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Is India’s Covid-19 curve flattening? Cases now double every 10 days, from 3 before lockdown

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Employees of Health Tele Helpline center work during a nationwide lockdown in the wake of coronavirus pandemic, at IMA house Ernakulam District in Kochi on 18 April, 2020 | PTI
Employees of Health Tele Helpline center work during a nationwide lockdown in the wake of coronavirus pandemic, at IMA house Ernakulam District in Kochi on 18 April, 2020 | PTI


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New Delhi: India is entering its fourth week of a nationwide lockdown, aimed at curbing the spread of the Covid-19 infection that has no cure yet, but new infections continue to be reported. In the past 24 hours, around 1,300 new cases were recorded, taking the total number of active cases to 12,974 as of Sunday morning.

However, there is a silver lining.

The number of cases have been doubling every 10 days instead of every three days — which was the situation before the lockdown, according to Shamika Ravi, senior fellow at Brookings Institute, India centre, and a former member of the Prime Minister’s Economic Advisory Council.

Ravi has been posting daily updates on the rate of Covid-19 infection in India, and her analysis over the weeks has shown several trends.


Also read: It took India 74 days to cross 10,000 Covid-19 cases — much slower than US, UK


The doubling factor

Before we call the lockdown a complete success, India needs to stop seeing fresh cases of Covid-19 for at least 15 days given that the virus has an approximately two-week incubation period.

The data, at present, shows that the curve may be beginning to flatten.

“In the beginning, of course, there was a very rapid growth — numbers doubling every three days, but the curve had first begun to flatten around 23 March,” Ravi told ThePrint.

The number of cases went from doubling every three days to every five on 23 March, just two days before the lockdown was imposed. The total number of cases in India was 987 at the time.

This decline was attributed to a 13 March decision to ban travel to certain countries, and to shut schools and colleges. Since coronavirus symptoms take about 14 days to manifest, the effect of mitigation measures on case numbers began to show only after two weeks.

“It (the growth rate) began to pick up again around 29 March — that’s when all the cases from the Tablighi congregation came to light. Then we see a considerable escalation for the next 10-12 days. That is when the growth rate began to increase again at a very rapid rate,” Ravi told ThePrint.

Around April 2, cases began to double every four days.

Just a day after, the rate of growth increased further — with the number of cases doubling every three days.

The sudden spike in new cases was attributed to the Tablighi Jamaat religious congregation that took place in Delhi’s Nizamuddin Markaz Mosque in March. Despite a government ban on religious gatherings, over 2,000 people attended the event on 13 March.

It was only on 24 March, after six people had tested positive for Covid-19, that authorities were made aware of the spread of the disease among the attendees of the congregation. By then, participants of the event had travelled back to different states — further spreading the disease.

As of 6 April, there were a total 4,067 cases reported, of which over 1,400 were linked to the event.


Also read: Tablighi Jamaat chief Saad charged with culpable homicide for spread of Covid-19


Change in trend in April

The next change in trend happens around 6 April, Ravi said.

The rate of growth of new cases was at 16 per cent, which meant the number of cases were now doubling every four days instead of three. At this point, the total number of cases in India was 4,778.

However, on 10 April — 16 days since the lockdown began — the growth rate of infection began to decline again, with cases doubling every six days. India’s death toll due to the coronavirus however had crossed 300 by now.

By this time, India had negated the spike that happened when cases were doubling every three days, Ravi said.

In the next four days, the growth rate declined further to 10 per cent, meaning that the number of cases were doubling every seven days.

What this data means

Ravi’s estimate of the growth rate indicates that the lockdown is having a desired effect on flattening the curve. And it isn’t the only parameter that says so.

An estimate of the R0 value (read R-Naught, and indicates the infectiousness of a disease), went down to 1.55 from 1.8, according to Sitabhra Sinha, a researcher at The Institute of Mathematical Sciences in Chennai.

R0 is the basic reproduction number of a disease, and indicates the number of people a patient can directly infect in a healthy population.

His plot of the active cases in India shows a significant deviation from the trend.

The progress of Covid-19 epidemic in India, with the number of active cases shown using logarithmic scales | Sitabhra Sinha’s research paper on ‘Epidemiological dynamics of the COVID19 pandemic in India: An interim assessment’

While any lapses in the ability to curb the spread will only show up about two weeks later, for now, numbers indicate that the stringent lockdown is taking the curve in the desirable direction.

“Right now what we are seeing is an outcome of measures we took as a country two weeks back, which was one week into the lockdown … Remember at the time there was a lot of movement of migrants, but since then the lockdown only got more intensified. People have been taking precautions themselves and even states began to impose restrictions more strictly,” Ravi said.

So there is good reason to believe that in the next two weeks the numbers will keep decreasing further, she added.

There is a fear that the growth rate of cases will again rise when the lockdown is lifted, but Ravi believes that this increase will not be anywhere close to the spikes we have seen in the past weeks.

This is because the fear of infection will make people take precautions, she said.


Also read: If you have flu symptoms, tell us — new health ministry advice to detect more Covid-19 cases


 

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Andhra doctor, suspended for alleging PPE shortage, now beaten by cops for ‘creating nuisance’

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doctor with a stethoscope
A doctor with a stethoscope (Representative image) | Pixabay


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Bengaluru: A doctor with a government hospital in Andhra Pradesh, who was suspended for questioning the shortage of PPE kits, was admitted to a mental health facility Sunday, a day after he was allegedly manhandled by the police and arrested for creating nuisance in Visakhapatnam.

Dr Sudhakar Rao, a government civil surgeon, was beaten, his hands tied behind his back and dragged by police officers Sunday. During the incident, Sudhakar allegedly verbally abused the Jagan Mohan Reddy government in an inebriated state. Videos of the incident have since been widely shared online.

“The police control room received a call about a person creating nuisance on Beach Road Hospital in Visakhapatnam. The Fourth Town police was rushed there and found that the person was the suspended doctor, Sudhakar.

“When the police tried to control him, he snatched the mobile phone of an officer and threw it away. He is suffering from mental disorder and he was drunk. He was sent for a medical examination,” Vishakapatnam Police Commissioner R.K. Meena told the media Sunday.

Sudhakar was admitted to a mental hospital Sunday after doctors at the King George Hospital in Vishakapatnam said he suffered from anxiety.

“Since the doctor is in anxiety and talking irrelevant things, I have referred him to a mental care hospital in Visakhapatnam,” said Dr Radha Rani, medical superintendent, King George Hospital.

A statement released by the hospital said: “Dr Sudhakar was brought to the KGH casualty ward at 6.30 pm. From the smell, it was found that he was in a drunk condition. Under the influence of alcohol, he did not cooperate with anybody there and kept abusing all. Still, his pulse, BP were checked. Pulse was 98, BP 140/100. Blood samples were sent to forensic lab to ascertain alcohol content in his blood.”


Also read: 6 toilets for 20 houses, inadequate testing: Why Mumbai’s Worli chawls are a Covid hotspot


‘Treatment towards Sudhakar was inhuman’

Sudhakar, who spent more than 10 years at the Narsipatnam Government Hospital in Andhra Pradesh, was suspended from his duties in March after he openly criticised the Reddy government for failing to provide PPE kits and N95 masks to doctors treating Covid-19 patients.

He had alleged that the state government was giving N95 masks and PPE kits meant for doctors to politicians and the police.

A video of Sudhakar criticising the government was also shared widely. In the clip, he can be heard saying: “We are putting our lives at risk here. We are asked to use the same mask for 15 days and a fresh mask will be provided only twice a month.”

Speaking to ThePrint, Dr P. Gangadhar Rao, member of the National COVID Committee of the Indian Medical Association, said the manner in which Sudhakar was manhandled by the police was “inhuman” and “violated” human rights.

“We strongly condemn the way he was taken into custody. He was not carrying a weapon, he was alone, the number of policemen outnumbered him. Why treat him like that? We also saw a video where a policeman beats him with a lathi,” said Dr Gangadhar.

He added that Rao was one of the most experienced anaesthetists the Andhra Pradesh government had.

“Our next step of action is to get Sudhakar to write an unconditional apology for having used filthy language, abusing the chief minister and the government. We will then take our appeal to the CM seeking that he be reinstated,” Gangadhar said.


Also read: Face shields, gowns, masks — the new attire for cabin crew post lockdown


 

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