World #COVID19 13th April: 210 Countries, Cases crosses 1.85 million, Deaths will cross 150,000, Minimum expected reported deaths 121822, more than 5000 deaths per day, 14.7 deaths per million population

On Apr 13, 2020

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

1st 100,000 in 67 days, 2nd in 11 days, 3rd in 4 days, 4th in 3-day, 5th in 2.5 Days, 6th in 2 days, 7th in 2 days, and subsequent in 1.5 days

First reported Case: 10th January

Situation Around the Globe

Likely minimum deaths (114208 + 50758 x 15 = 7614) = 121822

Total cases 1,852,652

Deaths: 114,208

Recovered: 423,400

ACTIVE CASES: 1,315,044

Currently Infected Patients

Mild 1,264,286 (96%)

Serious: 50,758 (4%)

New cases on 10th April: 72616

New deaths on 10th April: 5415

Cases per million population (global) 238

Deaths per million population (global) 14 .7

India: 9205 cases and 331 deaths as per World Meter (7 am 13th April).

759 new cases and 43 new deaths in India [source] [source] [source] [source] [source] [source]

Strategies

1. Why should the hospitals be closed if a COVID 19 positive case is found. Gujrat government has decided not to do so. We have seen in the past focal outbreaks of infections in the nurseries ibn the past and the protocol has been close for 24 hours and decontaminate the area.

2. When thos doctors who have close their clinics, open them should first go for decontamination of the clinic.

3. Unless we get this globally under control, COVID 19 may assume a seasonal nature.

4. Quick answer needed: if those who got BCG vaccination in childhood got the infection or not, jamatis who got it how many were BCG vaccinated.

5. Mandate CSR funds for COVOD 19 research

6. ARDS (cytokine storm) require specific ventilator settings, prone ventilation and trained staff with standby ECMO. tPA and heparin may help in such cases.

7. https://mobile.twitter.com/ChestImaging?s=08: Post COVID positive X rays, CT images.

8. Collateral benefits: Reduction in air pollution levels and Ganges water pollution. Reduction in overall deaths from other causes (low pollution, less stress, more hygiene, no traffic accident deaths).

9. It’s a National Health Emergency

10. ZIKA Brazil Model: Crisis in Brazil was successful only because of deployment of Army.

11. Indian Lock down model: Janta curfew on 22nd followed by complete country lock down on 24th night for three weeks

12. Quarantine model: Lock down for forty days

13. Wuhan Model: Selective sealing of the city/state with epicentre

14. Vietnam Model: Sealing of a village with most cases

15. Bhilwada CLUSTER Model: Seal an area of 2 km all around the cluster, sanitise each house, house to house survey for ALI and SARI, isolate infected cases, test all close contacts

16. Bird flu model: On April 20, 2016, the Lebanonese Ministry of Agriculture confirmed the presence of avian influenza A(H5N1) virus on 2 poultry farms in Nabi Chit village located in the Bekaa region, adjacent to the border of Lebanon with Syria. This virus caused the deaths of 20,000 domestic birds. The Ministry of Agriculture culled all domestic birds within a 3-km radius of infected farms. A total of 60,000 birds were culled from 7 farms (including the 2 infected farms) and 10 households with backyards. All farms were disinfected, and organic remains were disposed safely.

17. Germany and Japan model: Selective isolation of elderly and high risk comorbid patients

18. S Korea Model: Intensify testing amongst all or high risk group

19. Italy model: Deploy younger health care workers and women as front-line fighters (2 hospitals posted young doctors < 40 years, 60% women on duties with no mortality in healthcare workers)

20. Singapore Model: Make available surgical masks at reception to be worn by all patients entering the hospital. Give N 95 masks to all health care providers and use AII rooms for all procedures on infected cases

21. India Testing Model: Symptomatic cases only, from

22. 2nd April started testing asymptomatic contacts and now all SARI cases

23. S Korea testing model: test test and test

24. Use donated plasma of all cured patients and use them for serious patients ( Kerala has started it)

25. Delhi HCW model: Keep all the healthcare workers on duty in hotels (like air lines staff) till so that they are not a risk to their family

26. Protect healthcare workers: 61 doctors died in Italy & in Spain 14% of those infected are healthcare workers. In China, till the first week of March, 3,400 healthcare workers were infected while in Wuhan, 18 doctors and other healthcare workers succumbed to the disease.

27. New definition: Significant exposure to Covid-19 as face-to-face contact within 6 feet with a patient with symptomatic Covid-19 that is sustained for at least a few minutes (and some say more than 10 minutes or even 30 minutes). The chance of catching Covid-19 from a passing interaction in a public space is therefore minimal.

28. New policy: All health workers in health care setting should sue surgical and general public should wear cloth mask when on the roads (India).

29. A team of Australian scientists at Monash University in Melbourne has shown a single dose of the Ivermectin drug was able to stop the SARS-CoV2 virus growing in cell culture. [Journal Antiviral Research]

Country, Other	Total Cases	New Cases	Total Deaths	New Deaths	Total Recovered	Active Cases	Serious, Critical	Tot Cases/ 1M pop	Deaths/ 1M pop	Total Tests	Tests/ 1M pop
World	1,852,359	+72,616	114,194	+5,415	423,311	1,314,854	50,776	238	14.7
USA	560,402	+27,523	22,105	+1,528	32,634	505,663	11,766	1,693	67	2,832,258	8,557
Spain	166,831	+3,804	17,209	+603	62,391	87,231	7,371	3,568	368	355,000	7,593
Italy	156,363	+4,092	19,899	+431	34,211	102,253	3,343	2,586	329	1,010,193	16,708
France	132,591	+2,937	14,393	+561	27,186	91,012	6,845	2,031	221	333,807	5,114
Germany	127,854	+2,402	3,022	+151	60,300	64,532	4,895	1,526	36	1,317,887	15,730
UK	84,279	+5,288	10,612	+737	344	73,323	1,559	1,241	156	352,974	5,200
China	82,052	+99	3,339	77,575	1,138	139	57	2
Iran	71,686	+1,657	4,474	+117	43,894	23,318	3,930	853	53	263,388	3,136
Turkey	56,956	+4,789	1,198	+97	3,446	52,312	1,665	675	14	376,100	4,459
Belgium	29,647	+1,629	3,600	+254	6,463	19,584	1,223	2,558	311	102,151	8,814
Netherlands	25,587	+1,174	2,737	+94	250	22,600	1,384	1,493	160	101,534	5,926
Switzerland	25,415	+308	1,106	+70	12,700	11,609	386	2,937	128	193,800	22,393
Canada	24,383	+1,065	717	+64</