Talking sense about the Coronavirus epidemic!
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Really a good read! Thanks Dr Malpani
This makes sense in today’s date. This should happen. But this won’t happen. Not so soon. Dr Aniruddha Malpani
The only reason – Some people have displayed aggresive stupidity than in the history of India, in the recent days and will continue to do so.
Herd immunity will develop, but herd stupidity has to be eliminated first.
We all need to develop ______ immunity, whether (1) adaptive (2) innate (3) herd .. it is always desirable. But that’s passive approach. Human beings “fight or flight” while facing danger. That’s how we are hard-wired to respond. Until we are able to fight, we all chose to collectively flight(hide in-home).
.
Of course, you can have a difference of opinion – irrespective of what decisions are imposed on you. If you don’t do lock-down, then another author like him would criticize – why we let our citizens die? … while they had the opportunity to develop immunity in the future?
.
Happy blogging! Stay safe and blessed!
Sir your guiding us I am very relax coz of you Sir
Sir you are in noble profession your need is for country at present and for humanity.
It’s my opinion your expertise and guidance is more valuable even if your not practicing your presence will make difference. Dr Aniruddha Malpani
For now herd immunity seems on offered experimental basis, and it may be too early for that sort of an experiment.
Dr. Muliyil himself says – “For measles, around 90% of the population needs to be vaccinated to achieve herd immunity and for influenza, it is 40%. But one has to stagger the process of reaching the herd immunity and slow down the spread of the infection so that you can handle much more efficiently and not lose too many patients.”
Doctor…How does a society develop Hers Immunity in absence of a vaccine ?
Doc, talking of the possibility of death for some people is anathema to many!
Sanket Mankar why is it so easy for us to assume that we are intelligent and everyone else is stupid. Doesn’t that strike you as being arrogant?
Ram Mannepalli yes, so we need to start phasing out the lockdown!
Devan K Chheda innate immunity is powerful!
Dr Aniruddha Malpani why don’t we try odd-even rule for people too with DOB, everybody in the young working age group
Maybe in “green zones” by letting people move out without crowding too much, with continued city/town/region lockdown still in place… so that people in areas without an positive cases can slowly get back to their lives – with abundant caution and close monitoring
Dr Aniruddha Malpani I understand your position but with due respect I said “some people”. Never pointed to anyone or anything specific. Hope that clarifies.
True, we cannot lock down for ever. But, Herd Immunity is almost a suicide mission for many.
Hope to get to the magic number soon!
Opinion of credible experts is that tuberculosis vaccinated population is much more resistant to covid19 ( comparables: Portugal Vs Spain ). India, if this is true, is very lucky. Also India is a pharma generics powerhouse that has the most supply of the supposedly working and quite cheap medicine on covid19.
I believe neither a permanent lockdown is feasible nor complete opening of the economy back to what it was 3 weeks back.
This is a major black swan event which is going to change not just the global economic landscape but also the way people socially interact.
For the foreseeable future, they may open the economy a little, but it’s too big a risk to open the economy completely.
Singapore and south Korea are already seeing some relapse cases and they’ve already implemented partial lockdown again
Herd immunity only works if you can test everyone for disease and serology, have hospitals stock piled with PPE, ventilators, enough beds to handle the influx of infectious patients, and keeping people over age 60yrs in isolation.
Thanks for sharing
We should read more about community living
Anuj Singh
The herd immunity concept is what got the UK in the situation that it is in! Herd immunity without any sight of large scale vaccination in sight might as well be suicidal!
Herd immunity has already started, when community infection spread started, when 7crore strong migrant labour moved in ‘herds’. The virus shall touch all of us, many of us will play ball with it, some of us will be played ball with, by the virus. The latter part needs to be better managed and in the staggered manner as we have limited ICUs and ventilators and even oxygen generators / concentrators.
So let’s start from the supply side. Let the demand be staggered accordingly…but do we have the right data?
For counterpoint: https://www.newyorker.com/news/q-and-a/how-covid-19-will-hit-india
Quoting:
So, bringing this back up is going to take a fair amount of time, and the damage will probably last months, if not even further than that. But this was a trade-off that was made. The trade-off was that we take a huge hit with the visible impact of the disease, or we give ourselves some time to prepare and risk the economic consequences, and I’m glad that they chose the latter. I understand there are trade-offs here, but some decision had to be made, and this was the decision that was made.
A sensible approach suggested by someone with knowledge and experience with epidemics.
Vineet Rastogi – Partnerships for Health most of the cases will recover on their own!
Dr Aniruddha Malpani I hope I don’t come off as negative, I am just being logical.
“Can we stop the disease from spreading? No. Now, it will reach an exponential phase…”
Thank god, the learned epidemiologist is retired now!
Ram Mannepalli the biggest flaw in the publicized numbers is not knowing what % of +ves resulted in mortality.
Just flashing numbers of +ves or dead is sensationalism.
As the asymptomatic, who are +ve but not counted are excluded, we never get the full and correct picture.
It’s true,makes sense
Giridhar Pai on the contrary, actual numbers may be a better indication, %ages can sensationalize… and %ages are available (deaths/+ives)… we have a small of infections due to the lockdown mostly, any experimentation could be dangerous – enough examples in the form of SE Asian countries, UK, US etc… In any case my comment here was about relaxation of the lockdown for younger folks – it is risky imho…. I would rather advocate for a staggered relaxation in low-risk areas
Rupinder Singh In the absence of a vaccine what other possibility exists to achieve “Herd Immunity”?
Arvind, herd immunity should be targeted only with existence/availability of a vaccine. By innoculating the susceptibles. That’s the classic definition.
What I understood from UK is they will do antibody test, anyone who got antibody can return to normal life . London is already Highly infected by end of this month they are introducing antibody tests which confirms who had virus and recovered advised to return to normal life. what about people who are self isolated ? will they infect then in controlled process so they get antibodies ?
Further there is no empirical and peer reviewed evidence to support the statement that these risks are pure conjecture. Maybe a couple of obscure opinion papers or biased studies at the most.
Ankur Sharma you seem to consistently underestimate innate immunity,and the wisdom of the human body. Sad
Maliha Mannan Ahmed
Arvindh Pradheep Shanmugam recently recovered moderate/severe patients- Yes that is a better option for sure.
Arvindh Pradheep Shanmugam Absolutely different, I agree, and that brings us back to the implementation of herd immunity with fewest deaths. Herd immunity absolutely works and has been for the flu virus but it took a few years and lot of deaths. So why not be a little more defensive with CV?
Dr Aniruddha Malpani Yes. I am worried about only the 2-3% needing tertiary care, God Forbid, should such a need arise.
Herd immunity? It’s almost always on a case-by-case basis. CDCP defines this as “Typically, herd immunity arises when a certain percentage of the population becomes vaccinated and controls the spread of a virus.”
With the possibility a winter resurgence of COVID-19, herd immunity could help to mitigate the dangerous effects later on this year. However, with its current state of mitigation, the virus seems unstoppable.
Oh yes, lockdown consequences could increase potential risk “nine months later”. Are the newborn or neonates likely to be protected by “herd immunity??”. We are just kicking the can down the road, in the hope someone else will pick it up…
Yes, true
Someone said – Herd Immunity development is based on the principle of “Survival of Fittest”… and let the weaker species die. This is logical.
.
What is not logical is HOPE – that – nothing will happen to me, or even if it happens, I can develop a winning immune response(Herd Immunity) to overcome it.
Dr Aniruddha Malpani no Doc I’m not following TV news at all. This is a immediate response after reading the article.
Really a good read! Thanks Dr Malpani
This makes sense in today’s date. This should happen. But this won’t happen. Not so soon. Dr Aniruddha Malpani
The only reason – Some people have displayed aggresive stupidity than in the history of India, in the recent days and will continue to do so.
Herd immunity will develop, but herd stupidity has to be eliminated first.
We all need to develop ______ immunity, whether (1) adaptive (2) innate (3) herd .. it is always desirable. But that’s passive approach. Human beings “fight or flight” while facing danger. That’s how we are hard-wired to respond. Until we are able to fight, we all chose to collectively flight(hide in-home).
.
Of course, you can have a difference of opinion – irrespective of what decisions are imposed on you. If you don’t do lock-down, then another author like him would criticize – why we let our citizens die? … while they had the opportunity to develop immunity in the future?
.
Happy blogging! Stay safe and blessed!
Sir your guiding us I am very relax coz of you Sir
Sir you are in noble profession your need is for country at present and for humanity.
It’s my opinion your expertise and guidance is more valuable even if your not practicing your presence will make difference. Dr Aniruddha Malpani
For now herd immunity seems on offered experimental basis, and it may be too early for that sort of an experiment.
Dr. Muliyil himself says – “For measles, around 90% of the population needs to be vaccinated to achieve herd immunity and for influenza, it is 40%. But one has to stagger the process of reaching the herd immunity and slow down the spread of the infection so that you can handle much more efficiently and not lose too many patients.”
Doctor…How does a society develop Hers Immunity in absence of a vaccine ?
Doc, talking of the possibility of death for some people is anathema to many!
Sanket Mankar why is it so easy for us to assume that we are intelligent and everyone else is stupid. Doesn’t that strike you as being arrogant?
Ram Mannepalli yes, so we need to start phasing out the lockdown!
Devan K Chheda innate immunity is powerful!
Dr Aniruddha Malpani why don’t we try odd-even rule for people too with DOB, everybody in the young working age group
Maybe in “green zones” by letting people move out without crowding too much, with continued city/town/region lockdown still in place… so that people in areas without an positive cases can slowly get back to their lives – with abundant caution and close monitoring
Dr Aniruddha Malpani I understand your position but with due respect I said “some people”. Never pointed to anyone or anything specific. Hope that clarifies.
True, we cannot lock down for ever. But, Herd Immunity is almost a suicide mission for many.
Hope to get to the magic number soon!
Opinion of credible experts is that tuberculosis vaccinated population is much more resistant to covid19 ( comparables: Portugal Vs Spain ). India, if this is true, is very lucky. Also India is a pharma generics powerhouse that has the most supply of the supposedly working and quite cheap medicine on covid19.
I believe neither a permanent lockdown is feasible nor complete opening of the economy back to what it was 3 weeks back.
This is a major black swan event which is going to change not just the global economic landscape but also the way people socially interact.
For the foreseeable future, they may open the economy a little, but it’s too big a risk to open the economy completely.
Singapore and south Korea are already seeing some relapse cases and they’ve already implemented partial lockdown again
Herd immunity only works if you can test everyone for disease and serology, have hospitals stock piled with PPE, ventilators, enough beds to handle the influx of infectious patients, and keeping people over age 60yrs in isolation.
Thanks for sharing
We should read more about community living
Anuj Singh
The herd immunity concept is what got the UK in the situation that it is in! Herd immunity without any sight of large scale vaccination in sight might as well be suicidal!
Herd immunity has already started, when community infection spread started, when 7crore strong migrant labour moved in ‘herds’. The virus shall touch all of us, many of us will play ball with it, some of us will be played ball with, by the virus. The latter part needs to be better managed and in the staggered manner as we have limited ICUs and ventilators and even oxygen generators / concentrators.
So let’s start from the supply side. Let the demand be staggered accordingly…but do we have the right data?
For counterpoint: https://www.newyorker.com/news/q-and-a/how-covid-19-will-hit-india
Quoting:
So, bringing this back up is going to take a fair amount of time, and the damage will probably last months, if not even further than that. But this was a trade-off that was made. The trade-off was that we take a huge hit with the visible impact of the disease, or we give ourselves some time to prepare and risk the economic consequences, and I’m glad that they chose the latter. I understand there are trade-offs here, but some decision had to be made, and this was the decision that was made.
A sensible approach suggested by someone with knowledge and experience with epidemics.
Vineet Rastogi – Partnerships for Health most of the cases will recover on their own!
Harsh Shethia because they continue barking up the wrong tree! https://swprs.org/a-swiss-doctor-on-covid-19/
Sarosh Pakhi and people call me negative ?
Dr Aniruddha Malpani I hope I don’t come off as negative, I am just being logical.
“Can we stop the disease from spreading? No. Now, it will reach an exponential phase…”
Thank god, the learned epidemiologist is retired now!
Ram Mannepalli the biggest flaw in the publicized numbers is not knowing what % of +ves resulted in mortality.
Just flashing numbers of +ves or dead is sensationalism.
As the asymptomatic, who are +ve but not counted are excluded, we never get the full and correct picture.
It’s true,makes sense
Giridhar Pai on the contrary, actual numbers may be a better indication, %ages can sensationalize… and %ages are available (deaths/+ives)… we have a small of infections due to the lockdown mostly, any experimentation could be dangerous – enough examples in the form of SE Asian countries, UK, US etc… In any case my comment here was about relaxation of the lockdown for younger folks – it is risky imho…. I would rather advocate for a staggered relaxation in low-risk areas
Rupinder Singh In the absence of a vaccine what other possibility exists to achieve “Herd Immunity”?
Arvind, herd immunity should be targeted only with existence/availability of a vaccine. By innoculating the susceptibles. That’s the classic definition.
What I understood from UK is they will do antibody test, anyone who got antibody can return to normal life . London is already Highly infected by end of this month they are introducing antibody tests which confirms who had virus and recovered advised to return to normal life. what about people who are self isolated ? will they infect then in controlled process so they get antibodies ?
Further there is no empirical and peer reviewed evidence to support the statement that these risks are pure conjecture. Maybe a couple of obscure opinion papers or biased studies at the most.
Ankur Sharma you seem to consistently underestimate innate immunity,and the wisdom of the human body. Sad
Maliha Mannan Ahmed
Arvindh Pradheep Shanmugam recently recovered moderate/severe patients- Yes that is a better option for sure.
Arvindh Pradheep Shanmugam Absolutely different, I agree, and that brings us back to the implementation of herd immunity with fewest deaths. Herd immunity absolutely works and has been for the flu virus but it took a few years and lot of deaths. So why not be a little more defensive with CV?
Dr Aniruddha Malpani Yes. I am worried about only the 2-3% needing tertiary care, God Forbid, should such a need arise.
Herd immunity? It’s almost always on a case-by-case basis. CDCP defines this as “Typically, herd immunity arises when a certain percentage of the population becomes vaccinated and controls the spread of a virus.”
With the possibility a winter resurgence of COVID-19, herd immunity could help to mitigate the dangerous effects later on this year. However, with its current state of mitigation, the virus seems unstoppable.
Oh yes, lockdown consequences could increase potential risk “nine months later”. Are the newborn or neonates likely to be protected by “herd immunity??”. We are just kicking the can down the road, in the hope someone else will pick it up…
Yes, true
Someone said – Herd Immunity development is based on the principle of “Survival of Fittest”… and let the weaker species die. This is logical.
.
What is not logical is HOPE – that – nothing will happen to me, or even if it happens, I can develop a winning immune response(Herd Immunity) to overcome it.
Dr Aniruddha Malpani no Doc I’m not following TV news at all. This is a immediate response after reading the article.