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COVID-19 Epidemic Study II: Phased Emergence From the Lockdown in Mumbai

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 Added by Sandeep Juneja
 Publication date 2020
and research's language is English




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The nation-wide lockdown starting 25 March 2020, aimed at suppressing the spread of the COVID-19 disease, was extended until 31 May 2020 in three subsequent orders by the Government of India. The extended lockdown has had significant social and economic consequences and `lockdown fatigue has likely set in. Phased reopening began from 01 June 2020 onwards. Mumbai, one of the most crowded cities in the world, has witnessed both the largest number of cases and deaths among all the cities in India (41986 positive cases and 1368 deaths as of 02 June 2020). Many tough decisions are going to be made on re-opening in the next few days. In an earlier IISc-TIFR Report, we presented an agent-based city-scale simulator(ABCS) to model the progression and spread of the infection in large metropolises like Mumbai and Bengaluru. As discussed in IISc-TIFR Report 1, ABCS is a useful tool to model interactions of city residents at an individual level and to capture the impact of non-pharmaceutical interventions on the infection spread. In this report we focus on Mumbai. Using our simulator, we consider some plausible scenarios for phased emergence of Mumbai from the lockdown, 01 June 2020 onwards. These include phased and gradual opening of the industry, partial opening of public transportation (modelling of infection spread in suburban trains), impact of containment zones on controlling infections, and the role of compliance with respect to various intervention measures including use of masks, case isolation, home quarantine, etc. The main takeaway of our simulation results is that a phased opening of workplaces, say at a conservative attendance level of 20 to 33%, is a good way to restart economic activity while ensuring that the citys medical care capacity remains adequate to handle the possible rise in the number of COVID-19 patients in June and July.



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We highlight the usefulness of city-scale agent-based simulators in studying various non-pharmaceutical interventions to manage an evolving pandemic. We ground our studies in the context of the COVID-19 pandemic and demonstrate the power of the simulator via several exploratory case studies in two metropolises, Bengaluru and Mumbai. Such tools become common-place in any city administrations tool kit in our march towards digital health.
India has been hit by a huge second wave of Covid-19 that started in mid-February 2021. Mumbai was amongst the first cities to see the increase. In this report, we use our agent based simulator to computationally study the second wave in Mumbai. We build upon our earlier analysis, where projections were made from November 2020 onwards. We use our simulator to conduct an extensive scenario analysis - we play out many plausible scenarios through varying economic activity, reinfection levels, population compliance, infectiveness, prevalence and lethality of the possible variant strains, and infection spread via local trains to arrive at those that may better explain the second wave fatality numbers. We observe and highlight that timings of peak and valley of the fatalities in the second wave are robust to many plausible scenarios, suggesting that they are likely to be accurate projections for Mumbai. During the second wave, the observed fatalities were low in February and mid-March and saw a phase change or a steep increase in the growth rate after around late March. We conduct extensive experiments to replicate this observed sharp convexity. This is not an easy phenomena to replicate, and we find that explanations such as increased laxity in the population, increased reinfections, increased intensity of infections in Mumbai transportation, increased lethality in the virus, or a combination amongst them, generally do a poor job of matching this pattern. We find that the most likely explanation is presence of small amount of extremely infective variant on February 1 that grows rapidly thereafter and becomes a dominant strain by Mid-March. From a prescriptive view, this points to an urgent need for extensive and continuous genome sequencing to establish existence and prevalence of different virus strains in Mumbai and in India, as they evolve over time.
76 - Luca DellAnna 2020
We study a simple realistic model for describing the diffusion of an infectious disease on a population of individuals. The dynamics is governed by a single functional delay differential equation, which, in the case of a large population, can be solved exactly, even in the presence of a time-dependent infection rate. This delay model has a higher degree of accuracy than that of the so-called SIR model, commonly used in epidemiology, which, instead, is formulated in terms of ordinary differential equations. We apply this model to describe the outbreak of the new infectious disease, Covid-19, in Italy, taking into account the containment measures implemented by the government in order to mitigate the spreading of the virus and the social costs for the population.
Epidemics generally spread through a succession of waves that reflect factors on multiple timescales. On short timescales, super-spreading events lead to burstiness and overdispersion, while long-term persistent heterogeneity in susceptibility is expected to lead to a reduction in the infection peak and the herd immunity threshold (HIT). Here, we develop a general approach to encompass both timescales, including time variations in individual social activity, and demonstrate how to incorporate them phenomenologically into a wide class of epidemiological models through parameterization. We derive a non-linear dependence of the effective reproduction number Re on the susceptible population fraction S. We show that a state of transient collective immunity (TCI) emerges well below the HIT during early, high-paced stages of the epidemic. However, this is a fragile state that wanes over time due to changing levels of social activity, and so the infection peak is not an indication of herd immunity: subsequent waves can and will emerge due to behavioral changes in the population, driven (e.g.) by seasonal factors. Transient and long-term levels of heterogeneity are estimated by using empirical data from the COVID-19 epidemic as well as from real-life face-to-face contact networks. These results suggest that the hardest-hit areas, such as NYC, have achieved TCI following the first wave of the epidemic, but likely remain below the long-term HIT. Thus, in contrast to some previous claims, these regions can still experience subsequent waves.
Background: Wuhan, China was the epicenter of COVID-19 pandemic. The goal of current study is to understand the infection transmission dynamics before intervention measures were taken. Methods: Data and key events were searched through pubmed and internet. Epidemiological data were calculated using data extracted from a variety of data sources. Results: We established a timeline showing by January 1, 2020, Chinese authorities had been presented convincing evidence of human-to-human transmission; however, it was not until January 20, 2020 that this information was shared with the public. Our study estimated that there would have been 10989 total infected cases if interventions were taken on January 2, 2020, versus 239875 cases when lockdown was put in place on January 23, 2020. Conclusions: Chinas withholding of key information about the 2020 COVID-19 outbreak and its delayed response ultimately led to the largest public health crisis of this century and could have been avoided with earlier countermeasures.
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