Corona Daily 424: Honda Hit by a Virus

On Monday, 8 June, Honda admitted their control systems had been attacked. The company was unable to access its own servers or use emails. Production and shipments, already hit hard by the lockdown, stopped. Honda employees worldwide were asked to go home.

Honda, the Japanese company, is the world’s leading motorcycle maker for the past sixty years. Always in the top ten carmakers’ list, its turnover is $150 billion. It is an excellent target for cyber crime.

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Experts believe Honda has been attacked by the Ekans ransomware. (Read Ekans backward to understand its toxicity). First observed in December 2019, it encrypts data and leaves a ransom note. Industrial control systems usually shut down as a result of the attack.

Imagine on returning home, you find someone has locked it. You can’t get inside. A note left at the doorstep asks you to pay money in order to get the key to re-enter your house.

To put pressure on the victim, the cyber criminals can auction some of the stolen data online. In such auctions confidential cash flow analyses, company’s future plans, distributor lists, vendor agreements and images of employees’ driving licenses have been sold. If our bank or our government’s tax department were to be hacked, we may find our most intimate financial details sold to criminal gangs.

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Is this related to the pandemic? It probably is.

Work From Home (WFH) is an absolute nightmare for IT managers. Any individual employee can be lured to download a link he shouldn’t. Since the beginning of the pandemic, thousands of Covid-links, ‘helping the poor’ sites and dashboards have been used by cyber criminals. Johns Hopkins University had to issue a public statement on malware disguised as a Covid-19 map. Unfortunately a few thousand non-suspecting people had already downloaded the impostor map.

Several poly-criminal, multinational gangs now give priority to cyber-crime. When wildlife trafficking stopped in March and April, some organized crime groups switched over to cyber-crime.

Because they operate in cyberspace, it is difficult to catch the operators. Like Al-Qaeda in the real world, these operators are often known by the ransomware they promote. DoppelPaymer and Maze are large organizations that deploy and facilitate the payment of ransomware. They are happy to take payment in virtual currencies like bitcoin, making it even more difficult to trace them. On 18 March, in a press release, Maze promised to stop attacking health organizations (but not pharma companies, because they are for profit). Most cyber criminals have said if they accidentally target hospitals, nursing homes, or health agencies, the victim should contact them (contact details are given anyway to enable ransom payment).  They will decrypt for free.

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Times are such that we need to protect both ourselves and our gadgets from viruses. Your devices must have strong anti-malware protection. It is best to avoid downloading anything non-essential. You may think of it as internet social distancing if you like. If you are working from home, your employer’s safety is in your hands.

However, if you own a Honda vehicle, your contact details may already be in the hands of a cyber-gang.

Ravi

Corona Daily 426: Brazilian Miracle

Brazil, at 212 million, is the world’s sixth most populous country. Its coronavirus infections and deaths are second only to the USA. Testing is abysmally low. The University of Sao Paolo and other researchers have published studies suggesting the real cases are 16 times the reported cases. Cities like Amazonas with lack of health care are burying five coffins at a time in mass graves. Hospitals around the country are shattered and in a mess. Since the beginning of June, daily deaths have exceeded 1000. But soon, starting today, all this is going to change. It’s possible in a few weeks; Brazil will be virus-free. The credit for the transformation must go to Jair Bolsonaro, its president.

*****

For those who don’t know him, he is best described as Brazil’s Donald Trump, but worse. (Yes, such a thing is possible). He is an ex-military man. Since the beginning of the pandemic, he has called Covid-19 a “little flu”. It’s a media trick, global mass hysteria. Jobs and the economy are more important, and as Brazil’s president he opposes any lockdowns. When asked about the high mortality, he said death is everybody’s destiny. Some will die because such is life. However, God is Brazilian, the cure is right here.

Just like the USA, Brazil has a federal structure. Governors and mayors have the authority to take certain steps for their states. But as president of the nation, Bolsonaro has been opposing lockdown policies, arranging rallies of his own and shaking hands, encouraging his supporters to oppose closing factories, tweeting to say Brazil should remain open.

Luiz Mandetta was Brazil’s sensible health minister, believing in science, health experts and data. He advocated lockdowns, social isolation, testing, tracing. Bolsonaro sacked him on 16 April. Nelson Teich, the new health minister, was expected to be loyal to the president. Despite his objections, Bolsonaro was publicly marketing Chloroquine, a malarial drug, for Covid-19. Behind Teich’s back, Bolsonaro signed a presidential decree opening all gyms, beauty salons and barbers across Brazil. The decree termed them as essential services. On 15 May, Teich resigned. Every health minister gets sick of Bolsonaro’s company. Now the president has filled the ministry with army generals, with no health minister appointed yet.

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Bolsonaro doesn’t like cumulative numbers. Because no matter what, they always go up.

The Brazilian miracle began last week. In a daily bulletin on TV at 7 pm, the health ministry updates Brazilians on the coronavirus situation. The bulletin includes total infections and deaths, new infections and deaths and other relevant data. On Wed. 3 June, the ministry postponed the bulletin from 7 pm to 10 pm. We can get better data by 10 pm, it said. On Friday, 5 June, the ministry’s official website was cleaned up. All past data regarding infections and deaths was wiped out. Bolsonaro tweeted that in future new adapted data would be presented. The cumulative data will not be shown any more, because it doesn’t portray today’s situation.

On Saturday, 6 June, the Johns Hopkins dashboard removed Brazil, but reinstated it on Sunday, until further clarity is obtained.

Please don’t be surprised if in a few days you hear the news of Brazil becoming free of coronavirus. No numbers, no problems.

Ravi

Corona Daily 427: Novel Life of an Air hostess

A friends’ elderly parents are trapped in Mumbai, while their son lives in New York. They usually stay with him, but happened to be in Mumbai during the lockdown.

Another friend, M., is an air-hostess with Air India. AI flies a Mumbai-Newark non-stop 16 hour service. The 93-year old man, and his 85-year wife, would like to take that flight when an opportunity presents itself. I wanted to know how well they would be taken care of on the flight. I called M. to check.

*****

M answered.

“Are you home or abroad?” That’s the first question I always ask M.

“I am in Mumbai.”

“Great. A. must be happy to see you.” A. is M’s school-going son.

“Haven’t met him yet. I am in Mumbai, but not at home.”

“Oh, on the way from the airport?”

“No, in a hotel. Haven’t got my results yet.”

“What results?”

“On arrival, they take our swab test. Then we are sent to a hotel, where we wait for the results. If it’s negative, we can go home. Takes at least 48 hours. I should get it tomorrow.”

“You will go home tomorrow then.”

“It depends. We also have to do a test before departure. Until that result comes through we can’t fly out. I may have another flight soon. Without going home I can use the arrival test and fly out.”

“Looks strict.”

“Yes, you know what happened to the Moscow flight, don’t you?”

Yes, I knew. On Saturday, 30 May, when flying the AI plane to Moscow, its pilot received a message saying his test result was positive. The plane was above Uzbekistan. He immediately turned around and brought the plane back to Delhi. A human error, somebody had read his result as negative.

*****

I explained to M the situation with the 93/85 couple. They will have a business class, maybe a first class ticket. They will be taken good care of, won’t they, I asked M.

“The class doesn’t make any difference. We are not allowed to service any passengers.” M explained. “We don’t go anywhere close to them. The passengers must have Arogya setu (India’s contact tracing app) on the smartphone. Without that they can’t travel. On the 16-hour flight, meals in boxes and drink bottles will be kept on their seats in advance. Also gloves, mask and a sanitiser. They must wear the mask and gloves.”

I imagined the Indian air-hostesses in sarees wearing masks and gloves. Do you also wear them, I asked M.

“Oh, we wear everything. We wear Hazmat suits, masks, face shields and gloves. Wearing all of it, we just sit quietly through the flight. What a nightmare. Hot, humid and suffocating. And you can’t imagine the acrobatics when we go to the loo. Some pursers have started wearing diapers. On arrival, the Hazmat suits are disposed off.” M said the suits had a price tag of Rs 3000 ($40) printed on them.

“With so much protection, why do they need to test you on arrival?” I asked.

“Protection is not guaranteed. Some pilots and air-hostesses tested positive. In Mumbai, they are then sent to the Raheja hospital. They stay there until they test negative.”

“M, you are like frontline soldiers. Are they compensating you for that?” I asked.

“Well, we continue to get our salaries.” M said with pride in her voice.

*****

Ravi

Corona Daily 428: Patient 91 in Vietnam

The Vietnam government publishes information about each Coronavirus case. For privacy reasons, patients can’t be named, only numbered. In March, for example, newspapers mentioned that patients 88, 89 and 90 were Vietnamese girls studying in Europe or the US, who had flown to Ho Chi Minh City.

Patient 91 was a 43 year old British male, living in district 2 of Ho Chi Minh City. A pilot with a Vietnamese Airline, Ho Chi Minh was his base. Between 13 and 18 March, he ate and drank at different bars and restaurants. The well known Buddha bar and grill is close to his house. On 14 March, he attended a party there. On 16 March, he piloted VN 272 to Hanoi and VN 607 back on the same day.

On 17 March, he felt feverish, tired, and started coughing. On 18 March, he was admitted to the hospital of Tropical Diseases. His X-ray showed damage to the right lung tissue. As per procedure two swab samples were taken. Results of all tests were positive. Immediately local authorities locked down Ascent apartment, where he lived with 764 residents, including 158 foreigners.

On 8 April, the British pilot began to deteriorate. Vietnam’s Ministry of Health appointed its best experts to look after the case. The government sought a rare coagulation (blood clotting) drug from abroad. By mid-April, patient 91 went into coma. He was put under ECMO (extracorporeal membrane oxygenation) intervention, actively resuscitated with mechanical ventilation, put on antibody-filtered dialysis and given antibiotics and anti-fungal drugs.  

On 15 May, Nguyen Van Vinh Chau, the hospital director said the pilot’s lungs were seriously damaged and a transplant was essential. Vietnam mounted an all-out effort. More than 50 people offered to be lung donors. Patient 91’s parents are not alive. The Vietnamese hunted down his closest relatives in the UK to get permission for a lung transplant.

Then doctors discovered patient 91 suffered from cytokine storm syndrome, where the immune system overreacts to the virus and releases too many cytokines (proteins released by white blood cells), damaging the organs. The doctors kept treating each condition. In total, Vietnam spent $215,000 treating patient 91.

On 27 May, he awoke from coma. He had been on life support for two months. When checked, his lungs were working 20-30% as compared to the earlier 10%. Drinking sugar water, his limb strength began improving. His latest Corona tests were negative. Soon he was off dialysis.

On 3 June, he was disconnected from the ECMO machine, after 57 days. He cried when he saw the nurses and doctors around him. On 5 June, the doctors declared he was safe and on his way to recovery.

*****

This saga may remind you of Spielberg’s film Saving Private Ryan. Did Vietnam take this effort because the patient was British? A foreigner? Luong Ngoc Khue, the medical director was surprised at the question.

It had nothing to do with his nationality. Vietnam borders China. Since the pandemic began, it has aggressively pursued testing, tracing, isolation. It is the only large population country (97 million) with zero Corona deaths.

 ‘A corona death will be a stigma on our overall effort,’ said Luong Khue. ‘We must do absolutely everything to avoid the first death in Vietnam, and that’s all we did.’

Ravi

Corona Daily 429: Living with a Pandemic

Two months of pandemic make it easier for the world to understand the life of many gay people. Frequent HIV testing is second nature to them. Forty years since the beginning of the HIV/AIDS pandemic, no vaccine or definite cure has been found. Gay men determine the frequency of blood testing based on their sexual practices. But the days, hours, minutes before the result is a nightmare every time.

Gays are comfortable about knowing their HIV status and letting the partner know about it. In Gay language, not knowing the status means converting uncertainty into risk. Recently, immunity passports have been proposed as a way to segregate Covid-19 infected people from others. This may be done by way of a certificate on your smartphone. Straight people in Germany, UK and Brazil expressed shock at the concept, comparing it to Fascism or Nazism. But Gays supported the idea, because they are used to disclosing private health information to others.

*****  

Talk about AIDS began in the early 1980s. It was transmitted by primates, perhaps chimpanzees, to humans. The AIDS pandemic didn’t shock the world the way the current pandemic does. Primarily because initially it was stigmatized as affecting only homosexuals. This was not true. Though the rock star Freddie Mercury was gay, Arthur Ashe, the tennis champ, was not. He got HIV through blood transfusion during an operation.

AIDS resulted in a slow, subtle but permanent behavioural change. Before AIDS, a single syringe could be used for several patients. Then blood donors made sure the syringe was disposable. In India, where trust in immunity and God is more important than hygiene, customers in barber shops started demanding fresh razor blades. Worldwide, the sale of condoms skyrocketed. Earlier the condom was used mainly for contraception. Multiple partners, some of them casual, some of them paid, meant the risk of HIV transmission existed in each sexual encounter. The world became more careful, if not more moral, following AIDS. It is said that the risk of getting HIV is reduced by 85% by the use of a condom. It was a condom for that pandemic; it is a mask for this one.

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Currently some 40 million people, including 2 million children (below 15) are living with AIDS. (Many African girls are infected as a result of sexual violence). At least 34 million have died. In the 1980s/90s, there was a horrible period of 15 years of unmitigated death, with absolutely no treatment. Although some drugs are available now 800,000 people died in 2018 alone.

AIDS had given rise to xenophobia, racism and homophobia. For 22 years, 1987-2010, USA had banned entry to all non-citizens with HIV. (Though in the 1980s, USA itself had the highest number of HIV infected people).

With the Coronavirus, some Chinese Americans have been attacked, and all Chinese airlines have been banned from flying to the US.

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The HIV virus and the novel Coronavirus are different in terms of transmission and mutation. We must hope their trajectories and life expectancies are different as well. The HIV/AIDS raises an uncomfortable question. Why has mankind failed to produce a vaccine for forty years? What makes us think we will achieve it quickly for Covid-19?   

Perhaps AIDS can teach us how to coexist with a virus.  

Ravi

Corona Daily 430: Zen Enlightenment

In the mountains of Vermont, surrounded by unending acres of forest, is the Monastic Academy founded by one Soryu Forall. He runs the institution in the Rinzai Zen tradition. An apprentice pays $6000 and can live for a year or more to transform himself and the world. The academy’s aim is classical enlightenment.

One of the staff members is a young and enthusiastic Daniel Thorson, 33. A few years ago, he had organized the Occupy Wall Street movement. He joined the academy to be able to serve the world better in times of crisis. Daniel is a podcaster and online philosopher. Silent meditation and retreat from the day-to-day world are said to be one of the highest paths to enlightenment. Daniel had been waiting for a couple of years to get to do a solo retreat. Its purpose was to understand true awakening and enlightenment. This year he finally got the golden opportunity.

On 13 March, he tweeted he would be offline for the next 75 days. He then switched his phone off, and entered his log cabin retreat, to begin life without a smartphone, Wifi, TV, or newspapers. Most of his awaken hours were spent meditating with eyes shut. Twice every day, he silently walked to the kitchen to pick up the vegan meal provided by the Academy. Interaction with humans was prohibited. Days, then weeks, began to pass without Daniel speaking or hearing a single word.

On Tues. 23 May, he rejoined the material world. He switched the phone on, but had no time to look at the thousands of Twitter messages. Before going out of the cabin, he posted a single tweet: “I am back from 75 days of silence. Did I miss anything?”

Daniel decided to visit the nearby supermarket. Buy things he hadn’t seen for 75 days. For some reason, he felt everyone in the supermarket was staring at him. He wondered if his face shone with enlightenment. Then he noticed the masks. Why masks? His hand inadvertently stroked his long unshapely beard.

When he queued up at the counter, a lady ahead of him said, “Excuse me, you are standing too close.” Her tone was accusatory. Daniel’s face turned red. He took a couple of steps back, and those behind him avoided him as if he was a leper.

Back at the academy, he thought he would check the strange events in the supermarket with his camp mates. But his colleagues were meditating. He decided to check the internet first. After 75 days of silence, he must catch up on the US presidential election, Brexit, the baseball scores, Australian wildfires. Every newspaper he opened was carrying a special edition on Coronavirus. He opened his Twitter account. All messages were about a virus. His cousin had messaged him saying he had found a new girlfriend, but had not met her yet. Many friends invited him to Zoom. Zoom, where was this place?

When contacted yesterday, he was trying to figure out how the George Floyd protestors across USA were maintaining social distance to be safe. Daniel, the 75-day Rip Van Winkle, will perhaps need a few more weeks to get truly enlightened.

Ravi

Corona Daily 431: Virus Eradicated from Italy?

‘In reality, the virus clinically no longer exists in Italy.’ Announced Dr Alberto Zangrillo, triumphantly, on Sunday. He heads the intensive care unit at a hospital in Lombardy, Milan, Italy’s pandemic hotspot. Italians know Dr Zangrillo as the personal doctor of Silvio Berlusconi. ‘Experts are too alarmist about predicting a second wave of infections.’ He added.  For him, the Italian government’s plan to add another 150,000 IC beds makes no sense. Holding the country hostage to such predictions must stop. SARS and MERS disappeared, so will this virus. Dr Matteo Bassetti supported him by saying the virus had weakened and today Covid-19 was different.

Italians watching the TV interview and the Corona-skeptics slept wonderfully on Sunday night.

*****

Monday, 1 June, brought a wave of reactions from doctors and professors in the UK.

Prof. Francois Balloux, UCL, London: There is no evidence the virus has lost its ‘strength’. The outbreak in Italy is waning, but we should definitely not rule out a second wave later this year.

Dr Elisavetta Groppelli, St George’s, London: In Italy, the age of confirmed cases has been decreasing. Disease severity is less in the younger groups. The virus genome is being monitored worldwide. Consensus is there is no evidence for change in virus features.

Prof. Martin Hibberd, London: Even among symptomatic patients, 80% have mild disease. During a major outbreak, those cases are overlooked. When the number of severe cases falls, those with mild symptoms get more attention – giving the impression the virus is changing. 

Dr Oscar MacLean, Glasgow: These claims are fairly implausible on genetic grounds. Making them on the basis of anecdotal observations is dangerous.

WHO too jumped in, cautioning world leaders about reports that the virus was “losing potency”. That is not the case at all, said WHO.

Maria Van Kerkhove, the WHO epidemiologist said: The virus has not changed either in terms of severity or transmissibility. This is still a killer virus, and thousands of people are dying daily.

*****

In April and May, the two strictest lockdown months worldwide, Coronavirus killed 6000 people every day. (Compare SARS outbreak 2002-2003 had 8000 confirmed cases and 774 people died in total).

The arrival of summer and relaxation of lockdowns create a feeling that the worst is over. But seasonality of the virus is not known yet. And when the northern hemisphere has summer, the south has winter. Last week, Mexico touched a daily 500 death figure. Yesterday, Brazil had 1232 Covid-19 deaths.

Yes, Italy is waning, but more than 50 Italians still die every day. Unless a 12-month cycle is gone through, it will be premature to claim victory. Unfortunately, every summer is followed by a winter. The cases may rise again in the fall itself.

Among politicians and masses we see many self-proclaimed virologists who equate Covid-19 to the flu, who think the lockdown business is complete nonsense, who refuse to wear masks, who recommend preventive drugs, who want the world to run as always by ignoring the virus. The virus will miraculously disappear, most likely once the sun is up, they think.

I have made a request to those skeptics. Please go to your neighborhood hospital and work as volunteers in the Covid-19 wards. Volunteers are needed desperately.

Not a single person has taken up that challenge.

*****

Ravi

Corona Daily 432: Coronavirus Detectives

If you are looking for a new profession these days, an interesting one is that of a Contact Tracer. The world will need a few million of these over the next two years.

“Testing. Tracing. Isolation.” An emerging worldwide consensus terms this as the only strategy to combat the virus, to flatten the curve. Contact tracing is locating where the virus might strike next. By warning, quarantining and isolating likely patients, the transmission chain is broken.

It starts with a caller working from home or a call center talking to a patient over the phone. The caller may speak for up to 30 minutes trying to recreate the last few days of the patient. This is a delicate task. Without ever meeting him, the caller is asking the patient to disclose his private life. All the places the patient visited, and all the people he came in contact with.

The only contacts considered are face-to-face contact, with a distance of less than six feet, for 15 minutes or more. As the patient recalls each of them, the contact tracer records them. If 15 such people are found, the tracer starts calling each of them. The rule is to never disclose who gave the name (in this case, the patient).

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Contact tracing is easier in small countries, and in dictatorships. Singapore is both.

M, a Singaporean woman got one such call. ‘Were you in a taxi at 18.47 on Wednesday?’ The question was so precise, M panicked, but she confirmed. Next day three people in protective gear turned up at her house. One of them produced a contract. It prescribed the quarantine period, and mentioned the amount of fine and prison sentence for breach of contract. M never learnt if it was the taxi driver or another passenger in the same taxi who had tested positive.

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In Iceland, Europe’s most sparsely populated country with 364,000 citizens; the first contact tracer was Evar Palmi Palmason, a police detective. He formed a team with two cops, two nurses and a criminologist, even before Iceland’s first case. When they heard of the first suspect, Palmason used the same techniques he uses in his detective work. The tracing produced 56 names. By midnight, all of them were contacted and asked to quarantine themselves for two weeks. As cases in Iceland grew rapidly, the team grew as well, eventually to 52 members.

One patient had attended a concert. Palmason used his police training to find everyone who attended that concert, and sent all of them into quarantine.

Iceland successfully flattened the curve. It had ten deaths in all, and nobody has died since 19 April.

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South Korea has used a combination of credit card data, CCTV records, and smartphone locations. Countries using phone apps have realized the apps can only support but can’t replace human tracing. Contact tracing has been used for measles, food poisoning outbreaks, AIDS and syphilis. The requirement in the current pandemic, though, is high.

The USA and UK are just starting. USA needs 180,000 contact tracers, but has only 25,000. UK fewer than that.

An interesting profession that combines the work of a detective, social worker, salesman and data collector.  Job guaranteed for the next 24 months.

Ravi

Corona Daily 433: Your Corona Risk Score

This article discusses the risk of dying from Covid-19, rather than the risk of getting infected. If you live in New York, London, Moscow, Mumbai or a similar urban jungle, it is safe to assume you may get infected at some stage. That’s fine; more than 96% infected are guaranteed to recover. This paper offers a formula to compute our chances and the precautions we must take to be among the 96%.

Academic papers by professional statisticians are replete with confusing symbols. Their formulas are usually so convoluted as to befuddle potential users. Some statisticians specializing in survival analysis have offered hazard ratios. But without a PhD in statistics, you can’t understand or use them. The following proposal, though not scientifically precise, is simple and easy to implement. It is like the points-based immigration system. Except here, a low Corona score is better, high score is bad.

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Age: Start with your age.

Sex: If you are a female, add 0. / If male, add 10.

Race: Whites: add 0. / Blacks: add 10. / Brown, yellow, mixed, others: add 5.

Health conditions: (Heart disease, diabetes, asthma, high blood pressure, cancer, major liver, lung, kidney disease) First health condition: add 20/ every subsequent health condition: add 50/ Any organ transplant (such as kidney): add 70.

Profession: work mainly online: add 0. / Working among people (office/factory): add 10. / Working in care home or hospital: add 50.

Your Corona Score= Age+ points for sex +race +health conditions +profession.  

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Let us look at four examples.

Emily, a 26 year old white healthy school teacher in London.

Her score: 26 (age) + 0 (female) + 0 (white) + 0 (health) +10 (profession among people) = 36.

Joseph, a 55 year old black, on prescribed medicines for diabetes and high blood pressure, works at a museum in New York.

His score: 55 (age) +10 (male) + 10 (black) + 20+50 (two health conditions) +10 (work among people) = 155.

Vinay, an 81 year old Indian, no health conditions nor prescribed medicines, retired.

His score: 81 (age) +10 (male) +5 (Brown) + 0 (health) +0 (work) = 96.  

Ivan, a 49 year old healthy doctor working in a Covid ward in a Moscow hospital.

His score: 49(age) +10 (male) +0 (white) + 0 (health) + 50 (work at hospital) =109

*****

Based on the scores, I suggest four bands and the strategy for each of them.

Scores below 50: Essentially made of healthy young people not working at hospitals/care homes. They should be able to mix with people their age, hug, kiss, have sex, and able to lead a completely normal life without fear. They should take care (masks, handwash, distance) when meeting with their parents or grandparents.

Scores 51-100: Mainly people above 30 with no medical condition. This group should focus on maintaining their fitness level. Social mixing is possible, but with masks, handwash, and 1-meter distance both at work and in public places. Subject to that, should be able to lead fairly normal lives. But at the first hint of a cough or fever, must take precautions and rest.

This group includes healthy doctors, nurses and care home workers. They must wear protective gear, and test themselves regularly.

Scores 101-150: This is a mild danger zone. Elderly people with a health condition or younger people with multiple health conditions. Also organ transplant patients of any age. They should avoid using public transport. Avoid working among people. Keep a 2-3 month stock of essential medicine. Maintain a lockdown lifestyle, irrespective of what is happening outside your house.

Scores above 150: Group with the highest risk. Mainly elderly people with multiple health conditions. Migrate to a virus-free location (village?) if possible. If not, meet people exclusively on Zoom. Take walks alone. Watch Netflix. Make sure everyone living with you strictly observes mask, handwash, distance.

*****

Ravi  

Corona Daily 434: What’s Your Corona Risk Score?

Irrespective of numbers, many countries plan to slacken the lockdown in June. After ten weeks of confinement, millions will begin jogging, hugging (privately), shopping, attending schools, going to offices, flying. The epidemic is global, but the medical risk is individual. Our actions, or inactions, must be dictated by our individual risk. This article explains the factors that influence the risk. Tomorrow, I will give a mathematical formula.

We must first distinguish between (a) the risk of getting infected and (b) the risk of dying. The second event is contingent on the first. One cannot die of Covid-19 without getting infected. The best strategy to lower the risk is of course to not get infected. But if you are locked down in New York, London or Mumbai, that is nearly impossible. One piece of advice I w0uld offer to the super-rich afraid of Covid-19 is to buy quality protective gear, fly to Vietnam, Bhutan or Mongolia, and settle there till the pandemic ends. (Immunity immigration visa?) Syria's infections are few as well, but the survival rate in general can be low there.

Significant data is now available from China, USA and the UK. Six key factors define your individual risk. (a) Age (b) Sex (c) Race (d) Health conditions (e) Location (f) Profession.

Age: For those below 45, with no health condition, the risk is almost non-existent. After 65 the risk starts growing, after 80 it is significant, and after 90, very high. Declining immunity in old age contributes to this risk graph. This doesn’t mean every 80+ is in danger. Healthy 100 year olds can survive this infection, and indeed have.

Sex: Men are far more vulnerable. In China, the risk of men dying as compared to women is 1.65 times, in New York, 1.77 times. In general, women have a longer life expectancy. (It is said men are more fortunate than women. They marry later and die earlier).

Race: I was reluctant to include this. But in the USA and UK, the death of blacks is disproportionately larger to whites.

Health conditions (Comorbidities): A super-important factor. Heart disease, diabetes, asthma, high blood pressure, cancer all add to vulnerability. For a patient with two or three conditions, the risk skyrockets. UK scientists have added obesity to this list.

Location (post code):  Location was initially important for your government’s strategy. In a complete lockdown, the risk of getting infected was 1 out of 100,000. Under mitigation strategy (testing/tracing/isolation), it was 1 in 10. In ‘do nothing’ strategy, it is about 8/10. Lockdown fatigue may convert communities to ‘do nothing’. Zip Code 11369 in Queens, NYC has half its population officially infected. Newham and Brent in London have suffered the maximum deaths in the UK. Mumbai, my home town, is a hot spot.

Profession: Will you work online or offline? If offline, how many co-workers and customers you will come in contact with? The risk score of workers in care homes and hospitals rises dramatically.

Based on these factors, tomorrow’s article will offer a formula to calculate our individual risk score. Our strategy and behavior should be based on that score. 

Ravi