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Across the world, researchers are busy developing analytics/procedures/ methods of forecasting to identify the likelihood of getting affected by coronavirus at the individual level as well as for the macro level to formulate national/state policies. The present study is an attempt to forecast the total number of COVID-19 cases across Indian states individually and cumulative for the country so that the resources could be sourced well advance in time to prevent healthcare failure and/or mismanagement of existing resources to minimize the impacts of the pandemic as well as to identify the need of mobilization of required healthcare support to appropriate places vis-à-vis to develop new facilities like isolation, quarantine centers, and medical facilities, etc. Key points are the surge of pandemic across India and to prevent the healthcare disaster. There is a strong need for forecasting number of possible cases which is vital to restrict subsequent spread and fatality. The main objective is to develop a methodology for forecasting the number of possible cases so that future healthcare requirements shall be generated at the state level for the development of a better healthcare system. Employing autoregressive moving-average models for each state in India based on daily frequency. The impact of the epidemic is not uniform across the nation and estimating one model may generate erogenous results. 20ARIMA model has been estimated, for India and major states of India. It is based on the Cumulative Active Cases (CAC) from April 01, 2020 to September 07, 2020 in a machine learning environment where short-term forecasting was the target to understand and determine new requirements, of the healthcare system and related measures, on daily basis. Although the rate of change in daily active cases is a small fraction of the rate of new cases confirmed daily, most of the states including India are showing stationarity on second order which is a clear sign of a nonlinear sharp upward trend. In such a situation, it seems that India is about to enter the third stage of the epidemic where spread will be maximum, and so the catastrophic conditions. In such circumstances, predictions may be the only way to procure the desired amount of facilities to avoid forthcoming health-related hazards. To avoid healthcare hazards, it is recommended to opt for a system to understand the futuristic need for requisite health and medical infrastructure, both for the short and long run. © 2023 by Apple Academic Press, Inc.
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Introduction: Bharat Biotech International Ltd in partnership with National Institute of Virology (NIV), has developed an indigenous whole virion inactivated Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) viral vaccine BBV-152 (Covaxin), formulated with Toll Like Receptors 7/8 agonist Imidazoquinoline (IMDG) molecule adsorbed to alum (Algel). Variety of factors other than environmental ones can affect vaccines efficiency outside the strict setting of clinical trials, like how the vaccine is stored or transported, and even how patients are vaccinated. In addition, the intrinsic capacity of the recipient to respond to a vaccine which is determined by sex, genetic factors, age, psychological stress, nutrition and other diseases are also likely to have an impact. Aim(s): To determine the safety, reactogenicity and immunogenicity of the inactivated whole virus vaccine (Covaxin) amongst hospital-based population groups. Material(s) and Method(s): The prospective analytical study was conducted in the Department of Microbiology, Sawai Man Singh Medical College, Jaipur, Rajasthan, India, from January 2021 to March 2021.The study primarily included Healthcare Workers (HCWs) employed at SMS Medical college and attached hospitals. In-vitro quantitative IgG antibodies against SARS-CoV-2 spike Receptor Binding Domain (RBD) were measured using Chemiluminescence Immunoassay (CLIA) based Advia centaur SARS-CoV-2 IgG, manufactured by Siemens Pvt Ltd, Munich, Germany, as per manufacture's instructions. Result(s): Out of total 223 individuals, 61.88 % (138/223) showed neutralising antibody titre of >1 index value by CLIA, rest 38.12% (85/223) were non reactive i.e., titre <1 index value, after four weeks of receiving first dose of Covaxin. After 2 to 4 weeks of receiving second dose 84.30% (188/223) showed neutralising antibody titre of >1 index value by CLIA, rest 15.70% (35/223) were non reactive i.e., titre <1 index value. After receiving first dose, 100% (223/223) of the participants developed localised pain and bodyache 33.63% (75/223). None of the participants showed any anaphylactic reaction or any emergency condition just after vaccination. Conclusion(s): Covaxin is a well-tolerated vaccine, and induces good humoral response against SARS-CoV-2 with a significant rise in the neutralising antibody titres. Copyright © 2022 Journal of Clinical and Diagnostic Research. All rights reserved.
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Introduction: As new strains of SARCOV2 virus emerge across the world, it is imperative to investigate measures which restrict the movement of the general population such as social and travel restrictions by lockdowns to mitigate the effects of COVID-19. Thus, our paper helps in two ways: 1) Drastic measures like lockdown are essential but cannot be a feasible long-term intervention. Therefore, it is crucial to understand if the same unlock down can be reversed without compromising public health needs. Our paper provides evidence on the same;and 2) Our report also provides an insight into the trends of disease transmission during different phases of the un-lockdown. Methods: We examine the spread of pandemic during different phases of Un-lockdown (8th June to 31st October 2020). Since Rt calculation takes into consideration numerous factors, we use β, the transmission coefficient that governs the transition of population from Susceptible to Exposed pool, to examine the effect of public heaThelth interventions on disease spread. Results: The comparison of the distribution of fitted β values, thus calculated using SEIR model and GLM have been done and a Welch Two Sample t-test suggests that the GLM fitted β and SEIR β data sets are not significantly different from one another. Conclusion: We provide evidence that un-lockdown can be achieved without increasing the transmission of disease disproportionately. Thus, a phased wise approach to un-lockdown is encouraged. We also provide the rationale for using β over Rt values to specifically assess the effect of public health interventions designed to decrease exposure. Copyright (c) 2022: Author(s).
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Background: The possibility of recurrence in COVID-19 is very rare and hence mostly underdiagnosed. In the face of pandemic, this can lead to circulation of the virus like a hidden iceberg. Better understanding about this topic can improve our knowledge of the COVID-19 pathogenesis and ways to control the transmission. Case presentation: A 41 year old male with no known comorbidities was admitted five times during a period of 7 months each time after being detected RTPCR positive for SARS-CoV-2 and more symptomatic than previously. He had no contact with other COVID-19 patients and was asymptomatic in between admissions. Despite this, he did not develop antibodies against SARSCoV-2. Later on, he was diagnosed with thymoma on biopsy of the anterior mediastinal mass. Patient’s condition deteriorated on last hospitalization and he died, despite the treatment. Here we present an interesting report on multiple times recurrent COVID-19 infection, probably a case of reactivation and different plausible explanations on the role of thymoma. Conclusion: Acknowledging the potential of SARS-CoV-2 to cause recurrence is very important during the pandemic as a part of the long term transmission mitigation. The case report shows that previous infection does not guarantee complete immunity from COVID-19, especially in immuno-compromised patients. Hence, despite the status of prior infection, vulnerable individuals who recovered from COVID-19 should be under surveillance. © 2022 Journal of Association of Physicians of India. All rights reserved.
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Introduction: In the fight against COVID-19, doctors, nurses, administrative staff, police personnel and other supporting staff have been in the frontline providing emergency services. While performing their duties, they are at risk of getting infections and transmitting them to their near and dear ones. This can lead to increased psychological stress levels among them. This study was conducted to assess the level of stress among health care workers and police personnel during the COVID-19 pandemic period in Delhi. Methodology: This is a cross-sectional study among the COVID-19 warriors working in designated COVID-19 hospitals using Google forms. The relationship between various social, demographic, and administrative factors and the level of stress experienced by the study subjects was assessed using Perceptive Stress Scale (PSS-10). Results: The results describe heightened severity of perception of stress among the study cohort. We found at least 10 risk factors that showed statistically significant association with increased TPSS in the studied cohort group. Conclusion: There is an urgent need for screening, proper diagnosis, and management of psychiatric issues among FLCWs, and for expanding mental health services for reducing stress among the target population. © 2021 Indian Society for Malaria and Communicable Diseases. All rights reserved.
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Background: On January 30, 2020, the World Health Organization (WHO) declared COVID-19 as a “public health emergency of international concern.” In order to contain the outbreak, China used quarantine measures. India was among the first few to evacuate its citizens. Methods: It is a retrospective cohort study of Indian evacuees who returned from Wuhan, China. Standard operative procedures were developed for daily screening, sample collection, medical management, transport and referral, biomedical waste management, food safety, etc. Lessons learned were incorporated in subsequent trainings to improve effectiveness. Results: India evacuated 647 nationals including seven Maldivian citizens from Wuhan, China in many batches (with first two batches having 104 and 302 evacuees respectively) during the consecutive days of February 1st and 2nd, 2020. These 2 batches of evacuees including seven Maldivian citizens were stationed at Indo-Tibetan Border Police (ITBP) Chhawla Camp, Delhi;the first quarantine facility in India for novel Coronavirus. Rest of the spassenger were sheltered at a military quarantine facility at Manesar. Conclusion: Developing standard procedures/checklist for routine activities and effective trainings were key to successful quarantining the evacuees in the initial phase of outbreak of COVID-19. Copyright (c) 2021: Author(s).
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Introduction There has been an exponential rise in number of coronavirus disease 2019 (COVID-19)-positive infections since March 23, 2020. However, cancer management cannot take a backseat. Objective The aim of this study was to identify any difference in the complication and mortality rates for the cancer patients operated during the ongoing COVID-19 pandemic. Materials and Methods This was a retrospective study of a prospectively maintained database of five centers situated in different parts of India. Variables such as demographics, intraoperative, and postoperative complications were compared between COVID-19 (group A-March 23, 2020-May 22, 2020) and pre-COVID time period (group B-January 1 to January 31, 2020). Results One-hundred sixty-eight cancer surgeries were performed in group B as compared with 148 patients who underwent oncosurgeries in group A. Sixty-two percent lesser cancer surgeries were performed in the COVID-19 period as compared with the specific pre-COVID-19 period. There was no significant difference in age group, gender, comorbidities, and type of cancer surgeries. Except for the duration of surgery, all other intraoperative parameters like blood loss and intraoperative parameters were similar in both the groups. Minimally invasive procedures were significantly lesser in group A. Postoperative parameters including period of intensive care unit stay, rate of infection, need for the change of antibiotics, and culture growth were similar for both the groups. While minor complication like Clavien-Dindo classification type 2 was significantly higher for group A, all other complication rates were similar in the groups. Also, postoperatively no COVID-19-related symptoms were encountered in the study group. A subset analysis was done among the study groups between those tested preoperatively for COVID-19 versus those untested showed no difference in intraoperative and postoperative parameters. No health-care worker was infected from the patient during the time period of this study. Conclusion Our study shows that there is no significant difference in the incidence of postoperative morbidity and mortality rates in surgeries performed during COVID-19 pandemic as compared with non-COVID-19 time period.
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The 2020 world pandemic has brought into limelight an already existing and refurbished methodology of working known as 'Work from Home'. With preventive and curative treatments steadily reaching out most parts of the world now, the existence of Novel Coronavirus and its variants still cannot be denied. When more than 80% of the world was under lockdown and nearly a million people were at a risk of losing their lives, sectors like corporate, education, business and many others, on the recommendation of World Health Organization decided to allow their employees to work from remote locations where they can self-isolate themselves and prevent the spread on this infectious virus thereby some completely while others partially adhering to the work from home methodology. While being at home, people saw social media as a major platform to showcase their views and thinking over the ongoing and post-pandemic scenarios. The main aim of this study is to analyze public sentiments and emotions over Work from Home methodology based upon their views laid out on Twitter by using TextBlob, VADER and various Machine Learning Classification Algorithms to create a conclusive yet generalized picture of the presented positive, negative and neutral aspects of the viewpoints with the objective of identifying the most prominent one. Experimental evaluations show that people, in general, reflect 'positive to neutral' opinions towards the Work from Home methodology with Support Vector Classifier classifying the data into their respective sentiment classes with highest possible accuracy of 94.67%. © Grenze Scientific Society, 2021
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COVID-19 is causing a large number of causalities and producing tedious healthcare management problems at a global level. During a pandemic, resource availability and optimal distribution of the resources may save lives. Due to this issue, the authors have proposed an Analytical Hierarchy Process (AHP) based optimal distribution model. The proposed distribution model advances the AHP and enhances real-time model applicability by eliminating judgmental scale errors. The model development is systematically discussed. Also, the proposed model is utilized as a state-level optimal COVID-19 vaccine distribution model with limited vaccine availability. The COVID-19 vaccine distribution model used 28 Indian states and 7 union territories as the decision elements for the vaccination problem. The state-wise preference weights were calculated using the geometric mean AHP analysis method. The optimal state-level distribution of the COVID-19 vaccine was obtained using preference weights, vaccine availability and the fact that a patient requires exactly rvaccine doses to complete a vaccination schedule. The optimal COVID-19 vaccine distribution along with state and union territory rank, and preference weights were compiled. The obtained results found Kerala, Maharashtra, Uttarakhand, Karnataka, and West Bengal to be the most COVID-19 affected states. In the future, the authors suggest using the proposed model to design an optimal vaccine distribution strategy at the district or country level, and to design a vaccine storage/inventory model to ensure optimal use of a vaccine storage center covering nearby territories. © 2020. All Rights Reserved.
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BACKGROUND: Mortality rates provide an opportunity to identify and act on the health system intervention for preventing deaths. Hence, it is essential to appreciate the influence of age structure while reporting mortality for a better summary of the magnitude of the epidemic. OBJECTIVES: We described and compared the pattern of COVID-19 mortality standardized by age between selected states and India from January to November 2020. METHODS: We initially estimated the Indian population for 2020 using the decadal growth rate from the previous census (2011). This was followed by estimations of crude and age-adjusted mortality rate per million for India and the selected states. We used this information to perform indirect-standardization and derive the age-standardized mortality rates for the states for comparison. In addition, we derived a ratio for age-standardized mortality to compare across age groups within the state. We extracted information regarding COVID-19 deaths from the Integrated Disease Surveillance Programme special surveillance portal up to November 16, 2020. RESULTS: The crude mortality rate of India stands at 88.9 per million population (118,883/1,337,328,910). Age-adjusted mortality rate (per-million) was highest for Delhi (300.5) and lowest for Kerala (35.9). The age-standardized mortality rate (per million) for India is (<15 years = 1.6, 15-29 years = 6.3, 30-44 years = 35.9, 45-59 years = 198.8, 60-74 years = 571.2, ≥75 years = 931.6). The ratios for age-standardized mortality increase proportionately from 45 to 59 years age group across all the states. CONCLUSION: There is high COVID-19 mortality not only among the elderly ages, but we also identified heavy impact of COVID-19 on the working population. Therefore, we recommend further evaluation of age-adjusted mortality for all States and inclusion of variables like gender, socio-economic status for standardization while identifying at-risk populations and implementing priority public health actions.
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Antibody test is used in seroprevalence surveys for Coronavirus Disease-2019 (COVID-19). Apart from estimating the proportion of population infected, they can help in drawing plenty of inferences about the extent, progress and course of the pandemic. They can potentially be helpful in planning and prioritising vaccine distribution by providing a broad overview into proportion of population immune to COVID-19 in a geographic area and also help in understanding the pockets of high or low seroprevalence. This review was conducted with an aim of compiling an updated and comprehensive information about the seroprevalence of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) antibody in various pockets of India in the year 2020, and thus to understand the current pandemic situation in the country. A total of 35 studies were identified through all resources and detailed review was carried out based on these studies. Additionally, indicators were devised to understand and compare the results. Results were further classified into states/Union Territories (UTs), districts, Sub-district regions. The study findings show that the anti SARS-CoV-2 antibodies seroprevalence estimates vary across different regions (states/UTs, districts, sub district regions) of India and can increase or in some instances decrease over the course of time. The study concludes by asserting the need for repeated seroprevalence surveys as well as follow-up studies for current pandemic surveillance.
Subject(s)
Angiomatosis , COVID-19 , Exanthema , Angiomatosis/diagnosis , Humans , Immunization , SARS-CoV-2ABSTRACT
Introduction: In India, laboratory diagnosis of SARS - CoV-2 infection has been mostly based on real-time reverse transcriptase polymerase chain reaction (RT-PCR). Studies have shown that Viral titres peak within the first week of symptoms, but may decline post this time frame, thereby hampering RT-PCR based diagnostic strategies. These reasons have prompted the call for adoption of antibody testing as a potential source of data to address the gap in data and inform public health and governance policies oriented towards COVID-19. Materials and Methods: A Cross-sectional study with a sample size of 9000 was conducted for 11 days (Dec 11-21, 2020) including all the 79 wards under Jabalpur Municipal Corporation. Serum samples were tested for the presence of specific antibodies to COVID19 using ICMR- Kavach IgG ELISA kits. The data collected was compiled on Microsoft Excel and data analysis was carried out using STATA 15E statistical software. Result: Overall seroprevalence of the study population was found to be 28.70% (weighted). Wards of the city of Jabalpur were classified into three categories based on the case prevalence - High (27 wards), Medium (26 wards) and Low (26 wards). Based on the overall seroprevalence, the estimated number of total infections were calculated to be 3, 54,870 for the study population. Overall Case Infection Ratio was 31.41.
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Significant public health events of the 21st century include epidemic prone diseases such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), influenza A (H1N1), Ebola virus disease, and coronavirus (SARS-COV-2). Preparedness as well as risk mitigation strategies play an integral role for the success of responses to such health emergencies. An extraordinary cluster of cases of respiratory disease of unknown cause triggered a series of events that constituted a public health risk across the globe through international spread from China and was declared a Public Health Emergency of International Concern (PHEIC) on 30 January, 2020 by the World Health Organization (WHO). To monitor implementation of activities in order to contain the local transmission of COVID-2019 in India, a control room was established at the National Centre for Disease Control (NCDC), New Delhi on 23rd January, 2020 under the Integrated Disease Surveillance Project (IDSP). The main objectives of the control room were to alleviate the concerns and address queries of passengers arriving from the affected countries and also to provide the general public information regarding the measures to be taken as well as the contact details of the respected district health authorities for further necessary action. A total of 183 hunting lines were established at the NCDC, Noida, TB Centre, and the National Health Authority (NHA) Hyderabad and Bengaluru by March 2020. A total of 79,013 calls, 1,04,779 emails, and 1,787 international calls were received w.e.f. 23 January to 30 March, 2020 at the NCDC control room. The NHA Bengaluru and Hyderabad Control room received 3,52,176 calls w.e.f. 15 March to 30 March and TB Noida control room received 55,018 calls w.e.f. 16 March to 30 March, 2020. This prompt action of the center to set up a control room at the NCDC gave the states enough grace period to train their staff and start their individual help lines for addressing people's queries and allay fears.
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The 2019-nCoV is officially called SARS-CoV-2 and the disease is named COVID-19. The Novel coronavirus (SARS-CoV-2) caused pneumonia in Wuhan, China in December 2019 is a highly contagious disease. The World Health Organization (WHO) has declared it as a global public health emergency. This is the third serious Coronavirus outbreak in less than 20 years, following SARS in 2002-2003 and MERS in 2012. Currently, the research on novel coronavirus is still in the primary stage. It is currently believed that this deadly Coronavirus strain originated from wild animals at the Huanan market in Wuhan by Bats, snakes and pangolins have been cited as potential carriers. On the basis of current published evidence, we systematically summarize the epidemiology, clinical characteristics, diagnosis, treatment and prevention of COVID-19. This review in the hope of helping the public effectively recognize and deal with the novel coronavirus (SARS-CoV-2) and providing a reference for future studies.
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The coronavirus disease 2019 (COVID-19) outbreak, which originated in Wuhan, China, has now spread to more than 200 countries and administrative regions infecting 3,09,04,45 individuals of all ages as of 3rd April, 2020. Though most of the infected individuals exhibit mild symptoms including fever, upper respiratory tract infections, shortness of breath and diarrhea or are asymptomatic altogether. Severe cases of infection can lead to pneumonia, multiple organ failure and death. Globally, at least 2, 07,973 deaths have been directly attributed to COVID-19 and this number is expected to rise with the ongoing epidemic. WHO declared the outbreak to be a public health Emergency of International concern on January 30, 2020. The same day, a laboratory confirmed case of COVID-19 was reported in Kerala. That was the first reported case of COVID-19 in India. Since then 498 disease cases were reported in Kerala, while in India this has gone up to 33,050 with 1,074 deaths. During the first phase of the COVID-19 outbreak in Kerala, the health authorities have responded in a stellar manner. Kerala has not only traced hundreds of contacts of the confirmed cases and notified them to the Integrated Disease Surveillance Programme (IDSP) for monitoring, but also used unique community-based isolation methods, innovated while dealing with the Nipah virus outbreaks of 2018 and 2019. The model of monitoring with the District Collector as the administrative unit has been shared as a best practice with all states. © 2020 Indian Society for Malaria and Communicable Diseases. All rights reserved.