and people follow the lockdown. You can snuff the virus out. At the beginning of the lockdown, assume someone just got it and lives at home with others no symptoms but they spread it to other's that live at home, assume those don't have symptoms and they stay in for the recommended quarantine period, then the virus should have subsided. In the case of sars-cov-2 2weeks+2weeks. So 4 weeks minimum, add 1 or 2 more for safety measure. If people are sick enough to go to the hospital, they get treated, contact tracing is done. It's tough, but if everyone said home for 6 weeks. Absolutely no contact, the virus will burn out since it won't have any new hosts to infect. China didn't do their lockdown to flatten the curve, they did it to snuff out the virus, that's the same strategy India is attempting.

Snuffing out the virus would be a pretty impressive feat and it might just work. It might even be awesome for a while - but wouldn't you have to completely eliminate any potential vectors for the virus to get into the country again? Does that really mean virtually no immigration? Even with rigorous testing, if there's a single false negative, wouldn't that completely eliminate the gains of having gotten rid of the virus?

Obviously a lockdown can cause the number of cases to go down. There's no mystery here. There are many countries doing the same.

Yes, it is "supposed" to flatten the curve always keeping some manageable number of people infected. So if you reduce the number of cases any further you are doing it wrong; because no, you won't extinguish the virus, you'll only prolong the lockdown.

You can absolutely extinguish the virus if you have good border control. What makes you think you can't? The infection numbers exponentially decay toward zero when the replication rate is below one. At some point, the last infection recovers or dies without passing it on, and the virus is gone.

So what do you think is the alternative?

Reduce activity as little as possible (if your local health care is overwelmend, that is a total lockdown), and keep watching the curve. If you get spare health care capacity, free people a bit, if that capacity fills-up put restrictions back.

> Obviously a lockdown can cause the number of cases to go down.

Maybe I'm just ignorant, but could you explain how a lockdown is supposed to decrease the total number of cases rather than just prolong it?

A lockdown does not make a population more resilient to a virus. It just reduces contagion vectors so it spreads more slowly. The virus still spreads, though. Eventually, enough of the population will catch the virus and build up a resistance to it so that herd immunity kicks in. At that point, enough people will have been exposed to the virus that it does not have enough people to spread to and simply dies out.

I suppose the threshold for herd immunity is lower in a lockdown situation, but I am skeptical about it working to that extent. If my skepticism is misplaced and the lockdown really is that effective, then that also means India will have to stay on lockdown for a very long time to keep that herd immunity threshold low and completely starve the virus out.

>Maybe I'm just ignorant, but could you explain how a lockdown is supposed to decrease the total number of cases rather than just prolong it

It's not so black and white. We're talking about the area under the curve. The area under the curve varies nonlinearly with R0. But yes, because of the nature of the logistic function, a flatter curve will lead to fewer cases overall, once you factor in time and the assumption that eventually for whatever reason it will go away.

Once you get "R" below 1, the number of cases goes down.

Once the number of cases is small enough, you can identify and quarantine all of them. With a good enough testing infrastructure this gets easier. You can then have a "selective" lockdown only around actual cases.

Yes. A bunch of countries have entered (or are about to enter) this phase: New Zealand, Australia, South Korea, Taiwan

> Once the number of cases is small enough, you can identify and quarantine all of them.

A nation is not a closed system so I don't see that ever working out.

What about the eventual vaccine?

It only takes one person to turn it around: https://www.aljazeera.com/news/2020/03/31-south-korea-sudden...

Did you see police beating people yourself? I have a suspicion that it was made just for camera to scare people.

I have heard first-hand reports from people that saw a little of it.

Police beating people with lathis happened in many places all across the country, where people were insisting on breaking curfew, until people got the message. It’s also not terribly uncommon for the police to use such measures, especially where curfews are involved. I see no reason to doubt that it has been happening.

‘Beaten’ for stepping out for biscuits, UP teen dies

'Eyewitnesses said the cops beat Rizwan with batons and rifle butts'


In India there's never a shortage of people (police or civilians) beating each other with sticks. Happened long before COVID and will continue long after.

One of the most eye-opening things I've ever seen was the crush of people trying to get on the general admission train car being beaten back with sticks before the train even stopped moving.

You could see several videos of it on major Indian news outlets. (With people in masks standing around.)

Corporal punishment is still very much a thing in many parts of India, for better or for worse.

As a foreigner who has spent time working in India over several years, I've seen it happen multiple times. Each time I was with India colleagues, and nobody batted an eyelid. It seems to be pretty "normal".

That did happen. A good number of people in India only take things seriously when there is some degree of harshness from the administration.

Ah yet another cant-be-true-they're-hiding-something article? Surely they can't be doing better than developed countries?

FWIW, India did implement a stronger lockdown much earlier on in the curve than other countries. State and federal authorities went lock-step in their actions, and with consistent messaging. Police enforced the lockdown at times even brutally, getting the point across to the general public. Indians watched UK and US struggle through a denial and late response in disbelief, like watching a car crash in slow motion.

This is something that has really struck me during the Corona crisis: the misplaced Western believe of superiority towards Asian countries. I am European and I feel embarrassed about how much arrogance is displayed by some people and governments.

It started already in the beginning, when the virus was spreading rapidly in China. Reports about the failing Chinese authority were all over the place, but nobody seemed to worry that when the virus would eventually reach Europe, we would be in trouble as well. After all how could we, with our superior health system and our governments that would react quickly and rationally on such a trivial threat as this.

When the virus had reached Europe, it had already reached South Korea and Taiwan as well. These countries had learned from the earlier SARS outbreak how to deal with it and thoroughly tested everyone that could possibly have the virus, symptoms or not. The reaction I saw in the media was mostly about the breach in privacy that these measures brought. Surely this was not something that we, as enlightened Western societies, would want. And anyway, what were we frightened of. This virus could never spread so fast in Europe as it did in China, because .. Well because of what actually.

Now that the pandemic has wrecked havoc in the entire Western world and most people are realising that a strategy of first constraining the virus (like in Wuhan) and then testing everybody to contain in (like in South Korea) is the only realistic way to deal with it, one might think that a bit of humbleness towards Asia would be in place. Think again. What we're seeing more and more instead is denial. Investigations are started if the Covid virus was manifactured in a laboratory in Wuhan for instance.

I agree with you and I’ve made the same observation but I don’t think it’s due to some misplaced sense of superiority.

I think it’s simply because it has been a while since disease and pestilence was a worry for the average Western country so the average citizen (and therefore the leaders) are complacent in a sort of “It can’t happen here” way. There have been outbreaks such as the AIDS epidemic or swine flu but nothing as impactful, infectious, and at the scale of COVID.

Whereas Asian countries have grappled with issues of SARS, Malaria, AIDS, Polio, and many more in the not so distant past and have learned the importance of taking public health seriously. The experience of the outcome of mismanaging a response to a previous epidemic is still “fresh” so to say in many of these countries. I think a good example of this is how South Korea dealt with SARS and evolved their response to COVID based on the learnings from that.

Lastly I wonder if the prevalence of more communal societies in Asian cultures make a difference. I can imagine it could make the problem worse but it could also be beneficial in the sense of providing strong societal pressures to quarantine/hand wash/social distance/etc.

Edit: And of course the misguided leaders in particular Western countries are not helping. Maybe the US this particular time is just a statistical outlier due to some mismanagement and there is nothing more to read into further than that?

> I think it’s simply because it has been a while since disease and pestilence was a worry for the average Western country so the average citizen (and therefore the leaders) are complacent in a sort of “It can’t happen here” way. There have been outbreaks such as the AIDS epidemic or swine flu but nothing as impactful, infectious, and at the scale of COVID.

I agree that this is the main factor. Consequently I proposed the concept of the "civilization immune system" to explain how it works: https://www.sonyasupposedly.com/civilizational-immune-system...

China’s first response to doctors reporting the virus was to send police to them and shut them up. I’ll gladly believe I live in a better country.

I had the impression, based on news articles at the time, that local officials were behind the initial coverup in Wuhan, lasting until national officials rectified the situation.

I'm not sure local officials would be behind all the censorship and police abuse that's happened like this:

> Three Chinese citizen journalists have also gone missing after they uploaded videos showing a critical view of the situation in Wuhan to YouTube and Twitter.


> Cai Wei, a Beijing-based man who participated in one such project on GitHub, the software development website, was arrested together with his girlfriend by Beijing police on April 19. The couple were accused of “picking quarrels and provoking trouble,” a commonly used charge against dissidents in China, according to Chen Kun, the brother of Chen Mei, another volunteer involved with the project.


Both of the articles you linked to mention local police, in Wuhan and Beijing.

This is a common political trope in China used to shift responsibility away from the center and should not be taken at face value.

> I had the impression, based on news articles at the time, that local officials were behind the initial coverup in Wuhan, lasting until national officials rectified the situation.

CPP propaganda strategically concentrates blame for any kind of domestic problem on local officials in order make the central authorities seem trustworthy and competent by comparison. While the local Wuhan officials definitely had an independent hand in the mismanagement, the central government had its role, too.

It's also arguable that the central government is responsible for the coverup activities by the Wuhan officials, because they're the ones who've created and sustained the system those local officials operate in.

>It's also arguable that the central government is responsible for the coverup activities by the Wuhan officials, because they're the ones who've created and sustained the system those local officials operate in.

I like this line of thinking, I think it better reflects reality then the often heard knee-jerk reaction assuming that China is an evil monolith.

I wonder sometimes why I bristle at the comments painting China as an evil monolith. They probably do the same to us. Both systems have their own ways of enriching and defending those in power.

Perhaps it is because I don't like to blame others for our problems? The US bungled tests, was late to quarantine, the feds were contradicting states, states were contradicting cities, hospitals muzzled health care workers, etc. None of that really has anything to do with China. It comes across to me as propaganda to blame them for all that!

The US can make mistakes and guess what - the political oppression and police abuse in China is still nothing short of evil.

I've not seen this - which country are you in? I've seen acknowledgement of South Korea's success, and criticism of China's failings.

How about acknowledgement of success in Vietnam, Eastern Europe, India, China, etc?

GP is right, that you hardly hear it in the news.

Right, we can't have it both ways:

Either Asian countries are lying because they are extremely advanced in their population centers and also authoritarian, which would be the only way for it to be news.


Asian countries are lying because they have the exact same organizational dysfunction as every country in 'the west', and also authoritarian, in which case it isn't news.

so which is it folks, superior technology cohesive culture and leadership, or organizational dysfunction no different from the west.

There was some interesting article about possibility that this virus is artificial. Author came to conclusion that it's possible, but there's no way to prove that (other than insider leaking strong proofs, of course). Modern virusology laboratory can create such a virus indeed and it'll be indistinguishable from a wild virus.

Unfortunately this article is in Russian, I'll provide google translate link, but it probably will be translated with errors.


I flew from India to the US in early February (2nd week).

Indian airports were doing thermal checks on passengers (using tech that had been installed during the Zika virus scare a few years back, I believe). The newspapers also had info about how anyone found with elevated temperatures were being asked to self quarantine, and the police was also following up.

The US had, absolutely nothing. Nada. Before the flight I was afraid that entering the US would be difficult, but it was clear (and it remained this way for over a month), that if anything, entering India, if not difficult, would actually involve checks, something that was non existent in US ports.

Further, and I don’t know if this is mentioned, the flight into India involved the cabin crew spraying some sort of pest control spray in the cabins before we landed. They mentioned it was due to regulations. Considering SARS-COV-2 has been found to have been easily killed (within minutes) of exposure to common disinfectants, could this spray have greatly minimized the virus entering the country, on baggage’s and clothing, etc?

Similar situation here. I travelled from Bangalore to the UK, around the first week of March, almost everyone at Bangalore airport had masks, workers had masks and gloves.

When I landed at Heathrow, not even immigration folks had masks

People in India took it seriously in the beginning

To be fair with the disinfectant that's been the case with India for years - I went in 2016 and they were doing it then as well.

Yep, since 2014 at least. I always assumed it was some kind of insecticide/pesticide? Is it just a disinfectant?

It's a disinsection (i.e. insect-killing) procedure; the pesticides permitted by the WHO are synthetic pyrethroids like permethrin.

ref. https://www.cdc.gov/features/pesticides-aircraft/index.html

Pyrethoids are really used everywhere for everything

That is why bed bugs have become resistant to it

Insecticide. It's mainly to kill mosquitos. IIRC they introduced it when Zika and Chikungunya were spreading.

It's an insecticide. It's common on routes to/from a number of countries.

They started doing it after SARS-COV-1 back in 2002. The rest of the world actually respects intelligence and science (so far) but unfortunately in India it looks like the Fox-News/AM-Radio playbook is starting to win.

I flew into the US end of last week, more than a month since shelter in place started in many states. Still no checks of any sort. There were a couple of questions by the airline during check in but nothing after that. No questions at customs, no temperature checks.

I don't think that's disinfectant they were spraying, but rather insecticide for biosecurity. They do it on the way into Australia and New Zealand too prevent the spread of agricultural pests.

The entire gist of the article isn't "it can't be true they're hiding something", it's "if statistics in the West are underreported which they likely are, why on earth would one believe they're not underreported in a country with far more limited access to medical care for much of the population where deaths from respiratory diseases are far more commonplace in normal times"

India's lockdown started the day after the UK, and whilst undoubtedly the government has taken some strong measures to make the lockdown viable, it also faced unique challenges like significant parts of the urban poor population attempting to return home to families in their villages. Of course, despite being later than Western lockdowns chronologically, India's lockdown was earlier with respect to the known spread of the disease, but that in itself is a phenomena worthy of explanation.

When New York went in to lockdown, it had ~7000 cases (20th March) [1]

When UK went in to lockdown, it had 6700 cases. (23rd March) [2]

When India went in to lockdown, it had 657 cases. (25th March) [2]

[1] https://edition.cnn.com/2020/03/20/politics/new-york-workfor... [2] https://coronavirus.jhu.edu/map.html

To top it, some states announced a lockdown a couple days before the country wide annoucnement. TN went into lockdown on 23rd Mar for ex. Overall, I think the local govt of some states (esply Kerala) did well by their people. However, we aren't out of risk by any measure. There are some interesting developments in the region as well. A friend in SG mentioned the 6000 odd cases of migrant workers who tested +ve in Singapore, but during the same period ICU occupancy reduced there, with only one case reaching critical condition .. and recovering. Most migrant workers in SG are from the Indian subcontinent and are generally young and healthy.

It sure feels like there are something not well understood about this virus from infection/death stats alone.

CPI(M) continues to tak ZERO Ls. Lal Salam!

These are confirmed cases, i.e. people who have tested positive. Actual cases, either in India or the UK, are unknown.

Even if India’s number is off by 2 orders of magnitude so the number of cases were actually ~70000 (highly unlikely, since those numbers would show up in hospitalizations), that would 70,000/1.4Bn, so about 1 in 20,000.

NYC at 6000 cases meant it had approx 1 positive in 1000, and the UK at 6000 cases meant it had approx 1 positive in 10,000.

So even if we assume that the US and UK were not undercounting, and that India was undercounting by a factor of 100 (!), India was about half as infected as the UK and an order of magnitude less infected than NYC when it entered lockdown.

India is a pretty big country and just assuming an equal distribution of cases doesn't seem very useful.

The difference between a confirmed case and all cases is that in a confirmed case is a case which has had a viral confirmation. But all cases still involves only those people who have presented for medical attention, because a case is effectively a file about a person. What is unknown is infections.

Comparing cases is pretty meaningless if you don't also compare test rates.

There is no good metric for comparing test rates as well, tests per million makes no sense when a lot of states within the country have almost zero cases. India's less than 5% positive ratio on tests even in hotspot regions do not indicate a massive lack of testing.

This extremely simple point is missed by almost everyone, to the point where I think it's malicious (hey US media).

> Comparing cases is pretty meaningless if you don't also compare test rates.

True. I'd argue that there are other factors such as demographics, time elapsed since first cases, etc. But I guess it's hard not to. Specially for media needing to fill column inches or otherwise capture our attention :-) It should be possible to simply look at numbers and draw any conclusions but it seems to be very difficult for human beings to do that. We feel the need create a narrative around and find an explanation for our observations.

Also, there are a few factors that are in favor of India. The number of international travelers between China and India is much lesser compared to European countries. I suspect this may have played a huge role in reducing the initial exposure.

Added to that, apart from major cities, international travelers are minuscule in the general population. Consequently, the largest group of exposed citizens are from Mumbai & Delhi. Other cities are relatively less exposed.

I agree with you. The condescending tone by Western media towards India is awful and disgusting.

The reality is probably that it's a combination of doing the lockdown well and the disease being far less deadly than initially thought due to very high asymptomatic infection rates. The latter is an emerging fact that the media here are in denial over. Therefore, they think India must be undercounting or something else. Awful and insulting.

BTW, in regards to US, the lockdowns here worked. NYC was the only place in the entire country that ended up getting hit bad. The rest of the nation has not been hit anywhere approaching what was predicted by models which took into account lockdowns. Outside of NYC, US statistics match Germany.

NYC certainly got hit bad, but I wouldn't say it's the only badly hit city. Here is deaths/total pop for some other cities >1mil population which I would also call "hit hard".

NYC: 1.07‰

New Orleans: 0.65‰

Detroit: 0.60‰

Boston: 0.44‰

Source: https://www.nytimes.com/interactive/2020/04/03/upshot/corona...

I think you're off by a factor of 10 in your numbers

I'm using the per-mille (‰) rather than per-cent (%) symbol. Sorry for the confusion, but it's a more convenient unit for these quantities. This is how it'd look in percentages:

NYC: 0.107%

New Orleans: 0.065%

Detroit: 0.060%

Boston: 0.044%


I've never seen that notation in my entire life. Learn something new every day.

Just want to point out that you didn't call that out explicitly. 99% (note that it's a percent) of people who saw your comment would see it and view it as a percent. I did, and I work with data all day every day.

It's unintentionally misleading to use notation like that without calling it out.

Just type "per mille" next time.

You're right, I should have called it out in the text. I thought ‰ was okay because I was comparing the other cities to NYC, not to an absolute value. Also, I think it's a fun symbol, and I want more english speakers to use it.

Ahh, today i learned

I live in Kazakhstan and so far out country seems to be doing a right thing. We're heavily quarantined and I don't think that states are hiding anything. Economy implications of such a lockdown probably will be harsh, but that's a different thing. There was ill person in the building I'm living in and now entire building section just closed, nobody can go out and regular desinfections are performed (I don't think that they make any sense, but whatever).

So I'm absolutely sure that Kazakhstan is doing better than many European countries and for sure better than US. May be our government is not the most democratic one out there, but they care about citizens and their tight grip over country allows them to make an unpopular but effective decisions.

Some western people just think that they are strictly superior everywhere to the developing countries. That might be true in a lot of areas, but it's not an universal truth.

> Some western people just think that they are strictly superior everywhere to the developing countries.

The so-called western people, I'd argue, have the right mindset. I agree governments capable of draconian measures tend to do well when such behaviour control is desirable at a nationwide scale. That doesn't mean it is the only solution or even the best one.

I personally would pretty much prefer prevention, absent which, a measured, well thought-out, least disruptive policy around epidemics (I am looking at you South Korea, Taiwan, and Vietnam). Curtailing liberties, harsher restrictions, oppressive policing, regressive policies don't really fill me up with any sort of confidence. In fact, I worry that the citizens that are not just in acceptance of such a response, but in appraisal of it, are in for a grim reality-check when another unrest, epidemic or otherwise, rears its ugly head.

South Korean government did have strong laws on their side, some of which can be considered as draconian by American standards[1].

Considering behaviour of American population to the lax government measures, I guess strong laws/measures are the way to go.

1. https://www.lawfareblog.com/lessons-america-how-south-korean...

Came here to say this. When compared to the Western world, India did fare well and its not a mystery. Though the lock-downs were brutal for many Indians, they were strictly implemented and most people had the sense to follow the procedures. No denying that economic repercussions will be brutal as well but not many lives were lost. In my hometown, there isn't a single active case of COVID19 and its essentially a "green zone" now with most things returning back to normal. Local Police did a phenomenal job contact tracing and enforcing the lock-down. I wonder if life in USA would have gone back to normal by now if there was a better response and acceptance of the impending crisis. I am glad they don't have Fox news in India.

The Police, despite their shortcomings and inspite of their over-zealousness, must be commended. They really did show up for their country at the time of utmost need.

It's not really about judging or comparing unfairly, it's more about india's population density in the case of a contagious disease.

It seems countries are learning something from the those affected earlier which is good. But there are a huge number of under counts to be seen in the all-cause mortality data.

I have my fingers crossed for everyone going through this, but only after the fact are we going to get a good idea of what happened (and that goes for Western countries too).

"U.S. deaths soared in early weeks of pandemic, far exceeding number attributed to covid-19"



The TL;DR is in the final sentence: "we don't know".

So many keystrokes and clicked bait on something nobody has any concrete insight into.

India started lockdown when confirmed Covid deaths was at about 200 or 300 total. Its now at ~900 and doubling every ~10 days.

You got the facts completely wrong, India started the lockdown when total deaths were just 10 !

Source: https://www.covid19india.org/

Right. My bad. I was looking at the lockdown extension date sorry.

It's not just COVID-19 deaths, raw death numbers (as measured by death certificates, you cannot cremate/bury people without one) are down as well -- this report has some evidence, including lower business in at crematoriums[1]. This is likely due to the very stringent lockdown in India, and the somewhat underrated fact that traffic collisions and accidents kill huge numbers of people every day in India.

That said, while lower death rates (India's seem to be about half of the world's death rate) are to be celebrated, there are confounding factors.

1) The reported death count are mostly hospital deaths only. Home deaths aren't counted.

2) As the article notes, mis-diagnosing is a problem especially outside hospitals.

But if there's something that genuinely is reducing the death rate, then that's obviously a huge opportunity to study and learn from.

[1] https://www.livemint.com/news/india/india-s-lower-death-rate...

IIRC, during the lockdown, every death is to be notified to the authorities.

Is that not normally the case? The pp says that every burial or cremation requires a death certificate, and who else but the authorities has the right to issue a death certificate?

The process for getting a death certificate usually takes a couple of weeks to a month or so. And normally, for natural deaths, there is nothing to be reported to anyone.

But during lockdown, reporting is to be done immediately.

It is mainly with a sense of relief (rather than disbelief) that I watch the progression of numbers daily. The lockdown was early and quite stringent and has definitely made a difference. The most stringent lockdown has little chance of being executed effectively in India and there are innumerable cases of people cheerfully ignoring or doing so in desperation. Regardless, the awareness of COVID-19 is extremely high, probably more than any other single critical disease that afflicts us. This should have made a significant difference in influencing the behaviour of the majority. Tests are for the most part only for the symptomatic or with known contact, if asymptomatic. Almost certainly infection cases will be much, much higher. But fatalities are tough to ignore. In today's environment even a death unrelated to COVID causes consternation amongst neighbours and gets known widely. I take that to mean that the fatalities are probably close enough to reality. And that's unbelievably good and I can only hope that it doesn't get bad in the near future.

Yup, there is a very large percentage of the population, even in rural areas, that are awareof the danger posed.

Politicians, including the PM have clearly and multiple times explained their actions in a very clear and lucid language. Stateministers also have conveyed the same in a similar manner.

There was no tolerance on stupid questions from the beginning, and a huge emphasis has been put on scientists amd healthcare experts. Most of the experts also did not talk publicly, but advised the politicians.

True. There has fortunately been no dithering or mixed messages. The clarity and consistency of the messaging has probably saved India.

The article while making some valid points is full of insinuations. This is disingenuous.

The main reason for the low death rates is the lock-down/quarantine in place. India did this very quickly and very comprehensively. I would never have believed that such a lock-down would be followed and enforced in India if i were not living through it. It would be interesting to see how quickly the slope changes once the lock-down is lifted.

Other maybe contributing factors are; Sunlight & UV exposure, High Humidity, a healthy younger population, a better immune system (hygiene hypothesis) etc.

Simply said, the "Developed Western Nations" dropped the ball on recognizing the threat and putting in counter-measures and are now paying the price.

Most Western nations are doing fine. There's really just a dozen or so countries that have been hit hard, and even then the impact has been uneven within the hardest hit countries.

Sorry, for 330 Million people, USA has had 60k deaths from C19 so far, whereas India has had about 1000 deaths in about 1300 Million people.

The western Nations are doing abysmally.

You ignored my comment to say what you wanted to say. Many Western nations are doing great. They are handling the pandemic very well and have less strict lockdowns than India.

A stringent lockdown in India is not an option but a necessity considering the population. In fact, as others have pointed out, areas with confirmed cases are sealed with all movement in and out of it tightly restricted.

I fail to follow from:

> USA has had [...]


> The western Nations are doing [...]

Erasing the plural makes it better, though I have to wonder why wouldn't you just write "USA is doing" however you think it is.

Who counts as a 'Western Nation'? [0] I think most people would assume Western Europe and the Anglophones (USA, CAN, AUS, NZ).

If we assume that the US counts in the "hit hard" category, then we can partition western nations by per-capita deaths[1] like so:

Hit Hard: Belgium, Italy, France, Spain, UK, Netherlands, Ireland, Sweden, Switzerland, US

Not: Portugal, Canada, Denmark, Germany, Austria, Norway, Finland, Iceland, Australia, New Zealand

So I'm guessing that you either a) have a different definition of "hit hard" or b) have an expanded definition of "Western Nation". Eastern Europe and Latin America as regions haven't been hit hard yet.

The impact of covid-19 depends a lot on when it started spreading in a region. Most of the differences between European nations are probably due to when it started. A nation's response mostly affects how it compares to other nations which had outbreaks at the same time. I would guess that India is benefiting most from reacting early in the disease progression relative to other nations.

[0] https://en.wikipedia.org/wiki/Western_world

[1] https://www.worldometers.info/coronavirus/#countries

You excluded a dozen or more nations that are part of the Western world and have not been "hit hard" by your metric. The "hard hit" nations list is an exclusive club, even when you add in the rest of Europe.

The US and the UK are seeing a massive number of deaths.

It varies significantly within the US. In Oregon we have had 92 deaths for 4.2M people. Not massive at all.

That is in spite of what is pretty weak compliance with the shelter-in-place directives.


Please thoroughly read the HN guidelines: https://news.ycombinator.com/newsguidelines.html

This is no way to argue on HN. Be respectful to others even if they seem to not understand your point, then clarify further. Rhetorical questions like this are insulting and lead to poor discussions.

> Most Western nations are doing fine.

I think except the US, the UK, France, Spain and Italy; all other Western nations are doing fine.

Minor nitpick on reporting : literally every person they quoted with Indian sounding names live and work outside of India. And the lone Indian source they quoted, Prof Reddy, was the only one who lived in India and he was the only one who was not skeptical of the numbers. Not one expert from India was used in the article,besides Prof. Reddy, which is a relatively open society.

BBC and a myriad of British mainstream publications are decisively Anti India in their general narrative.

The NYT is also notorious for the same narrative building. Anyone who is serious about Indian news knows NYT, BBC et al report stories that are far away from ground realities.

With respect to coverage of India, this is definitely true across center and left leaning media in Western countries these days. It has especially come about because the American progressive left has built their political coalition in alignment with Muslim/pro-Muslim groups, which has blinded them to a neutral view. I saw the John Oliver piece on Modi recently, and was shocked to hear how one sided it was from Indian colleagues.

Wow, I just noticed this after you pointed it out. I have learned to take news with a huge pinch of salt. Many of the "reputed" establishments fail miserably when covering India or China. If you are writing an opinion piece, fine. But whatever happened to nuance and covering multiple PoVs? I think with Covid it is really important for us to wait and watch and stop competing.

In case of China, they report it with fear and respect. In case of India it is a case of only one sided reporting and agenda building wrapped in fine English prose and intellectual arrogance.

I generally have a very poor opinion of the govt officials in my country owing to some very bad past experiences in India. But this time I too was pleasantly surprised.

My friend lives in a very populated area in Delhi called Tilak nagar and he told me in feb end iirc that the house opposite his has a huge plaque on it that says *Quarantine, this house has a covid patient" put on by police. This was the time when nobody knew how serious this thing was. So yeah it does seem they got some things right too this time.

Similar in my Apartment. An air hostess got quarantined for 14 days in her house with a big poster on outside door “ Flat under Quarantine “. It was not Red colour because it was not confirmed case. So basically National Disaster Mechanism are quite well planned and implemented.

In the state of India that I live in, at least three people have died in the hospital of very Covid-19-like symptoms, but they were not counted as Covid-19 deaths.

Two of double pneumonia, both with travel history, but their tests came up negative. They were both healthy until very recently. One had arrived from the US, where the chances of community-acquiring-pneumonia are low as I gather.

One of cardiac arrest, but AFAIK she wasn't tested because she had no travel history.

We shouldn't be including deaths in the Covid-19 total just because they involve similar symptoms. Lots of other problems cause pneumonia and cardiac arrest, and you said yourself that the pneumonia patients tested negative. Apparently healthy people die suddenly all the time, sadly.

The RT-PCR test apparently has a very high false negative rate; I've read up to 30% or even 40%.

Also, they had all the other symptoms as well including fever and shortness of breath. One arrived in India with respiratory distress. The other fell ill a week after visiting a Covid hotspot -- Mumbai -- which he managed to visit despite a travel ban because he was a hotshot politician.

Where did you read that? Was it a reputable source that cited peer-reviewed data? We use RT-PCR every single day at our company (vaccine development) and we couldn't do our jobs if it performed so abysmally. The RT-PCR is the gold standard when it comes to detection.


Sorry, I should have qualified that fully. I meant clinical sensitivity for RT-PCR for SARS-CoV-2 for samples drawn from throat swabs, specifically. I know that my local hospital is only taking throat swabs, not nasal swabs; and all the press photos I've seen for testing in India is of throat swabs.

Well, then that's not really the RT-PCR that's at fault, its the way the disease presents itself, that makes it difficult to find a reliable point of sampling. Although, I can see how in casual conversation one might say that the RT-PCR test isn't reliable.

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