No abstract

The second surge of COVID-19 had a large mortality impact in India. However, there are few reliable estimates of the magnitude of this impact for India’s poorer states. This note presents results of a small-scale phone survey in Bihar which interviewed a random sample of beneficiaries of the state’s Public Distribution System. This pilot survey was conducted in June 2021 and asked more than 500 respondents about any deaths in their household since April 1, 2021.We observe an annualized Crude Death Rate of 24.3 deaths per 1,000 [95% CI 13.0-37.4] during the second surge of the pandemic in Bihar. The observed death rate is more than four times baseline mortality (5.8 deaths per 1,000 per year). The probability that mortality during the second surge was at least thrice the level of baseline mortality is 0.88. This large surge in mortality warrants an urgent public discussion on state priorities in Bihar. It also suggests the viability of and need for continuous large-scale mortality surveys.

Several strains of the novel Coronavirus have been identified and countries around the world are conducting research to identify, map and compare each type. Its infection can manifest with symptoms ranging from uncomplicated non-specific illness to a more damaging syndrome that include mild to moderate pneumonia (Co-vid 19 pneumonia broadly categorised into the phenotypes: L-type and H-type); Acute Respiratory Distress Syndrome; Sepsis and Septic shock. Although, this virus has a low mortality rate, the danger lies in its virulence and transmission dynamics. With more and more cases being reported, researchers and clinicians are promptly identifying and triaging the cases for treatment. Till date, there has been no drug identified to be efficacious cure for this infection. Using the WHO guidelines as a base, various medical institutions are continuously updating their guidelines for the identification and therapeutic management of persons infected with Co-vid 19, with a strong emphasis on IPC measures. The guidelines also highlight detailed supportive treatment including supplemental oxygen therapy, ventilation, intubation and management of specific complications. The current treatment is tailored to patient centred management for the existing co-morbidities and appreciate a progress in the prognosis. What is needed at this hour however, is a definitive drug therapy or vaccine. Different countries are rushing to find this and various trials are already underway. The aim of this article is thus to review salient features of specific therapies being used now and summarise the different clinical trials being conducted so as to stay abreast of the possible treatment modalities.