Is Wudu the Secret of Pakistan's Success Against COVID19?

 الطُّهُورُ شَطْرُ الإِيمَانِ” – “Cleanliness is half the faith [Sahih Muslim Hadith] 



 India is setting new global records in daily COVID19 cases while neighboring Pakistan has seen an unrelenting decline in coronavirus cases in recent weeks. This is happening in spite of the fact that both nations have taken similar measures on paper to contain the spread of the novel coronavirus. Both have imposed lockdowns. Both have required people to wear face masks in public. Both share similar climates, demographics and socioeconomic conditions. Then why this difference? Is it in the implementation of such measures? Or the fact that people in Muslim-majority Pakistan wash their hands before prayers much more often everyday with or without soap, a hygiene practice highly recommended by public health experts during the pandemic? Or could it be that fewer women in Pakistan participate in the work force?  Let's examine this difference.

Muslim Wudu Includes Hand-washing
The best practice to limit transmission of coronavirus is to wash your hands with soap and water. Multiple studies have shown that hand-washing even without soap is quite effective in killing viruses and bacteria. A 2011 study from researchers at the London School of Tropical Hygiene found that washing with water alone reduced bacteria on hands to about one-quarter of their prewash state. A Japanese study reported that Washing your hands under running water — even without soap — is more effective at stopping the spread of flu germs than using ethanol-based hand sanitizers. When a significant percentage of a large population such as Pakistan's does indeed wash their hands under running water even without soap, the collective benefit has the potential to be large. 
As the COVID19 pandemic began, many Muslim scholars began to recommend that people wash their hands for 20 seconds with soap before doing wudu.  While British urban neighborhoods with large ethnic minority populations make up more than three quarters of England's coronavirus hotspots, the numbers coming from Muslim communities in areas which could be expected to be hard-hit are low.

Coronavirus Case Trajectory in India, Pakistan, Bangladesh & United States

In terms of global numbers, there are no major Muslim-majority countries among the most affected by coronavirus, with the possible exception of Iran. As of now, the top 5 nations most affected by COVID19 cases are: United States, Brazil, India, Russia and Peru. Measuring by deaths per million, the top 5 are: Belgium, Spain, UK, Italy and Sweden. Muslims make up a tiny percentage of populations in these countries.

COVID19: Government Response Stringency Index. Source: Our World in Data

Professor Richard Webber of Newcastle University has attributed this phenomenon to cultural habits such as frequent hand washing (wudu) that may be protecting England's Muslims from coronavirus. The Webber Phillips report shows that of 17 coronavirus hotspots in Britain – three quarters of which have large minority populations – Muslim areas are ‘conspicuous by their absence’.
Muslim women, however, may be protected and contribute to lower rates among their communities because so few of them have jobs – a report by the Young Foundation shows just 29 per cent of British Muslim women are employed. Labor force participation rate of women in India and Pakistan is about the same at 22%.
COVID19 Impact. Source: Worldometer August 24 2020

Dr. Syra Madad,  the 34-year-old Pakistani-American head of New York City’s Health and Hospitals System-wide Special Pathogens Program, conveys the importance of personal hygiene in containing the spread of viruses. She takes regular breaks to say her prayers at the Islamic Center of New York University. Before entering the prayer room, Madad stops to perform wudu, and washes her hands, mouth and face as well as her feet, according to a Washington Post report.

Dr. Madad is featured in a 6-part Netflix documentary series "Pandemic: How to Prevent an Outbreak". She had warned of a deadly pandemic in December, 2019, just days before China reported to the World Health Organization that it was treating dozens of patients for a novel virus of unknown origin.  We now know it as coronavirus or Covid-19. The series debuted in January 2020, but recent events have pushed it into Netflix’s “Top 10 in the U.S. Today.”

Dr. Syra Madad is a devout Muslim. The Netflix series shows her praying at her home in Long Island, New York. She says, "I live and breathe being a Muslim. It shapes my daily life. I don't drink I don't meat that's not halal.....I do no harm and help others".

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Comments

Riaz Haq said…
#India's new grim milestone: India adds 76,456 cases new cases to pass #Brazil for 2nd spot for nations worst hit by #COVID19. Only #Trump's #US now has more #coronavirus cases than #Modi's India. Coronavirus case growth in India now the world's fastest. http://covid.gov.pk/stats/global

https://twitter.com/haqsmusings/status/1302308856614117377?s=20
Riaz Haq said…
#Pakistan records lowest daily death toll of 2 deaths from #COVID19. Pakistan's infection rate has significantly dropped to around 500 per day or less in recent weeks, compared to an average of 5,000 daily cases in May and June. #coronavirus #SouthAsia http://v.aa.com.tr/1964317


Pakistan recorded just two deaths from the coronavirus Sunday, the lowest single-day fatality number since the surge of the pandemic in May, according to health officials.

The number of deaths stand at 6,342, with the additional fatalities.

Another 484 infections were reported, bringing that tally to 298,513.

More than 90% of all patients, or 285,898, have recovered, but 535 are in critical condition.

Pakistan's infection rate has significantly dropped in recent weeks, compared to an average of 5,000 daily cases in May and June.

The highest number of single-day cases was nearly 7,000 last month.

The government is currently following a "mini smart lockdown" strategy. Instead of closing entire streets or shopping centers, only houses or workplaces where infections are reported will be sealed.

The country has conducted more than 2.7 million tests, according to statistics.
Riaz Haq said…
No wonder #Modi's #India has such a serious #COVID19 #pandemic! MP minister Imarti Devi: "Born in cow dung, #coronavirus can't come near me. #Indian #Hindutva politicians have come up with their own version of Covid-19 “cures” #Modi https://indianexpress.com/article/trending/viral-videos-trending/madhya-pradesh-minister-imarti-devi-born-in-cow-dung-coronavirus-cant-come-near-me-6586835/ https://www.southasiainvestor.com/2020/08/is-wudu-secret-of-pakistans-success.html


From injecting disinfectant, drinking alcohol to having papads as immunity booster, politicians of all hues have come up with their own version of Covid-19 “cures”, albeit without any scientific basis. The latest to join the list is Madhya Pradesh minister Imarti Devi, who recently said in Gwalior that she cannot be infected with Covid-19 because she was born in gobar (cow dung) and mitti (mud).

In a viral clip, Devi can be seen telling journalists in Gwalior how wrongly it was reported by the media that she had tested positive for Covid-19.

“Tumahi they, akele tum. Tumey humein corona bata deo. Imarti Devi matti mey paida bhai, gobar mein paida bhai, itte karre kitanu hain ki, Corona ke aas paas nahi aa payein.” (Only you were there and you said that I have corona. I was born in soil and cow dung. There are so many germs there that corona will not come anywhere near me.)


Riaz Haq said…
#Woodward book: #Trump says he knew #coronavirus was ‘deadly’ and worse than the flu while intentionally misleading #Americans. It's based in part on 18 on-the-record interviews Woodward conducted with the president between December and July. #COVID19 https://www.washingtonpost.com/politics/bob-woodward-rage-book-trump/2020/09/09/0368fe3c-efd2-11ea-b4bc-3a2098fc73d4_story.html

Trump shared with Woodward visceral reactions to several prominent Democrats of color. Upon seeing a shot of Sen. Kamala D. Harris of California, now the Democratic vice-presidential nominee, calmly and silently watching him deliver his State of the Union address, Trump remarked: “Hate! See the hate! See the hate!” Trump used the same phrase after an expressionless Rep. Alexandria Ocasio-Cortez (D-N.Y.) appeared in the frame.

Trump was dismissive about former president Barack Obama and told Woodward he was inclined to refer to him by his first and middle names, “Barack Hussein,” but wouldn’t in his company, to be “very nice.”

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“Trump never did seem willing to fully mobilize the federal government and continually seemed to push problems off on the states,” Woodward writes. “There was no real management theory of the case or how to organize a massive enterprise to deal with one of the most complex emergencies the United States had ever faced.”

Woodward questioned Trump repeatedly about the national reckoning on racial injustice. On June 3, two days after federal agents forcibly removed peaceful protesters from Lafayette Square to make way for Trump to stage a photo opportunity outside St. John’s Church, Trump called Woodward to boast about his “law and order” stance.

“We’re going to get ready to send in the military slash National Guard to some of these poor bastards that don’t know what they’re doing, these poor radical lefts,” Trump said.

In another conversation, on June 19, Woodward asked the president about White privilege, noting that they were both White men of the same generation who had privileged upbringings. Woodward suggested that they had a responsibility to better “understand the anger and pain” felt by Black Americans.

“No,” Trump replied, his voice described by Woodward as mocking and incredulous. “You really drank the Kool-Aid, didn’t you? Just listen to you. Wow. No, I don’t feel that at all.”

As Woodward pressed Trump to understand the plight of Black Americans after generations of discrimination, inequality and other atrocities, the president kept answering by pointing to economic numbers such as the pre-pandemic unemployment rate for Blacks and claiming, as he often has publicly, that he has done more for Blacks than any president except perhaps Abraham Lincoln.

In another conversation about race, on July 8, Trump complained about his lack of support among Black voters. “I’ve done a tremendous amount for the Black community,” he told Woodward. “And, honestly, I’m not feeling any love.”


Riaz Haq said…
Pakistan has used the infrastructure it developed in its fight against polio to tackle COVID-19, said the Director-General. Community health workers, previously used to vaccinate children for polio, have been redeployed for contact tracing and monitoring.


https://www.weforum.org/agenda/2020/09/5-countries-we-can-all-learn-from-to-fight-future-pandemics-according-to-the-who

7 countries (Pakistan, Italy, Thailand, Mongolia, Mauritius and Uruguay) to learn from

The Director-General highlighted 7 countries, amongst many, whose preparation and response offer lessons for the rest of the world.

Thailand

Thailand has benefited from 40 years of health system strengthening, he explained.

A well-resourced medical and public health system is supported by strong leadership. Coupled with 1 million village health volunteers, and strong communication, the nation has built trust and compliance and confidence among the general population, he said.

Italy

Italy was one of the first countries to experience a large outbreak outside of China, said Dr Tedros. It "took hard decisions based on the evidence and persisted with them". Unity and solidarity, along with the dedication of health workers, helped bring the outbreak under control, he explained.

Mongolia

Mongolia also reacted quickly. It activated its State Emergency Committee in January and didn't report a case until January and still has no reported deaths.

Mauritius

Mauritius used previous experience with contact-tracing and a swift response to overcome high-risk issues - high population density, high rate of non-communicable diseases and lots of international travellers.

Uruguay

Uruguay has one of Latin America's most 'robust and resilient' health systems in Latin America, explained Dr Tedros. Sustainable investments in public health were built on political consensus, he added.

Pakistan

Pakistan has used the infrastructure it developed in its fight against polio to tackle COVID-19, said the Director-General. Community health workers, previously used to vaccinate children for polio, have been redeployed for contact tracing and monitoring.


And more...

There are many other countries who've done well, added Dr Tedros. From Japan to New Zealand and Viet Nam, many countries have fared better because of lessons learned during previous outbreaks of disease, such as SARS or Ebola.

Having learned the lessons of previous pandemics, it's therefore "vital that we learn the lessons this pandemic is teaching us," he concluded.


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Dr Tedros called on countries to invest in public health, as a "foundation of social, economic and political stability".

Significant progress has been made in medicine, he said, but too many countries have neglected their public health systems:

"Part of every country’s commitment to build back better must therefore be to invest in public health, as an investment in a healthier and safer future."

But there are countries the rest of the world can learn from, he said in his opening remarks. Here's a summary of what he said.

Riaz Haq said…
WHO Director-General's opening remarks at the media briefing on COVID-19 - 7 September 2020

https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---7-september-2020

Pakistan deployed the infrastructure built up over many years for polio to combat COVID-19. Community health workers who have been trained to go door-to-door vaccinating children for polio have been utilized for surveillance, contact tracing and care.

There are many other examples we could give, including Cambodia, Japan, New Zealand, the Republic of Korea, Rwanda, Senegal, Spain, Viet Nam and more.

Many of these countries have done well because they learned lessons from previous outbreaks of SARS, MERS, measles, polio, Ebola, flu and other diseases.

That’s why it’s vital that we all learn the lessons this pandemic is teaching us.

Although Germany’s response was strong, it is also learning lessons.

I welcome the announcement by Chancellor Angela Merkel over the weekend that her government will invest 4 billion euros by 2026 to strengthen Germany’s public health system.

I call on all countries to invest in public health, and especially in primary health care, and follow Germany’s example.
Riaz Haq said…
Inside Pakistan’s COVID-19 Contact Tracing
Detective work is at the heart of efforts to fight the pandemic. Will it be enough?

By Niha Dagia


https://thediplomat.com/2020/07/inside-pakistans-covid-19-contact-tracing/


How Can We Make Contact Tracing Successful?

To identify as many contacts as possible and as fast as possible takes a large-scale organized mechanism. According to the United States Centers for Disease Control, the staff required for contact tracing varies depending on several factors including the daily tally of cases as well as the number of contacts who have been identified, isolated, notified, and advised to monitor symptoms and practice social distancing.

With local transmission varying between 95 to 98 percent across provinces, Pakistan lacks the capacity to investigate and trace all suspected cases.

But the Polio Eradication Initiative (PEI) has been on the frontline in the fight against the pandemic ever since its assets — including surveillance, data, and communication capabilities — were rerouted by the government in March 2020.

Their surveillance system has been adopted for COVID-19 contact tracing, tracking the disease’s spread, and creating awareness on prevention and containment.

Active surveillance for influenza-like illness (ILI), severe acute respiratory infections (SARI), and suspected COVID-19 cases has been integrated into the ongoing acute flaccid paralysis (AFP) active and passive surveillance system used in the fight against polio.

For contact tracing to work, the community needs to be involved. Since polio staff are already trained for door-to-door campaigns and carrying out risk perception in the community, it is now mobilizing defense against the fast-spreading virus.

“We have found significant positives amongst those traced via contact tracing and thus it has impacted on reducing further spread via self isolation, education and sensitization of the contacts,” said Dr. Sultan. “Quantification is sometimes not easy, but is being analyzed to see if a numerical value could be assigned with confidence.”

For a country that lacks a functioning healthcare system, its only defense against the virus is to contain the spread. Success will depend on the network of contract tracers, working behind the scenes to map out the pandemic in Pakistan.
Riaz Haq said…
WHO Credits Pakistan's Community Health Program For Success Against COVID19

https://youtu.be/uZW9hADNo08

Pakistan Polio Eradication Initiative (PEI) has been on the frontline in the fight against the novel coronavirus pandemic ever since its assets — including surveillance, data, and communication capabilities — were rerouted by the government in March 2020. Their surveillance system has been adopted for COVID-19 contact tracing, tracking the disease’s spread, and creating awareness on prevention and containment. Active surveillance for influenza-like illness (ILI), severe acute respiratory infections (SARI), and suspected COVID-19 cases has been integrated into the ongoing acute flaccid paralysis (AFP) active and passive surveillance system used in the fight against polio. For contact tracing to work, the community needs to be involved. Since polio staff are already trained for door-to-door campaigns and carrying out risk perception in the community, it is now mobilizing defense against the fast-spreading virus. “We have found significant positives amongst those traced via contact tracing and thus it has impacted on reducing further spread via self isolation, education and sensitization of the contacts,” said Dr. Sultan. “Quantification is sometimes not easy, but is being analyzed to see if a numerical value could be assigned with confidence.”
Riaz Haq said…
#Coronavirus: #India reports record daily jump of almost 100,000 new cases for 2nd consecutive day. India has more than 4.65 million infections, with only #UnitedStates recording a higher figure, with more than 6.4 million. #COVID19 #Modi #BJP #Hindutva https://news.sky.com/story/coronavirus-india-reports-record-daily-jump-of-almost-100-000-new-cases-12069672

The western state of Maharashtra has been particularly hard-hit, with total confirmed cases of coronavirus passing one million late on Friday, the first place anywhere in the world to cross that mark.

If the state, which is India's richest, were a country, it would rival Russia for the fourth highest number of cases globally.

Russia has now recorded 1,057,362 after a further 5,488 new infections were recorded on Saturday, with authorities saying a further 119 people have died, pushing the total number of deaths to 18,484.


Government officials and experts have claimed the increases in Maharashtra and elsewhere across the country are likely to be down to the economy re-starting, local festivals and lockdown fatigue.

"I am so disappointed with the pandemic situation in India," said Bhramar Mukherjee, a professor of biostatistics and epidemiology at the University of Michigan, who has been tracking India's COVID-19 situation closely.

In a tweet, she continued: "It is getting worse and worse each week, but a large part of the nation seems to have made the choice to ignore this crisis."

Riaz Haq said…
No peak in sight for #India #coronavirus cases with huge daily increases in new cases. https://scroll.in/article/972767/was-health-official-lav-agarwal-right-in-saying-indias-covid-19-peak-may-never-come

https://twitter.com/haqsmusings/status/1305315803454038017?s=20

Lav Agarwal, the joint secretary in the Union health ministry assigned to brief the media during the early days of the pandemic, had on several occasions remarked that India’s peak in terms of daily cases “may never come”.

At the time, it seemed like a baffling claim. The conventional epidemiological understanding is that the curve of a pandemic is usually symmetric: a sharp surge of cases is followed by a peak or a plateau after which news cases start declining.

But six months into the pandemic in India, Agarwal’s words seem to have been curiously prophetic – India’s Covid-19 graph continues to shoot up with no peak or plateau in sight.

This is almost singularly unique. Most countries have seen at least one peak or plateau even as some have seen new infections rise again. (India’s graph did momentarily slow down in mid-August raising some hope, but it did not sustain).

What explains this?

India, after all, clamped down one of the world’s harshest and longest lockdowns to contain the spread of the virus.

Six months after the lockdown started, why is the graph still rising?

Multiple pandemics
Observers say the explanation is rather simple: India’s size. This has meant that different places are at different stages of the pandemic.

“While in some of the original high-burden cities, the curve has largely plateaued or even gone down, in some other places growth is picking up,” said health economist Riju M John. “The national average is just an aggregation of what is happening around the country.”

DCS Reddy, who heads the research group on epidemiology and surveillance constituted by the Indian government’s National Task Force for Covid-19, explained: “The pandemic has now entered the rural areas where a larger number of people actually leave, so no wonder the overall numbers are going up because of the sheer size of our population.”

Other countries
But how did other big countries rein in the virus then?

Epidemiologists say India’s situation cannot directly be compared to any other country. “The only country you can maybe think of is the United States,” said Reddy, a former professor and head of community medicine at the Institute of Medical Sciences at Banaras Hindu University.

The United States, Reddy said, experienced two major surges: the first driven by eastern states like New York and New Jersey, and the second largely by Texas and Florida.“These are heavily populated states,” Reddy pointed out. “After they peaked, the virus moved inwards where fewer people live.”

In contrast, in India, rural areas are heavily populated. “In fact, almost 70% of our total population lives there,” said Reddy. To make matters worse, health infrastructure is weak in these areas. “I also doubt how much the messaging of physical distancing and mask wearing has reached those places.”

India’s lockdown did not help, Reddy added, since it led to a mass exodus of itinerant workers, stranded without jobs and money, from urban centres to rural areas, carrying the virus with them.


A lockdown that did not work
T Jacob John, one of India’s leading virologists, agreed that India’s harsh lockdown had made things worse. “I would compare India to Europe,” he said, pointing out that Indian states are as large, if not larger, than European countries. “So, a nationwide lockdown was illogical – what we needed was staggered and localised lockdowns in each state depending on the stage of the pandemic in that place.”

That way, Jacob John said India’s pandemic curve could have been flatter, leading to less pressure on medical facilities and, consequently, possibly fewer deaths. “Over a long period, say a year and a half, the number of infections would be the same anyway, but we would buy time and not have such a high peak as we are now.”
Riaz Haq said…
Your #Coronavirus Test Is Positive. Maybe It Shouldn’t Be. In 3 sets of data in #Massachusetts , #NewYork and #Nevada , up to 90% of people testing positive for #COVID19 carried barely any virus. Low virus load may not be contagious.- The New York Times

https://www.nytimes.com/2020/08/29/health/coronavirus-testing.html

Some of the nation’s leading public health experts are raising a new concern in the endless debate over coronavirus testing in the United States: The standard tests are diagnosing huge numbers of people who may be carrying relatively insignificant amounts of the virus.

Most of these people are not likely to be contagious, and identifying them may contribute to bottlenecks that prevent those who are contagious from being found in time. But researchers say the solution is not to test less, or to skip testing people without symptoms, as recently suggested by the Centers for Disease Control and Prevention.

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The PCR test amplifies genetic matter from the virus in cycles; the fewer cycles required, the greater the amount of virus, or viral load, in the sample. The greater the viral load, the more likely the patient is to be contagious.

This number of amplification cycles needed to find the virus, called the cycle threshold, is never included in the results sent to doctors and coronavirus patients, although it could tell them how infectious the patients are.

In three sets of testing data that include cycle thresholds, compiled by officials in Massachusetts, New York and Nevada, up to 90 percent of people testing positive carried barely any virus, a review by The Times found.

On Thursday, the United States recorded 45,604 new coronavirus cases, according to a database maintained by The Times. If the rates of contagiousness in Massachusetts and New York were to apply nationwide, then perhaps only 4,500 of those people may actually need to isolate and submit to contact tracing.

One solution would be to adjust the cycle threshold used now to decide that a patient is infected. Most tests set the limit at 40, a few at 37. This means that you are positive for the coronavirus if the test process required up to 40 cycles, or 37, to detect the virus.

Tests with thresholds so high may detect not just live virus but also genetic fragments, leftovers from infection that pose no particular risk — akin to finding a hair in a room long after a person has left, Dr. Mina said.


Any test with a cycle threshold above 35 is too sensitive, agreed Juliet Morrison, a virologist at the University of California, Riverside. “I’m shocked that people would think that 40 could represent a positive,” she said.

A more reasonable cutoff would be 30 to 35, she added. Dr. Mina said he would set the figure at 30, or even less. Those changes would mean the amount of genetic material in a patient’s sample would have to be 100-fold to 1,000-fold that of the current standard for the test to return a positive result — at least, one worth acting on.

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Instead, new data underscore the need for more widespread use of rapid tests, even if they are less sensitive.

“The decision not to test asymptomatic people is just really backward,” said Dr. Michael Mina, an epidemiologist at the Harvard T.H. Chan School of Public Health, referring to the C.D.C. recommendation.

“In fact, we should be ramping up testing of all different people,” he said, “but we have to do it through whole different mechanisms.”

In what may be a step in this direction, the Trump administration announced on Thursday that it would purchase 150 million rapid tests.

The most widely used diagnostic test for the new coronavirus, called a PCR test, provides a simple yes-no answer to the question of whether a patient is infected.

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But yes-no isn’t good enough, he added. It’s the amount of virus that should dictate the infected patient’s next steps. “It’s really irresponsible, I think, to forgo the recognition that this is a quantitative issue,” Dr. Mina said.
Riaz Haq said…
#US #CDC director says face #masks may offer more protection against #COVID19 than a #vaccine. Dr. Redfield: "And I will continue to appeal for all Americans, all individuals in our country, to embrace these face coverings." #coronavirus https://www.cbsnews.com/news/covid-face-mask-protection-vaccine-cdc-director/ via @CBSHealth

Dr. Robert Redfield, the director of the Centers for Disease Control and Prevention, said during his testimony before a Senate subcommittee on Wednesday that wearing face masks may be more effective at protecting against COVID-19 than a vaccine.


Lawmakers asked Redfield and other top health officials about the government's response to the coronavirus pandemic, and he was questioned about the CDC's recommendation that people wear masks — a practice President Trump has often dismissed.

"I'm not going to comment directly about the president, but I am going to comment as the CDC director that face masks, these face masks, are the most important powerful public health tool we have," Redfield said. "And I will continue to appeal for all Americans, all individuals in our country, to embrace these face coverings."

Redfield said if Americans wore face masks for several weeks, "we would bring this pandemic under control," because there is scientific evidence they work and they are our "best defense."

"I might even go so far as to say that this face mask is more guaranteed to protect me against COVID than when I take a COVID vaccine, because it may be 70%. And if I don't get an immune response, the vaccine is not going to protect me," Redfield said. "This face mask will."

Several experts contacted by CBS News agree with that assessment: Since vaccines do not guarantee an immune response, masks may be more effective at preventing COVID-19. The FDA has previously said it would approve a coronavirus vaccine that was at least 50% effective. While that could significantly reduce the number of hospitalizations and deaths, it would not completely eliminate the disease or guarantee protection.

George Rutherford, a professor of epidemiology and biostatistics and director of the Prevention and Public Health Group at UC San Francisco, said the CDC director is "completely right."

"The good thing about a vaccine is you don't need to remember to put it on every day," Dr. Rutherford told CBS News on Friday. "The bad thing is, it's probably not going to work nearly as well as masks."

"Let's say masks are 95% effective — and who knows what the vaccine is going to be, but say it's 80% effective — in that sense, masks could be better than vaccines," he continued. "I don't think we know yet, but for right now, it's the total name of the game. It's the most effective thing we have."

Rutherford said a large proportion of the population — about 60 or 70% — would need to get vaccinated in order to achieve something close to herd immunity. "Once you're vaccinated... you're probably pretty safe. Now, if we're still walking around with lots of transmission going on, among people who didn't get vaccinated, you may want to wear a mask as well."
Riaz Haq said…
'So many bodies,' says ambulance driver as #India struggles to stem #COVID19 death toll. Businesses are reopening, hospitals are full and doctors see no end in sight."The most optimistic scenario is plateauing, but it's not going to end soon."- ABC News - https://abcn.ws/331Hnnd

With the windows of his ambulance rolled down and the siren blaring, Mohsin Khan, 41, told his attendant why he drives ambulances.

"I lost my mother because no ambulance came on time to attend to her," he said. "The helplessness I felt, I don't wish that on my worst enemy."

On COVID-19 duty since the beginning of the pandemic in India, Khan has seen and done it all: from rushing patients to hospitals across Delhi to being the sole witness to last rites being performed. But this particular trip to the cremation ground brought him a sense of complete helplessness, as it involved him shifting the body of a 3-year-old COVID-19 victim, the youngest he has ever carried.

"She just reminds me of my daughter, she is somebody's child," he said tearfully.

"Sometimes I end up spending my entire day in cremation grounds and cemeteries. There are just too many bodies," he said as he waited to hand over the stretcher at the crematorium.

Since April 17, when Khan picked up his first COVID-19 patient, he has seen the numbers in cases and deaths rise consistently.

"My ambulance was the only one in the fleet until then," he said. "But with an increase in the number of cases and deaths, we now have 17 ambulances."

Some days, death is the only thing he sees.

"There are so many bodies and so many patients," he said. "On some days, we don't even have time to eat. There have been times when I have had to take six patients at once."

India this month surpassed Brazil as the country with the world's second-highest number of recorded infections. According to the Johns Hopkins Coronavirus Resource Centre, the country has 5.6 million total cases, putting it not far behind the United States, which has 6.8 million.

Testing in India also includes the rapid antigen tests, which result in a higher portion of false negatives, Dasgupta told ABC News.

"Antigen tests have been there for quite some months now and were meant for special situations like containment zones and people with high probability of illness," Dasgupta said. "But it's being done more generally now. On the plus side, this has pushed up testing numbers, but on the minus side you're picking up less than you would from such a high number of tests."

In March, India instituted a stringent lockdown to curb the crisis and give India's overburdened health care system a shot at dealing with the pandemic. But the lockdown plan did not account for the millions of internal migrants working in cities. Most of them were daily wage laborers who, overnight, found themselves without work and shelter.

They were left with no choice but to undertake arduous journeys, often on foot, to go back to their villages located thousands of miles away. And that contributed to the spread of the virus.

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