31^st March COVID-19 Update: Deaths will cross 45,000 in 200 Countries, Minimum expected deaths 42,213

1^st one lac were infected in 67 days, 2^nd in 11 days, 3^rd in 4 days, 4^th in 3 days, 5^th in 2.5 days, 6th in 2 days, 7th in 2 days

USA and Italy cross China’s mark, Spain may cross today

First reported case: 10^th January

 India: 1251 cases, 32 deaths

Containment Strategies

1. Study to see whether those who got BCG vaccination in childhood get the infection or not
2. Will India mandate all CSR funds be diverted to COVID-19 control?
3. Will India mandate 100% exemption to any contribution to COVID-19 funds?
4. Casualties are in patients with ARDS (cytokine storm) which requires specific ventilator settings and trained staff. All hospitals should list their ARDS management qualities along with availability of ECHMO machine
5. The government should start COPY LEFT policy and collect all the ideas
6. https://mobile.twitter.com/ChestImaging?s=08All should post their COVID positive X rays on the stated link. Similarly, one should post and share CT scan and lab parameters
7. The government should share district wise data and enlist all hotspots. Similarly, all private labs should disclose the number of positive lab samples on a common platform
8. In India we expected reduction in cases starting 30th March in view of a Nationwide Restriction of movement on 22nd and Lock Down on 24^thnight (Mean incubation period 5.2 days). However, we did notice a jump in daily cases on 30^th March, but that was again due to a hotspot
9. Reduction in pollution levels; effect is already seen in Delhi and Noida
10. Reduction in overall deaths from other causes (low pollution, less stress, more hygiene, no traffic accident deaths). The effect is already seen in Delhi’s cremation numbers. There is also a trend of shifting towards CNG cremation. One of the cremation grounds on 25^th and 26^thMarch showed 20% reduction in deaths (just an observation)
11. The government has the option of putting a Restricted National Health Emergency and take law and order, health and finance regarding COVID-19 in its hand.
12. ZIKA crisis in Brazil was successful only because of deployment of Army.
13. The government has an option of taking help of Final Year MBBS students, nurses with one-time extended prescription powers, foreign doctors waiting to pass entrance exam with some incentives, if crisis occurs.
14. The government also has the option of employing post MBBS students aspiring for PG, to be posted in COVID-19 duty and give them extra marks in PG NEET.
15. Options for containment: Lock down for three weeks (India model); Lock down for forty days; selective lockdown of states with rising cases (Wuhan model); Selective lockdown of cities with hot spots (Vietnam model); Selective lock down for elderly and persons with comorbid conditions (Germany and Japan model); Intensify testing amongst all or high-risk groups (South Korea Model); Deploy younger healthcare workers and women as front-line fighters (Italy - two hospitals posted young doctors <40 years, 60% women on duties with no mortality in healthcare workers); Make available surgical masks at reception to be worn by all patients entering the hospital (Singapore model).
16. Use the donated plasma of all cured patients for serious patients
17. Keeping all the healthcare workers on duty in hotels (like air lines staff) till the COVID-19 pandemic is over so that they are not a risk to their family
18. A dozen doctors in five states have been infected mainly due to lack of masks, gloves and personal protection equipment (PPE)
19. 14 medical staffof Delhi’s Ram Manohar Lohia Hospital, which includes 6 doctors and 4 nurses, were quarantined after coming into contact with a COVID-19 positive patient that led to one of the nurses developing symptoms of the disease.
20. Protecting the lives of the medical and healthcare workers is crucial considering the tragic experiences in countries like Italy and Spain — 51 doctors have succumbed to the deadly virus in Italywhile in Spain, 14% of those infected are doctors and healthcare workers. In China, the country of origin of the SARS-Cov-2 virus, till the first week of March, 3,400 healthcare workers had been infected with the virus while in Wuhan, from where it was first reported, 18 doctors and other healthcare workers succumbed to the disease. [TOI]

Situation around the Globe

Likely minimum deaths (37789 + 29492 x 15 = 4424) = 42213     

New cases on 30^th March: 60263

New deaths on 30^th March: 3204

Cases per million population (global): 92.8

Deaths per million population (global): 4.4

Total Cases: 784,794

Deaths: 37,789

Recovered: 165,387

ACTIVE CASES: 581,618

Currently Infected Patients Mild: 552,126 (95%)

Serious: 29,492 (5%)

Highlighted in green

= all cases have recovered from the infection 

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

 Clusters in India

1. Nizamuddin West in Delhi is acommon link among several confirmed cases reported from different parts of the country. The number includes 9 deaths (6 in Telangana and one each in Srinagar, Tamil Nadu and Karnataka), 9 confirmed cases in Andaman and Nicobar Islands and 18 confirmed cases in Delhi. All of the infected had attended a religious congregation conducted by Tabligh-e-Jamaat from the first through the second week of March in Nizamuddin. Nearly 250 foreign nationals attended the event, who later travelled to other states in the country. About 300 people have developed symptoms including fever, cough and heavy breathing.

1. Bhilwara in Rajasthan: 25 cases and two deaths. The infection came into notice after 6 doctors and medical staff at a private hospital tested positive.
2. Kerala’s northern district of Kasargod recorded 15 more cases, taking the total there to over 30. [TOI]