COVID-19 Infection In India Research Articles

Counting the uncounted: estimating the unaccounted COVID-19 infections in India

Counting the uncounted: estimating the unaccounted COVID-19 infections in India

Evaluation of SARS Cov-2 disease epidemiology, clinical and diagnostic profile-a regional study from tertiary care center of North India

Background: A novel coronavirus severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) that emerged in China in December 2019 has spread rapidly globally to many countries including India and World Health Organization declared it as a pandemic on March 11th, 2020. Aims and Objectives: The current study endeavors to determine the SARS-CoV-2 positivity rate as well as epidemiological, clinical, and diagnostic profiles from the second wave. Materials and Methods: We performed a retrospective analysis of all suspected COVID-19 cases from January 2021 to October 2021 presenting at a large testing center for SARS-CoV-2 infection by real-time polymerase chain reaction (RT-PCR). Descriptive analysis has been performed for profiling of clinical-epidemiological aspects of suspected cases. Results: A total of 694427 participants were enrolled during the study from January 2021 to October 2021. Overall RT-PCR positivity rate was found to be 1.7% in the year 2021 and the positivity was maximum in April 2021 which represents the second wave of COVID-19 infection in India. In the study population, more than half (57.07%) of the persons screened for COVID-19 infection were between 21 and 40 years of age, and about two-thirds (65.20%) of the persons screened were male followed by 34.79% were female. Conclusions: SARS-CoV-2 poses a high burden of infections in the community. Males had a higher RT-PCR detection rate as compared to females. The younger age group (<20 years) expressed the least RT-PCR positivity rate and the elderly population (>80 years) expressed the highest positivity rate.

Reconstructing the COVID-19 incidence in India using airport screening data in Japan.

A major epidemic of COVID-19 caused by the Delta variant (B.1.617.2) occurred in India from March to July 2021, resulting in 19 million documented cases. Given the limited healthcare and testing capacities, the actual number of infections is likely to have been greater than reported, and several modelling studies and excess mortality research indicate that this epidemic involved substantial morbidity and mortality. To estimate the incidence during this epidemic, we used border entry screening data in Japan to estimate the daily incidence and cumulative incidence of COVID-19 infection in India. Analysing the results of mandatory testing among non-Japanese passengers entering Japan from India, we calculated the prevalence and then backcalculated the incidence in India from February 28 to July 3, 2021. The estimated number of infections ranged from 448 to 576 million people, indicating that 31.8% (95% confidence interval (CI): 26.1, 37.7) - 40.9% (95% CI: 33.5, 48.4) of the population in India had experienced COVID-19 infection from February 28 to July 3, 2021. In addition to obtaining cumulative incidence that was consistent with published estimates, we showed that the actual incidence of COVID-19 infection during the 2021 epidemic in India was approximately 30 times greater than that based on documented cases, giving a crude infection fatality risk of 0.47%. Adjusting for test-negative certificate before departure, the quality control of which was partly questionable, the cumulative incidence can potentially be up to 2.3-2.6 times greater than abovementioned estimates. Our estimate of approximately 32-41% cumulative infection risk from February 28 to July 3, 2021 is roughly consistent with other published estimates, and they can potentially be greater, given an exit screening before departure. The present study results suggest the potential utility of border entry screening data to backcalculate the incidence in countries with limited surveillance capacity owing to a major surge in infections.

Eastern India's response to the pandemic: a comparative assessment of West Bengal, Bihar, and Odisha

Background: The three eastern states of India (Odisha, Bihar, and West Bengal) share common borders with similar cultural and socio-demographic characteristics due to historical ties. In the recent past, these states witnessed large-scale return migration of workers, leading to increasing numbers of COVID-19 cases. Despite the increasing number of cases, the testing capacity in Odisha, Bihar, and West Bengal is significantly lower compared to the testing capacities in the western, southern, and northern regions. Methods: This study utilized a nine-month retrospective longitudinal design, focusing on the COVID-19 situation and healthcare facilities in Odisha, West Bengal, and Bihar from May 2020 to January 2021. Data were extracted from various Government and research institution websites, and descriptive analyses employed bar and line diagrams. Results: Odisha and Bihar show declining COVID-19 cases, deaths, and test positivity rates, while West Bengal is on the rise. Testing rates are consistently increasing in all three states. West Bengal has the highest doctors per million, Odisha has the most nurses per million, and more pharmacists are registered in West Bengal. In health infrastructure, Odisha has COVID-19 special hospital testing centers, while West Bengal leads in hospital beds and ICU beds. Conclusions: The burden of COVID-19 infection in India was heterogeneous, with evidence of high transmission in the eastern, northeast, western, and southern regions. The study findings will be helpful in making informed decisions about the current state-wise health status in eastern India.

Crisis leadership in Sigmoid Group: proactiveness for business continuity

Learning outcomes After completion of the case study, students will be able to describe the crisis types and the various phases in mapping a crisis and outline appropriate actions during each phase; identify stakeholders in the context of change management initiatives and map them through their power, influence and interest needs; identify the needs and resistance present in change management initiatives through the systems-thinking perspective; recognize the leadership competencies for an effective crisis management approach; and identify the way to conduct challenging conversations with important stakeholders whose support and influence are required. Case overview/synopsis Stella Fernandez, the vice president of human resources management in a family-managed business organization, was disturbed by the media reports on rising number of cases of COVID-19 infection in India during the first week of March 2020. She thought that a continued rise in the number of infection cases could affect the business continuity as well as the safety of the employees. In her opinion, a faster introduction of a work-from-home policy could help to reduce the impact of the potential crisis. Fernandez understood that without the senior management team’s consent, she could not drive the information technology team to implement the work-from-home measure. However, she felt that there could be challenges in convincing the senior management team, who did not treat this outbreak to be of grave importance. Anticipating the unfavourable reaction, Fernandez planned her approach carefully by identifying and convincing influential members to support this change management initiative; nevertheless, to her dismay, her meticulous plan failed to convince the powerful members of the team, who continued to resist the change proposed by her. Disappointed and surprised by their reaction, Fernandez wondered what she could have done to make the senior management team to accept her proposal. Complexity academic level This case study is designed for use in undergraduate- or graduate-level programmes. Supplementary material Teaching notes are available for educators only. Subject code CSS 6: Human resource management.

A Retrospective Observational Study on the Comparison of Different Diagnostic Modalities of Post-COVID Mucormycosis.

Background Mucormycosis, attributed to a group of molds known as mucormycosis, is a rare yet life-threatening fungal infection often colloquially referred to as black fungus. While its incidence notably surged during the second wave of COVID-19 infections in India, it's essential to recognize that mucormycosis was a significant concern even before the advent of the pandemic. Understanding the prevalence and characteristics of this infection in the pre-COVID era provides a crucial context for evaluating its impact and dynamics during the pandemic. Multiple diagnostic methods, such as potassium hydroxide (KOH) mount, culture, matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), and histopathological examination (HPE), are available for identifying this lethal infection. The primary objective of this study is to ascertain the sensitivity of various diagnostic methods for mucormycosis and to analyze the comparative effectiveness of microbiological versus histopathological diagnoses. Methods We conducted a retrospective observational study spanning six months, from May 2021 to October 2021, encompassing all mucormycosis cases meeting the inclusion criteria and diagnosed via histopathological examination (HPE) in the departments of pathology and microbiology. Microbiological tests were performed prior to the histopathological examinations. Sensitivity was assessed through statistical analysis, and the relationship between microbiological and histopathological diagnoses was evaluated using the chi-square test. Results Biopsy samples of 77 patients were collected, comprising 56 male and 21 female patients. Regarding age distribution, most patients fell within the 41-60 age bracket, while the smallest proportion was over 60 years old. The sensitivity and specificity of histopathological diagnosis, confirmed with periodic acid-Schiff (PAS) and Grocott-Gomori's methenamine silver (GMS) staining, both recorded a flawless 100%. KOH mount sensitivity stood at 88.3%, while fungal culture and MALDI-TOF exhibited sensitivities of 75.3%. Histopathological analysis revealed that 17% of cases displayed minimal fungal hyphae alongside necrotic tissue, whereas 58% exhibited abundant fungal hyphae accompanied by inflammatory cells. Additionally, absolute neutrophilia was observed in 55% of cases. Conclusions In our study, histopathology and KOH mount emerged as not only compassionate but also cost-effective diagnostic tools for identifying mucormycosis. The economic aspect of these diagnostic methods is highlighted in the results section to provide a comprehensive understanding of their cost-effectiveness. Additionally, we utilized MALDI-TOF MS as a straightforward, economically viable, and expeditious method specifically for confirming the fungal subtype in mucormycosis cases. The rationale behind choosing either MALDI-TOF MS or KOH for the diagnosis is elucidated, contributing to a clearer interpretation of our diagnostic approach. Furthermore, our findings indicate that absolute neutrophilia consistently manifests in 55% of mucormycosis cases.

Alternative biosimilar drugs impact on Global COVID-19 Pandemic and Regulatory approval Repurposed in Emergency periods (2020-2022)

Corona Virus (Covid-19) infection was developed from the SARS-CoV-2 virus. People have infected by the virus in all around the world with moderate issues on the respiratory system. As well the recovery has successful without taken any special treatment. As per the world record, illness and death have the serious medical attention on the chronic diseases; maximum infected people belongs to the diabetes (Type I and Type II), Cardio vascular issues, asthma, respiratory illness, more immunity disorder and cancer etc. In Indian, CDSCO board (Central Drugs Standard Control Organization), Ministry of Health and Family Welfare, India, DBT (Dept. of Biotechnology), Ministry of Science and Technology, Indian council of Medical Research (ICMR) has published the notification to the public section with the NDCT (New Drugs Clinical Trials) rules. In addition, various other rules were applicable for the designing the COVID-19 drugs such as Drugs and Cosmetics Act and Rules, on Similar Biologics with the Regulatory aspects to make the market authorization in India. Biosimilar drug has designing with rules and regulation of COVID-19 repurposed medicines (drugs) were approval in emergency aspects during the COVID-19 infection in India around March 2020 to till date. In this study, we have emphasize the pandemic COVID -19 situation i) biosimilar drugs used in emergency aspects; ii) the list of biosimilar drugs under Govt. of India approval regulatory aspects; iii) the list of biosimilar repurposed drugs doses, time period, sources of the respective drugs and the applications with the successful rate were optimized in the COVID -19 emergencies period.

Infection and mortality trend of COVID-19 over the years in India and measures taken to curb the epidemic: a comprehensive review

Background and Aims: The trend of COVID-19 infections in India has been dynamic as well as complex, with several peaks and troughs since the pandemic began, including the rise of advanced and more contagious variants of the virus, increased public complacency towards health guidelines, and the challenges posed by vaccine hesitancy and misinformation. The current article comprehends the patterns of COVID-19 infection in India, with highlights of infection patterns and mortality in several states. Methods: With the use of keywords, we looked through the National Library of Medicine, Google Scholar, and PubMed electronic databases. We have all the specific information from the case reports and clinical series of the patients from the various COVID-19 pandemic waves in India. In order to assess the national impact of these epidemic waves, we then carefully review the case reports.

Routine child immunizations in India during the COVID-19 pandemic

Disruptions in health service delivery and utilization during the COVID-19 pandemic may have caused many children worldwide to not receive vital preventative health services. We investigate the pandemic’s effects on routine childhood vaccinations in India, which has the world’s largest child immunization program. Using data from the Government of India’s health management information system and interrupted time series analyses, we estimate district-level changes in routine child vaccinations during the pandemic relative to typical monthly vaccinations in the pre-pandemic period. Our results indicate there were significant reductions in child vaccinations during the pandemic, with declines being extremely large in April 2020 when a strict national lockdown was in place. For example, district-level administration of the final required dose in the polio series declined by about 60% in April 2020 relative to the typical monthly vaccination levels observed prior to the pandemic. Vaccinations subsequently increased but largely remained below levels observed before the outbreak of COVID-19. Additional declines in vaccinations occurred in 2021 during the second wave of COVID-19 infections in India. Heterogeneity analyses suggest that vaccinations declined the most in districts with the strictest lockdowns and in districts with low health system capacity at baseline. There is a vital need for corrective actions, such as catch-up vaccination campaigns, to limit the deleterious consequences that will arise for the children who missed routine immunizations during the COVID-19 pandemic.

Does BCG Or MMR Or Routine Vaccination Coverage Protect Against COVID Infection And Mortality In India?

Background: The routine vaccinations and acquired immunity by other viral infections were believed to be acting as a protective factor against severe COVID-19 outbreaks in some countries. This study is overviewing the relationship of routine BCG, MMR vaccinations and reported MMR disease outbreak with reported COVID-19 infection across the Indian states. Methods: The data on vaccination coverage and respiratory disease infection was obtained from Universal immunization program and Integrated disease surveillance project reports. spearman rank Correlation has been used to assess the relationship of routine vaccination and COVID-19 infection. Results: The result did not find any relationship of routine vaccination with BCG and MMR or exposure to MMR infection on COVID-19 infections in India. Conclusion: The exposure to BCG or MMR vaccination did not have a non specific protection against COVID-19 infection. The results imply that a larger proportion of the Indian population is still vulnerable to COVID-19 infection.

A Comprehensive Review on Covid-19 Variants

Abstract: SARS-Cov-2, the new coronavirus which caused COVID-19 was first detected in Wuhan, China in december 2019.The first case of COVID-19 infection in India was reported in Kerala on Jan 27, 2020. Later on this contagious disease had quickly spread around the world. This review article aims at providing an exhaustive knowledge about the COVID-19 outbreak, mutant strains of coronavirus, mutation in spike protein of the virus, efficiency of vaccines on variants of concerns. It’s important to study the epidemiology of each variants/strains [alpha (B.1.1.7), beta (B.1.351), delta(B.1.617.2), omicron(B.11.529)] in order to develop vaccines and to cure this malady. How symptoms of different variants/strain and the reaction of these variants to different types of vaccines is also discussed.

Mandating Self-Imposed Curfew - An Analysis of PM Modi's Janta Curfew Speech

This study explores the persuasive strategies used by the Indian Prime Minister (PM) Narendra Modi to appeal to the citizens of India, to observe ‘Janta Curfew’ or People’s Curfew, as a preventive measure to contain the spread of Covid-19 infections in India. The study maps the speech to established strategies and theories of persuasion such as Aristotle’s Rhetorical Triangle, Elaboration Likelihood Model, Monroe's Motivated Sequence, and Cognitive Dissonance Theory; and ascertains the indispensability of the aforementioned theoretical frameworks. The study also identifies Modi’s unique persuasive strategies such as wheedling, building-up (before delivering), complimenting before criticizing, Eutrepismus, and subtly titling the task; and analyzes their effectiveness in persuading the citizens of India to comply with Janta Curfew.

COVID-19 Antibodies as Predictor of Severe Dengue among Hospitalized Children with Dengue Illness in the Post-third-wave Period of COVID-19 Infection in India.

There were widespread unconfirmed reports about the increased severity of dengue post-second wave of the COVID-19 pandemic in India. It is known that a second dengue infection with a different strain in an individual can trigger antibody-dependent enhancement (ADE). A similar phenomenon is hypothesized for severe COVID-19 infection since both dengue and COVID-19 are viral diseases with different and varying strains. However, much research is needed to confirm this hypothesis. In this context, we intended to assess the severity of dengue illness in relation to previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, possibly the role of COVID-19 antibodies as an early predictor of severe dengue illness. To assess the utility of COVID-19 antibodies for early identification of severe dengue illness among children in the post-third-wave period of COVID-19 infection in India. All hospitalized children with dengue illness were categorized as severe (shock and/or hemorrhage and/or multi-organ dysfunction) and non-severe dengue illness (dengue with or without warning signs) as per WHO definition. COVID-19 antibody titers were estimated in both groups. Clinical features and seroprevalence of COVID-19 antibodies were compared in both groups. A total of 31 children were studied (13 severe and 18 non-severe dengue illnesses). The most common symptoms prior to presenting to the hospital included fever (100% in both groups), vomiting (85% in severe and 63% in non-severe), abdominal pain (85% in severe and 50% in non-severe), poor feeding (54% in severe and 28% in non-severe), and skin rashes (15% in severe and none in non-severe). The mean duration from the onset of fever to the first hospital visit was 4.6 days in severe illness and 5.3 days in non-severe dengue illness. The mean duration of hospitalization was 9.7 days in severe dengue illness and 4.1 days in non-severe dengue illness. While 92.3% of all severe dengue had significantly higher COVID-19 antibody titers, it was found elevated only in 44.4% of the children with non-severe dengue illness (p-value 0.0059; Yates' corrected p-value 0.0179). Clinical symptoms prior to presenting to the hospital were fever, vomiting, abdominal pain, poor oral feeding, and skin rashes. While fever, vomiting, and abdominal pain were seen commonly in both severe and non-severe dengue illnesses, the presence of skin rash during febrile phase is associated with severe dengue illness only. Hospitalized children having severe dengue had increased seroprevalence of COVID-19 antibodies (92.3%) compared to children with non-severe dengue (44.4%). However, there is no corelation of the severity of dengue illness with absolute values of COVID-19 antibody levels. Therefore, the presence of COVID-19 antibodies (previous COVID-19 infection) can be a predictor of severe illness in children with dengue especially if associated with poor oral feeding and skin rashes. The limitation of the study is its lesser sample size to conclude any definitive statement; nevertheless, the study paves way for a similar cohort of a larger sample size to draw conclusions.

Mapping of SARS-CoV-2 spike protein evolution during first and second waves of COVID-19 infections in India.

Aim: The aim of this study was to investigate the SARS-CoV-2 spike protein evolution during the first and second wave of COVID-19 infections in India. Materials & Methods: Detailed mutation analysis was done in 763 samples taken from GISAID for the ten most affected Indian states between March 2020 to August 2021. Results: The study revealed 242 mutations corresponding to 207 sites. Fifty one novel mutations emerged during the assessment period, including many with higher transmissibility and immune evasion functions. Highest number of mutations per spike protein also rose from 5 (first wave) to 13 (second wave). Conclusion: The study identified mutation-rich and no mutation regions in the spike protein. The conserved spike regions can be useful for designing future diagnostics, vaccines and therapeutics.

Competitiveness of Indian Agricultural Exports: A Constant Market Share Analysis

The 1991 Indian reforms aimed at economic liberalization, as a part of its economic structural adjustment, and transformed the nation’s economy into a more global market-based and service-oriented system, which revolutionized its agricultural trade facet. The new regime paved the way for self-reliant Indian agriculture to expand its roots into the spheres of global competitiveness and export orientation. India enjoys a competitive advantage in the international market and considering the growth in India’s exports of major agricultural commodities. This study employed the Constant Market Share model to analyze the export performance of its various facets such as diversification, instability, elasticity, competitiveness, etc. The findings revealed that India’s growth performance of major agricultural commodities’ exports both in terms of quantity and value was found satisfactory (except wheat and cashew nuts, shelled (quantity)) during 1991-2020. During the recent past decade, i.e., 2011-2020, World Demand Effect (WDE) is the main source of India’s agricultural export performance (due to the general rise/fall in world demand given a constant market share of India, unlike Market Distribution Effect (MDE), Commodity Composition Effect (CCE) and the Residual Competitiveness Effect (RCE) due to high inconsistency arising out of changes in the external environment). Both MDE and RCE with respect to commodity-wise exports and CCE and RCE with respect to country-wise exports are found negative for the majority of commodities and countries (markets) respectively. Consistently negative CCE for exports of agricultural products, total and across major export destinations were found more disheartening and this should deserve special attention. So, it is imperative to boost the export competitiveness of agricultural commodities from India and the future prospects of exports depend on how much the latest surge in COVID-19 infections in India affects its agricultural production and global demand conditions.

Indian study on probability attributed to COVID-19 coronavirus infection using machine learning algorithm

As a result of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) outbreak, the present COVID-19 public health crisis has resulted in the loss of human life as well as significant economic disruptions. Using a machine-learning algorithm, we can determine if a patient is more likely to survive than die, or the other way around, for a particular case. We use previous data, such as medical records, demographics, and information specific to the COVID-19, to fine-tune this algorithm. Data on confirmed and probable COVID-19 infections in India, which the Indian Government has collated and made publicly accessible, is used in this report. We show that the suggested technique can predict high-risk patients with high accuracy in each of the four indicated clinical phases, hence enhancing hospital capacity planning and prompt treatment. Our approach may be expanded to produce optimum estimations for hypothesis-testing procedures that are extensively used in biological and medical statistics. With the present epidemic, we hope that the information we've gathered may help doctors make better, more timely decisions about patient treatment.

A cross-sectional study of COVID-19 outbreak in Indian population

BackgroundPresently India is the second most populous country in the world with an estimated population of 1.4 billion people and has recently been affected by COVID-19 pandemic and subsequent mutant viral outbreak. To date, India has administered its population with over 1.30 billion cumulative doses of COVID-19 vaccine. The consequences of COVID-19 vaccination on the outbreak in India has not been reported until now. Therefore, we probed to assess the impact of COVID-19 outbreak in India from December 2019 to December 2021. MethodsIndian COVID-19 related data were extracted from “ourworldindata.org” and “cowin.gov.in” databases. The incidence rate of COVID-19 per million people was calculated and other parameters such as new cases, positive rate, reproduction rate, new death and stringency index values were extracted from the database for statistical analysis. ResultsData indicate that the COVID-19 positive rate declined as the number of vaccinations rose over time. The Pearson correlation values between new cases and the cumulative percentage of vaccination or the percentage of fully vaccinated population showed no correlation (P < 0.01). COVID-19 vaccination has significantly decreased the R-value and positive rate of SARS-CoV-2 in India (P < 0.01). Furthermore, containment measures showed no correlation with the incidence rate of SARS-CoV-2 in India which may be in contradictory to the global trends. ConclusionVaccination against COVID-19 was efficacious in the control of the SARS-CoV-2 outbreak and the decrease in the positive rate. Further, the containment measures had no effect on the spread of COVID-19 infection in India, thus far.

A discrete-time epidemic model for the analysis of transmission of COVID19 based upon data of epidemiological parameters.

The forecasting of the nature and dynamics of emerging coronavirus (COVID-19) pandemic has gained a great concern for health care organizations and governments. The efforts aim to to suppress the rapid and global spread of its tentacles and also control the infection with the limited available resources. The aim of this work is to employ real data set to propose and analyze a compartmental discrete time COVID-19 pandemic model with non-linear incidence and hence predict and control its outbreak through dynamical research. The Basic Reproduction Number (R_{0}) is calculated analytically to study the disease-free steady state ( R_{0}<1), and also the permanency case (R_{0}>1) of the disease. Numerical results show that the transmission rates alpha left( >0right) and beta left( >0right) are quite effective in reducing the COVID-19 infections in India or any country. The fitting and predictive capability of the proposed discrete-time system are presented for relishing the effect of disease through stability analysis using real data sets.

COVID-19 vaccine inequity, dependency, and production capability in low-income and middle-income countries: the case of Bangladesh

COVID-19 vaccine inequity, dependency, and production capability in low-income and middle-income countries: the case of Bangladesh

Seroprevalence of COVID-19 antibody among children aged 5-17 years in an urban and rural area of Ernakulam District, Kerala.

The age group of 5-17 years belongs to the vulnerable segment of the population for COVID-19 infection in India. Seroprevalence in this population can therefore allow inferences to be made about the extent of infection. The objective of this study was to assess the seroprevalence and to determine the factors associated with COVID-19 antibody among children aged 5-17 years in an urban and rural area of Kochi, Kerala. A community-based cross-sectional study was undertaken in the urban and rural field practice areas of the community medicine department in a medical college, Kochi. A semi-structured questionnaire was used to collect information about sociodemographic data, history related to COVID-19, and the severe acute respiratory syndrome coronavirus 2 antibody test result. Blood samples were collected and tested for the presence of COVID-19 antibodies using the Wantai test kit after attaining informed assent from the parent/guardian. The seroprevalence of the COVID-19 antibody was 48.3% among participants. The seroprevalence of COVID-19 antibody was higher among children of mothers with skilled/unskilled occupation, residents of rural area, above poverty line category, those with a history of COVID-19, and those who had a history of contact with COVID-19-positive patients. Half of the study population were COVID antibody positive, and the rest were at risk of infection. Therefore, adherence to COVID-19 guidelines is essential to control further spread of infection among children.