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Research Last Updated: Jan 2, 2021 - 12:10:45 PM


2021 Will Mark End of Covid-19 Pandemic
By Dr. Nasrullah Khan, Comsats, 1/1/21
Jan 1, 2021 - 11:07:18 AM

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High level of care, vaccinations and awareness will evaporate Covid-19 Pandemic in 2021. EU, UK and USA are the most Covid-19 affected countries yet fighting back on the frontiers of medical sciences.

Covid-19 cases, hospitalizations and deaths surged worldwide at end of 2020. Covid-19 cases peaked in USA at 255,809 on 18 December 2020. Covid-19 cases peaked in UK at 55,892 on 31 December 2020. Covid-19 cases and deaths surged in India in Middle of September 2020 and in Brazil in last week of July 2020. Cases may rise and fall in various countries the year 2021 will mark decline of Covid-19 due to care and vaccination facilities.

President-elect Joe Biden is constituting a task force to brainstorm how to find viable solution to reverse regenerative waves of coronavirus by preventive measures, vaccinations and precautions. He also intends to rejoin WHO, Paris Accord and energy transition initiatives. President Donald Trump was moving in opposite direction, at least Biden has taken first step in right direction on a long road ahead. Chaos will fizzle out into order after end of lame duck period.

World community and USA are facing third wave of covid-19 pandemic. India reported 97,859 cases on 16 September 2020 and USA reported 255,809 cases on 18 December 2020. More than 200,000 daily cases and 1000 deaths are alarming numbers. Ratio of peak covid-19 cases and deaths in first and second waves are rising in Iran and falling in Pakistan as well as in New Zealand.

Global community with 84 million covid-19 cases and more than one and half million deaths is facing second wave of covid-19 pandemic wave. Brazil with 7.6 million cases and 195 thousand deaths and India with 10 million cases and 149 thousand deaths are recovering from first wave. Russia with 3.1 million cases and 57 thousand deaths, France with 2.6 million cases and 64 thousand deaths and Spain with 1.9 million cases and 50 thousand deaths are facing second wave.  Iran with 1 million cases and 55 thousand deaths and USA with 24 million cases and 354 thousand deaths are in third wave.

A number of countries are facing risks of second and third waves after end of first wave. First wave has started subsiding in Brazil and India. UK, Spain and France are facing second wave, several countries like USA and Iran are facing third wave. Global covid-19 cases exceed 84 million, recoveries 59 million and deaths 1.8 million at end of December 2020.

Coronavirus affected countries may be classified into four categories. Category 1 includes those countries where first wave of covid-19 pandemic is declining like Brazil and India. Category 2 includes those countries where second wave remained negligible like New Zealand and Pakistan. Category 3 includes those countries where second wave affected more people than the first wave like France, Spain and UK. Category 4 includes those countries which are facing third wave. Second wave affected more people than first wave and third wave affected more people than second wave like Iran, Russia and Israel.

Ratios of peak coviid-19 cases and deaths in first and second waves are 5.84 and 4.0 in New Zealand, and 8.06 and 8.05 in Pakistan, which mean cases and deaths in second waves many times lesser than first wave. Ratios of peak coviid-19 cases in second and first waves are 1.93, 3.39 and 6.86 in Spain, UK and France; and ratio of peak covid-19 deaths in first and second waves are 3.68, 4.84 and 4.82 in Spain, UK and France, which mean covid-19 cases are higher in second wave yet death rate was higher in first wave. Russia and Israel are two countries ratios of peak covid-19 cases in second and first wave are 1.49 and 14.79 and ratios of peak deaths in second and first waves are 1.37 and 5.61 respectively, which means cases and deaths in second wave are higher than the first wave. Global pattern is higher cases in third wave compared to first (5.6) and second waves (1.72). However, peak ratios of deaths in first and second waves is 2.2) and second and third wave is 1.03. However, ratios of covid-19 cases for first and third waves in USA is 2.23 and ratio of third and second wave is 1.03. In USA, ratio of peaks of deaths in first and third wave is 0.3.

Air, water and food systems mediate covod-19 transmissions. Schools, mosques, churches, temples, shrines, shopping malls, gas stations, bars, gatherings, hugging, restaurants, parks, buses, trains and airlines play key role in local and global spread of Covid-19 Pandemic.

Sequence of covid-19 symptoms is fever, cough, muscle pain, nausea/vomiting and diarrhea. Talks, coughs and sneezes cause translocal infections, buses and trains mediate transnational transmissions, ships and airlines conduct transcontinental spread of Covid-19 Pandemic.

Public display of affection, social cultures and group activities have spread the coronavirus worldwide. Kiss culture in western countries, hugging culture in Arab countries, hand shaking culture in Islamic countries and social activities in India have exacerbated covid-19 transmissions. 

Covid-19 cases used to be 50,000 to 70,000 per day from 7-July to 15-August 2020 after which new cases started declining in USA. New daily cases used to be more than 50,000 from 24-July to 13-August 2020 after which started declining in Brazil. Covid-19 cases in India have been rising in India since discovery of patient zero in January 2020.

USA, India, Brazil, Russia, Europe and China are the most Covid-19 hit countries. Total covid-19 deaths are highest in USA, Brazil, India, Mexico, UK, Italy and France but per million deaths are highest in San Marino, Belgium, Peru, Andorra, Spain, Brazil and Chile as shown in Table 1.

 

 

Population

Total tests

Total cases

Total deaths

Tests/Million

Cases/Million

Deaths/Million

New cases

New deaths

Active cases

Critical cases

China

China

USA

USA

F/Islands

Andorra

S/Marino

USA

USA

USA

USA

India

USA

India

Brazil

Gibraltar

Bahrain

Belgium

France

India

France

India

USA

India

Brazil

India

Andorra

Qatar

Peru

India

Mexico

Italy

Brazil

Indonesia

Russia

Russia

Mexico

Luxemburg

Aruba

Andorra

Italy

Italy

India

Iran

Pakistan

UK

France

UK

Bermuda

Belgium

Spain

Poland

Iran

Belgium

Argentina

Brazil

Germany

Spain

Italy

UAE

Czech

Brazil

UK

UK

Brazil

France

Nigeria

Brazil

Argentina

France

Monaco

Luxemburg

Chile

Brazil

Russia

Russia

Spain

 

Covid-19 death rates have been reported 2% in India, 4% in Brazil and 5% in United States. Death rates are high in some countries and lower in others with global average of 3%. Death rates in India are same as Pakistan, yet covid-19 transmission rate is higher in India.


India had become covid-19 hot spot on global map. SAARC countries fearing from second wave from India through air, water, food or animals. Indian leaders have nothing in mind how to stop explosive expansion of covid-19 in 1.37 billion people.

India must pay attention to expansion of covid-19 pandemic instead of expending time and money on foul games against minorities. Prime Minister Modi has granted domiciles to more than 1.2 million Hindus to alter population proportions in Kashmir valley. This is time to fear from curse of nature.

Air, water and objects mediate covid-19 transmission. Social setups, embracing cultures and physical interactions expedite infectious diseases. Social freedom and kiss cultures played key role in exploding covid-19 cases in western countries.

Survey of views on rapid rise and fast fall of Covid-19 outbreak in Pakistan. How Covid-19 curve flattened in Pakistan, and not in other nearby countries having similar weather conditions. Data shows start and end of pandemic depends upon culture and social structure. In Pakistan, rising public laxity on standard operating procedures haunts coming of second wave.

Covid-19 infection and death rates started rising in Pakistan after second week of April, peaked in third week of June, and started declining in first week of August 2020. Maximum 6,822 cases were reported on 14 June and maximum 153 deaths on 20 June 2020 [Ashfaq 2020].

There are several theories on rapid rise and faster decline of covid-19 in Pakistan. Government agencies attribute to testing, contact tracing and smart lockdown strategies, spiritual scholars to periodic ablution for prayer, medical experts to malaria or tuberculosis vaccination programs, and environmentalist to heat and humidity. Media refers it to be miracle beyond science.

Mathematical modelers, simulation experts, epidemiologists and government spokespersons predicted 1.5 to 10 million cases by end of July 2020 which actually never exceed 0.2 million by the end of August 2020 [Ayaz 2020]. Security agencies have played a key role in contact tracing to isolate and quarantine covid-19 victims. Public has given good response by observing SOPs.

It is human nature to attribute unknown to supernatural powers. Heat and humidity, physical distancing and enforcement of smart lockdowns could be the reasons behind earlier end of covid-19 pandemic. India and Pakistan have similar weathers yet covid-19 cases in India are far more than Pakistan. The central reason may be contact tracing and isolation strategy.

Government of Pakistan imposed first lockdown at province levels, then smart lockdown at city levels and later micro lockdown at street levels to contain infected people. As on 27 August 2020, total covid-19 cases were 293,711, recoveries 278,425 and deaths 6,255. Pakistan conducted 2,487,744 tests at rate of 11,230 per million populations.

Global statistics shows most countries had one surge of covid-19 disease and several second surge too.  The first wave of covid-19 cases peaked in second week of April globally and second wave in second week of August 2020. First wave of covid-19 deaths peaked in third week of April and second wave in second week of August 2020. Second wave started in Spain and Australia weeks after they had assumed virtual end of coronavirus pandemic.

USA, Brazil and India have total 5,955,728, 3,674,176 and 3,231,754 cases which are still increasing at rate 40,000 to 70,000 cases per day. First waves of vovid-19 in America and Brazil peaked in second week of April and second waves in fourth week of June 2020. First wave of covid-19 in India was on steady rise since many months. Environmental conditions like humidity, monsoon rains, winds and temperatures are alike yet how covid-19 cases are rising in India and falling in Pakistan?

India conducted 1,055, 027 tests on 30 August 2020 and found 79,457 new covid-19 cases. This shows positive test rate of 7.53%. Pakistan conducted 77,714 tests on 30 August and found 264 positive cases that refers to positive test rate of 0.34%. Possibility of testing covid-19 positive is 22 times more in India than Pakistan although death rate 2% in both countries.

India recorded maximum 79,457 new cases on 30 August and maximum deaths 2,006 deaths on 16 June 2020. Pakistan recorded maximum 6,825 new cases on 14 June and maximum 153 deaths on 20 June 2020. Indian data is inconsistent with average 7-days delay between maximum cases and maximum deaths. Period between maximum deaths and cases is 74 days.

United States of America recorded maximum 78,586 new cases on 24 July and maximum 2,748 deaths on 21 April 2020. This data is also inconsistent as maximum deaths should follow maximum new cases. Brazil recorded maximum 70,869 new cases and maximum 1,554 new daily deaths on 29 July 2020 as it happened in UK.  Ideally peak of new cases should lead peak of deaths by 7 to 14 days.

India has conducted many tests, yet her per million tests are much lesser than other similar covid-19 affected countries. Indian covid-19 testing rate was 31, 342 per million populations on 1 September that was much lower than USA (251,558), Russia (252,834), UK (239,497) and Israel (252,656). China and India conducted total 90,410,000 and 43,324,834 tests to detect covid-19 among their people.

India conducted 47 to 48% lesser tests compared to China, although, both countries have almost similar populations. Indian economic development rate has gone negative and Chinese growth rate is still positive. China is launching new products like solar air conditioners, market competitive solar panels and rooftop wind turbines and Indian IT experts face visa denials in USA that affects her overseas remittances that used to be her major source of foreign exchange. Pakistan’s stock exchange rise was on third position on 3 September 2020. Indian economy is world’s most affected covid-19 economy.

How did Pakistan flatten the curve despite limited resources? Is it a miracle or magic? A study conducted by Agha Khan University and World Health Organization claims that 11% people have developed immunity against covid-19, and the rest 89% are at risk. Urban residents, smokers and person aging 20 to 40 years old are more susceptible to covid-19 contagion.

Global studies show normally 11 to 20% people are exposed to coronavirus. Pakistan stayed on lower edge of global probability statistical analysis. Medical scientists in Pakistan say the key to success was lockdowns, testing, contact tracing. There is global consensus that virus spread may be contained by the behavioral changes like social and physical distancing, quarantine programs, face coverings and hand washing. Media and mobiles played vital role in creating awareness [Niha 2020].

Pakistan deployed over 10,000 contract workers and more than 3,000 contact tracing teams coupled with smart and micro lockdowns in high risk areas and hotspots. Security agencies, tiger force and volunteers played important role in handling the covid-19 cases. Public cooperated by observing standard operating procedures (SOPs) in mosques, markets and offices. Total cases and death toll forecasts were high, but government strategies worked well. Second wave has also been controlled.

One reason may be the social circles are not expansive here as those in India and West, as ordinary citizens stay within bounds of their neighborhood. High humidity and temperatures seem to have played some role in containing coronavirus. Indian test rate was higher yet social stigma and fear of arrest forced prevented public from being tested. Pakistan has lower cases yet morality rate is higher than India that rejects the theory that people of Pakistan have stronger immune system.

Coronavirus has more than eight strains and more than 75,000 gemone sequences globally. A change in DG41G mutation was first noted in February that is the major strain in Europe and America. WHO has been searching how changes in viruses behave differently. HSA rejects theory of having herd immunity in Pakistan as 70% people should have developed antibodies through exposure or vaccination to achieve that level that is not true in the case of Pakistan. It is also a puzzle how long the immunity protects a general guess is a bit more than three months.

According to data of Islamabad some 15514 covid-19 cases were recorded by third week of August 2020, out of which 1-10 years were 1475 cases, 11-20 years 1177 cases, 21-31 years 3209 cases, 31-45 years 4762 cases, 46-60 years 3014 cases, 61-80 years 1403 cases and beyond 80 years were only 111. Most affected age group was 31 to 45 years.

Seroprevalence study suggests to refrain from opening schools and colleges yet government is adamant to open in middle of September 2020. Private school operators have nothing to do with health of children as their focus are fees. Start of education institutions in September is last fear of second wave. The Punjab government has already warned of second wave in case of defiance to SOPs at public places [DNA 2020].

Covid-19 cases have substantially declined in Pakistan, yet coronavirus is lurking around. Government has closed 28 restaurants in Naran, Kaghan and Sugran valleys flooded with visitors due to sultry summer. Smart lockdown enforced on tourist places after 47 workers tested positive in fourth week of August 2020. Real strength of coronavirus is its rapid spreading through aerosols in air.

A recent study claims physical isolation of 6 feet might not be enough as aerosol borne viruses may roam inside high occupancy poorly ventilated places even during short contact time. Face mask wearing and shouting people in even low occupancy places are on high risk of contracting virus. Shouting people may contract virus in low occupancy outdoors during long time exposures. People with no face mask are on risk during long exposures even if they keep silent [Nicholas 2020]. However, CDC advises no need for test if exposure time is less than 15 minute at more than 6 feet distance.

Covid-19 has mobilized three key trends in global economy. These trends include multifaceted productivities, industrial digitalization and over protectionism. According to expert opinions the economy may recover in L (14%), V (18%), U (24%) and W (44%) shapes [Mahesh 2020]. Consumer will go for online shopping and universities will adhere to online education. Working from home, video conferencing and virtual gatherings will be new normal.

Pakistan is planning to open all sectors including education in September 2020 that is a milestone beyond which fear of second wave haunts analysts. At the moment government has closed all covid-19 centers in cities and most hospitals have ended covid-19 emergency testing wards. Deep throat analysts our testing rate or mechanism may have set high threshold to declare covid-19 cases. Whatsoever, the covid-19 cases have rapidly declined in Pakistan.

It is time to share local and global experiences to combat the viral attack again human race.


References

Ashfaq A, COVID: 19:Pakistan fears rapid spread of coronavirus pandemic during Ramadan, Gulf News, 26 June 2020. https://gulfnews.com/world/asia/pakistan/covid-19pakistan-fears-rapid-spread-of-coronavirus-pandemic-during-ramadan-1.71184081
Ayaz G, Pakistan Says Its COVID-19 Cases Could Rise to 1.2 Million by End of July, VOA, 14 June 2020. https://www.voanews.com/covid-19-pandemic/pakistan-says-its-covid-19-cases-could-rise-12-million-end-july

Niha D, How Did Pakistan Flatten the Coronavirus Curve? The Diplomat, 24 August 2020. https://thediplomat.com/2020/08/how-did-pakistan-flatten-the-coronavirus-curve/
DNA, Punjab health dept warns of second coronavirus wave, Tribune, 15 August 2020. https://tribune.com.pk/story/2259676/punjab-health-dept-warns-of-second-coronavirus-wave
Nicholas RJ, Zeshan UQ, Robert JT, Jessica PJL, Trisha G, Lydia B, Two metres or one: what is the evidence for physical distancing in covid-19? BMJ 2020;370:m3223 | doi: 10.1136/bmj.m3223

Mahesh N, 3 key investment trends for a post-COVID world, Refinitiv, 20 August 2020. https://www.refinitiv.com/perspectives/future-of-investing-trading/3-key-investment-trends-for-a-post-covid-world/


Source:Ocnus.net 2021

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