Global Scenario

Coronavirus Cases: 197,319,270                                                                    

Deaths: 4,213,978                              

Recovered: 178,492,133                                                                                                        

ACTIVE CASES: 14,613,159                                                                        

Serious/Critical Cases: 87,077                                                                                  

(Source: https://www.worldometers.info/coronavirus/; July 29, 2021)

(Source: https://www.worldometers.info/coronavirus/; July 29, 2021)

Weekly Trends

(Source: https://www.worldometers.info/coronavirus/; July 30, 2021 @ 11:45 am)

Indian Scenario

29^th July: New Cases 44673, New Deaths 549, Total Cases 31571295, Total Deaths 423244, Active Cases 411810

28^th July: New Cases 43211, New Deaths 641, Total Cases 31526622, Total Deaths 422695, Active Cases 409805

27^th July: New Cases 42928, New Deaths 640, Total Cases 31483411, Total Deaths 422054, Active Cases 405967

26^th July: New Cases 30844, New Deaths 418, Total Cases 31440483, Total Deaths 421414, Active Cases 405131

25^th July: New Cases 38153, New Deaths 411, Total Cases 31409639, Total Deaths 420996, Active Cases 417244

24^th July: New Cases 40284, New Deaths 542, Total Cases 31371486, Total Deaths 420585, Active Cases 415411           

23^rd July: New Cases 39498, New Deaths 541, Total Cases 31331202, Total Deaths 420043, Active Cases 415721

22^nd July: New Cases 34865, New Deaths 481, Total Cases 31291704, Total Deaths 419502, Active Cases 411898

21^st July: New Cases 41697, New Deaths 510, Total Cases 31256839, Total Deaths 419021, Active Cases 416005

20^th July: New Cases 42123, New Deaths 489, Total Cases 31215142, Total Deaths 418511, Active Cases 413630

19^th July: New Cases 29424, New Deaths 372, Total Cases 31173019, Total Deaths 418022, Active Cases 412375

18^th July: New Cases 38325, New Deaths 501, Total Cases 31143595, Total Deaths 414141, Active Cases 428692

17^th July: New Cases 41283, New Deaths 517, Total Cases 31105270, Total Deaths 413640, Active Cases 429397

16^th July: New Cases 38112, New Deaths 560, Total Cases 31063987, Total Deaths 413123, Active Cases 430681

15^th July: New Cases 39072, New Deaths 544, Total Cases 31025875, Total Deaths 412563, Active Cases 437006

14^th July: New Cases 41854, New Deaths 580, Total Cases 30986803, Total Deaths 412019, Active Cases 438301

13^th July: New Cases 40215, New Deaths 623, Total Cases 30944949, Total Deaths 411439, Active Cases 436414

12^th July: New Cases 30827, New Deaths 546, Total Cases 30904734, Total Deaths 409338, Active Cases 439266           

11^th July: New Cases 37676, New Deaths 720, Total Cases 30873907, Total Deaths 408792, Active Cases 457915

10^th July: New Cases 41475, New Deaths 899, Total Cases 30836231, Total Deaths 408072, Active Cases 460681           

9^th July: New Cases 42648, New Deaths 1206, Total Cases 30794756, Total Deaths 407173, Active Cases 461700

8^th July: New Cases 43538, New Deaths 910, Total Cases 30752108, Total Deaths 405967, Active Cases 465417           

7^th July: New Cases 45674, New Deaths 817, Total Cases 30708570, Total Deaths 405057, Active Cases 467048

6^th July: New Cases 43957, New Deaths 930, Total Cases 30662896, Total Deaths 404240, Active Cases 466689

5^th July: New Cases 34067, New Deaths 552, Total Cases 30618939, Total Deaths 403310, Active Cases 470798

4^th July: New Cases 40387, New Deaths 743, Total Cases 30584872, Total Deaths 402758, Active Cases 489128

3^rd July: New Cases 43296, New Deaths 947, Total Cases 30544485, Total Deaths 402015, Active Cases 492301

2^nd July: New Cases 47252, New Deaths 797, Total Cases 30501189, Total Deaths 401068, Active Cases 502383

1^st July: New Cases 43360, New Deaths 796, Total Cases 30453937, Total Deaths 400271, Active Cases 517579

30^th June: New Cases 48878, New Deaths 991, Total Cases 30410577, Total Deaths 399475, Active Cases 529580

29^th June: New Cases 45699, New Deaths 816, Total Cases 30361699, Total Deaths 398484, Active Cases 543718

28^th June: New Cases 37037, New Deaths 907, Total Cases 30316000, Total Deaths 397668, Active Cases 559124

27^th June: New Cases 46643, New Deaths 981, Total Cases 30278963, Total Deaths 396761, Active Cases 579942

26^th June: New Cases 49851, New Deaths 1256, Total Cases 30232320, Total Deaths 395780, Active Cases 593205

25^th June: New Cases 49052, New Deaths 1186, Total Cases 30182469, Total Deaths 394524        , Active Cases 602386

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

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 29

• 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, 96M January 20, 97M January 21, 98M January 23, 99M January 25, 100M January 26

• 101M January 29, 102M January 30, 103M February 1, 104M February 4, 105M February 6, 106M February 8, 107M February 11, 108M February 13, 109M February 16, 110M February 18

• 111M February 21, 112M February 24, 113M February 28, 114M March 1, 115M March 4, 116M March 6, 117M March 9, 118M March 11, 119M March 13, 120M March16

• 121M March 18, 122M March 19, 123M March 22, 124M March 24, 125M March 26, 126M March 27, 127M March 30, 128M March 31, 129M April 2, 130M April 3

• 131M April 5, 132M April 7, 133M April 8, 134M April 9, 135M April 11, 136M April 12, 137M April 14, 138M April 15, 139M April 16, 140M April 17

• 141M April 19, 142M April 20, 143M April 21, 144M April 22, 145M April 24, 146M April 25, 147M April 26, 148M April 28, 149M April 29, 150M April 30

• 151M May 1, 152M May 3, 153M May 4, 154M May 5, 155M May 6, 156M May 7, 157M May 9, 158M May 10, 159M May 11, 160M May 13

• 161M May 14, 162M May 16, 163M May 17, 164 M May 19, 165M May 21, 166M May 23, 167M May 25, 168M May 27, 169M May 28, 170M May 31

• 171M June 2, 172M June 4, 173M June 7, 174M June 9, 175M June 12, 176M June 15, 177M June 18, 178M June 20, 179M June 23, 180M June 26

• 181M June 28, 182M July 1, 183M July 3, 184M July 6, 185M July 8, 186M July 11, 187M July 13, 188M July 15, 189M July 17, 190M July 19

• 191M July 21, 192M July 23, 193M July 24, 194M July 26, 195M July 28     

COVID-19 Variants

SARS-CoV-2 Variants of Concern

(Source: WHO)

* A new “Delta plus” variant (B.1.617.2.1 or AY.1) has been formed due to a new mutation K417N in the Delta variant. The Union Health Ministry has said that the Delta Plus variant is now a Variant of Concern in India.

• 56 cases of the Delta Plus variant of COVID-19 were found in the country till June 30.

• States where Delta Plus variant has been detected are Madhya Pradesh, Maharashtra, Punjab, Gujarat, Kerala, Andhra Pradesh, Tamil Nadu, Orissa, Rajasthan, Jammu, Karnataka, Haryana, and Himachal Pradesh.

SARS-CoV-2 Variants of Interest

(Source: WHO)

“B.1.621”: A new Variant under Investigation

Sixteen confirmed cases of B.1.621 – first identified in Colombia - have been found across the United Kingdom (UK) thus far, and a large proportion of the cases has been linked to overseas travel. At present, there seems to be no evidence of community transmission in the country.

According to Public Health England, there is no evidence to state that this variant causes more severe disease or makes the vaccines currently being used, less effective. However, the variant contains a number of mutations of concern. It has the N501Y mutation, also found in the Alpha variant and made it more transmissible. It also has E484K, also found in the Beta variant that, which, according to experts, can partially evade vaccines.

As per the World Health Organization (WHO), the first known case of B.1.621 was in Colombia in the month of January. Twenty five other countries have also recorded cases since then, including the US, Spain, Mexico and the Netherlands.

This new variant is now spreading in the U.S. and accounts for nearly 10% of cases that were genetically sequenced recently at the University of Miami’s pathology lab in Florida. The WHO has stated that the variant requires further monitoring.

Hybrid of Indian and UK COVID-19 variants

Vietnam has uncovered a new Covid-19 variant combining characteristics of the two existing variants first found in India and the UK, which can spread quickly by air. The concentration of virus in the throat fluid increases rapidly and spreads very strongly to the surrounding environment. The WHO has said that there is no new hybrid strain. The strain detected in Vietnam is part of delta strain first detected in India.

Some consequences of emerging variants

• Potential for quicker spread (increased transmissibility) 
• Potential to cause milder or more severe disease in people
• Potential to evade detection by viral diagnostic tests: 1.1.7 has S gene target failure
• Diminished susceptibility to therapeutic agents like monoclonal antibodies
• Potential to evade natural or vaccine-induced immunity

Variants of concern might require one or more appropriate public health actions, such as notification to WHO under the International Health Regulations, reporting to CDC, local or regional efforts to control spread, increased testing, or research to determine the effectiveness of vaccines and treatments against the variant. Based on the characteristics of the variant, additional considerations may include the development of new diagnostics or the modification of vaccines or treatments (CDC).

India predictions: Formulas for better understanding of data

1. Death rate is number of deaths today vs number of cases today
2. Corrected death rate is number of deaths today vs number of cases 14 days back.
3. Estimated number of deaths = Reported deaths x 2
4. Number of expected deaths today is 15% of the number of serious patients 14 days back.
5. For one symptomatic positive case, there are 10-30 asymptomatic cases and 20 untested cases.
6. 85-90% positive cases are asymptomatic or have mild infection; 10-15% of positive cases may develop severe infection (require oxygen, steroids, remdesivir); about 5% cases become critical (require ventilator and stronger medicines).

COVID Sutra

COVID-19 pandemic is due to SARS 2 Beta-coronavirus (different from SARS 1 where spread was only in serious cases); 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), Origin Possibly from Bats (Mammal); spreads through the air (by inhalation of air carrying very small fine droplets and aerosol particles, human to human transmission via large and small droplets or touching inanimate surfaces contaminated with virus . Enters through MM of eyes, nose or mouth and the spike protein gets attached to the ACE2 receptors, which are found in organs throughout the body (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.

10 Sutras to remember

• Universal masking (correct, consistent and 3-layered) is THE prevention.
• RTPCR Ct is THE gold standard test for diagnosis. 
• Zinc is THE mineral; D is THE vitamin.
• Day 5 is THE day in COVID phase for mortality prevention. 
• Day 90 is THE day after which the word COVID ends.
• Home isolation is THE modality of treatment. (The policy may vary from country to country.)
• 12 years is THE age when the mortality starts. (Children 12 years or older should wear masks as recommended for adults – WHO UNICEF guidelines)
• CRP is THE lab test for seriousness.
• Loss of smell and taste are THE symptoms equal to RTPCR test.
• 15 minutes is THE contact time to get the infection.

Some more numbers

• If hospital capacity reaches 80%, we may have to stop admitting patients to prevent the hospital from being overwhelmed.
• 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.
• Cases will double after the average doubling time of the country at that time
• 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
• Lock down effect: Reduction in cases after average incubation period (5 days)
• Lock down effect in reduction in deaths: Reduction in number of deaths on day 14 (average time to death of that country)
• Requirement of ventilators on day 9: 1-3% of number of new cases detected
• Requirement of future oxygen on day 7: 10% of total cases detected today
• Number of people which can be managed at home care: 90% of number of cases today
• Requirement of ventilators: 1-3% of number of cases admitted 7-9 days back
• Requirement of oxygen beds today: 10% of total cases admitted seven days back
• Oxygen requirement on that day in the hospital at 6am: Number of cases detected to have hypoxia on six minutes walk test.