Why the massive surge in India?

6,334 Views | 43 Replies | Last: 4 yr ago by RangerRick9211
scd88
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AG
I am Indian and have friends and family there. One of the main culprits of their surge is the "help" that comes in daily to do any or all of the following:

Driver
Clean the house
Wash clothes
Cook
Clean dishes
Etc

These folks have become more valued and are not just servants anymore. But, many of them come from their village on the outskirts of town (or even some part in town) where they live in a multigenerational household with no prevention measures.

These folks were banned from coming to the place of work for a long time. Now they have been in contact with many others along the journey to get to their "house" and the members of the household itself.

Add in the recent political rallies and festivals and you get a surge that has come from different sources. In a country as densely populated as India, this was bound to happen. They had so many restrictions at first they eliminated contact with other humans. How long can that go on? The answer is never.

This was always going to happen. They do have vaccines that are made in India. But there are just so many people that you can't vaccinate them that quickly.

Hospitals are pressed and even the wealthy are not guaranteed a spot anymore. They have three different levels of hospital care:

Public - government run. Think Ben Taub or Parkland
Academic - teaching hospitals
Private - Methodist, St Luke's.

(I think I remember that right)

Anyway, all lines have been blurred as to who goes where. They have a problem, for sure. Very different issues than we ever had in the US.
beerad12man
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AG
Far more reasonable than just variants like many fear mongering people spread. The rate at which variants spread has been overstated since day 1. I'm not saying it might not add a little more of an exponential element to it, but I would put it way down the scale as the reasons, and the servant thing being lifted, along with political gatherings / festivals makes far more sense.

I've also always thought that, depending on your area, going too hardcore of a lockdown was a bit of a disaster. Getting a slow, steady case rate to build up population immunity was always the way to go to avoid this. I think Texas did this well overall.

other than just eliminating all life unti the vaccines came out. But as we are seeing with lockdown fatigue, the vaccines came out in record time, and it still wasn't quick enough. You can't expect people to do what they've done for a year of their lives. After a few months, it gets harder and harder.
beerad12man
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To me, the two biggest concerns with india isn't their current LISTED cases. It's...

1) How much capability do they have to report cases? I know in the US, it is estimated we were about 3-4x the cases reported, but mostly from asymptomatics, or minor symptoms not getting tested. In India, it might be much worse just in terms of people being able to get the attention to diagnose it.

2) Their healthcare system being able to provide what a place like the US can

Two major, major differences between us and them.
jamey
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AG
Complicated mess, lots of factors

https://www.sciencemag.org/news/2021/04/will-india-s-devastating-covid-19-surge-provide-data-clear-its-death-paradox
AggieUSMC
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AG
Many parts of India are densely populated s**tholes. It was only a matter of time before an outbreak like this would occur.
bay fan
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S
Ranger222 said:

The variant in India contains an accumulation of mutations in the spike protein that most likely cause the variant to be more transmissible than other variants that had impacted that region/country. You can see from the data how this particular variant has become the dominant variant in circulation in that part of the world. Its also a two-fold problem -- not only is this variant most likely more transmissible, but also immunity from previous infections a year ago is waning and if this variant is able to escape the immune response a little better compared to other variants, it would be more likely that it can breakthrough immunity and cause a re-infection and escape some of the herd immunity effects from previous outbreaks.


Quote:

Preliminary evidence suggests that B1.617 is more contagious than previous strains of the virus. A study published Tuesday found that the L452R mutation may enhance the ability of viruses to infect human cells in the laboratory. The variant in California, which carries this same mutation, is about 20 percent more transmissible than older strains of the virus.
B.1.617 is also spreading quickly in India. Over the past few months, it has become the dominant strain in the state of Maharashtra, Nature has reported.

But, Andersen says, no one knows for sure if B.1.617 is more transmissible and thus driving India's surge. "We also know the B.1.1.7 [the variant first detected in the U.K.] is circulating in India, and we know that P.1. [the variant first detected in Brazil] is also circulating there, too. So they could also play a role in this surge. We simply don't have the data yet."

https://www.npr.org/sections/goatsandsoda/2021/04/24/988744811/people-are-talking-about-a-double-mutant-variant-in-india-what-does-that-mean


Just a small change in transmissibility of these variants, couple with India's conditions, can greatly impact doubling rates and infection rates. You have to remember that infections are exponential growths on a log scale -- just a slight change can dramatically impact how many people can get infected and the outcome of an outbreak. That's always been the worry with variants popping up every so often. Like I mentioned -- India's conditions in terms of not only sanitation but how many people live in a household no doubt also impact the equation
Interesting your information on variants mentions the LA variant. It was the LA variant that reinfected my Dallas daughter's room mate in March after having had it in Dec. (Please save the it didn't happen from those who have no first hand knowledge of the situation, it happened.)
Bird Poo
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AG
We will never beat this thing. We'll just have to live with the variants.
GAC06
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AG
I'm glad you found another reason to bring that up
scd88
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beerad12man said:

To me, the two biggest concerns with india isn't their current LISTED cases. It's...

1) How much capability do they have to report cases? I know in the US, it is estimated we were about 3-4x the cases reported, but mostly from asymptomatics, or minor symptoms not getting tested. In India, it might be much worse just in terms of people being able to get the attention to diagnose it.

2) Their healthcare system being able to provide what a place like the US can

Two major, major differences between us and them.


Sorry, I never got around to responding to this. You know, there are villages between towns and cities that don't have running water and sewer. It's not like these people go to the hospital or get their cases reported. Who knows what Covid looks like in these places.

Next, I don't believe the Indian health care system had an incentive to report positives like our hospitals here do. They have a fast improving healthcare infrastructure but not many countries match up to the US with regards to access to the best doctors and technology. We have politics get in the way like no other country in the world, though.
RangerRick9211
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AG
Are there any good recommendations for non-profits making a difference in India?

I adore our off-shore teams and emails/IMs aren't enough right now. They are always so willing to do the work we want to push on them at EY. The few I've pinged the past weeks are out right terrified of what's happening.

I know that it will pass. But I would like to show some real support.

Edit: To propagate the impacts stateside. We have a team of 40-50 in India to support various work efforts in our practice. I have OOO replies from every member of my immediate team and a note from their manager to expect no backfill for a month. I'm just one small cog in a massive off-shore machine.
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