Ambergris

Seychelles 1,842 infections per 100K people reported last 7 days as of May 13, 2021, highest per capita level in Africa. Average number of new infections reported each day in Seychelles now at 257 new infections reported each day, mostly mild. According to the country's health ministry, "more than one third of new active cases are people who are fully vaccinated." Seychelles has administered at least 128,919 doses of COVID vaccines so far, and is understood to have vaccinated 66% of the population. According to the health ministry, 57% were given the Chinese vaccine Sinopharm, while 43% were given Covishield, a version of AstraZeneca that had been manufactured in India. India has stopped AZ exports, and is not talking about the Seychelles. China, which insists that Sinopharm is nearly 80% effective, is scrambling for excuses. Remember the comment in the earlier article about Sinopharm being just over 50% effective? And remember that another vaccine, offhand I can't recall whether that was AZ or J&J, was apparently designed not to keep you from getting sick, but to keep you from dying from it. Apparently, quality matters.

Robin MILLARD with AFP bureaus Wed, May 12, 2021, 1:55 AM An expert panel on Wednesday blamed bad coordination as well as dithering by national governments and international organisations for the failure to tackle Covid-19 before it became a full-blown pandemic, as India's death toll topped 250,000. India added a record 4,205 deaths to its Covid-19 toll in the past 24 hours, with the variant stoking the country's surge now present in dozens of other countries across the globe. ++++++ Those are the official numbers. Given the undercounting described in the articles above, that means real death toll around 2,500,000 (almost all of it in the past two and a half months) and about 42,000 on the 24 hours of May 11.

BBC India's Covid crisis: The newsroom counting the uncounted deaths Soutik Biswas - India correspondent Tue, May 11, 2021, 2:08 AM. On 1 April, the wife and daughter of an editor of a leading newspaper in India's western state of Gujarat went to a state-run hospital to get the daughter a Covid-19 test. Waiting in the queue, they noticed two body bags on gurneys. Workers at the hospital in the capital, Gandhinagar, said the patients had died of Covid-19. The mother and daughter returned home and told Rajesh Pathak, who edits a local edition of Sandesh, what they that had seen. Mr Pathak called his reporters that evening and decided to investigate further. "After all, the government press statements were showing no Covid-19 deaths for Gandhinagar yet," he said. Only nine deaths from Covid-19 were officially recorded in Gujarat that day. The next day a team of reporters began calling up hospitals treating Covid-19 patients in seven cities - Ahmedabad, Surat, Rajkot, Vadodara, Gandhinagar, Jamnagar and Bhavnagar - and kept a tab on deaths. Since then, Sandesh, a 98-year-old Gujarati language newspaper, has published a daily count of the dead, which is usually several times more than the official figure. "We have our sources in hospitals, and the government has not denied any of our reports. But we still needed first-hand confirmation," Mr Pathak says. Sandesh reporters checked 21 cremation grounds and found more than 200 Covid-19 funerals in one night So the newspaper decided to do some old-fashioned shoe-leather journalism. On the evening of 11 April, two reporters and a photographer staked out the mortuary of the 1,200-bed state-run Covid-19 hospital in Ahmedabad. Over 17 hours, they counted 69 body bags coming out of a single exit before they were loaded into waiting ambulances. Next day, Gujarat officially counted 55 deaths, including 20 from Ahmedabad. On the night of 16 April, the journalists drove 150km (93 miles) around Ahmedabad and visited 21 cremation grounds. There they counted body bags and pyres, examined registers, spoke to cremation workers, looked at "slips" which assigned the cause of death, and took photographs and recorded videos. They found that most of the deaths were attributed to "illness", although the bodies were being handled under rigorous protocols. At the end of the night the team had counted more than 200 bodies. But the next day, Ahmedabad counted only 25 deaths. All of April, Sandesh's intrepid reporters have diligently counted the dead in seven cities. On 21 April, they counted 753 deaths, the highest single-day tally since the deadly second wave washed over the western state. On a number of other days, they counted in excess of 500 deaths. On 5 May, the paper counted 83 deaths in Vadodara. The official figure was 13. The Gujarat government denies under-counting and says it is following federal protocols. But reportage by other newspapers has stood up the alleged under-counting. The English language Hindu newspaper, for example, reported it had information that 689 bodies were cremated or buried in the seven cities following Covid-19 protocols on 16 April, when the official death toll for the entire state was 94. Some experts reckoned that last month alone Gujarat might have under-counted Covid-19 deaths by a staggering factor of 10. With the pandemic forcing people to stay away from the rituals of grief, newspapers were overflowing with obituaries. {picture} The number of funerals at a cremation ground in Bharuch district on Saturday also did not tally with the official death statistic, according to this report in Gujarat Samachar, another leading local newspaper: {picture} Gujarat has so far officially registered more than 680,000 Covid-19 infections and over 8,500 deaths. Under-counting of deaths have been reported from several Indian cities badly hit by the pandemic. But the scale of Gujarat's under-counting appears to be massive, and has even provoked the state's high court to admonish the state government, run by Prime Minister Narendra Modi's ruling BJP. "The state had nothing to gain by hiding the real picture and hence suppression and concealment of accurate data would generate more serious problems including fear, loss of trust, panic among the public at large," the judges said in April. Many believe that most Covid-19 deaths are being attributed to the patient's underlying conditions or co-morbidities. A senior bureaucrat, who preferred to remain unnamed, told me only patients testing positive for the virus and dying of "viral pneumonia" were being counted as Covid-19 deaths. Chief minister Vijay Rupani says "every death is being investigated and recorded by a death audit committee". To be sure, counting bodies at mortuaries or cremation grounds and tallying them with official figures for the day can be imprecise as official statistics come with a time lag, according to Prabhat Jha of the University of Toronto, who led India's ambitious Million Death Study. Countries such as UK have reduced the official death toll from coronavirus after a review of how deaths are counted. Covid-19 deaths have been under-reported by as much as 30 to 40% worldwide, studies have shown. Gujarat has officially reported more than 600,000 cases "Reporting and recording systems are swamped during a pandemic, so officials often take time to update [numbers]. But update they must, and record all the deaths. Counting body bags at hospitals and cremation grounds is a good way to put pressure on authorities to come clean," Dr Jha says. For the journalists, it has been a harrowing experience. Hitesh Rathod, a photographer at Sandesh, recounted the harrowing experience of counting the dead. "People were getting admitted and coming out as body bags," he said. He found six-hour-long queues of bodies at crematoria, which he says reminded him of the "long queues of people outside banks after demonetisation," Mr. Modi's controversial 2016 ban on high denomination currency. "Five years later, I found similar queues outside hospitals, mortuaries and cremation grounds. This time there were queues of the people struggling to stay alive and queues of the dead," he said. Ronak Shah, one of Sandesh's reporters, says he was shaken up by the wails of three young children piercing the still night when the hospital's PA system announced the death of their father. "The children were saying they had come to the hospital to pick up their father and go home. They returned with his corpse seven hours later," Mr. Shah says. Dipak Mashla, who led the team to the cremation grounds, says he returned home "scared and shaken. ...I saw parents come with body bags of their dead children, pay money to the funeral worker and tell them, 'Please take my child and burn him'. They were too scared to even touch the corpse." Imtiyaz Ujjainwala, another reporter on the team, believes the scale of under-counting has been considerably more, considering he and his colleagues only counted bodies from one hospital. There were more than 171 private hospitals treating Covid-19 patients in Ahmedabad, he said. "And nobody is counting there."

Countries reporting the most new infections each day (averaging last seven days) INDIA 390,996 BRAZIL 61,411 USA 41,384 TURKEY 20,688 ARGENTINA 20,354 Countries reporting the most deaths each day (averaging last seven days) INDIA 3,880 BRAZIL 2,100 USA 679 COLOMBIA 451 ARGENTINA 439 Currently hospitalized USA May 2-9 average: 34,315 The average number of COVID-19 patients in US hospitals fell 9%, the second weekly drop in a row. DEATHS TO DATE ONE-WEEK TOTAL for the week ending May 9 State Total deaths Per 100K New deaths Per 100K 1-wk chg. United States 582,085 175 4,756 1.4 –1.3% Michigan 19,377 194 484 4.8 +0% Florida 36,445 170 477 2.2 +9.9% California 61,957 157 403 1.0 –11.2% Texas 50,851 175 386 1.3 +24.5% New York State 52,387 269 330 1.7 –8.8% Pennsylvania 26,589 208 262 2.0 –9.3% Illinois 24,577 194 219 1.7 +0% New Jersey 25,801 291 201 2.3 –8.6% Georgia 20,367 192 155 1.5 –34.6% Ohio 19,428 166 144 1.2 –11.1% North Carolina 12,780 122 129 1.2 +0.8% Virginia 10,895 128 104 1.2 +4.0% Wisconsin 7,652 131 85 1.5 –9.6% Missouri 9,173 150 76 1.2 +13.4% Maryland 8,851 146 75 1.2 –34.8% South Carolina 9,592 186 72 1.4 –20.0% Minnesota 7,231 128 71 1.3 –12.3% Kentucky 6,586 147 69 1.5 +1.5% Indiana 13,418 199 69 1.0 –8.0% Alabama 10,978 224 65 1.3 +4.8% Washington 5,564 73 65 0.9 +0% Arizona 17,409 239 65 0.9 –14.5% Massachusetts 17,682 257 61 0.9 –14.1% Puerto Rico 2,374 74 59 1.8 +18.0% Colorado 6,508 113 59 1.0 –9.2% Tennessee 12,255 180 58 0.8 +5.5% Louisiana 10,433 224 51 1.1 +10.9% Oklahoma 6,832 173 44 1.1 –38.9% Connecticut 8,137 228 40 1.1 –20.0% West Virginia 2,726 152 40 2.2 –129.6% Kansas 5,016 172 34 1.2 +142.9% Nevada 5,498 179 34 1.1 –19.0% New Mexico 4,098 195 31 1.5 –27.9% Oregon 2,530 60 29 0.7 +81.3% Mississippi 7,228 243 29 1.0 +20.8% Iowa 5,985 190 26 0.8 –18.8% Utah 2,224 69 20 0.6 –9.1% Montana 1,592 149 18 1.7 +63.6% Arkansas 5,760 191 17 0.6 –32.0% Rhode Island 2,687 254 16 1.5 +45.5% Idaho 2,061 115 15 0.8 +0% South Dakota 1,980 224 13 1.5 +44.4% Delaware 1,636 168 10 1.0 +0% New Hampshire 1,315 97 10 0.7 –52.4% Nebraska 2,251 116 6 0.3 +100.0% Maine 795 59 6 0.4 –64.7% Hawaii 488 35 5 0.4 +0% North Dakota 1,499 197 5 0.7 –37.5% Washington, D.C. 1,110 157 4 0.6 –42.9% Wyoming 710 123 3 0.5 +50.0% Vermont 249 40 2 0.3 –33.3% Alaska 349 48 2 0.3 –84.6%

Miss you, Snowmom.

Countries reporting the most new infections each day on the average of the last seven days: INDIA 391,280 BRAZIL 59,986 USA 44,754 TURKEY 23,819 ARGENTINA 20,328 Countries reporting the most deaths each day * INDIA 3,831 BRAZIL 2,126 USA 688 COLOMBIA 449 ARGENTINA 420

Here's what's known about the coronavirus variants By Maggie Fox, CNN Updated 7:48 PM ET, Fri May 7, 2021 (CNN)The US Centers for Disease Control and Prevention said this week it had designated a coronavirus variant first seen in India as a "variant of interest," adding it to the growing collection of viral variants it's keeping an eye on. Vaccine makers are so worried about the chance new variants will escape the protection offered by immunization that they are already testing booster shots and tweaking their vaccine formulas to specifically target some of the more troubling variants. And doctors around the world are warning that even more variants will arise as the virus continues to evolve inside the bodies of the tens of millions of people it is infecting. The CDC has designated three levels of variants: variants of interest, which have the potential to be dangerous but haven't caused much disruption yet; variants of concern, which are more contagious, evade some treatments, cause more severe disease or get past diagnostic tests; and variants of high consequence, which significantly evade the effects of vaccines or treatments. "Currently there are no SARS-CoV-2 variants that rise to the level of high consequence," CDC says. Here's what's known about the variants of interest and variants of concern: Variants of interest In laboratory tests, all the CDC-designated variants of interest have been found to resist the immune attack in blood taken from people who have recovered from Covid-19, as well as from people who have been vaccinated. B.1.526 - First seen in New York last November, B.1.526 has what's called a 484 mutation. To understand the variants, it's important first to understand the mutations that characterize them. The E484K mutation is a change in the part of the virus called the spike protein -- that's the knobby structure that sticks out from the surface of the virus. The change, in a region called the receptor binding domain, makes the virus attach more easily to the cells it infects and also makes the virus less recognizable to the immune system. Tests show it can in theory resist the effects of Eli Lilly's combined monoclonal antibody treatment, although it's not clear if that translates into treatment failure, the CDC says. Regeneron's antibody cocktail treatment for Covid-19 seems to work against it. It has also been shown to resist the immune attack in blood taken from people who have recovered from Covid-19, as well as from people who have been vaccinated. It accounted for just under 9% of samples sequenced in the US as of April 10. New CDC research published this week shows it's not associated with more severe infection or a greater risk of reinfection. B.1.526.1 - Also first seen in New York, B.1.526.1 has a different pattern of mutations when compared to the original strain sequenced from China, including one called L452R that seems to help the virus infect cells more easily while at the same time making it harder for antibodies to attack. B.1.617 - First seen in India in February, this one is sometimes misleadingly called a "double mutant" because it has both an L452R mutation and a 484 mutation -- although not quite the same 484 mutation seen in other worrying variants. B.1.617.1, B.1.617.2 and B.1.617.3 - These were all first seen in India, and were circulating before B.1.617. They all have the same mutations as B.1.617, plus a few extras. Although Indian officials have said these new variants are driving the spike in coronavirus cases that is currently overwhelming the country's hospitals, the director of India's National Center for Disease Control, Sujeet Singh, said this week the evidence is lacking. "We have not been able to establish the epidemiological and clinical correlation completely yet," Singh said Wednesday. British health officials, however, upgraded B.1.617.2 to a variant of concern Friday because of its rapid spread there. "There is currently insufficient evidence to indicate that any of the variants recently detected in India cause more severe disease or render the vaccines currently deployed any less effective," Public Health England said in a statement. Dr. Chris Whitty, chief medical officer for England, said during a Royal Society webcast Thursday that the B.1.617 variants probably fall in the middle in terms of danger between B.1.1.7, which seems almost fully susceptible to vaccines and treatments, and B.1.351, which has been documented to infect people who recovered from infection with earlier variants of coronavirus, and also to partly evade the protection offered by vaccines. B.1.525 - First seen in the UK and Nigeria, this one carries the E484K mutation. It's been found in fewer than 1% of samples tested in the United States. That surveillance is incomplete. This week, CDC director Dr. Rochelle Walensky said the United States is now sequencing approximately 8% of the country's roughly 450,000 weekly Covid-19 cases. P.2 - Circulating in Brazil since last year, this variant also carries the worrying E484K mutation and has not been found widely globally. Variants of concern CDC defines these as variants for which there is evidence they are more transmissible, cause more severe disease, fail to respond to treatment, evade immune response or fail to be diagnosed by standard tests. B.1.1.7 - The B.1.1.7 variant first seen in the UK has been shown to be at least 50% more transmissible and some evidence suggests it may cause more severe disease, although at least one study found no evidence of this. It carries 23 mutations, including one called N501Y that increases transmission. It accounted for 60% of all samples tested in the US as of April 10, according to CDC. The University of Washington's Institute for Health Metrics and Evaluation estimates it now accounts for virtually all new infections in 23 states. It's fully susceptible to monoclonal antibody treatments and vaccines. "We are confident that the vaccines that are least currently available in the UK work against that, for practical purposes," Whitty said. A team in the Gulf state of Qatar tested the effectiveness of the Pfizer/BioNTech vaccine during a time when Qatar was seeing circulation of the B.1.351 variant first seen in South Africa and the B. 1.1.7 variant first seen in the UK. "The estimated effectiveness of the vaccine against any documented infection with the B.1.1.7 variant was 89.5% at 14 or more days after the second dose. The effectiveness against any documented infection with the B.1.351 variant was 75%," the researchers wrote in a letter to the New England Journal of Medicine. B.1.351 - First seen in South Africa, this variant has both the E484K mutation that is linked with immune escape and the N501Y mutation suspected of helping make other variants more contagious. It has been shown to be 50% more transmissible and evades Lilly's dual monoclonal antibody treatment but not others. Blood tests and real-life use both suggest it can infect people who have recovered from coronavirus and also people who have been vaccinated against Covid-19. Vaccine makers trying to get out ahead of the new variants by developing booster shots have focused on B.1.351, as it's the variant scientists most fear could elude vaccine protection. Moderna said Wednesday that a booster shot of its vaccine revs up the immune response against B.1.351 and another variant, P.1. The good news is it does not seem to cause more severe disease, as initially feared, said Dr. Salim Abdool Karim, Director of the Center for the AIDS Program of Research in South Africa. "It turns out in South Africa the evidence we have now is that it is not more severe," he told the Royal Society briefing. It does, however, escape the human immune response to a significant degree. It spread rapidly across South Africa, Karim has reported, accounting for 11% of viruses sequenced in October and 87% of samples sequenced in December. "If you were infected with the virus before, you are not fully protected this time," Karim said. "About one-half of the individuals who were exposed did get infected again." P.1 - First seen in Brazil, it also has both the E484K and N501Y mutations, with more than 30 others. It has been demonstrated to evade the effects of Lilly's monoclonal antibody treatment but not one made by Regeneron. Blood tests show it might escape both natural and vaccine-elicited immune responses. B.1.427 - First seen in California, this one has the L452R mutation. CDC says it's about 20% more transmissible and may partly resist the effects of Lilly's monoclonal antibody treatment. Blood tests suggest it might be able to re-infect people who have been vaccinated against Covid or who have recovered but that has not been demonstrated in real life yet. B.1.429 -- Another so-called California variant, this one has the L452R mutation along with others and is similar to B.1.427 in other ways. It accounted for 4% of samples sequenced nationally as of April 10. Last month a team at the University of California, San Francisco did in-depth sequencing of more than 2,000 samples from people who tested positive for coronavirus across California. They found the B.1.427/B.1.429 variants increased from no samples in September to half of all samples taken in January. They seem to replicate better in the noses of infected people, something that could explain their faster spread, the UCSF team, led by Dr. Charles Chiu, reported in the journal Cell. But they are not as transmissible as the B.1.1.7 variant. CNN's Virginia Langmaid contributed to this story.

Axios Sat, May 8, 2021, 6:57 AM·1 min read The CDC acknowledged Friday that airborne spread of COVID-19 among people more than 6 feet apart "has been repeatedly documented." Why it matters: This is "a change from the agency’s previous position that most infections were acquired through 'close contact, not airborne transmission,'" the N.Y. Times reports. The new guidance says airborne transmission is more common when people are close, but "These transmission events have involved the presence of an infectious person exhaling virus indoors for an extended time (more than 15 minutes and in some cases hours) leading to virus concentrations in the air space sufficient to transmit infections to people more than 6 feet away, and in some cases to people who have passed through that space soon after the infectious person left." The bottom line: Aerosol expert Linsey Marr "pointed out that one updated page on the C.D.C. website, entitled 'How Covid-19 Spreads,' says that inhaling the virus when people are far apart is 'uncommon,'" the Times noted. "The statement is 'misleading and potentially harmful,'" Dr. Marr said.

Mucormycosis: The 'black fungus' maiming Covid patients in India Soutik Biswas - India correspondent Sat, May 8, 2021, 9:37 PM· On Saturday morning, Dr Akshay Nair, a Mumbai-based eye surgeon, was waiting to operate on a 25-year-old woman who had recovered from a bout of Covid-19 three weeks ago. Inside the surgery, an ear, nose and throat specialist was already at work on the patient, a diabetic. He had inserted a tube in her nose and was removing tissues infected with mucormycosis, a rare but dangerous fungal infection. This aggressive infection affects the nose, eye and sometimes the brain. After his colleague finished, Dr Nair would carry out a three hour procedure to remove the patient's eye. "I will be removing her eye to save her life. That's how this disease works," Dr Nair told me. Even as a deadly second wave of Covid-19 ravages India, doctors are now reporting a rash of cases involving a rare infection - also called the "black fungus" - among recovering and recovered Covid-19 patients. What is mucormycosis? Mucormycosis is a very rare infection. It is caused by exposure to mucor mould which is commonly found in soil, plants, manure, and decaying fruits and vegetables. "It is ubiquitous and found in soil and air and even in the nose and mucus of healthy people," says Dr Nair. It affects the sinuses, the brain and the lungs and can be life-threatening in diabetic or severely immunocompromised individuals, such as cancer patients or people with HIV/AIDS. Doctor believe mucormycosis, which has an overall mortality rate of 50%, may be being triggered by the use of steroids, a life-saving treatment for severe and critically ill Covid-19 patients. Steroids reduce inflammation in the lungs for Covid-19 and appear to help stop some of the damage that can happen when the body's immune system goes into overdrive to fight off coronavirus. But they also reduce immunity and push up blood sugar levels in both diabetics and non-diabetic Covid-19 patients. It's thought that this drop in immunity could be triggering these cases of mucormycosis. Steroids are an essential life-saving drug for Covid patients "Diabetes lowers the body's immune defences, coronavirus exacerbates it, and then steroids which help fight Covid-19 act like fuel to the fire," says Dr Nair. Dr Nair - who works in three hospitals in Mumbai, one of the worst-hit cities in the second wave - says he has already seen some 40 patients suffering from the fungal infection in April. Many of them were diabetics who had recovered from Covid-19 at home. Eleven of them had to have an eye surgically removed. Between December and February, just six of his colleagues in five cities - Mumbai, Bangalore, Hyderabad, Delhi and Pune - reported 58 cases of the infection. Most of the patients contracted it between 12 to 15 days after recovery from Covid-19. Mumbai's busy Sion Hospital has reported 24 cases of the fungal infection in the past two months, up from six cases a year, according to Dr Renuka Bradoo, head of the hospital's ear, nose and throat wing. Eleven of them had to lose an eye, and six of them died. Most of her patients are middle-aged diabetics who were struck down by the fungus two weeks after recovering from Covid-19. "We are already seeing two to three cases a week here. It's a nightmare inside a pandemic," she told me. In the southern city of Bengaluru, Dr Raghuraj Hegde, an eye surgeon, tells a similar story. He has seen 19 cases of mucormycosis in the past two weeks, most of them young patients. "Some were so sick that we couldn't even operate on them." Doctors say they are surprised by the severity and the frequency of this fungal infection during the second wave, compared to some cases during the first wave last year. Dr Nair says he has come across not more than 10 cases in Mumbai in the past two years. "This year is something different," he says. In Bengaluru, Dr Hegde had never seen more than one or two cases a year in over a decade of practice. Patients suffering from the fungal infection typically have symptoms of stuffy and bleeding nose; swelling of and pain in the eye; drooping of eyelids; and blurred and finally, loss of vision. There could be black batches of skin around the nose. Doctors say most of their patients arrive late, when they are already losing vision, and doctors have to surgically remove the eye to stop the infection from reaching the brain. In some cases, doctors in India say, patients have lost their vision in both eyes. And in rare cases, doctors have to surgically remove the jaw bone in order to stop the disease from spreading. An anti-fungal intravenous injection which costs 3,500 rupees ($48) a dose and has to be administered every day up to eight weeks is the only drug effective against the disease. One way to stall the possibility of the fungal infection was to make sure that Covid-19 patients - both in treatment and after recovery - were being administered the right dose and duration of steroids, says Dr Rahul Baxi, a Mumbai-based diabetologist. He says he treated some 800 diabetic Covid-19 patients in the past year, and none of them contracted the fungal infection. "Doctors should take care of the sugar levels after the patients are discharged," Dr Baxi told me. A senior government official says there is "no big outbreak". Yet it is difficult to say why a growing number of cases of mucormycosis are being reported from all over the country. "The strain of the virus appears to be virulent, sending blood sugars soaring to very high levels. And strangely, the fungal infection is affecting a lot of young people," says Dr Hegde. His youngest patient last month was a 27-year-old man, who was not even a diabetic. "We had to operate on him during his second week of Covid-19 and remove his eye. It's pretty devastating."

Egypt may be one of the next headlines countries. Cases are on the rise, and deaths are averaging not quite 30% less than they were at the peak of their one-month death spike. My guess is that deaths are significantly higher now, but not being fully reported. The fun information is that the one of the main vaccines there is BBIBP, also known as Sinovac, which as you might have guessed is a Chinese product. The Chinese government is testing it in places including Egypt, and it is an "inactivated-virus" vaccine. Surely nothing could go wrong with that. Interim data from late-stage trials in Turkey and Indonesia showed that the vaccine was 91.25% and 65.3% effective respectively. Researchers in Brazil initially said it was 78% effective in their clinical trials, but in January 2021 revised that figure to 50.4% after including more data in their calculations. Earlier in November, their trials were briefly halted after the reported death of a volunteer, but resumed after the death was found to have no links to the vaccine.

Dry air makes it worse. Circulating a breath deep in your lungs and projecting it out into the air is more likely to project the virus particles with it, thus the ban on singing outdoors and sports/cheerleading. With at least nineteen variants having been identified that have at least 1000 cases each in the US, however, there's a lot of room for each to have its own comfort zone.

Here's a chart for which variants are found where: https://covid.cdc.gov/covid-data-tracker/#variant-proportions I haven't found the Indian on it, because "sporadic" is a thin slice.

May 6: Brazil recorded 73,380 additional confirmed cases of the coronavirus in the past 24 hours, the Health Ministry said on Thursday, bringing the total number of confirmed cases in Latin America's largest country above the 15 million mark. The ministry also said Brazil recorded 2,550 fatalities from COVID-19 in the last 24 hours, lifting the official death toll to 416,949. (per Reuters)

Gudwaras are offering free oxygen where available, by the way. ++++++++ May 7 Reuters Anuron MitraNivedita Bhattacharjee India's main opposition leader Rahul Gandhi warned on Friday that unless the deadly second COVID-19 wave sweeping the country was brought under control it would decimate India as well as threaten the rest of the world. In a letter, Gandhi implored Prime Minister Narendra Modi to prepare for another national lockdown, accelerate a country-wide vaccination programme and scientifically track the virus and its mutations. Gandhi said the world's second-most populous nation had a responsibility in "a globalised and interconnected world" to stop the "explosive" growth of COVID-19 within its borders. "India is home to one out of every six human beings on the planet. The pandemic has demonstrated that our size, genetic diversity and complexity make India fertile ground for the virus to rapidly mutate, transforming itself into a more contagious and more dangerous form," wrote Gandhi. "Allowing the uncontrollable spread of the virus in our country will be devastating not only for our people but also for the rest of the world." India's highly infectious COVID-19 variant B.1.617 has already spread to other countries such as Britain, forcing nations to cut or restrict movements from India. In the past week, India has reported an extra 1.5 million new infections and record daily death tolls as its hospitals run out of beds and medical oxygen. Since the start of the pandemic, it has reported 21.49 million cases and 234,083 deaths. It currently has 3.6 million active cases. Modi has been widely criticised for not acting sooner to suppress the second wave, after religious festivals and political rallies drew tens of thousands of people in recent weeks and became "super spreader" events. His government has also been criticised for lifting social restrictions too soon following the first wave and for delays in the country's vaccination programme, which medical experts say is India's only hope of controlling the second COVID-19 wave. While India is the world's biggest vaccine maker, it is struggling to produce and distribute enough doses to stem the wave of COVID-19. Modi has stressed that Indian states must keep up vaccination rates. Although the country has administered at least 157 million vaccine doses, its rate of inoculation has fallen sharply in recent days. "After having achieved a rate of around 4 million a day, we are now down to 2.5 million per day due to vaccine shortages," Amartya Lahiri, an economics professor at University of British Columbia was quoted as saying in the Mint newspaper. "The 5 million a day target is the lower bound of what we have to aim for, since even at that rate, it will take a year for us to get everyone two doses. The situation unfortunately is very grim." India reported another record daily rise in coronavirus cases, 414,188, on Friday, bringing total new cases for the week to 1.57 million. Deaths from COVID-19 rose by 3,915 to 234,083. Medical experts say the real extent of COVID-19 in India is five to 10 times the official tallies. India's healthcare system is crumbling under the weight of patients, with hospitals running out of beds and medical oxygen. Morgues and crematoriums can not handle the number of dead and makeshift funeral pyres burn in parks and carparks. Prominent U.S. disease modeller Chris Murray, from the University of Washington, said the sheer magnitude of infections in India in a short period of time suggests an "escape variant" may be overpowering any prior immunity from natural infections. Infections are now spreading from overcrowded cities to remote rural villages that are home to nearly 70% of the 1.3 billion population. Although northern and western India bear the brunt of the disease, southern India now seems to be turning into the new epicentre. The share of the five southern states in the country's daily surge in infections rose from 28% to 33% in the first seven days of May, data shows. In the southern city of Chennai, only one in a hundred oxygen supported beds and two in a hundred beds in intensive care units (ICUs) were vacant on Thursday, from a vacancy rate of over 20% each two weeks ago, government data showed. In India's tech capital Bengaluru, also in the south, only 23 of the 590 beds in ICUs were vacant, and only 1 in 50 beds with a ventilator were vacant, a situation officials say points to an impending crisis. The test-positivity rate — the percentage of people tested who are found to have the disease — in the city of 12.5 million has tripled to almost 39% as of Wednesday, from about 13% two weeks ago, data showed. Bengaluru has 325,000 active COVID-19 cases, with demand for ICU and high-dependency unit (HDU) beds up more than 20 fold, said H. M. Prasanna, president of the Private Hospitals and Nursing Homes Association in Karnataka state, which includes Bengaluru. "Every patient coming to the hospital needs a ICU or a HDU bed...that is why patients are running from one hospital to another searching for an ICU bed," he said. "There is also short supply of medical oxygen...Most of the small hospitals now who can't procure oxygen on a daily basis are refusing to admit COVID patients."

WHEN WILL THIS END? Nearly two months on, India’s devastating Covid-19 wave is still unrelenting REUTERS/DANISH SIDDIQUI No end in sight. By Manavi Kapur It has been eight weeks since India’s second Covid-19 wave began, and millions of Indians continue their frantic search for basic healthcare facilities—oxygen, medicines, hospital beds. Once lauded for its low death rate, the country may be staring at an orphan crisis because of mass fatalities. India recorded 414,188 new Covid-19 cases and 3,915 deaths yesterday (May 6). At the start of the second wave around March 15, India was recording approximately 25,000 cases and 150 deaths a day. While India’s total Covid-19 fatalities were nearly 160,000 in one year of the pandemic till mid-March, it added 80,000 deaths to its tally since then. The catastrophic second wave Covid-19 took even the government by surprise, and two months on, efforts to actively mitigate this disaster are not nearly enough. Despite high-level meetings chaired by prime minister Narendra Modi, Covid-19 patients are dying at small hospitals even in some of India’s largest cities. There are not enough hospital beds, those with ventilators are even more scarce, and oxygen is the new currency Indians are either chasing or hoarding out of fear. All this while, people are dying even in glitzy urban agglomerations. On May 5, NDTV news channel reported that six people had died at Gurugram’s Kriti Hospital, allegedly because there wasn’t enough oxygen. A ghastly video shows a locked ICU room and all hospital staff missing from the scene. As patients’ relatives make their way into the ICU, they find body after body. Later, the administrator at the hospital admitted that the staff had to hide for their safety, till the police could reach them. Deaths by oxygen shortage are by no means isolated instances. At Delhi’s Batra Hospital, 12 people died because the hospital’s oxygen supply was not replenished on time on May 1. One of those dead was a senior doctor being treated for Covid-19. This oxygen crisis has persisted despite the Delhi high court and India’s Supreme Court hearing the matter on an urgent basis. Meanwhile, states have been in an ugly political tussle with the central government over oxygen allocation and supply. It was only on May 5 that Delhi, for instance, received the full 700 metric tons of medical oxygen that it was allocated. The Delhi chief minister claims that if this oxygen supply can be sustained—and augmented to over 900 metric tons—he can add nearly 9,000 oxygenated beds for Covid-19 patients. Delhi also announced a website for booking oxygen cylinders for those in home isolation through proper government channels. These measures have been too slow to come. Even now, Indians have had to stand in queues for hours to get oxygen cylinders filled, wait for the benevolence of strangers on social media, and risk getting duped by those in it to make a quick buck. And this is the story of India’s capital—one of the most developed cities in the country with some of the best health infrastructure. But the city still does not have a Covid-19 war room, a crucial aspect of triaging cases and managing access to healthcare that states like Maharashtra and Kerala have been able to successfully implement. There is no single entity coordinating hospital admissions even today, and patients are left running around the city looking for beds or calling in favours. Not only are steps like the oxygen website coming in with an undesirable lag, but the Indian government also has not recalibrated its priorities to take on this pandemic of unprecedented proportions head-on. Till the last week of April, Indian states were in the grip of a feisty election, hotly contested particularly in the state of West Bengal. Since the start of the second wave of Covid-19, cases in Kolkata, the state’s capital, have shot up exponentially, taking test positivity rates as high as 50%. But perhaps the largest toll of India’s elections came in the form of village-level polls in Uttar Pradesh. Teachers were forced to attend polling station duties, even if they were ill. Teachers’ unions have assessed that 700 such teachers died because of this polling duty. Religious events and polling aside, a large number of farmers are still camped at Delhi’s borders in protest against the Modi government’s farm laws. The fear now is that as Covid-19 spreads to India’s villages, the lack of awareness about the disease and the poor mechanism of reporting deaths is going to spell catastrophe for large swathes of the population. But the Indian government has other things on its plate. India’s foreign minister S Jaishankar is currently in London for the G7 meeting but has now been forced to attend it virtually. Source-based reports say that two members from the Indian contingent tested positive for Covid-19, and sent the rest of the team into a forced quarantine in London. India is currently on the UK’s red list for travellers because of its current outbreak. This is not a good look for a government that has been worried about the global perception of its pandemic response. For instance, reacting to a news report published in The Australian newspaper, the Indian High Commission in Canberra said that it took exception to the report as being “completely baseless, malicious, and slanderous.” The news report directly blamed prime minister Narendra Modi for the “viral apocalypse.” India’s information & broadcasting ministry also held a virtual workshop for officers to help them “create a positive image of the government,” according to a source-based report in the Hindustan Times newspaper on May 5. As if that weren’t enough, India’s foreign ministry had to sweep into action when it found out that embassies in India were sending out SOS calls for oxygen cylinders to members of the opposition party instead of the ministry. After Srinivas BV, an Indian Youth Congress leader, helped the embassy of the Philippines and the high commission of New Zealand in Delhi, the foreign ministry sent out a protocol document for how these emergencies should be handled. This included going through the ministry’s Covid Cell channel. An investigation by news platform Article 14 revealed that the foreign ministry’s Covid Cell for diplomatic missions was reactivated—after it was initially set up in March 2020—only on May 1, after the SOS call from the Philippines embassy. If that diplomatic embarrassment wasn’t enough, the Delhi high court asked the central government about why 3,000 oxygen concentrators, which came as part of foreign aid, were stuck at the customs, based on photographs circulated by newswires. India’s customs authority had to issue a clarification that no such consignment was stuck at the airport, and yet, if someone found said consignment, they should immediately alert the authority.

Generally speaking, the deaths are a couple of weeks behind the contagion and the contagion is in reverse order of percentage of the population that is vaccinated, except in the very thinly populated states.

Countries reporting the most new infections each day, averaged over seven days: INDIA 385,841 BRAZIL 58,413 USA 47,167 TURKEY 29,224 ARGENTINA 20,372 Countries reporting the most deaths each day INDIA 3,619 BRAZIL 2,316 USA 694 COLOMBIA 470 ARGENTINA 416 Basically, this means Colombia isn't testing, or isn't reporting results. Infection rates are high and increasing in (sorted by region, then by severity) Ireland, Lithuania, Bahrain, India, Cambodia, Sri Lanka, Maldives, Nepal, Honduras, Trinidad and Tobago, Guyana, Costa Rica, Ecuador, Seychelles, Angola, Egypt, Réunion, Cameroon, and New Zealand. Where cases increased (or not) in the last week For the week ending Sunday, May 2, 2021 CASES TO DATE ONE-WEEK TOTAL State Total cases Per 100K New cases Per 100K 1-wk chg. United States 32,491,117 9,787 347,438 104.7 –15.1% Michigan 940,175 9,414 28,375 284.1 –25.5% Puerto Rico 250,430 7,841 7,629 238.9 –28.4% Colorado 513,765 8,922 11,523 200.1 –3.6% Minnesota 579,235 10,271 10,992 194.9 –7.3% Pennsylvania 1,161,184 9,070 22,655 177.0 –16.6% Rhode Island 148,186 13,988 1,862 175.8 –14.4% Delaware 104,909 10,774 1,687 173.2 –18.3% Florida 2,242,778 10,442 34,194 159.2 –13.8% Maine 61,847 4,601 2,071 154.1 –16.9% Alaska 68,148 9,316 1,089 148.9 –4.3% Illinois 1,342,067 10,591 18,721 147.7 –0.5% West Virginia 153,918 8,589 2,536 141.5 +1.6% North Dakota 107,708 14,134 1,020 133.8 +9.2% Oregon 186,344 4,418 5,644 133.8 +1.2% Connecticut 339,233 9,515 4,467 125.3 –21.7% Washington 404,709 5,315 9,397 123.4 –3.7% North Carolina 969,752 9,246 12,820 122.2 –3.2% Massachusetts 691,172 10,028 8,388 121.7 –17.2% New York State 2,044,164 10,508 23,412 120.3 –23.9% Indiana 723,058 10,740 7,862 116.8 +17.0% New Hampshire 95,377 7,015 1,556 114.4 –30.4% South Carolina 580,273 11,270 5,288 102.7 –7.3% Maryland 449,180 7,430 5,737 94.9 –20.6% Kentucky 445,139 9,964 4,184 93.7 +14.9% Tennessee 847,430 12,409 6,381 93.4 –39.6% Ohio 1,075,004 9,197 10,698 91.5 –3.9% Iowa 395,205 12,526 2,837 89.9 –9.9% Wisconsin 661,685 11,364 5,159 88.6 +3.6% Vermont 23,126 3,706 550 88.1 –1.8% Montana 109,030 10,201 933 87.3 –2.0% Georgia 1,105,423 10,411 9,067 85.4 –5.0% Nevada 315,438 10,241 2,598 84.3 –0.3% Virginia 661,314 7,748 7,104 83.2 –12.0% Idaho 187,656 10,501 1,473 82.4 +4.2% Utah 398,012 12,415 2,581 80.5 –3.5% Texas 2,893,866 9,980 23,173 79.9 –1.5% Wyoming 58,142 10,046 446 77.1 +4.0% South Dakota 122,660 13,865 674 76.2 –27.5% Washington, D.C. 47,855 6,781 532 75.4 –19.5% New Mexico 197,733 9,430 1,512 72.1 +11.8% Nebraska 220,127 11,380 1,395 72.1 –38.2% Arizona 863,927 11,869 5,190 71.3 +4.3% Louisiana 458,581 9,865 3,040 65.4 –15.2% Missouri 521,069 8,490 3,779 61.6 +14.0% Kansas 309,130 10,611 1,758 60.3 +16.3% Mississippi 311,900 10,480 1,551 52.1 +33.4% Alabama 528,597 10,781 2,466 50.3 –33.9% Arkansas 336,105 11,137 1,399 46.4 +11.6% Hawaii 32,580 2,301 656 46.3 +20.8% Oklahoma 448,305 11,330 1,755 44.4 +4.0% California 3,746,006 9,481 13,376 33.9 +1.4% New Jersey 1,000,010 11,259 2,119 23.9 –88.9% Where the highest share of the population has been vaccinated Most recent data as of May 2, 2021 State First dose Fully vaccinated Total doses United States 44.7% 32.3% 249,566,820 New Hampshire 61.2% 30.3% 1,159,614 Vermont 58.4% 40.2% 599,965 Massachusetts 58.0% 39.0% 6,495,919 Connecticut 56.2% 41.1% 3,361,098 Maine 56.1% 42.0% 1,234,253 Hawaii 54.1% 37.0% 1,264,136 Rhode Island 53.8% 38.9% 951,345 New Jersey 52.8% 38.4% 7,600,716 New Mexico 52.0% 39.3% 1,860,755 Pennsylvania 51.2% 34.1% 10,531,067 California 50.1% 32.4% 31,670,889 Maryland 49.9% 36.1% 5,005,250 Washington, D.C. 49.5% 31.8% 626,082 New York State 48.9% 37.0% 16,353,467 Virginia 48.4% 35.0% 6,947,022 Minnesota 48.2% 36.1% 4,535,336 Washington 48.0% 34.1% 6,099,153 Delaware 47.9% 34.8% 793,383 Illinois 47.6% 31.8% 9,748,918 Colorado 47.6% 34.8% 4,649,806 Wisconsin 46.4% 37.0% 4,786,435 Oregon 46.2% 32.6% 3,207,617 South Dakota 45.2% 38.3% 716,196 Iowa 44.9% 36.1% 2,473,624 Nebraska 43.8% 34.7% 1,470,513 Michigan 43.5% 33.6% 7,373,940 Kansas 43.1% 32.9% 2,070,420 Florida 42.8% 30.5% 15,721,876 Alaska 42.3% 36.2% 564,720 Kentucky 41.6% 32.9% 3,213,684 Arizona 41.5% 30.2% 5,216,530 Montana 41.4% 33.3% 777,944 Ohio 41.1% 33.7% 8,622,766 Utah 40.5% 25.5% 2,225,385 Nevada 40.4% 29.4% 2,122,615 North Carolina 39.9% 30.9% 7,266,480 North Dakota 39.6% 33.4% 569,428 Puerto Rico 39.5% 26.1% 2,006,360 Texas 39.0% 28.4% 19,519,836 Oklahoma 39.0% 30.6% 2,736,824 Missouri 38.3% 28.9% 4,118,674 South Carolina 37.1% 28.5% 3,329,233 Indiana 36.9% 28.3% 4,311,755 Arkansas 36.1% 26.6% 1,845,530 West Virginia 36.0% 31.0% 1,189,041 Georgia 35.6% 26.0% 6,550,721 Tennessee 34.9% 25.8% 4,150,612 Idaho 34.6% 28.2% 1,108,625 Wyoming 34.4% 28.6% 363,149 Alabama 33.0% 24.5% 2,670,926 Louisiana 32.4% 26.9% 2,733,787 Mississippi 31.6% 24.5% 1,625,364 deaths in the last week For the week ending Sunday, May 2, 2021 DEATHS TO DATE ONE-WEEK TOTAL State Total deaths Per 100K New deaths Per 100K 1-wk chg. United States 577,329 174 4,819 1.5 –3.1% West Virginia 2,686 150 -135 0.0 N/A Nebraska 2,245 116 3 0.2 –89.7% Wyoming 707 122 2 0.3 +0% Oregon 2,501 59 16 0.4 –36.0% Hawaii 483 34 5 0.4 +25.0% Kansas 4,982 171 14 0.5 –6.7% Vermont 247 40 3 0.5 +50.0% Utah 2,204 69 22 0.7 +22.2% Tennessee 12,197 179 55 0.8 –40.9% Arkansas 5,743 190 25 0.8 +4.2% Idaho 2,046 115 15 0.8 +7.1% Mississippi 7,199 242 24 0.8 +9.1% Washington 5,499 72 65 0.9 +20.4% Montana 1,574 147 11 1.0 –35.3% Arizona 17,344 238 76 1.0 –33.9% Iowa 5,959 189 32 1.0 –30.4% Delaware 1,626 167 10 1.0 –28.6% Massachusetts 17,621 256 71 1.0 –19.3% Rhode Island 2,671 252 11 1.0 –15.4% Louisiana 10,382 223 46 1.0 –14.8% North Dakota 1,494 196 8 1.0 +14.3% South Dakota 1,967 222 9 1.0 +80.0% Washington, D.C. 1,106 157 7 1.0 +133.3% Texas 50,465 174 310 1.1 –13.2% California 61,554 156 454 1.1 +3.9% Colorado 6,449 112 65 1.1 +20.4% Missouri 9,097 148 67 1.1 +21.8% Indiana 13,349 198 75 1.1 +50.0% Virginia 10,791 126 100 1.2 –9.1% North Carolina 12,651 121 128 1.2 –5.9% Alabama 10,913 223 62 1.3 +1.6% Maine 789 59 17 1.3 +142.9% Nevada 5,464 177 42 1.4 –26.3% Connecticut 8,097 227 50 1.4 –3.8% Ohio 19,284 165 162 1.4 +23.7% Minnesota 7,160 127 81 1.4 +37.3% Kentucky 6,517 146 68 1.5 –38.7% New Hampshire 1,305 96 21 1.5 +50.0% Puerto Rico 2,315 73 50 1.6 –13.8% Wisconsin 7,567 130 94 1.6 +77.4% South Carolina 9,520 185 90 1.7 –4.3% Illinois 24,358 192 219 1.7 +19.0% Alaska 347 47 13 1.8 N/A Oklahoma 6,788 172 72 1.8 +278.9% New York State 52,057 268 362 1.9 –10.0% Maryland 8,776 145 115 1.9 +16.2% Florida 35,968 168 434 2.0 +2.1% New Mexico 4,067 194 43 2.1 +87.0% Georgia 20,212 190 237 2.2 +9.2% Pennsylvania 26,327 206 289 2.3 –1.7% New Jersey 25,600 288 220 2.5 –7.2% Michigan 18,893 189 484 4.8 +1.9% Data is incomplete with regard to the 135 people apparently risen from the dead in West Virginia.

https://www.who.int/news-room/feature-stories/detail/who-advises-that-ivermectin-only-be-used-to-treat-covid-19-within-clinical-trials https://jamanetwork.com/journals/jama/fullarticle/2777389 Note the results.

B.1.617 yes

In a situation like this, a substance as common as black pepper could have been the answer, and it would have been pushed in order to save the Pre-Covid economy. A few people are doing very well out of the Covid economy, but way more are not. Entire societies are shifting, and establishments crumble when that happens. Right now we are going to be facing extraordinary inflation, because the government is going to have to literally print money to send it out to people the way it has been doing. The doctors' retirement funds' dollars will be devaluing like every other dollar out there.

Vaccination is not the answer, but it can hold back the tsunami until a better answer can be found. There isn't a better answer available yet.

"One in five deaths are medically reported..." in India in normal times, according to Indian medical journals. "One in twenty cases" of Covid is estimated to be counted officially in India per the Indian medical establishment.

Everyone on some of my loops is unhappy with these. Some TSC stores have stopped carrying chicks this season.

Public hospitals are free but overcrowded and undersupplied. That's where private hospitals come into the picture. Also, the phrase "daily carnage on Mumbai roads" is, I am told, all too accurate. They don't use lines or signals. It's a free-for-all. And the social structure is authoritarian and getting worse. A friend of mine was advised by her mother that it was time to come home and arrange her daughters' marriages. She promptly applied for (and received, luckily for us) US citizenship.