62nd Update on Corona Virus Pandemic with Dr Peter (last update was 3-15)

Dr Peter will be adding a mid-month update that he writes for his clinic team and board of directors starting this month. Presentations to Ananda will continue once a month.

Dr Peter explained that he usually does about an hour a day of prep for his presentation but he put extra effort into studying hours of video and interviews, etc, on what is happening in India for today’s talk.

1.4 billion people. The world’s largest democracy. One way to see the difference between a democracy and an authoritarian government is the kind of information we can observe coming out of India. We can see what is happening on a daily basis and keep up to date. There is a transparency of information.
Compare to China – information is totally controlled. But now that we have seen what happened in NY, Italy, Brazil and India, it seems obvious that probably something similar happened in Wuhan back in January 2020. Only admitting to 5000 deaths. Probably not the reality.

Many days with over 400,000 new cases. Number of deaths is over 3000 per day. By all accounts the numbers are very under reported – not deliberately. Probably somewhere between 2-10 X the new case count. Case positivity rate is about 30% and they can’t test fast enough.

Deaths are most likely 4 – 10 X the 3000 reported deaths. It is obvious – hospitals don’t have room for all the bodies and they have to have funeral pyres in the parking lots just to take care of the dead. They are running out of wood to do cremations. The burials and cremations are being done without the traditional rituals and family involvement as well.

There are deaths because of the collapse of the hospital system – non Covid related illnesses not treated because there are no beds and it is not safe to go in.

Hospital system in India is two tier. There are private, fee-for-service hospitals that have excellent facilities and care. The public hospitals are not as advanced and are for the majority of the population. Both tiers are running out of beds, oxygen and medicine. People are dying when oxygen is not available.

Hard hit areas are Mumbai and Pune. They are running out of medications like dexamethasone and remdesivir. Diabetes is a big complicating factor in India, where 20% of the population has type II diabetes. In the U.S. it is only about 5%. Diabetes increases how lethal Covid is. It is a genetic tendency in India, even for people who are not obese.

Only 2% of Indian people are vaccinated. This is definitely a factor in the outbreak.
Israel has successfully fought the virus with vaccines.

There was a time a few months ago that there was a feeling that India had reached herd immunity and there was relaxation of restrictions and a change in protective behaviors. How could there have been such wrong thinking? There were serological tests that showed 50-60% immunity to the virus in some populations. But now there is understanding that when the first waves went through the metro areas, it hit largely poorer and younger population who had better ability to survive the virus. The current wave is the B117 variant or the B1617 (Indian) variant which are both more transmissable.
With the relaxation of behaviors, there were religious festivals that were allowed and generally, masks were discontinued. Political rallies were also allowed. Probably some of these were “super spreader” events.

What now? Likely this is not the peak number of cases. The specialists doing modeling are saying the earliest peak may be May 7th. Other models are showing more like mid May – about May 15th.

It’s unimaginable to most people in the West. Can’t say how rapidly it will come down after cases peak. Deaths peak about 2 weeks after the peak in cases. Deaths will come down very slowly.

US State department has encouraged US citizens to come home and quarantine. Will probably stop flights from India.

Australia has controlled travel into the country very tightly. They have required incoming people to quarantine in designated quarantine hotels for 2 weeks. Now they are not allowing anyone in who has been to India in the last 2 weeks. They are just now getting vaccines.

The political situation in India will be affected by the current crisis. The economy will be affected as well. There will be global affects from the fact that India has been hit so hard.

When was SARS II Corona virus actually in Italy?
There was a tremendous outbreak in Feb and March 2020. There were Chinese immigrants that had come into Italy for work and it was thought that’s when things originated. Now they have been able to look at blood samples from the fall of 2019 (Sept – Dec) and found that there were people who had antibodies to the classic SARS II virus as early as Sept 2019. This was the IGM or immediate antibody type that was detected and this shows people had recent infections.

Probably in the fall of 2019 over 10% of people in Italy had already been exposed and this means the virus was in northern Italy in August of 2019. In Nov-Dec there was an increased number of cases of a flu-like illness that caused an unusual kind of pneumonia. But it wasn’t recognized as SARS II and then the cases exploded in Jan-Feb in Lombardi. This is information we are processing and it is very interesting to understand more clearly how it came about.

When was it in China?
Reports in Jan said it was not transmissable to humans and WHO said it was not a concern for humans. Most likely it was present in late summer and early fall of 2019. Satellite data shows unusual crush of cars at the hospitals in the Wuhan area during that period of time. Another clue is the crematories and mortuaries were running at full capacity. It probably was much more like what was seen in Italy.

Johnson and Johnson and AstraZeneca Vaccines
J and J vaccine and AstraZeneca vaccines were “paused” due to potential side effects. The good news is that the monitoring of side effects was effective and administering of the vaccine was stopped until further investigation. There were rare occurrences of blood clotting in women under age 50 in the cerebral sinuses. Clotting factors were oddly low. This is called : “vaccine induced thrombotic (clotting) thrombocytopenia (low platelets) ” Most people survived without long term problems.

Occurrence of problems was about 2 per million. The chance of having the same problem is about 8-10X higher if you are infected with SARS II virus.

Some countries in Europe are offering the AstraZeneca only to people over the age of 50, to reduce risk. Some places are issuing a warning. The US is informing people there is a risk with women younger than 50 and they have a choice to avoid the J and J vaccine. Encouraged to watch for unusual side effects (severe headache) and seek care immediately if they are concerned.

Moderna and Pfizer vaccines:
Interesting that in Israel the military were vaccinated and they found increased incidence of mild heart inflammation (myocarditis) that was transient. 1 in 20,000 men under that age of 30. Did not occur in women. Very few had to be hospitalized. Would recommend that if you are under age 40, male, and have symptoms following the vaccine, report to your doctor. Probably only treated with more rest.

Remember, this was discussed early in the pandemic. Many people recovering from SARS II developed myocarditis and heart damage. Much higher incidence of heart damage in those with the virus. Vaccinations would prevent that.

No reason to hold off on getting first or second shots of the Moderna or Pfizer vaccines.

Who should get vaccinated?

What about those who have conditions or are in treatment that suppresses their immune system?
Anyone with any kind of immune disorder should think about getting vaccinated because your risk is high with Covid. Being pregnant is also high risk and vaccination is encouraged and there is good evidence now of safety in pregnant women.  Talk to your care provider about it.

*Nevada County and other counties are having a slight uptick in their case numbers. Being watched carefully.

Jyotish and Devi – in touch with India. Devarshi reports that doctors have told him that the numbers could be 30X more than what is reported. Ananda India doctors are doing a weekly update and education for the sangha there. Ananda Italy reports a lot of resistance to the vaccine there.

Next update with Peter in a month. He will be sharing a written summary in 2 weeks.