Grim Reaper Stalks The Land

The end of election season couldn바카라�t possibly have brought more relief바카라�the Covid graph breached the 4 lakh cases a day mark the same day and tragic stories were still streaming in. They came from remote towns바카라�in Karnataka바카라�s Chamarajnagar district, a hospital ran out of oxygen supply in the middle of the night on May 2, leading to the death of 24 patients바카라�and from big cities, where people waited in queues to refill oxygen cylinders or made frantic attempts to get essential medicines for patients. And in between these heart-rending scenes, the menace of overcharging, hoarding and blackmarketing.

Where are we in the battle now? The grim forecasts haven바카라�t changed much바카라�a model by the Seattle-based Institute for Health Metrics and Evaluation projects 6.3 lakh deaths from April 26 to August 1, with the count of daily deaths peaking around May 20. There has been a growing call for a nationwide lockdown to break the chain of transmission바카라�currently, many cities have local versions of lockdowns.

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As the epicurves suggest, the scenario varies from state to state. Take Maharashtra, where signs of the second wave appeared in mid-February바카라�the clue to this was the effective reproduction number, or R, rising above 1 on February 12. An R value greater than 1 points to increasing transmission. 바카라�After staying that way for several weeks, the R number dipped below 1 in the last week of April,바카라� says Prof Sitabhra Sinha of the Institute of Mathematical Sciences in Chennai. So also in the case of Chhattisgarh.

바카라�If it is a genuine change, it means the growth is slowing. And interestingly enough, the two states also happen to be the ones that showed extremely high growth rates early on. But it바카라�s still too early to make that correlation,바카라� says Sinha. Firstly, the R values of Maha­rashtra and Chhattisgarh aren바카라�t substantially below 1바카라�currently, they are hovering around 0.9. 바카라�There바카라�s no guarantee that next week, it is not going to climb above 1 again,바카라� he adds. Besides, Punjab, which too saw a surge in Febru­ary, is not yet showing a declining R value바카라�hence a counterexample, in that sense. 바카라�Some of the states that currently have the highest R number바카라�Rajasthan, Uttarakhand, Gujarat, West Bengal and Karnataka바카라�have not shown any change in the week ending April 30,바카라� says Sinha.

Anecdotally, some of that apparent slowing in Maharashtra is visible, even though the state still has the highest number of active cases in India. 바카라�The present week, following a fortnight-long lockdown, is showing some sign of relief,바카라� says Mumbai-based internist Dr Samrat D. Shah. 바카라�In OPDs, we are seeing at least a drop by 25-30 per cent of new Covid cases and hospital beds are now available on short notices. Even critical medicines are available more easily. Hopefully, the following weeks will continue to get better and the burden on the healthcare system should come down considerably.바카라� Concurs Dr Vispi Jokhi, CEO at Masina Hospital. 바카라�The Covid situation in Mumbai city and at our hospital is certainly improving, and the pressure on the number of beds is decreasing,바카라� says Dr Jokhi, who reckons the lockdown in Mumbai has helped control the wave of new infections. However, he warns that the vaccination rollout, if not decentralised quickly, can negate the benefits of the lockdown as citizens rush to the limited number of centres for vaccination. 바카라�We need to be vigilant and keep stringently following the guidelines on treatment to enable rational use of resources and beds,바카라� he adds.

In Delhi, the situation is still grim. 바카라�All the hospitals in Delhi-NCR were choked a week back and things are still bleak,바카라� says Dr Mrinal Sircar, director and head of pulmonology at Fortis Hospital, Noida. 바카라�From what I am gauging, people are still looking for beds and patients coming to us are sicker. I do not foresee any immediate change in the next two to three weeks.바카라�

The challenges are many, including the fact that more young adults are falling sick now than earlier, doctors reckon. 바카라�The virus is showing different clinical pictures in all possible age groups now, varying from early lung involvement, continuous unrelenting fever for days on end, breakthrough fevers and longer time to recover from lung inflammation,바카라� says Dr Shah. Dr Jokhi points out that the need and consumption of oxygen is significantly higher compared to the first wave. Speaking at a Union health ministry briefing this week, All India Institute of Medical Science director Prof Randeep Guleria drew attention to some common panic reactions, especially the 바카라�misuse바카라� of CT scans. 바카라�There is no benefit from doing a CT scan, especially if you have a mild infection, are in home quarantine, and if your oxygen saturation is fine,바카라� he said.

According to the Union health ministry, the data of daily recoveries vis-à-vis daily new cases has improved over the past fortnight바카라�from 1.5 lakh recoveries versus 2.59 lakh new cases on April 20, it rose to 3 lakh daily recoveries against 3.6 lakh daily new cases by May 3. Meanwhile, how does the vaccination graph look amid a vaccine supply shortage? The pace has certainly tapered off over the past month (April 3-May 3) from a peak of 45 lakh doses administered on April 5 to a little less than 17 lakh on May 3. Though registrations have been opened up for the 18-45 age group, supply shortages have forced some states to delay vaccinations for this group as they prioritise older adults.

For the first time since the vaccination drive started, the number of second doses administered overtook first doses on May 3바카라�out of the total vaccinations on that day, as many as 8.62 lakh people received a second dose, while 8.35 lakh got their first shot. The likely reason for this, as former WHO official Rajesh Bhatia notes, is that senior citizens were anxious to get their second shots before younger adults started to stream in, amid a shortage of vaccines. 바카라�There would be a larger number of people chasing smaller quantities of vaccines, so they are trying to go quickly and get their second dose,바카라� says Bhatia. 바카라�When more vaccines come into the centres, then people will have more confidence.바카라�

Yet, these numbers were still lower than the high points during the month바카라�on April 23 and 26, over 12 lakh second doses had been given. Cumulatively, over 15 crore doses had been administered during the vaccination drive as of May 3, out of which nearly 3 crore were second doses. Adar Poonawalla, CEO of Serum Institute of India, said in a statement this week that his firm has so far supplied more than 15 crore doses of Covishield out of a total order from the government for over 26 crore doses바카라�the remaining tranche of 11 crore doses would be supplied in the next few months, he said. This tranche, along with an order for 5 crore doses for Bharat Biotech바카라�s Covaxin, would cover the period from May to July, according to the health ministry.