Covid- 19 date: April 2020
PKGhatak,MD
COVID-19.
The precise number of people infected with SARS-CoV-2 virus is not
known. The Johns Hopkins University epidemiology department on April 25,2020 reported 3
million infections worldwide and 900,000 in the USA.
(October, 2022: This article was written in 2020 when the first wave of Covid-19 became a pandemic. Towards the end of 2022, about 7 million people worldwide have died, countless number of people are suffering from Long Covid. Initial in- hospital mortality in US was 15 %, this year the rate fell to 1 % but still 300 + people are dying daily from covid related complications. The covid-19 virus has mutated several times and no one is counting how many waves of infections are spreading in a particular region or country. Several vaccines are approved, for use - beginning from 5 yr. old to very old, but anti-vaccine propaganda has become a formidable force to be reckoned with.
In the meantime Monkey pox and Ebola have become endemic and are continuing)
Many believe the number should be multiplied by 3 to 9 to get a more correct practical number because of the lack of diagnostic test facilities in many countries including in the US. Regrettably, the US ranks far below Germany, South Korea and other less prosperous counties in this respect.
As of today, the virus SARS-CoV-2, has taken 200,000 lives worldwide and 70,000 in the US alone.
The illness is known as COVID-19
This virus resembles the corona of the sun, hence, so named.
The coronaviruses 229E, NL63, OC43, HKU1 are responsible for the common cold.
Severe Acute Respiratory Syndrome (SARS) is caused by SARS-CoV-1; a wild cat called Civet is the carrier of this virus.
Middle East Respiratory Syndrome (MERS) is due to MERS-CoV; camels are carriers of viruses.
COVID-19 pandemic is due to a virus initially called Wuhan virus, then nCoV and now SARS-CoV-2. The carrier unknown at present was initially thought to be an ant-eater named Pangolin.
How viruses infect other species:
A minor mutation of RNA of the virus, though happens randomly, makes the virus infectious to other animals.
How SARS-CoV-2 infects humans:
When an infected person sheds viruses and the virus directly infects another person. This is called human-to-human transmission.
SARS-CoV-2 is a respiratory virus. It infects respiratory organs. It starts at the nose, then the throat and down the bronchial tubes all the way to the lungs. Once the virus enters the lining of nose cells, it redirects cells to produce copies of the virus at an alarming rate. And the virus begins to appear in expired air, coughing up the sputum and saliva of the infected person. The virus remains suspended in the surrounding air for several minutes to 3 hours, in places like - closed rooms, public transport, shops, theaters, etc. The virus remains active in a 6ft circular space around the infected person. The virus spreads to a wider area when the person coughs or sneezes. On a metal surface, the virus remains viable for 4 hours, and on plastic for about 72 hrs. The virus fails to enter humans through the skin. Viruses landed in the eyes must travel to the nose by the nasolacrimal duct.
We touch our nose once in 2 hrs., and those viruses that land on fingers get transplanted in the nose and infection begins. As we breathe the air contaminated with the virus, the virus gains entry into the respiratory tract directly. Experts believe this mode may not be the primary route of infection in the community but is important in confined areas where the air is heavily saturated with the virus like concert halls, theaters, community centers, etc.
Mechanism of SARS-COV2 entry.
The
lining cells of the respiratory tract, GI tract, Kidneys and the Endothelial cells of the Cardiovascular system have ACE (angiotensin converting enzyme)
receptors on the cell surface. The ACE cell receptors are the anchor sites of the virus to gain entry inside the cells. In children, the ACE
receptors are much less in number in the respiratory tract and more numerous in the GI tract. Male
hormone favors the expression of ACE receptors and the female hormone estrogen suppresses it. Certain drugs and Leukotrienes IL-6 downgrade the ACE receptor expression. The use of ACE inhibitors and Angiotensin II receptor blocker drugs (ARB) make the ACE receptor sites open for the SARS-COV2 virus
to attach.
Incubation period:
The incubation period is between 3 to 14 days, and the average is 4 days.
How long a patient remains infectious:
This virus shedding begins on day 1. After the patient recovers, virus shedding continues for another 7 days but in fewer numbers. The virus is present in stool for 31 days after recovery, but whether it remains infectious is not known.
Incubation period:
The incubation period is between 3 to 14 days, and the average is 4 days.
How long a patient remains infectious:
This virus shedding begins on day 1. After the patient recovers, virus shedding continues for another 7 days but in fewer numbers. The virus is present in stool for 31 days after recovery, but whether it remains infectious is not known.
It is established that infected people with no or very few symptoms spread the covid-19 virus in larger numbers and for a longer time compared with more seriously ill patients.
How infectious SARS-CoV-2 is:
The measles virus is the most infectious. SARS-CoV-2 is next- given a free chance to spread, it will infect people exponentially. Exponential means 1 person to 2, then 2 to 4, 4 to 16, 16 to 256, then 6,5536, 4.8 million, 18.3 million and on and on. The doubling time of infection is 3 days.
What are the symptoms of covid-19:
Common cold like symptoms – runny nose, scratchy throat, body aches, headache, fever, loss of smell and taste, repeated waves of severe shaking chills, nausea, vomiting, occasional diarrhea and red eyes.
More severe symptoms – chest pain, shortness of breath, labored breathing, gray discoloration of the skin, blue fingers and toes. Occasional skin rashes, at times itchy lesions.
Ominous signs:
Hallucination, confusion, weakness of limbs, blurred vision, loss of pulse in foot. Frost bites like the skin on feet, specially in young children – called the frosty foot.
Rare symptoms:
Recently, in young children, Toxic shock syndrome like skin lesions was noted. A small number of children had multiple organ vasculitis, now called Multisystem Inflammatory Disease (MID-C). Some children developed lesions in the heart like seen in Kawasaki disease. Still rare but serious illnesses are - stroke in younger patients, meningoencephalitis, loss of smell, and blood clots in veins.
In severely ill patients the inflammation of the inner lining cells of blood vessels (endothelium) clinically presents as stroke, pulmonary embolism, coronary thrombosis, and renal failure.
Seriously sick patients exhibit two phases of illness. Initially mild to moderate symptoms lasting 7 to 10 days; followed by a short period of improvement. Then the sudden onset of shortness of breath and very rapid respiratory failure and death. Not unlike, seen in Hunta virus pneumonia. The second phase of the illness is due to excessive and prolonged immune overreactions - now called the Cytokine storm.
How infectious SARS-CoV-2 is:
The measles virus is the most infectious. SARS-CoV-2 is next- given a free chance to spread, it will infect people exponentially. Exponential means 1 person to 2, then 2 to 4, 4 to 16, 16 to 256, then 6,5536, 4.8 million, 18.3 million and on and on. The doubling time of infection is 3 days.
What are the symptoms of covid-19:
Common cold like symptoms – runny nose, scratchy throat, body aches, headache, fever, loss of smell and taste, repeated waves of severe shaking chills, nausea, vomiting, occasional diarrhea and red eyes.
More severe symptoms – chest pain, shortness of breath, labored breathing, gray discoloration of the skin, blue fingers and toes. Occasional skin rashes, at times itchy lesions.
Ominous signs:
Hallucination, confusion, weakness of limbs, blurred vision, loss of pulse in foot. Frost bites like the skin on feet, specially in young children – called the frosty foot.
Rare symptoms:
Recently, in young children, Toxic shock syndrome like skin lesions was noted. A small number of children had multiple organ vasculitis, now called Multisystem Inflammatory Disease (MID-C). Some children developed lesions in the heart like seen in Kawasaki disease. Still rare but serious illnesses are - stroke in younger patients, meningoencephalitis, loss of smell, and blood clots in veins.
In severely ill patients the inflammation of the inner lining cells of blood vessels (endothelium) clinically presents as stroke, pulmonary embolism, coronary thrombosis, and renal failure.
Seriously sick patients exhibit two phases of illness. Initially mild to moderate symptoms lasting 7 to 10 days; followed by a short period of improvement. Then the sudden onset of shortness of breath and very rapid respiratory failure and death. Not unlike, seen in Hunta virus pneumonia. The second phase of the illness is due to excessive and prolonged immune overreactions - now called the Cytokine storm.
The severity of the illness can be predicted by the elevated levels of IL6, D-dimer, LDH, C-Reacting protein, and ferritin in the blood.
How the recovered patients describe their COVID-19 experience:
The symptoms are much more severe than the common cold or flu. Chills are so deep seated appeared as if the bone marrow is frozen. Shaking is uncontrollable.
It takes weeks before they gain normal strength. Those who experience hallucinations describe meeting with deceased parents, friends, loved ones and other family members. Hallucination is recurrent over days.
Who are most venerable to catch infection and even face death:
First responders, doctors, nurses, all hospital employees, police officers, public transport workers, daily wage earners, essential workers.
Susceptible population:
Nursing home patients, elderly with multiple chronic illnesses.
People over 65 with a previous history of heart disease, hypertension, diabetes type II, Chronic lung disease, obesity and kidney disease.
Special risk to immunosuppressed patients, patients on chemotherapy for cancer, immune-suppression drugs following organ transplant. And patients on kidney dialysis.
What kills patients:
Severe oxygen deficiency due to pneumonia.
Multiple organ failure.
Heart attacks and cardiac arrest and arrhythmia.
What tests are performed to diagnose this illness:
The tests are in two separate groups.
Patients currently suffering suspicious symptoms of COVID-19 are given a Virus Identification test.
How the recovered patients describe their COVID-19 experience:
The symptoms are much more severe than the common cold or flu. Chills are so deep seated appeared as if the bone marrow is frozen. Shaking is uncontrollable.
It takes weeks before they gain normal strength. Those who experience hallucinations describe meeting with deceased parents, friends, loved ones and other family members. Hallucination is recurrent over days.
Who are most venerable to catch infection and even face death:
First responders, doctors, nurses, all hospital employees, police officers, public transport workers, daily wage earners, essential workers.
Susceptible population:
Nursing home patients, elderly with multiple chronic illnesses.
People over 65 with a previous history of heart disease, hypertension, diabetes type II, Chronic lung disease, obesity and kidney disease.
Special risk to immunosuppressed patients, patients on chemotherapy for cancer, immune-suppression drugs following organ transplant. And patients on kidney dialysis.
What kills patients:
Severe oxygen deficiency due to pneumonia.
Multiple organ failure.
Heart attacks and cardiac arrest and arrhythmia.
What tests are performed to diagnose this illness:
The tests are in two separate groups.
Patients currently suffering suspicious symptoms of COVID-19 are given a Virus Identification test.
Virus Identification tests are also two different kinds. 1, Antigen test. The test identifies a part of the virus and not the entire virus. The results are obtained in an hour or two but this antigen test should be considered as a Screening Test. Both false positive and false negative results are not unusual. And all negative tests require a follow up full RT-PCR test.
How the test is performed.
It involves taking a sample of the secretion from the distal part of the nasal passage or preferably, from the nasopharynx (point of meeting of the nasal passage and the back of the throat) by inserting a cotton swab. Identifying the RNA signature of this virus in a laboratory. This method is known as the Antigen test.
It involves taking a sample of the secretion from the distal part of the nasal passage or preferably, from the nasopharynx (point of meeting of the nasal passage and the back of the throat) by inserting a cotton swab. Identifying the RNA signature of this virus in a laboratory. This method is known as the Antigen test.
2. The more involved test is called the RT-PCR test. This test detects the COVID-19 virus. It takes several hours to run the test and results are reported in 3 days.
This test is a good test and false positive or false negative results rarely happen. One of the reasons for a false positive result is due to the presence of a corona common cold virus, and the virus load varies depending on the day of the onset of symptoms - virus load is maximum in earlier days and less after 10 days from the onset of symptoms.
This test is a good test and false positive or false negative results rarely happen. One of the reasons for a false positive result is due to the presence of a corona common cold virus, and the virus load varies depending on the day of the onset of symptoms - virus load is maximum in earlier days and less after 10 days from the onset of symptoms.
The other group of tests is called the Antibody test or Immunity test
Blood samples are tested for the presence of antibodies against the Covid-19 virus. Presence means that the person who had an illness and recovered.
This test is not yet standardized and results are not consistent, both false positive and false negative is beyond the acceptable range.
This test is not yet standardized and results are not consistent, both false positive and false negative is beyond the acceptable range.
Other tests are suggested of covid-19.
CT scan of the chest showing ground-glass appearance and B-line in chest ultrasound are almost always present in covid-19 pneumonia. But other causes of interstitial pneumonia also produce ground-glass opacities.
What are effective drugs:
As of today, Remdesivir, an antiviral drug, is found to be somewhat effective, other drugs and combinations of drugs are being tried. No antiviral drug is universally effective. That fact, however, did not stop people of all stripes, including the president of the USA, promote one drug or another for the treatment of covid19 illness.
Names of drugs claimed to be effective:
Chloroquine, hydroxychloroquine, melatonin, colchicine, ivermectin, propolis, ciclesonide, ketorolac, thalidomide, many other drugs, macromolecules, immune modulators.
Steroid – dexamethasone.
Antibiotic. - Azithromycin.
Antiviral agents. - used against HIV/AIDS, influenza, common cold, hepatitis, herpes, Ebola.
None of the above drugs were found to be clinically effective in the treatment of covid-19.
The above drugs are of two classes.
Antiviral drugs - like drugs used in HIV/AIDS.
Immune modulation drugs - like disease modifying drugs used in the treatment of Rheumatoid arthritis and Crohn's disease, etc.
What are the helpful therapies:
Oxygen therapy - when oxygen saturation is below normal in patients. Oxygen can be administered by nasal cannula. When a higher concentration of oxygen is required, increasing oxygen concentration can be achieved by successively using these devices- simple masks, tight fitting re-breathing masks, PAP masks and non-invasive ventilation.
Mechanical ventilation. - In respiratory insufficiency or respiratory failure. Turning patients to a prone position improves ventilation and oxygenation while on a ventilator and specially breathing spontaneously on oxygen. Dexamethasone 6 mg a day for 5 days given to patients on ventilators decreases fatality by 35 % and 20 % for patients requiring oxygen therapy by non-invasive methods.
Extracorporeal membrane oxygenation- when all methods of correcting oxygenation fail.
In critically ill patients, dexamethasone, monoclonal antibodies to IL2, IL6 and at times IL1 and recovered patients' antibody therapy improve survival rates.
Timing of drugs therapy:
In the stage of active viral pneumonia, antiviral drugs are indicated. Drugs that suppress inflammation are harmful and should not be used.
In the second stage of illness due to Cytokine induced respiratory failure, immune modulators are indicated.
General supportive care of –
nutrition, hydration, pain medications (Tylenol), etc.
How long it takes to recover:
Of the patients requiring mechanical ventilation, 80 to 90% died in the hospital. Those who improved required ventilatory support for 14 days or more. That in itself is unusual.
Then an additional week or two before hospital discharge. Less seriously ill patients require a hospital stay of 10 to 14 days.
All recovered patients needed additional weeks or a month to regain their usual strength back.
How long it takes to recover:
Of the patients requiring mechanical ventilation, 80 to 90% died in the hospital. Those who improved required ventilatory support for 14 days or more. That in itself is unusual.
Then an additional week or two before hospital discharge. Less seriously ill patients require a hospital stay of 10 to 14 days.
All recovered patients needed additional weeks or a month to regain their usual strength back.
Long covid:
Post covid period weakness, lethargy, depression, and various neurological symptoms noted for six months, even longer are known as Long covid.
What medical treatment appears promising:
Transfusion of plasma containing SARS-CoV-2 antibodies, obtained from recovered COVID-19 patients. Its use is limited by the availability of plasma.
One antiviral drug, Remdesivir, used without success in Ebola infection, has shown promise in lessening the duration of the severity of symptoms, and a 3% improved survival rate. A combination of Interferon-beta (immune modulator), Ribavirin (direct anticoagulant) and Ritonavir (antiviral) worked better than Remdesivir used alone. Improvement is also seen in another combination of drugs - Lopinavir, Ritonavir and Interferon beta.
Drugs that lessen the immune reaction. - Pneumonia in covid19 is due to the exaggerated and unchecked immune response to this virus. In addition, this process depletes certain classes of lymphocytes which under normal conditions down-regulate the immune reactions. Several drugs in this class are undergoing trials.
What medical treatment appears promising:
Transfusion of plasma containing SARS-CoV-2 antibodies, obtained from recovered COVID-19 patients. Its use is limited by the availability of plasma.
One antiviral drug, Remdesivir, used without success in Ebola infection, has shown promise in lessening the duration of the severity of symptoms, and a 3% improved survival rate. A combination of Interferon-beta (immune modulator), Ribavirin (direct anticoagulant) and Ritonavir (antiviral) worked better than Remdesivir used alone. Improvement is also seen in another combination of drugs - Lopinavir, Ritonavir and Interferon beta.
Drugs that lessen the immune reaction. - Pneumonia in covid19 is due to the exaggerated and unchecked immune response to this virus. In addition, this process depletes certain classes of lymphocytes which under normal conditions down-regulate the immune reactions. Several drugs in this class are undergoing trials.
An effective vaccine is urgently needed and should be administered worldwide.
Many well-known vaccine manufacturers in many countries, in corroboration with government agencies, are seriously engaged in the search for effective vaccine production. It is estimated that at least one such vaccine will be ready in 12 to 18 months.
When more than 60% of the population of a country is naturally infected by this virus, most people by then will have enough antibodies in their blood and will be immune (Herd Immunity) and the virus will die off. But that may take 2 to 3 years and by that time several thousand, if not, millions will die needlessly.
An effective antiviral drug will be most useful.
How to kill the virus outside the human body:
The covid-19 virus has an outer cover mainly made of fatty substances and it breaks down easily, in about 20 seconds when the virus comes in contact with soap.
70% isopropyl alcohol kills the virus in less than 20 seconds. But not with 100% alcohol because pure alcohol evaporates faster than it completes killing the virus.
Household bleach similarly kills the virus on contact.
Soap and running water are strongly recommended for washing hands after returning home from outdoor activity and frequently when at home. All surfaces, door knobs, railing, electrical switches, etc. should be wiped clean once a day with a cloth moistened with bleach.
However, household bleach should not be used on the skin. It should NEVER be injected into the body or ingested. You must ignore the US president's maddening idea when he suggested in a recent presidential task force public press briefing, that injecting bleach into the body or drinking bleach might kill the viruses in covid-19 patients.
Remember: Call the poison center before you contemplate carrying out the president's advice.
Read the Warning label glued on the container.
Bleach once comes in contact with human tissue, will destroy the tissues. It may lead to permanent disfigurements, scarring and permanent disability. It may kill young children.
Why is so much disparity seen between SARS-CoV2 and SARS-Cov-1 epidemics:
These two viruses are structurally closely related, both originated in China, bats are reservoirs of both and both are respiratory viruses.
The main reasons for this disparity are -
The combined rate of true asymptomatic and pre-symptomatic carriers is between 30 to 70%. This is the primary reason for the such a worldwide spread of this virus that took place before the alarm went off.
The SARS-CoV-2 shedding is at maximum on the day, the day the signs of infection appear, then gradually the viral shedding decreases but continue for another 7 days after patients recover.
SARS-CoV-2 infects at an alarming rate.
An unconfirmed report suggests the immune response following SAR-CoV-2, either, is too slow to appear in blood or short lived - meaning those who recovered have no protection for a significant time against a second infection.
That will also imply that an effective vaccine may not be coming out soon like it happened in HIV/AIDS.
Is there a genetic basis for the severity of covid-19 illness in certain ethnic groups.
There are two areas on chromosomes that are suspects. One area is on chromosome 9, near the ABO blood group, a certain variation makes people more venerable to covid-19 infection. Blood group A people are more susceptible to this virus and also develop more severe symptoms.
The second instance is a short segment containing 6 genes on chromosome 3, and according to scientists 65% of south Asians inherited one copy of these genes from the Neanderthals 60,000 years ago. This 6 gene segment on chromosome 3 provides an advantage in fighting all viral infections but is also responsible for hyperimmune reactions in south Asia. This is thought to be the reason for higher deaths in the Bangladeshi population in the U.K. from covid-19.
Is there a genetic basis for the severity of covid-19 illness in certain ethnic groups.
There are two areas on chromosomes that are suspects. One area is on chromosome 9, near the ABO blood group, a certain variation makes people more venerable to covid-19 infection. Blood group A people are more susceptible to this virus and also develop more severe symptoms.
The second instance is a short segment containing 6 genes on chromosome 3, and according to scientists 65% of south Asians inherited one copy of these genes from the Neanderthals 60,000 years ago. This 6 gene segment on chromosome 3 provides an advantage in fighting all viral infections but is also responsible for hyperimmune reactions in south Asia. This is thought to be the reason for higher deaths in the Bangladeshi population in the U.K. from covid-19.
Updates: 7.31,20
As of July 31, 2020, the total number of people infected with the covid-19 virus worldwide is 17.3 million and 673,284 people are dead. Many authorities believe these official numbers are not accurate because in countries like India, a large number of people in rural areas are getting ill and many are dying and no one is keeping records of those numbers. It is estimated that the official numbers should be multiplied by at least 3 for a more accurate estimate of infection and deaths from this viral pandemic.
Following countries continue to have high infection rate and deaths.
|
Name of country |
Total number of infections |
Number of deaths |
|
USA |
4.5 million |
152, 000 |
|
Brazil |
2.6 million |
91, 000 |
|
India |
1.6 million |
37, 700 |
|
Russia |
838, 000 |
13, 939 |
|
South Africa |
482, 000 |
7, 812 |
Patients recovered and discharged from hospitals continue to have various symptoms due to damage to their lungs, heart and nervous systems, generalized debility, shortness of breath and persistent cough. Symptoms may last for 2 to 3 months.
Antibody levels in recovered patients begin to fall within weeks and by 3 months, in most patients, the antibodies are not detectable or very low.
The question still remains its significance. Are these people being venerable to reinfections. Will this happen with the covid vaccine also. Some claim antibodies may persist in the blood for 12 to 18 months following the mRNA vaccine.
Oxford vaccine group expected to distribute a synthetic mRNA SARS-CoV-2 vaccine in early next year. Two doses of vaccine will be given in a 4-week interval. In addition to the usual antibody response, the T-Lymphocytes memory cells are also sensitized by the vaccine and it is believed by investigators that will protect people in long term but that period is undetermined at present.
An antiviral drug, Remdesivir is now accepted as a standard drug for this infection.
Seriously ill patients greatly benefited from Dexamethasone therapy. Monoclonal antibodies against IL-1, IL-2 and IL-6 are also used in order to minimize organ failure in seriously ill patients. But the effectiveness of monoclonal antibodies is not observed by all investigators.
Cardiology groups recommend recovered patients should be monitored for myocardial damage, heart failure and coronary insufficiency.
Mask use is made mandatory in many countries along with social distancing. At this time, in absence of a vaccine and or an effective antivirus prophylactic drug, it is only sensible that all people observe 5 recommendations namely weaning masks, social distancing, avoid crowded places and restaurants/bars, hand washing with soap and water and clean surface with disinfectant, in order to protect themselves and the most venerable elderly population.
UPDATES:
Updated Sept.1, 2020.
A recent report from India regarding antibody response to the covid-19 virus. Of patients who have recently recovered from the infection show 14 % have no
antibodies in their blood when tested. The investigators commented that the
timing of tests was important because the antibody levels fell in 2 to 3
weeks' time. So, the absence of antibodies did not mean 14 % did not have
antibodies at all. This again raises the question of protecting people by the covid vaccine - will it protect all the people and how often people
should be vaccinated. From Iceland, an opposite result is published.
They used 6 separate antibody tests, including two Pan Immunoglobulin
(IgG, IgM, IgA) assays to document antibodies in covid recovered
patients. Also, they used Quantitative Polymerase Chain Reaction (q-PCR) assays to identify covid-19 infected patients. In their study
antibodies remain in the blood for 4 months of those who recovered from
covid-19. And 91 % of patients had antibodies upto to 4 months.
Updates. Nov.1. 2020
46 million people worldwide were infected and 1.2 million died. In the USA 9.2 million infections are noted and 231,000 are dead.
A monoclonal antibody cocktail (a collection of antibodies acting on different viral genomes) is used in a selected group of patients. The success of this therapy varies from one country to the other. Most reputable journals reported rate of post covid antibody levels disappears between 90 days to 180 days. Post covid patients are liable, just like fresh victims, to 2nd SRS-CoV-2 virus infection, however, the second time infections are less severe. Kawasaki like syndrome in adults was reported but the incidence was rare. Young adults with covid may die suddenly from cardiovascular direct viral invasion. FDA has approved the antiviral drug Remdesivir for all symptomatic patients. At least one covid vaccine will be available for inoculation in mid-December 2020.
Updates: December 1, 2020.
In the USA a large section of the population is not following CDC recommendations regarding social distancing, travel restrictions and the like. During the Thanksgiving holidays, 3 million people took the air and millions of others drove. It is feared the hospitals will be overwhelmed with new covid cases, on top of 160,000 news cases a day on average at present. The total number of deaths in the USA alone passed 270,000 and at present 1.500 are dying every day and word wide 1.5 million have died.
Two vaccines are on the way for speedy approval.
Convalescent antibody therapy was found to be ineffective in reducing death rates but a monoclonal antibody cocktail is approved for moderately sick patients, to be given at the onset of symptoms and discharged from the hospital and followed at home. Remdesivir, though approved earlier, was found to be ineffective in reducing deaths or the severity of symptoms.
Interferon alpha 1 antibodies, among all other biological agents, hold the most promise to counteract cytokines induced multisystem failure.
Reports are coming out as experiences are growing about the long term effects of covid infection. The readmission rate is 11%, multiple admission rate is 1.6%. Some patients, though recovered, show significant symptoms. Important symptoms among them are "brain fog", recent memory loss, fatigue, cardiac arrhythmias, and various neuropsychiatric symptoms.
People are ignoring CDC guidelines regarding social distancing and wearing masks. During Thanksgiving and Christmas, 1.4 million people took airplanes every day to visit relatives and friends. That behavior was soundly criticized by medical communities but fell on deaf ears. The resultant spike of new infections are about 185,000, and 20,000 hospital admissions and 3,5000 deaths on a daily basis.
The cumulative cases and deaths worldwide are 83 million and 1.8 million respectively, in the USA are 20 million and 400,000. In 30 days in December, 130,000 people died in the US.
Though 12 million doses of two vaccines were delivered, only 2 million people were vaccinated.
It is suggested by some researchers that JAK inhibition reduces SAR-CoV19 virus inflammatory activities and infectivity of liver cells, thereby, mortality and morbidity from covid may be reduced. A mutant SAR-CoV19 - B 1.1.7 has emerged in the UK, now is known to be present in 32 countries, including the US. An R value of 1.5 to 1.7 of this mutant virus is causing havoc in countries with high covid patients.
The use of biological agents in Covid has claims of success and failure that have saturated the medical news. It is a fact that the same agent used early in the course of the disease may be helpful to control virus multiplication and facilitate inflammation but used at a later stage produces more harm than good. The reverse is true that limits cytokines mediated tissue damage.
The use of biological agents in Covid has claims of success and failure that have saturated the medical news. It is a fact that the same agent used early in the course of the disease may be helpful to control virus multiplication and facilitate inflammation but used at a later stage produces more harm than good. The reverse is true that limits cytokines mediated tissue damage.
January 8,2021.
300,000 new cases were recorded in a single day and 4,000 people lost their lives.
January 15, 2021
On this day nearly 2 million people have died and 94 million people contracted COVID worldwide, in the USA 400,000 are dead and 23.4 million got infected.
January 26, 2021.
100 million people contracted covid globally, and the number of deaths passed 2 million.
February 22, 2021
On this day 500,000 are dead in the USA; it took only 29 days to add 100,000 to this list. The total number of people infected is 28 million.
There are four major mutations of the covid-19 virus in circulation in the world, the South African mutation turned out to be the nastiest. In the USA two vaccines are approved and 40 million people received at least one dose of vaccine so far. Johnson & Johnson vaccine is on the path of approval in a few days.
1 March 2021.
Johnson & Johnson vaccine- adenovirus & spike protein complex vaccine, one dose only vaccine, is approved. To date, 75.2 million received at least one dose of the 2 shots vaccine in the USA. Worldwide 240 million doses have been administered; in India, only 14 million got one vaccine shot. Globally total infection number is 114 million, in India the number is 11 million and 157 thousand deaths are recorded.
USA numbers are infection #29 million, deaths # 515 thousand.
April 4,2021.
India is having a resurgence of new cases,103,000 /day. Total accumulated cases are 12.5 million and 105,000 deaths. Brazil has a similar picture- 13 million cases and 331,000 deaths. The number in the USA is 30 million and 555,000 deaths respectively. The USA leads vaccination in the world- given 103 million shots so far.
May1,2021.
India covid infections and deaths passed all previous records. The healthcare and government institutions do not appear to be functioning at all. Reports and pictures are shown on TV and in newspapers, showing the total breakdown of medical services. In any 24-hour period, 400,000 new cases are reported, soon it will reach 500,000/day. The number of deaths will reach 4000/day. The total number of deaths reported was 211,000. But no reasonable person believes those government released figures. No one is counting sickness and deaths in villages where the majority of people live.
May 31, 2021.
India has lost 329,000 lives officially, the actual number no one knows, estimated to be over a million, in 30 days over 100,000 died. The total number of new cases is over 28 million. Worldwide total number of cases- 170 million and deaths - 3.6 million. A highly infectious variant covid-19 has appeared in Vietnam, its official designation is yet to come but it is the deletion of the Y144 protein of the spike protein of the Indian variant B.1.617.2 and UK variant B.1.1.7.
WHO proposed Greek letters to identify covid variants - the Indian variant will be called Covid-19 delta.
1 July 2021
Worldwide the number of covid infections is 183 million, and 4 million deaths were officially recorded, but the actual number is estimated to be 3 times higher than that. In India the total number of people infected with covid-19 is 30 million and 400,000 died; only 25% of people were vaccinated in India.
August 8, 2021.
A repeating cycle of increased new covid cases, then mandated masking, travel restriction, limiting customers in restaurants, theaters, etc. followed by ease of controls and then the cycle begins again. This cycle has been going on for 6 months. Sad to say, people, for various reasons including political views, are refusing to be vaccinated. And the pandemic continues. Statistics have become mere numbers and lost their usefulness.
September 16, 2021.
In the USA 1 person out of 480 people died of covid, in Native Americans the deaths are highest,1 per 240, and in whites -1 in 1,300. The total number of covid deaths in the USA is over 66,000. In India, the official number of deaths is 45,000 but the true number is probably over 1.5 million.
October 8, 2021.
WHO says the actual number of deaths from COVID in India is 5 million, the official number of 500,000 is unreliable.
Dec 12, 2021
The total number of covid infections in the USA has reached 50 million and accumulated deaths 800,000. And 61% of the population is fully vaccinated which leaves out 130 million at risk of infection. The new covid mutated virus Omicron will dominate over the delta variety very soon. A third dose of mRNA vaccine offers 80% protection against the omicron variety.
February 6, 2022.
The total number of covid infections in the USA and India are 76 and 4.2 million respectively and the total number of deaths is 900,000 and 502,000 respectively. However, Indian official numbers are not accurate, to say the least.
Vaccine resistance.
As of today, 10 billion doses of vaccine are administered worldwide and every nation registered 70 to 90% protection against infection and death in the vaccinated population. And 396 million covid infections and 5.75 million deaths were recorded worldwide. Still, the anti-vaccine movement is spreading worldwide to the detriment of all.
March 7, 2022.
Today the death from Covid stands at 6 million, in the last 100 days 1 million died taken worldwide official numbers. Present deaths are mainly in the un-vaccinated population.
April 30,2022
513 million people are infected and 6.2 million died from COVID worldwide. In the USA number of death is reaching 1 million, 66.1 % of the population are fully vaccinated.
August 3,2002.
Total infections are approaching 6 billion and deaths stand at 6.4 million today. About 12 billion vaccine doses have been administered. BA.5 variant now is the primary covid-19 virus circulating.
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