Corona times 2020-13. The reality is sinking in ! Three stages of Corona in India

Stage I

Most of us didn't bother. We had heard of Bird flu, Saars and so on. Oh yes we said, a few died,      but it happens ! Experts did caution us that it could get serious, but being the positive, confident people we have become, we ignored them. We thrived on the mantra of 'Being positive'.               (Now we shiver at the word +ve!)

Stage II

January to march, it was still a sort of fun, we were worried but not anxious. We said it will go away soon, no virus can survive our summers. We hoped that the virus would be washed away by the few heavy showers we had in March. 

It became a carnival on Cable TV. The anchors being smart, articulate, literate and comfortable in front of the camera, they became the ringleaders of the invited panelists. They  toyed with them and encouraged them to bark at each other.  These new towers of babble, succeeded in confusing us more than educating us. They were openly partisan, one way or the other. We got into a euphoria and started believing that the Virus was defeated. Not all TV's,  there are exceptions!

The viewer was kept glued to the screen, we saw drama in high pitched voices, accusations, denouement, tragedy, bravery, motivational talks, manipulative politics, crookedness and hypocrisy. 

I just read about how our superstition and fear are already making us monsters. This happened yesterday. Victims are stigmatized. There has been instances of Lynching, These scars will stay forever in our psyche. We can only ask where did we err? How do we change this?  The future forebodes more ills than what the disease has brought us!

  ( I stopped watching) Hopefully they have cut-out the drama, calmed down and are living in the present.  Shakespeare would have been proud of them, may be learn a few more tricks on creating drama. 

Stage III

The mood has turned somber. The real test of us as a country has begun. Will we come together as a country?  It is not the time to keep waging the insidious war among ourselves, but to declare a cease fire.  It is time for us to regroup, contribute and do our utmost. We cannot assume that the good will automatically take over! 

We know that lock down would reduce the number of people getting killed. The lock down was required to buy time and prepare better while the graph keeps rising! Is there a list of what is planned? Is it announced? Wonder how prepared are the hospitals in the villages? How much money is allotted?  (God) Statistics hopefully will give us the numbers. 

Were there more reasons why the states extended the lock down? Will normalcy be back with states acting unilaterally. Even districts want to block outsiders! 

Should FM give us a report like the one we get for the Covid 19 spread?  The fiscal part of the war against it. Are the accountants and auditors and other are working on it? In addition to doctors and police? This will become crucial as coffers get emptied.

World status

I am sharing four articles  hoping they will  give us  the right perspective, we may not fully agree but need to debate on it.

A)( This happened yesterday!)

 Dear all.Our closest friend Dr. Pradeep who was the doctor who drove the ambulance wearing the PPE and buried Dr. Simon with his own hands narrated the horrific inhuman act that happened yesterday.

The ambulance with the mortal remains was stopped in front of Ega theatre and the drivers were beaten up and also the ambulance damaged. Further the body was left in the middle of the road opposite to the theatre.
Following this our friend Dr. Pradeep begged for the help of ambulance drivers who were in no shape to drive. Hence he along with two ward boys drove to another cemetery and using only one spade which was available there personally dug the grave along with help of one another police, buried the body. He is so traumatised about burying his own colleague and friend and feels such a death should not occur to even our enemies.
This is the narrative of the event happened from the doctor who was in the front-line
This brings out the narrow minded nature of the public and I wonder where these patients will go if all hospitals do not want to treat the COVID patients
We are not God and we also are vulnerable to get the disease but we work in spite of all adverse situations to deserve only this treatment from the public. I don’t think medical profession is considered as noble anymore
Dr. Narmada
Secretary IMA Vellore

B). Frankly speaking Here is an interesting article written by an eminent Cape Town Rhuematoligist who was born in Bulawayo and went to school here. (USA)

 There are some terrible harsh realities that the world must accept.The virus is NOT going away.The lockdown has been in place, but made us realize that new case numbers persist, and that we are delusional to think we are going to kill this virus.The lockdown will NOT get rid of the virus.To this end we have to accept certain realities. It’s not about getting rid of the virus, it’s about understanding that we will NOT get rid of it for the next year, or more, as it burns it’s way across the world, until we gradually develop a resistance, or even better, some REAL treatments or vaccines against it.

Unfortunately, we will have to literally start normalizing the consequences of the virus. Some people are going to die and we can only do our best to treat them as they come. (Are there estimates on how many could die without lock down) 

We have to accept that it’s an ongoing risk for all of us especially the elderly, and social distancing will be needed for the at risk populations.Other diseases and conditions will also need treatment, and we will see a rebound in these as people start to bring their complaints to the hospitals again.  A country as a whole, and its people, as individuals, cannot continue to exist without income. We have to resume life and the economy, and the politicians have to start to verbalize this TRUTH. (Perhaps it depends on how deep are the pockets of each country)

 This TRUTH, is that the virus is NOT going away for a long time, and that some, but in fact, relatively few people, are going to die, compared to the numbers of infections. It is VERY important to reassure people that the overwhelming majority of people, in fact more than 95% will be fine.The virus is much more prevalent than people realize. Spread is already much more than realized, due to failure to count asymptomatic individuals.The virus is therefore even LESS lethal than thought, since the true ratio of mortality is overestimated, by not including the asymptomatic, as yet, unknown numbers.

Politically...there will be blame: Of course , people are blaming Donald Trump.BUT, It’s not Trumps fault. The media have continued their three year resistance against trump, at all cost, and continue to use the virus to “get him”. To a degree the media have stirred up emotions, and influenced the world reaction into ongoing lockdowns and staggering destruction of economies, that are leading to incredible poverty, the consequences of which, are still to come.NO country or government could have been prepared for this.The expert advisors, ie Dr Fauci, amongst others, did NOT know what the realities of this virus are. 

There WAS no experience on this issue. Models were and are still, all wrong, because there has NEVER been a similar problem. The lockdowns have not worked to CURE the virus. The lockdowns did work in one respect...they lowered the curve of acute admissions and bought time, and enabled the systems to develop a better public health coping ability.

Contrary to media disinformation, Trump HAS listened to the experts. At every stage he followed their advice. Their advice has not worked to CURE the virus. NOTHING, would have worked.It’s about EXPECTATIONS of the public. The ONE mistake, has been, to give the public the expectation that the virus will be GONE. It will NOT go in short or medium term.The reality is that the lockdown has only enabled healthcare to cope by lowering the rapid spread and mass presentation of acute illness But the time of lockdowns has passed.The entire main stream media reaction, has just been aimed at Trump, not the virus. The media are spreading inappropriate expectations for a political end. Worse, the media are to blame for the ongoing attack and demise of hope. 

Hope is a human requirement. The media need to look at themselves and stop their ongoing negativity, which is simply based on their hatred for Donald Trump.If anything China bares largest responsibility for this literal viral Chernobyl facing the world, be it spread from their disgusting wet markets, or even worse, the claims of viral construction in a lab, that got out into communities.The truth has not come out of China and still does not do so, and in all likelihood, will NEVER do so.The world health organization, ( US Poltics. But does strike a chord!)

W.H.O, also bears a major responsibility for underestimating the severity and the contagious component of corona virus, and inappropriately defending Chinese disinformation, and failing in the early response to spread of the virus.

So what is going to happen?The virus will stay in the communities, until either natural resistance increases, or less likely, a vaccine is developed.The virus will spread and many people will get sick, but MOST will be fine.Some people who are at risk will get the virus, and regrettably may not survive.We have to accept that it’s an ongoing risk for all of us especially the elderly, and social distancing will be needed for these at risk populations.The economies will have to open up.Life will go on.Humanity will survive.

Hopefully humanity will learn from this.Humanity must henceforth look after the entire planet including wildlife, the environment and preserve it.People need to learn the fundamentals of life, especially togetherness and caring and thought for the less fortunate.There is hope, because at the end, hope is all we as a species have. ( Wishful thinking! Why not?)

The road ahead is going to be very hard.Keep strong. Keep safe. Hold on to your hope. And for those who have faith...keep that too!  

David Gotlieb. Physician, Rheumatologist.

Cape Town.April 19th 2020.

C). WE ARE NOT IN THE SAME BOAT ...I heard that we are in the same boat. But it's not like that. We are in the same storm, but not in the same boat. Your ship can be shipwrecked and mine might not be. Or vice versa. For some, quarantine is optimal: moment of reflection, of re-connection. Easy, in flip flops, with a whiskey or tea.For others, this is a desperate crisis. For others it is facing loneliness. For some, a peace, rest time, vacation. Yet for others, Torture: How am I going to pay my bills? ( True, is it also a way of distancing ourselves?!)

Some were concerned about a brand of chocolate for Easter (this year there were no rich chocolates).Others were concerned about the bread for the weekend, or if the noodles would last for a few more days.Some were in their "home office" .Others are looking through trash to survive.Some want to go back to work because they are running out of money.Others want to kill those who break the quarantine.Some need to break the quarantine to stand in line at the banks. Others to escape.Others criticize the government for the lines.

Some have experienced the near death of the virus, some have already lost someone from it, some are not sure their loved ones are going to make it, and some don't even believe this is a big deal.Some of us who are well now may end up experiencing it, and some believe they are infallible and will be blown away if or when this hits someone they know.

 Some have faith in God and expect miracles during this 2020.Others say the worse is yet to come.So, friends, we are not in the same boat.We are going through a time when our perceptions and needs are completely different.And each one will emerge, in his own way, from that storm.Some with a tan from their pool. Others with scars on the soul (for invisible reasons).It is very important to see beyond what is seen at first glance. Not just looking, more than looking, seeing.See beyond the political party, beyond religion, beyond the nose on your face.Do not underestimate the pain of others if you do not feel it.

Do not judge the good life of the other, do not condemn the bad life of the other. Don't be a judge. Let us not judge the one who lacks, as well as the one who exceeds him.We are on different ships looking to survive. Let everyone navigate their route with respect, empathy and responsibility.--Author unknown ( Each for himself, herself? I wish there was some talk of compassion, sharing. Help the needy!)

D).*An article in USA media*GBThe real pandemic starts the day lockdown ends. 

The coronavirus is a crisis of math.The coronavirus is an easy problem to solve…if we understood exponentials.

Unfortunately, the human mind is incapable of grasping exponentials. We cannot intuitively perceive how a small number can grow so large in such a small amount of time.An Indian parable is relevant at this point.A king wanted to reward the inventor of chess and asked him to name his prize. “I want you to fill up the entire chess board with wheat. One grain of wheat on the first square, 2 grains on the next square, double that on the next square for 4 grains, 8, 16, 32 and thus fill up the entire chess board,“ said the inventor.At first, the king was offended, and thought his paltry request was a joke, but the inventor of chess was serious.So, the king told his servants to fill up the chess board. The servants came back and told the king that it couldn’t be done. They had used up the entire wheat stock of the kingdom. There was no more left to continue to fill the chess board. Just the last square alone on the board would require 9 trillion grains of wheat. 

Just like the king in this story, every world leader has been fooled by a small number of coronavirus cases and the power of exponential growth.We are accusing China for hiding the exact number of cases. But the important aspect is that 80,000 cases in two months should have been enough for us to wake up to the scary reality of this exponential growth. Despite seeing the data, the world leaders did nothing.Some basic math around the virus:Starting from the first locally transmitted case in the US on February 26, 15 cases have grown to ~460,000 cases (April 9th) in only 6 weeks, in spite of lockdown measures being taken all over the country. On April 8, there were 31,000 new cases. Yesterday, there were 34,000 more new cases. And today, there will be even more.There is no current indicator that the virus’s exponential growth will stop. 

Our current lockdown measures have slowed the rate of this exponential growth.But due to the nature of exponents, decreasing the rate of exponential growth still leaves you growing exponentially, and only marginally slower.Exponential growth can only stop if there are no more people left for the virus to infect in its environment.There is a ~1% mortality rate for the virus in the best circumstances.Assuming our health care system can handle the influx of new cases (flatten the curve), if every US citizen got coronavirus, ~3 million people would die.Stopping exponential growth without infecting the full population requires cutting off the supply of healthy individuals that can be infected.The incubation period of the virus is ~14 days. 

If everyone is in complete isolation for 4–6 weeks, the virus will disappear. (really?) 

Complete isolation means no going out for any reason at all. No walks, no groceries, no “essential” businesses. This has been proven successful in China.This is effective because those within a household where no one is infected will have no means of contracting the virus without outside contact. For an individual who may have the virus, they will only be able to pass it to those quarantined with them, with 4–6 weeks as enough time for the virus to pass through the whole household.Those who end up at the hospital would only return to their homes once they are cleared of the virus.

We have two choices:*Everyone in the world gets the virus*, so that it can no longer spread. The body count would be horrific.The *whole world synchronously goes into a complete lockdown for 4–6 weeks*. The effects on the global economy would be horrific. Every nation is eagerly awaiting to lift its lockdown as soon as there are fewer cases.But when 15 cases become 460,000 in 6 weeks, how is it ok to lift a lockdown when we are down to, say, “only 100 new cases” in a given day? Once again, our human mind is incapable of thinking in exponentials. We will not have learned from history — a history that occurred just two months ago.

*The real pandemic will start the day we start lifting the lockdown*Every country or state has announced a date at which lockdown will be lifted. They should instead declare that they *will lift the lockdown the day the number of new cases has been zero for the past two weeks*. Period.We are setting ourselves up for a cycle of partial lockdown for weeks, followed by a lift, then a lock down again when the spread picks up — over and over again, for the better part of the year, at best. In the process, we will lose millions of lives, as well as our economies.If we take a hit of some percentage loss in the world GDP by locking down the entire world synchronously, we could save millions of lives. 

Or we do nothing and millions get killed with a loss in GDP anyway.The reality is that we will lose lives as well as the economy — just because we didn’t bother to understand the math.*We have a choice to make: do we want to throw money at the problem, or throw bodies at the problem?* ( Tough questions? Frankly there is no real one answer! Maths experts hopefully answer!)

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