Dr KK Aggarwal
| Country, Other |
Total Cases |
New Cases |
Total Deaths |
New Deaths |
Total Recovered |
Active Cases |
Serious, Critical |
Tot Cases/ 1M pop |
Deaths/ 1M pop |
Total Tests |
Tests/ 1M pop |
Population | |
| World | 14,634,732 | +220,073 | 608,559 | +4,316 | 8,730,163 | 5,296,010 | 59,809 | 1,877 | 78.1 | ||||
| 1 | USA | 3,898,550 | +65,279 | 143,289 | +412 | 1,802,338 | 1,952,923 | 16,552 | 11,774 | 433 | 48,341,735 | 146,002 | 331,102,850 |
| 2 | Brazil | 2,099,896 | +24,650 | 79,533 | +716 | 1,371,229 | 649,134 | 8,318 | 9,876 | 374 | 4,911,063 | 23,096 | 212,636,496 |
| 3 | India | 1,118,107 | +40,243 | 27,503 | +675 | 700,399 | 390,205 | 8,944 | 810 | 20 | 13,791,869 | 9,989 | 1,380,678,271 |
Doubling Time 20 days
| Date | Daily new cases | New Deaths | Total cases | Total Deaths |
| 18th July | 40243 | 675 | 1118107 | 27503 |
| 17th July | 37407 | 543 | 1077864 | 26828 |
| 16th July | 34820 | 676 | 1040457 | 26285 |
| 15th July | 35468 | 680 | 1005637 | 25609 |
| 14th July | 32682 | 614 | 970169 | 24929 |
| 13th July | 28179 | 540 | 907645 | 23727 |
| 12th July | 29108 | 500 | 879446 | 23187 |
| 11th July | 27755 | 543 | 850358 | 22687 |
| 10th July | 27761 | 521 | 822603 | 22144 |
| 9th July | 25790 | 479 | 794842 | 21623 |
| 8th July | 25571 | 491 | 769052 | 21444 |
| 7th July | 23135 | 479 | 743481 | 20653 |
| 6th July | 22510 | 474 | 720346 | 20174 |
| 5th July | 23932 | 421 | 697836 | 19700 |
| 4th July | 24015 | 610 | 673904 | 19279 |
| 3rd July | 22721 | 444 | 649889 | 18669 |
| 2nd July | 21948 | 377 | 627168 | 18225 |
| 1st July | 19428 | 216 | 654405 | 17848 |
| 30th June | 18256 | 506 | 585792 | 17410 |
| 29th June | 18339 | 417 | 567536 | 16904 |
| 28th June | 19620 | 384 | 549197 | 16487 |
India predictions
>90% of people are symptomatic within 2 weeks of infection
Death Rate is deaths today vs number of cases today
Corrected Death Rate is deaths today vs number of cases 14 days back
For one symptomatic test positive case there are 10-30 asymptomatic cases
Estimated Number of deaths = Reported deaths x 2
Number of deaths today should be 15% of the serious patients present 14 days back
Undocumented cases for each documented case [Iceland: 1: 2; German: 1: 5; New York City grocery store shoppers: 1: 10;California 1.5%]
Amongst active 2.37% are serious, 1.82% need oxygen, and 0.41% need ventilator support.
Extra Reading Background Material
China: Captured tiny droplets of viral genetic markers in 2 hospitals in Wuhan floating for > 2 hours. Infectivity? [Journal nature]
India: In states with average population density of 1185 /sk km the average number of cases were 2048. On the contrary in states with population density of 909/ sk km the number of cases were 56. (When Chandigarh and Pondicherry were taken out from this group) the Average Density of other states were 217 and the average number of cases were 35 [HCFI]
Revised COVID Sutras: It’s a COVID-19 Pandemic due to SARS 2 Beta Corona Viruses (different from SARS 1 where spread was only in serious cases); with three virus sequences floating (one similar to Wuhan, second similar to Iran and the third strain similar to USA – UK); has affected up to . 10% (5.7 % S Korea) of the population; Causes Mild or Asymptomatic Illness in 82%, Moderate to Severe Illness in 15%, Critical Illness in 3% and Death in 2.3% cases (15% of admitted serious cases, 71% with comorbidity< Male > Females); affects all ages but Predominantly Males (56%, 87% aged 30-79, 10% Aged < 20, 3% aged > 80); with Variable Incubation Period days (2-14; mean 5.2 days); Mean Time to Symptoms 5 days; Mean Time to Pneumonia 9 days, Mean Time to Death 14 days, Mean Time to CT changes 4 Days, Reproductive Number R0 1.5 to 3 (Flu 1.2 and SARS 2), Epidemic Doubling Time 7.5 days; Origin Possibly from Bats (Mammal); Spreads via Human to Human Transmission via Large and Small Droplets and Surface to Human Transmission via Viruses on Surfaces for up to three days. Enters through MM of eyes, nose or mouth and the spike protein gets attached to the ACE2 receptors. ACE2 receptors make a great target because they are found in organs throughout our bodies ( heart muscle, CNS, kidneys, blood vessels, liver) Once the virus enters, it turns the cell into a factory, making millions and millions of copies of itself — which can then be breathed or coughed out to infect others.
Prevalence:New York: 13.9%; New York City at 21.2%, S Korea 5.7%, world 5%; Ohio prison: 73% of inmates; New York: 21% mortality April 22 in JAMA.
Viral particles seen in tears, stool, kidneys, liver, pancreas, heart, semen, peritoneal fluid, CSF.
Thrombosis: University of Pennsylvania clots are seen in patients even on blood thinners. Netherlands study, 31%
Other human beta-coronaviruses has immunity lasting only for one year with no IMMUNITY PASSPORT.
In absence of interventions, prolonged or intermittent social distancing (till 2022-24)
Low levels of cross immunity from the other beta-coronaviruses against SARS-CoV-2 could make SARS-CoV-2 appear to die out, only to resurge after a few years. Surveillance till 2024.
During peak (trace and treat) and after the peak (trace and treat the close contacts
Increased spread: close environment, crowded place with close physical contacts with no ventilation
Strategies: From community mitigation to individual containment; broader good over individual autonomy; perfect cannot be the enemy of the good; pandemics are fought on the grounds and not the hospitals., Treat the patient and not the test report, Consider every surface and every asymptomatic person as virus carrier
HCW: Direct patient exposure time < 30 minutes; 7 days work and 7 days holidays.
Italy mortality reduced when they were short of ventilators.
Hospital at HOME: CHF, mild pneumonia, exacerbations of asthma and COPD, cellulitis, and urinary tract infections.
Great Imitator (protean manifestation)
IgM can be false positive in pregnancy, immunological diseases); Pooled tests (< 5) when seroprevalence is < 2%
Early treatment to reduce the viral load and prevent cytokine storm using off label use of drugs like hydroxy chloroquine with azithromycin; ivermectin, remdesivir; Tocilizumab interleukin (IL)-6 receptor inhibitor; convalescent plasma therapy ( given early; bridge compassionate therapy, donor 14 days symptoms free, single donation can help 4 patients), Lopinavir-ritonavir and Favipiravir).
Hypoxia: Low flow oxygen < 6l/mt, titrated to high flow oxygen using non breathing mask, Venti mask, HFNC and helmet CPAP, NAV in supine or prone position.
Early intubation with prone ventilation only if progressive. Hypoxia (walking dead) have capillary problem and not alveoli.
Formulas [Deaths in symptomatic cases 1; Deaths X 100= expected number of symptomatic cases; Cases after seven days: Cases today x 2 (doubling time 7 days); Cases expected in the community: Number of deaths occurring in a five-day period and estimate the number of infections required to generate these deaths based on a 6.91% case fatality rate; Compare that to the number of new cases actually detected in the five-day period. This can then give us an estimate of the total number of cases, confirmed and unconfirmed; Lock down effect = Reduction in cases after average incubation period (5 days); Lock down effect in reduction in deaths: On day 14 (time to death); Requirements of ventilators on day 9: Three percent 3% of number of new cases detected; Requirement of future oxygen on day seven: 15% of total cases detected today; Number of people which can be managed at home care: 80% of number of cases today; Requirements of ventilators: 3% of Number of cases today; Requirement of oxygen beds today: 15% of total cases today
