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World COVID Meter 20th January 2021: Acute manageable immunogenic thrombogenic inflammatory contagious viral disease pandemic

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Dr KK Aggarwal    20 January 2021

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, 10M June 29th, 11M July 4, 12M July 8, 13M July 13, 14M July 17, 15M July 23, 16M July 25, 17M July 29, 18M August 1, 19M August 6, 20M August 10, 21M August 16, 22M August 19, 23M August 21, 24M August 27, 25M August 30, 26M September 3, 27M September 7, 28M September 10, 29M September 14, 30M September 18, 31M September 21, 32M September 23, 33M September 28, 34M October 1, 35M October 4, 36M October 8, 37M October 11, 38M October 14, 39M October 17, 40M October 19, 41M October 22, 42M October 24, 43M October 26, 44M October 28, 45M October 30, 46M November 2, 47M November 4, 48M November 6, 49M November 7, 50M November 8, 51M November 10, 52M November 12, 53M November 14, 54M November 15, 55M November 17, 56M November 19, 57M November 20, 58M November 22, 59M November 24, 60M November 25, 61M November 27, 62M November 29, 63M December 1, 64M December 2, 65M December 4, 66M December 6, 67M December 7, 68M December 9, 69M December 10, 70M December 12, 71M December 13, 72M December 14, 73M December 15, 74M December 17, 75M December 19, 76M December 20, 77M December 22, 78M December 23, 79M December 26, 80M December 27, 81M December 29, 82M December 30, 83M December 31, 84M January 2, 85M January 4, 86M January 6, 87M January 7, 88M January 8, 89M January 9, 90M January 10, 91M January 12, 92M January 14, 93M January 15, 94M January 17, 95M January 18

 

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

Coronavirus Cases: 96,591,492

Deaths: 2,063,879

Recovered: 69,244,830

ACTIVE CASES 25,282,783

Currently Infected Patients 25,170,906 (99.6%) in Mild Condition

111,877 (0.4%) Serious or Critical

CLOSED CASES 71,308,709

Cases which had an outcome: 69,244,830 (97%) Recovered / Discharged

2,063,879 (3%) Deaths

 

 

#

Country,Other

TotalCases

NewCases

TotalDeaths

NewDeaths

TotalRecovered

ActiveCases

 

World

96,591,492

+577,554

2,063,879

+14,573

69,244,830

25,282,783

1

USA

24,802,241

+166,802

411,434

+2,716

14,780,856

9,609,951

2

India

10,596,228

+13,581

152,747

+154

10,244,839

198,642

3

Brazil

8,575,742

+63,504

211,511

+1,183

7,518,846

845,385

4

Russia

3,612,800

+21,734

66,623

+586

3,002,026

544,151

5

UK

3,466,849

+33,355

91,470

+1,610

1,558,503

1,816,876

6

France

2,938,333

+23,608

71,342

+441

211,816

2,655,175

7

Italy

2,400,598

+10,497

83,157

+603

1,781,917

535,524

8

Turkey

2,399,781

+6,818

24,328

+167

2,277,987

97,466

9

Spain

2,370,742

+34,291

54,173

+404

N/A

N/A

10

Germany

2,071,473

+12,159

49,244

+1,139

  

 (Source: https://www.worldometers.info/coronavirus/)

 

 

India:  

19th January: New Cases 13581, New Deaths 154, Total Cases 10596228, Total Deaths 152747, Active Cases 198642

18th January: New Cases 9975, New Deaths 137, Total Cases 10582647, Total Deaths 152593, Active Cases 202202

17th January: New Cases 13962, New Deaths 145, Total Cases 10572672, Total Deaths 152456, Active Cases 209519

16th January: New Cases 15051, New Deaths 181, Total Cases 10558710, Total Deaths 152311, Active Cases 210215

15th January: New cases 15151, New Deaths 176, Total Cases 10543659, Total Deaths 152130, Active Cases 212646

14th January: New Cases 15677, New Deaths 189, Total Cases 10528508, Total Deaths 151954, Active Cases 214472

13th January: New Cases 17015, New Deaths 201, Total cases 10512831, Total Deaths 151765, Active Cases 214812

12th January: New cases 15903, New Deaths 200, Total Cases 10495816, Total Deaths 151564, Active Cases 217839

11th January: New cases 12482, New Deaths 166, Total Cases 10479913, Total Deaths 151364, Active Cases 217881

10th January: New cases 16085, New Deaths 150, Total cases 10467431, Total Deaths 151198, Active Cases 224103

9th January: New Cases 18820, New Deaths 213, Total Cases 10451346, Total Deaths 151048, Active Cases 224903

8th January: New cases 18482, New deaths 229, Total Cases 10432526, Total Deaths 150835, Active Cases 225756

7th January: New cases 18106, New Deaths 234, Total Cases 10414044, Total Deaths 150606, Active Cases 226716

6th January: New Cases 20460, New Deaths 221, Total Cases 10395938, Total Deaths 150372, Active Cases 229403

5th January: New cases 17909, New Deaths 265, Total Cases 10375478, Total Deaths 150151, Active Cases 228833

4th January: New Cases 16278, New Deaths 200, Total Cases 10357569, Total Deaths 149886, Active Cases 232343

3rd January: New Cases 16660, New Deaths 215, Total Cases 10341291, Total Deaths 149686, Active Cases 245474

2nd January: New Cases 21222, New Deaths 266, Total Cases 10324631, Total Deaths 149471, Active Cases 248633

1st January: New Cases 17080, New Deaths 187, Total Cases 10303409, Total Deaths 149205, Active Cases 252275

31st December: New Cases 19046, New deaths 244, Total Cases 10286329, Total Deaths 149018, Active Cases 255525

30th December: New cases 21957, New deaths 299, Total Cases 10267283, Total Deaths 148774, Active Cases 258747

29th December: New cases 20529, New Deaths 285, Total Cases 10245326, Total Deaths 148475, Active Cases 263512

28th December: New Cases 16072, New Deaths 250, Total Cases 10224797,  Total Deaths 148190, Active Cases  269840

27th December: New Cases 20333, New Deaths 281, Total Cases 10208725, Total Deaths 147940, Active Cases 278840

26th December: New Cases 18574, New Deaths 280, Total Cases 10188392, Total Deaths 147659, Active Cases 279885

25th December: New cases 22350, New Deaths 251, Total Cases 10169818, Total Deaths 147379, Active Cases 28305724th December: New Cases 23924, New Deaths 350, Total Cases 10147468, Total Deaths 147128, Active Cases 283142

23rd December: New Cases 24236, New Deaths 302, Total Cases 10123544, Total Deaths 146778, Active Cases 284705

22nd December: New Cases 23886, New Deaths 331, Total Cases 10099308, Total Deaths 146476, Active Cases 290130

21st December: New cases 19174, New Deaths 302, Total Cases 10075422, Total Deaths 146145, Active Cases 293663

20th December: New cases 24589, New Deaths 330, Total Cases 10056248, Total Deaths 145843, Active Cases 305015

19th December: New Cases 26834, New Deaths 342, Total Cases 10031659, Total Deaths 145513, Active Cases 306465

18th December: New Cases 26991, New Deaths 342, Total Cases 10004825, Total Deaths 145171, Active Cases 309731

17th December: New cases 26762, New deaths 342, Total Cases 9977834, Total Deaths 144829, Active Cases 312961

16th December: New Cases 18164, New Deaths 357, Total cases 9951072, Total Deaths 144487, Active Cases 328922

15th December: New cases 26401, New Deaths 384, Total Cases 9932908, Total Deaths 144130, Active Cases 332985

14th December: New Cases 21791, New deaths 353, Total Cases 9906507, Total Deaths 143746, Active Cases 340929

13th December: New Cases 27336, New Deaths 338, Total Cases 9884716, Total Deaths 143393, Active Cases  353715

12th December: New Cases 30354, New deaths 393, Total Cases 9857380, Total Deaths 143055, Active Cases 357446

11th December: New cases 30034, Total cases 9827026, New Deaths 440, Total Deaths 142662, Active Cases 360572

10th December: New Cases 34666, New deaths 487, Total Cases 9796992, Total Deaths 142222, Active Cases 364582

9th December: New cases 26351, New Deaths 337, Total Cases 9762326, Total Deaths 141735, Active Cases 376086

8th December: New Cases 32067, New deaths 404, Total cases 9735975, Total Deaths 141398, Active Cases 379771

7th December: New Cases 27107, New deaths 404, Total Cases 9703908, Total Deaths 140994, Active Cases 385269

6th December: New Cases 32272, New Deaths 374, Total Cases 9676801, Total Deaths 140590, Active Cases 398040

5th December: New cases 36111, New Deaths 480, Total Cases 9644529, Total Deaths 140216, Active Cases 404367

4th December: New Cases 36638, New Deaths 509, Total Cases 9608418, Total Deaths 139736, Active Cases 410679

3rd December: New Cases 38309, New Deaths 570, Total Cases 9571780, Total Deaths 139227, Active Cases 416869

2nd December: New Cases 33761, New Deaths 498, Total Cases 9533471, Total Deaths 138657, Active Cases 424710

1st December: New Cases 36456, New deaths 500, Total Cases 9499710, Total Deaths 138159, Active Cases 429753

30th November:  New Cases 31179, New Deaths 482, Total cases 9463254, Total Deaths 137659, Active Cases 437000

29th November: New Cases 39036, New deaths 444, Total Cases 9432075, Total Deaths 137177, Active Cases 448585

28th November: New Cases 41815, New Deaths 495, Total Cases 9393039, Total Deaths 136733, Active Cases 454837

27th November: New cases 4135 3, New deaths 486, Total Cases 9351224, Total Deaths 136238, Active Cases 456100

26th November: New Cases 43174, New Deaths 491, Total cases 9309871, Total Deaths 135752, Active Cases 456410

25th November: New Cases 44699, New Deaths 518, Total Cases 9266697, Total Deaths 135261, Active Cases 453450

24th November: New cases 44276, New Deaths 489, Total Cases 9221998, Total Deaths 134743, Active Cases 445851

23rd November: New cases 37410, New Deaths  481, Total cases 9177722, Total Deaths 134254, Active Cases 439893

22nd November: New cases 44404, New Deaths 510, Total Cases 9140312, Total Deaths 133773, Active Cases 445095

21st November: New Cases 45295, New deaths 499, Total Deaths 9095908, Total Deaths 133263, Active Cases 442606

20th November: New Cases 46288, New Deaths 562, Total Cases 9050613, Total Deaths 132764, Active Cases 441952

19th November: New Cases 46182, New Deaths 584, Total Cases 9004325, Total Deaths 132202, Active Cases 445107

18th November: New Cases 45439, New Deaths 587, Total Cases 8958143, Total Deaths 131618, Active Cases 444755

17th November: New Cases 38532, New deaths 472, Total Cases 8912704, Total Deaths 131031, Active Cases 44866016th November: New Cases 28555, New Deaths 450, Total Cases 8874172, Total Deaths 130559, Active Cases 455444,

15th November: New cases 30715, New Deaths 435, Total Cases 8845617 (8.8. Million), Total Deaths 130109, Active Cases 467558

14th November: New Cases 41659, New Deaths 449, Total Cases 8814902, Total Deaths 129674, Active Cases 481491

13th November: New cases 45343, New Deaths 539, Total Cases 8773243, Total Deaths 129225, Active Cases 482551

12th November: New Cases 43861, New Deaths 521, Total Cases 8727900, Total Deaths 128686

11th November: New Cases 48285, New Deaths 549, Total Cases 10703056, Total Deaths 128164

10th November: New Cases 44679, New Deaths 511, Total Cases 8635754, Total Deaths 127615

9th November: New cases 37211, New Deaths 451, Total Cases 8591075, Total Deaths 127104, Active Cases 506765

8th November: New Cases 46661, New Deaths 491, Total Cases 8553864, Total Deaths 126653, Active Cases 511551

7th November: New Cases 46318, New deaths 557, Total cases 8507203, Total Deaths 126162, Active Cases 513750

6th November: New Cases 49851, New Deaths 576, Total Cases 8460885, Total Deaths 125605

5th November: New Cases 47622, New Deaths 675, Total Cases 8411034, Total Deaths 125029, Active Cases 3335730

4th November: New Cases 50465, New Deaths 704, Total Cases 8363412, Total Deaths 124354, Active Cases 528428

3rd November: New Cases 46033, New Deaths 511, Total Cases 8312947, Total Deaths 123650, Active Cases 534540

2nd November: New Cases 37592, New Deaths  497, Total Cases 8266914, Total Deaths 123139, Active Cases 542346

1st November: New Cases 46441, New Deaths 493, Total Cases 8229322, Total Deaths 122642, Active Cases 563775

31st October: New Cases 46715, New Deaths 468, Total Cases 8136166, Total Deaths 122149, Active Cases 571529

30th October: New Cases 48120, New Deaths 550, Total Cases 813666, Total Deaths 121681, Active Cases 583574

29th October: New Cases 49281, New Deaths 568, Total Cases 8088046, Total Deaths 121131

28th October: New cases 49912, New Deaths 509, Total cases 8038765, Total Deaths 120563, Active Cases 603251

27th October: New Cases 42965, New deaths 519, Total Cases 7988853, Total Deaths 120054, Active Cases 611605

26th October: New Cases 36838, New deaths 505, Total Cases 7945888, Total Deaths 119535, Active Cases 627638

25th October: New Cases 45158, New Deaths 463, Total Cases 7909050, Total Deaths 119030, Active Cases 656026

24th October: New Cases 50224, New Deaths 575, Total Cases 7863892, Total Deaths 118567, Active Cases 7075723

23rd October: New Cases 54028, New Deaths 656, Total Cases 7813668, Total Deaths 117992, Active Cases 682107

22nd October: New Cases 54482, New Deaths 683, Total Cases 7759640, Total Deaths 117336, Active Cases 695979

21st October: New cases 56000, New Deaths 703, Total Cases 7705158, Total Deaths 116653, Active Cases 716610

20th October: New Cases 54422, New Deaths 714, Total Cases 7649158, Total Deaths 115950, Active Cases 740658

19th October: New Cases 46498, New Death 594, Total Cases 7594736, Total Deaths 115236, Active Cases 748883

18th October: New Cases 55511, New Deaths 578, Total Cases 7548238, Total Deaths 114642, Active Cases 773701

17th October: New Cases 62092, New deaths 1032, Total Cases 7492727, Total Deaths 114064, Active Cases 784264

16th October: New Cases 65126, New Deaths 886, Total Cases 7430635, Total Deaths 113032, Active Cases 795969

15th October: New Cases 60439, New Deaths 835, Total Cases 7365509, Total Deaths 112146, Active Cases 813303

14th October: New cases 67988, New Deaths 694, Total Cases 7305070, Total Deaths 111311

13th October: New cases 63517, New Deaths 723, Total Cases 7237082, Total Deaths 110617, Active Cases 827760

12th October: New Cases 54265, New Deaths 710, Total Cases 7173565, Total Deaths 109894, Active Cases 938879

11th October: New Cases 67757, New Deaths 813, Total Cases 7119300, Total Deaths 109184, Active Cases 868689

10th October New Cases 74535, New Deaths 921, Total Cases 7051543, Total Deaths 108371, Active Cases 868309

9th October: New Cases 73196, New Deaths 929, Total Cases 6977008, Total Deaths 107450, Active Cases 884053

8th October: New Cases 70824, New Deaths 967, Total Cases 6903812, Total Deaths 106521

7th October: New Cases 78809, New Deaths 963, Total Cases 6832988, Total Deaths 105554, Active Cases 902972

6th October: New Cases 72106, New Deaths 991, Total Cases 6754179, Total Deaths 104591, Active Cases 908335

5th October: New cases 59893, New Deaths 886, Total cases 6682073, Total Deaths 103600, Active Cases 919363

4th October: New cases 74767, New Deaths 902, Total Cases 6622180, Total Deaths 102714, Active cases 936013

3rd October: New Cases 75479, New Deaths 937, Total cases 6547413, Total Deaths 101812

2nd October: New cases 79974, New Deaths 1071, Total Cases 6471934, Total Deaths 100875

1st October: New Cases 81693, New Deaths 1096, Total Cases 6391960, Total Deaths 99804

 

India predictions

  1. Death rate is deaths today vs number of cases today.
  2. Corrected death rate is deaths today vs number of cases 14 days back.
  3. For one symptomatic test positive case, there are 10-30 asymptomatic cases and 20 untested cases.
  4. Estimated number of deaths = Reported deaths x 2.
  5. Number of deaths today should be 15% of the serious patients present 14 days back.
  6. Undocumented cases for each documented case - Iceland: 1: 2; Germany: 1: 5; New York City grocery store shoppers: 1: 10; California: 1.5%.
  7. Amongst active cases, 2.37% are serious, 1.82% need oxygen, and 0.41% need ventilator support.

 

Facts

DENSITY: 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]

COVID Sutra: COVID-19 pandemic is due to SARS 2 Beta-coronavirus (different from SARS 1 where spread was only in serious cases); with over eleven virus sequences floating; Causes Mild or Atypical 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.

The most important

  1. Masking is THE prevention
  2. RT PCR Ct is THE test for diagnosis
  3. Zinc is THE Vitamin
  4. Day 5 is THE day in COVID phase for mortality prevention
  5. Day 90 is THE day after which the word COVID ends
  6. Home Isolation is THE modality of Treatment
  7. 12 years is THE age when the mortality starts
  8. CRP is THE lab test for seriousness
  9. Loss of Smell is THE symptom equal to RT PCR test
  10. 15 minutes is THE time to get the infection.

Numbers to remember

  1. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2770945: RDW at admission 14.5%

 

 

Other Sutras

  1. Viral particles are seen in tears, stool, kidneys, liver, pancreas, heart, semen, peritoneal fluid, CSF.
  2. Thrombosis: University of Pennsylvania has reported that clots are seen in patients even on blood thinners.
  3. Other human beta-coronaviruses have immunity lasting only for one year with no IMMUNITY PASSPORT.
  4. In absence of interventions, prolonged or intermittent social distancing (till 2022-24) is the key.
  5. Due to low levels of cross immunity from other beta-coronaviruses against SARS-CoV-2, the virus may appear to fade away, only to show resurgence after a few years. Surveillance till 2024.
  6. During peak, trace and treat, and after the peak, trace and treat the close contacts.
  7. Increased spread: Close environment, crowded place with close physical contacts with no ventilation.
  8. 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.
  9. HCW: Direct patient exposure time < 30 minutes; 7 days work and 7 days holidays.
  10. Italy: mortality reduced when they were short of ventilators.
  11. Hospital at HOME: CHF, mild pneumonia, exacerbations of asthma and COPD, cellulitis, and urinary tract infections.
  12. Great Imitator (protean manifestation).
  13. IgM can be false positive in pregnancy, immunological diseases; Pooled tests (<5, 20 Kerala, 64 Singapore RT PCR) when seroprevalence is <2%.
  14. Early treatment, day 3-5, to reduce the viral load and prevent cytokine storm using hydroxychloroquine with azithromycin or ivermectin with doxycycline with IV remdesivir and IV single dose tocilizumab (IL-6 receptor inhibitor) if very high D-dimer and IL-6; convalescent plasma therapy (given early; donor 14 days symptoms free, between day 28-40, single donation can help 4 patients), Lopinavir-ritonavir and Favipiravir if very low CD 4 counts.
  15. 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.
  16. Early intubation with prone ventilation only if progressive. Hypoxia (walking dead) have capillary problem and not alveoli.

 

Formulas and Predictions

Deaths

  1. The goal is to save lives. Monitoring deaths is important, especially when testing is limited.
  2. Daily deaths are the best indicator of the progression of the pandemic, although there is generally a 17- to 21-day lag between infection and deaths.
  3. Deaths in symptomatic cases: Less than one percent (best of the care).
  4. Therefore, Deaths X 100 = expected number of symptomatic cases
  5. Some may count probable or presumptive COVID-19 deaths when cases are not confirmed with a positive test but on the basis of symptoms and medical history. In New York, 3,700 presumptive deaths were added in one day in April when testing was limited.
  6. Case fatality rate: Number of total deaths as on date/number of total RTPCR positive cases as on today
  7. Infection fatality rate: Number of total deaths as on date/number of total calculated cases as on today
  8. Number of reported deaths: Number of confirmed deaths x 2

Prediction Metrics

  1. The University of Washingtons Institute for Health Metrics and Evaluation (IHME):

Is based on what is known about a disease and how peoples actions may affect that.

 

Forecasts are not fixed but change depending on public behavior. When people learn that new cases are rising, they start wearing masks and using social distancing again; and when they realize that fresh cases are dropping, they tend to drop their guard.  IHME makes use of real-time infection data from Johns Hopkins Universitys Coronavirus Resource Center to represent disease transmission and estimate how many Americans will die. The researchers then estimate how many Americans are wearing masks or using social distancing, which can modulate the final model.

The rate of infection in a population is based on the "R0," or reproduction number. R0 represents the average number of people who will contract the infection from a single infected person, in a population thats never been witness to the disease before. If R0 is 3, it suggests that one case will create an average of three new cases. When that transmission rate of infection occurs at a specific time, its called an "effective R," or "Rt."  R0 less than 1 means the epidemic is under control; and when its higher than 1, it is still spreading.

IHME found the "effective R over 1 in Oklahoma. In all other states the effective R was found to be less than 1.”

 

  1. CDC: Relies on positive tests results. CDCs report these as confirmed cases. The positivity rate suggests how tough or easy it is to find a case, which is an indicator of both the spread of COVID-19 and how widespread testing is. If the rate of positive tests is 20%, one doesn’t have to look hard to find a case, compared to 1%, which means that one has to do a lot of tests to get a positive one. The more COVID-19 spreads, the higher the positivity rate. A 60% positivity rate may suggest that testing is only being done in a nursing home during an outbreak or a hospital where the most apparent cases are and not the general population where cases may be milder.

 

  1. Marylands COVID-19 dashboard: It reports the daily positivity percentage (percentage of positive tests and total testing volume since March). While looking at testing, one wants to know how many tests were done historically with the ability to compare and understand if the number has increased or declined or is stable and the percentage that is positive. Maryland and Pennsylvania report a 7-day rolling average of the daily positivity percentages. The 7-day average rate better indicates a trend as compared to daily numbers.

 

  1. The testing numbers often fluctuate, depending on where testing is done and when the labs report test results. A sudden surge in testing numbers may point to a large number of tests done in a group setting such as a nursing home or prison on a single day. Laboratories and hospitals report test results on weekdays, so the numbers can decline on weekends.
  2. A major goal during the coronavirus epidemic has been to flatten the curve to maintain local hospital capacity. After expected COVID-19 surges, many hospitals limited surgeries and admissions to preserve their resources, including hospital beds, ventilators, and healthcare personnel. [WebMD]

 

Infrastructure Capacity

  1. If hospital capacity reaches 80%, we may have to stop admitting patients to prevent the hospital from being overwhelmed.
  2. In order to plan for surges and increase capacity: It is required to know the number of people who tested positive and were admitted to the hospital with symptoms of COVID-19.
  3. Pennsylvanias COVID-19 dashboard: has a hospital preparedness page that shows the number of hospitalized COVID-19 patients and the number and percentage of available beds by unit, including intensive care, medical/surgical, and airborne isolation.
  4. Pennsylvania: Reports the number of ventilators COVID-19 patients and non-COVID-19 patients use every day.
  5. Illinois lists the recovery rate: In Illinois, the recovery rate of 95% is calculated as recovered cases divided by recovered cases plus confirmed deaths. This indicates the quality of medical care and the severity of disease.[WebMD]
  6. Cases will double after the average doubling time of the country at that time
  7. Cases expected in the community: Get number of deaths occurring in a five-day period

Estimate the number of infections required to generate these deaths based on the country or area 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

  1. Lock down effect: Reduction in cases after average incubation period (5 days)
  2. Lock down effect in reduction in deaths: Reduction in number of deaths on day 14 (average time to death of that country)
  3. Requirement of ventilators on day 9: 1-3% of number of new cases detected
  4. Requirement of future oxygen on day 7: 10% of total cases detected today
  5. Number of people which can be managed at home care: 90% of number of cases today
  6. Requirement of ventilators: 1-3% of number of cases admitted 7-9 days back
  7. Requirement of oxygen beds today: 10% of total cases admitted seven days back
  8. Number of unreported or untested cases: Number of reported cases x 10-30 (depending on the country, New York 10, Delhi 23.8, Pakistan 30)
  9. Number of asymptomatic cases: For 6 symptomatic cases, 200 asymptomatic cases (CHINA); (1.78 M tests in Hong Kong, 32 asymptomatic cases, 10 symptomatic cases)
  10. Oxygen requirement on that day in the hospital at 6am: Number of cases detected to have hypoxia on six minutes walk test.

 

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

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