World Covid Meter 25th June: 213 Countries Affected |
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World Covid Meter 25th June: 213 Countries Affected
Dr KK Aggarwal,  25 June 2020
Coronavirus Live Count Map India

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Coronavirus Live Count Map World

#Multispeciality

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Cases: 1M April 2, 2M April 15, 3M April 27, 4M May 8, 5M May 20, 6M May 30, 7M June 7, 8M June 15, 9M June 22 

Ground Zero: Wuhan - in live animal market or cafeteria for animal pathogens: 10th January; Total cases are based on RT PCR, 67% sensitivity

Doubling time India 18 days, USA 33 days, Brazil 13 days, Russia 18 days, Spain 47 days, UK 35 days, Italy 55 days, France 49 days, Turkey 37 days

ikely minimum deaths (484925 + 58418 x 15 == 8763) =  493688

Coronavirus Cases: 9,525,937                                                                                  

Deaths: 484,925

Recovered: 5,174,686

ACTIVE CASES: 3,866,326

Currently Infected Patients 3,807,908 (98%) in Mild Condition

58,418 (2%) Serious or Critical

CLOSED CASES: 5,659,611

Cases which had an outcome: 5,174,686 (91%) Recovered/Discharged

484,925 (9%) Deaths

India Doubling Time: 18 Days.  Will cross Russia in around 20 days

#

Country,Other

TotalCases

NewCases

TotalDeaths

NewDeaths

TotalRecovered

ActiveCases

Serious,Critical

Tot Cases/1M pop

Deaths/1M pop

TotalTests

Tests/1M pop

Population

 

World

9,520,199

+173,100

483,959

+5,071

5,169,767

3,866,473

58,415

1,221

62.1

   

1

USA

2,463,271

+39,103

124,281

+808

1,040,605

1,298,385

16,541

7,443

376

30,059,864

90,823

330,970,517

2

Brazil

1,192,474

+40,995

53,874

+1,103

649,908

488,692

8,318

5,611

253

2,678,426

12,602

212,533,446

3

Russia

606,881

+7,176

8,513

+154

368,822

229,546

2,300

4,159

58

17,803,955

122,000

145,933,597

4

India

472,985

+16,870

14,907

+424

271,688

186,390

8,944

343

11

7,352,911

5,329

1,379,752,264

5

UK

306,862

+652

43,081

+154

N/A

N/A

311

4,521

635

8,542,186

125,842

67,880,218

28 Days Data - Doubling Time 18 days, no significant growth of new cases in last six days

Date

Daily new cases

New Deaths

Total cases

Total Deaths

24th June

16870

424

472985

14907

23rd June

15665

468

456115

14483

22nd June

13540

312

440450

14015

21st June

15183

426

426910

13703

20th June

13277

307

411727

13277

19th June

14721

366

395812

12970

18th June

13827

342

381091

12604

17th June

13103

341

367264

12262

16th June

11135

2006

354161

11921

15th June

10243

395

343026

9915

14th June

11382

321

333008

9520

13th June

12023

309

321626

9199

12th June

11320

389

309603

8890

11th June

11128

394

298283

8501

10th June

12375

388

287155

8107

9th June

10218

277

276146

7750 (2.8%)

8th June

8442

266

265928

7473

7th June

10864

261

257486

7207

6th June

10438

297

246622

6947

5th June

9471

286

236184

6649

4th June

9889

275

226713

275

3rd June

9633

259

216824

6088

2nd June

8821

221

207191

5829

1st June

7761

200

198370

5608

31st May

8782

223

190609

5408

30th May

8336

205

181827

5185

29th May

8105

269

173491

4980

28th May

7300

177

165386

4711

India predictions

  1. >90% of people are symptomatic within 2 weeks of infection.
  2. Death rate is deaths today vs. number of cases today.
  3. Corrected death rate is deaths today vs. number of cases 14 days back.
  4. For one symptomatic test positive case, there are 10-30 asymptomatic cases.
  5. Estimated number of deaths = Reported deaths x 2.
  6. Number of deaths today should be 15% of the serious patients present 14 days back.
  7. Undocumented cases for each documented case - Iceland: 1: 2; Germany: 1: 5; New York City grocery store shoppers: 1: 10;California 1.5%.
  8. Amongst active cases, 2.37% are serious, 1.82% need oxygen, and 0.41% need ventilator support.

Extra Reading Background Material

  • China: Captured tiny droplets of viral genetic markers in 2 hospitals in Wuhan floating for > 2 hours. Infectivity? [Journal Nature]
  • India: In states with average population density of 1185/sq km, the average number of cases were 2048. On the contrary, in states with population density of 909/sq km, the number of cases were 56. When Chandigarh and Pondicherry were taken out from this group, the Average Density of other states were 217 and the average number of cases were 35. [HCFI]
  • Revised COVID Sutras: It’s a COVID-19 pandemic due to SARS 2 Beta-coronaviruses (different from SARS 1 where spread was only in serious cases); with three virus sequences floating (one similar to Wuhan, second similar to Iran and the third strain similar to USA – UK); has affected up to 10%  (5.7% S Korea) of the population; Causes Mild or Asymptomatic Illness in 82%, Moderate to Severe Illness in 15%, Critical Illness in 3% and Death in 2.3% cases (15% of admitted serious cases, 71% with comorbidity< Male > Females); affects all but Predominantly Males (56%, 87% aged 30-79, 10% Aged < 20, 3% aged > 80); with Variable Incubation Period days (2-14; mean 5.2 days);  Mean Time to Symptoms 5 days;  Mean Time to Pneumonia 9 days, Mean Time to Death 14 days,  Mean Time to CT changes 4 Days, Reproductive Number R0 1.5 to 3  (Flu 1.2 and SARS 2), Epidemic Doubling Time 7.5 days; Origin Possibly from Bats (Mammal); Spreads via Human to Human Transmission via Large and Small Droplets and Surface to Human Transmission via Viruses on Surfaces for up to three days. Enters through MM of eyes, nose or mouth and the spike protein gets attached to the ACE2 receptors. ACE2 receptors make a great target because they are found in organs throughout our bodies (heart muscle, CNS, kidneys, blood vessels, liver) Once the virus enters, it turns the cell into a factory, making millions of copies of itself, which are then breathed or coughed out and infect others.
  • Prevalence:New York: 13.9%; New York City at 21.2%; S Korea; 5.7%; World: 5%; Ohio prison: 73% of inmates; New York: 21% mortality [April 22 in JAMA].
  • Viral particles seen in tears, stool, kidneys, liver, pancreas, heart, semen, peritoneal fluid, CSF.
  • Thrombosis: University of Pennsylvania reports that clots are seen in patients even on blood thinners.
  • Other human beta-coronaviruses have immunity lasting only for one year with no IMMUNITY PASSPORT.
  • In absence of interventions, prolonged or intermittent social distancing (till 2022-24) is the key.
  • Low levels of cross immunity from the other beta-coronaviruses against SARS-CoV-2 could make SARS-CoV-2 appear to fade away, only to return after a few years. Surveillance till 2024.
  • During peak, trace and treat, and after the peak, trace and treat the close contacts.
  • Increased spread: close environment, crowded place with close physical contacts with no ventilation.
  • Strategies: From community mitigation to individual containment; broader good over individual autonomy; perfect cannot be the enemy of the good; pandemics are fought on the grounds and not the hospitals. Treat the patient and not the test report; Consider every surface and every asymptomatic person as virus carrier.
  • HCW: Direct patient exposure time < 30 minutes; 7 days work and 7 days holidays.
  • Italy: mortality reduced when they were short of ventilators.
  • Hospital at HOME: CHF, mild pneumonia, exacerbations of asthma and COPD, cellulitis, and urinary tract infections.
  • Great Imitator (protean manifestation).
  • IgM can be false positive in pregnancy, immunological diseases; Pooled tests (< 5) when seroprevalence is < 2%.
  • Early treatment to reduce the viral load and prevent cytokine storm using off label use of drugs like hydroxychloroquine with azithromycin; ivermectin, remdesivir; Tocilizumab interleukin (IL)-6 receptor inhibitor; convalescent plasma therapy (given early; bridge compassionate therapy, donor 14 days symptoms free, single donation can help 4 patients), Lopinavir-ritonavir and Favipiravir.
  • Hypoxia: Low flow oxygen < 6l/mt, titrated to high flow oxygen using non rebreathing mask, Venturi mask, HFNC and helmet CPAP, NIV in supine or prone position.
  • Early intubation with prone ventilation only if progressive. Hypoxia (walking dead) have capillary problem and not alveoli.
  • Formulas: Deaths in symptomatic cases 1%; Deaths X 100= expected number of symptomatic cases; Cases after seven days: Cases today x 2 (doubling time 7 days); Cases expected in the community: Number of deaths occurring in a five-day period and estimate the number of infections required to generate these deaths based on a 6.91% case fatality rate; Compare that to the number of new cases actually detected in the five-day period. This can then give us an estimate of the total number of cases, confirmed and unconfirmed; Lock down effect = Reduction in cases after average incubation period (5 days); Lock down effect in reduction in deaths: On day 14 (time to death); Requirements of ventilators on day 9: 3% of number of new cases detected;  Requirement of future oxygen on day seven: 15% of total cases detected today;  Number of people which can be managed at home care: 80% of number of cases today;  Requirements of ventilators: 3% of Number of cases today;  Requirement of oxygen beds today: 15% of total cases today.

 

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

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