Tired of lockdown rules? Our analysis shows most Australians have curbed mixing and helped suppress COVID

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Christopher Baker, The University of Melbourne; Freya Shearer, The University of Melbourne; James McCaw, The University of Melbourne, and Nick Golding, Curtin UniversityUnthinkable in 2019, lockdowns have been a key public health measure to reduce the impact of COVID in Australia. However, lockdowns take a toll on the population, and there is a limit to how long people and communities can sustain these behaviours.

While governments set restrictions through policy, the actual reduction in spread is due to changes in people’s behaviour. Our collective choices have slowed the virus and stopped it on multiple occasions – until the recent Delta variant outbreaks in New South Wales and Victoria.

We have been modelling behaviours in Australia since April 2020 and how they relate to changes in the ability of the SARS-CoV-2 virus that causes COVID to spread. Our understanding of how people have responded to policy settings underpins the Doherty Modelling.

Concerns about “compliance fatigue” might make us question the role of lockdowns in the current outbreak. Has exhaustion led to rule-bending or breaking? In fact, Australians have shown themselves to be resilient and adaptable.

Macro-distancing and micro-distancing

Throughout the epidemic, Australians have shown an impressive ability to change how we interact with others.

In our analyses, we consider two key population behaviours that suppress transmission: macro-distancing and micro-distancing.

Macro-distancing is about the number of people we interact with, while micro-distancing is about our behaviours when we see people.

Both work together to reduce transmission at a population level. We monitor these behaviours using data from weekly anonymous nationwide surveys. We also draw together data on people’s mobility collected by technology companies including Google.

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Transmission potential and the effective reproduction number

We combine these behavioural data with data on vaccination coverage and our understanding of disease dynamics to calculate the transmission potential (TP). The TP measures how transmissible COVID should be, on average, in the community. If it is greater than one, then we expect the virus to be able to spread. If it is less than one, the virus should not be able to establish itself, even if seeded into the community.

The TP is updated weekly for each state and territory in the Common Operating Picture. Where the virus is circulating, we also measure the effective reproduction number (Reff), which measures the actual rate of spread among currently active cases.

Where the virus is circulating, we want to drive the Reff to below one. And for all of Australia, we aim to achieve a TP of near one.

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How behaviour has changed

Over the past 18 months, the levels of macro- and micro-distancing behaviour achieved under any given set of restrictions have changed. The first national lockdown saw the largest changes in behaviour, according to our modelling. Australians responded to the threat and we stopped the virus.

We have repeatedly observed in our modelling similarly low levels of mixing – both macro and micro – in response to outbreaks and restrictions, including at the height of Victoria’s second wave, and recently in NSW, Victoria and the ACT.

Outside of lockdown periods, different regions of Australia show very different patterns. Post the second wave, Victorians remained cautious, mixing less than anywhere else in the country and maintaining micro-distancing behaviours. In contrast, those not on the Eastern seaboard continued to mix more.

However, when the virus arrives and stay-at-home policies are enacted, we all respond similarly. Incursions of the virus into Western Australia and the Northern Territory in 2021 resulted in enormous changes in behaviour.

Our behaviour changes for reasons other than government policy. As our perception of risk increases, we naturally increase our distancing behaviours. We have noted increased macro- and micro-distancing behaviours as cases grow, and sometimes before stay-at-home measures are imposed. We have also seen reduced distancing as case numbers drop.

Has behaviour change driven spread of the Delta variant?

Probably not.

The emergence of the Delta variant has fundamentally changed our ability to control COVID. The Delta variant is approximately twice as infectious as ancestral strains from early 2020. Behaviours which stopped COVID in its tracks earlier in the pandemic can now only slow its spread.

Our modelling of distancing behaviours and of transmission potential allow us to test theories.

We can ask: if Delta were established and people behaved as they did in Victoria in August 2020 (during the second wave of the original COVID strain), could we control transmission? Back then, we estimated transmission potential to be 0.56. Adjusting for Delta by doubling 0.56 leads to a number greater than 1, meaning we would likely see a growing outbreak.

The reverse scenario can also be modelled. The current behaviours in the Australian Capital Territory, New South Wales and Victoria would all likely be sufficient to curb transmission of the earlier COVID strain.

Although case numbers are higher this year, we are still reducing our contacts and slowing the spread of the virus as we did in 2020.

People in lockdown are missing mixing with friends.
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Why aren’t lockdowns sufficient?

The aggregate measures of behaviour do not tell the whole story.

Some sections of the community are unable to work from home and are therefore limited in their ability to reduce their contacts. Lockdowns are not effective at reducing transmission in some workplaces. So despite careful behaviour we can still see rising caseloads.

It’s a pattern that’s played out throughout the pandemic.

In NSW, recent transmission has mainly been in essential workers. In the Victorian second wave, a large amount of transmission was in residential aged care homes, where workers and residents had unavoidable close contact.

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Signs of lockdown fatigue?

Illegal gatherings can lead to clusters of infections (as reported after the AFL Grand Final).

While these well-publicised events tend to be one-offs, they are costly because they seed the virus into new communities. Victoria’s Delta outbreak is now larger than it might have been.

Thankfully these types of events, driven by a minority of individuals, don’t reflect the broader population’s choices. They don’t reflect our collective ability to slow the spread of the virus.

Despite early challenges, we are now on a trajectory to achieving world-leading vaccine coverage. We have already seen high vaccine coverage help turn the NSW epidemic around. Victoria is not far behind.

Every vaccine administered makes outbreak control easier. And every choice we make about how we interact with others matters.

Christopher Baker, Research Fellow in Statistics for Biosecurity Risk, The University of Melbourne; Freya Shearer, Research Fellow, Epidemic Decision Support, The University of Melbourne; James McCaw, Professor in Mathematical Biology, The University of Melbourne, and Nick Golding, Honorary Research Fellow, Telethon Kids Institute, and Professor, Curtin School of Population Health, Curtin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Can I get AstraZeneca now and Pfizer later? Why mixing and matching COVID vaccines could help solve many rollout problems

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Fiona Russell, The University of Melbourne and John Hart, Murdoch Children’s Research InstituteIn the face of changing eligibility for the AstraZeneca vaccine, new variants of the coronavirus and supply constraints, many people are wondering whether they can “mix and match” COVID-19 vaccines.

This means, for example, having the AstraZeneca vaccine as the first dose, followed by a different vaccine such as Pfizer as the second dose, and boosters with other vaccines later on.

While many studies are ongoing, data has recently been released from mix and match trials in Spain and the United Kingdom.

This data is very promising, and suggests mix and match schedules may give higher antibody levels than two doses of a single vaccine.

While Australia’s drug regulator, the Therapeutic Goods Administration (TGA), hasn’t yet approved a mix and match COVID-19 vaccination schedule, some countries are already doing this.

So how does this work, and why might it be a good idea?

What’s the benefit of mixing and matching?

If the COVID-19 vaccine rollout can mix and match vaccines, this will greatly increase flexibility.

Having a flexible immunisation program allows us to be nimble in the face of global supply constraints. If there’s a shortage of one vaccine, instead of halting the entire program to wait for supply, the program can continue with a different vaccine, regardless of which one has been given as a first dose.

If one vaccine is less effective than another against a certain variant, mix and match schedules could ensure people who’ve already received one dose of a vaccine with lower effectiveness could get a booster with a vaccine that’s more effective against the variant.

Some countries are already using mix and match vaccine schedules following changing recommendations regarding the AstraZeneca vaccine because of a very rare side effect of a blood clotting/bleeding condition.

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Several countries in Europe are now advising younger people previously given this vaccine as a first dose should receive an alternative vaccine as their second dose, most commonly mRNA vaccines such as Pfizer’s.

Germany, France, Sweden, Norway and Denmark are among those advising mixed vaccination schedules due to this reason.

Is it safe?

In a UK mix and match study published in the Lancet in May, 830 adults over 50 were randomised to get either the Pfizer or AstraZeneca vaccines first, then the other vaccine later.

It found people who received mixed doses were more likely to develop mild to moderate symptoms from the second dose of the vaccine including chills, fatigue, fever, headache, joint pain, malaise, muscle ache and pain at the injection site, compared to those on the standard non-mixed schedule.

However, these reactions were short-lived and there were no other safety concerns. The researchers have now adapted this study to see whether early and regular use of paracetamol reduces the frequency of these reactions.

Another similar study (not-peer reviewed) in Spain found most side effects were mild or moderate and short-lived (two to three days), and were similar to the side effects from getting two doses of the same vaccine.

Is it effective?

The Spanish study found people had a vastly higher antibody response 14 days after receiving the Pfizer booster, following an initial dose of AstraZeneca.

These antibodies were able to recognise and inactivate the coronavirus in lab tests.

This response to the Pfizer boost seems to be stronger than the response after receiving two doses of the AstraZeneca vaccine, according to earlier trial data. The immune response of getting Pfizer followed by AstraZeneca isn’t known yet, but the UK will have results available soon.

There’s no data yet on how effective mix and match schedules are in preventing COVID-19. But they’re likely to work well as the immune response is similar, or even better, compared with studies using the same vaccine as the first and second dose. This indicates they will work well in preventing disease.

Might this be one way to help resolve Australia’s slow rollout?

In Australia, we’ve seen many people wanting to “wait for Pfizer” and not have the AstraZeneca vaccine. This is despite the UK’s recent real-world findings that, following two doses, both vaccines are similarly effective against the variants circulating in the UK.

Delays in vaccine uptake have also been due to concerns regarding the very rare but serious blood clotting/bleeding syndrome after the first dose of AstraZeneca, as well as changing age restrictions in terms of who can receive this vaccine.

This caused widespread uncertainty and meant some younger people in some countries in Europe who had already received a first dose were excluded from getting a second dose.

The results from these mix and match studies support the possibility of vaccinating people who have received the first dose from AstraZeneca, with a different booster, if the need arises.

Further studies are underway to evaluate mix and match schedules with Moderna and Novavax vaccines, both of which Australia has supply deals with.

Don’t delay getting vaccinated

As Victoria tackles its current outbreak, many other countries in our region are experiencing a surge in cases too. These include Fiji, Taiwan and Singapore, countries previously hailed as excellent examples of how to manage COVID-19.

These examples highlight the difficulty of sustained suppression in the absence of high vaccination coverage. This will be further exacerbated by the new, more transmissible variants.

The current cases in Victoria are caused by the B.1.617.1 (“Indian”) variant. Both vaccines are effective against the closely related B.1.617.2 variant (albeit a bit lower than against B.1.1.7) and we would expect similar effectiveness against B.1.617.1.

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COVID is surging in unvaccinated Taiwan. Australia should take heed

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It’s not clear what kind of evidence regulatory authorities, like Australia’s TGA, would require for a mixed schedule to be approved for use.

While we are waiting, it’s critical eligible people don’t delay getting vaccinated with the vaccine that’s offered to them now. Vaccination is an essential part of the pandemic exit strategy.

It’s likely the vaccination schedule will be modified in the future as boosters may be needed. This is normal for vaccination programs — we already do this each year with the influenza vaccine. This shouldn’t be seen as a policy failure, but instead an evidence-based response to new information.

Fiona Russell, Senior Principal Research Fellow; paediatrician; infectious diseases epidemiologist, The University of Melbourne and John Hart, Clinical researcher, Murdoch Children’s Research Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Pew Research Center: Many Americans mix multiple faiths

The religious beliefs and practices of Americans do not fit neatly into conventional categories. A new poll by the Pew Research Center’s Forum on Religion & Public Life finds that large numbers of Americans engage in multiple religious practices, mixing elements of diverse traditions, reports Pew Research Center.

Many say they attend worship services of more than one faith or denomination — even when they are not traveling or going to special events like weddings and funerals. Many also blend Christianity with Eastern or New Age beliefs such as reincarnation, astrology and the presence of spiritual energy in physical objects. And sizeable minorities of all major U.S. religious groups say they have experienced supernatural phenomena, such as being in touch with the dead or with ghosts.

One-third of Americans (35%) say they regularly (9%) or occasionally (26%) attend religious services at more than one place, and most of these (24% of the public overall) indicate that they sometimes attend religious services of a faith different from their own. Aside from when they are traveling and special events like weddings and funerals, three-in-ten Protestants attend services outside their own denomination, and one-fifth of Catholics say they sometimes attend non-Catholic services.

To read the full report, click here.

Report from the Christian Telegraph

India Briefs: Recent Incidents of Persecution

UTTARAKHAND, India, November 3 (CDN) — Hindu extremists from the Bajrang Dal on Oct. 25 disrupted the Sunday worship of a Ministry of the Gospel service in Rudrapur and accused the pastor of forceful conversion. The Evangelical Fellowship of India reported that the extremists barged into the worship service led by Pastor Victor Massey, tore Bibles and took all Christian literature. They threatened to attack anew if the congregation continued to meet for worship, adding that they would force Hindu rituals on them. Ministry of the Gospel leader S.K. Puri told Compass that church officials reported the matter to the district collector and superintendent of police, but when Hindu nationalists heard about the complaint they accosted Pastor Massey on Oct. 30 and again threatened to force Hindu rituals on the congregation. Christian leaders have asked local authorities to provide police protection.

Karnataka – A mob of about 50 Hindu extremists attacked a church on Oct. 25 in old Hubli, burning Bibles and Christian literature. The Evangelical Fellowship of India reported that at about 11 a.m. the Hindu hardliners barged into the prayer meeting of Assembly of God Church and dragged out Pastor David Raj. The attack reportedly began after an unidentified man in attendance repeatedly went in and out of the church building; he was requested to remain sitting so as not to disturb the sermon. The man left and returned with 50 extremists, led by area Bajrang Dal leader Jayathirtha Kati. After the Hindu extremists verbally abused the church members, set fire to the Christian literature and dragged the pastor out to the street, local police arrived and, as is customary in India, detained the victims. They took the pastor, his wife and two church members to the police station and only with local Christian leaders’ intervention were the Christians released at about 5 p.m.

Assam – Hindu extremists and the head of Dayung village called a meeting on Oct. 23 to oppose a Christian ministry after a young woman who became a Christian refused to renounce her faith, a source told Compass. Tara Sabha’s family beat and disowned her after she told the village council that she would not leave Christianity at any cost, the source said. Sabha had received Christ earlier in October. The source told Compass that Hindu extremists held Enosh Lepcha of First Evangelical Church Association of India (FECAI) responsible for the conversion, and on Oct. 23 they and the village head called a public meeting in which they threatened a social boycott if the ministry continued its activities. FECAI’s Abbay Pradhan told Compass that due to extremist pressure, the ministry has stopped many activities.

Andhra Pradesh – Suspected Hindu extremists set fire to India Mission Society Church in Warrangal on Oct. 22, damaging more than half of the building. The Global Council of Indian Christians reported that unidentified people set the church building ablaze at about 2 a.m. Pastor P. Kumarswamy contacted the fire department, which arrived after more than half of the building had been destroyed. Police registered a First Information Report, and an investigation is underway.

Karnataka – Hindu nationalists forced an evangelist and other Christians to go to a police station on false charges of forcible conversion on Oct. 21 after barging into the church leader’s home and demanding money for a Hindu festival in Undedasarahalli, Chikamaglur district. The Global Council of Indian Christians (GCIC) reported that Hindu radicals leveled the charges after evangelist Kumar Nayak of the Assemblies of God refused to give a donation for the Diwali festival. Nayak and his family were about to leave home for the last of a three-day prayer meeting when nearly 30 extremists led by Prakash Nayak forcibly entered their house and tried to force them to give money for the Hindu rite. The intolerant Hindus verbally abused them, warning that they would not be allowed to stay in the village, and forced Nayak, his wife Bembitha, 52-year-old widow Lalitha Bai and her three children to go to the Banavara police station and filed a complaint. With GCIC intervention, all but Kumar Nayak were released at 11:30 p.m., with the evangelist detained until midnight on condition of reporting to the police station at 9 a.m. the next morning. After extensive questioning the next day, Nayak was released at 4 p.m. without being charged.

Andhra Pradesh – Hindu extremists on Oct. 18 attacked a worship service in Hyderabad, beating a pregnant woman and her child and seriously injuring a pastor’s ear. The Global Council of Indian Christians reported that about 15 people from the Hindu extremist Rashtriya Swayamsevak Sangh barged into the service led by Pastor Siluvai Kumar and two others pastors, verbally abused the Christians and accused them of forceful conversion. The intolerant Hindus tore and threw Bibles and damaged the church facility, including musical instruments. The Hindu extremists later dragged a pastor identified only as Timothy to Kukatpally police station and filed a false charge of urinating on nearby temple idols. With the intervention of the local Christian leaders, police summoned the attackers to the police station, where the parties reached an agreement in which the extremists apologized to the Christians and pledged not to attack them.

Uttar Pradesh – On Oct. 15 Hindu extremists from the Vishwa Hindu Parishad (World Hindu Council) in Pratap Garh accused Pastor Sunil Singh of the Full Gospel Church of fraudulent conversion and threatened to kill him if his church continues its worship services. A source told Compass that the extremists went to the pastor’s house to deliver the threat. The Hindu hardliners filed a police complaint against the pastor of offering money to people to convert to Christianity. Police summoned the pastor to the police station for questioning, and an investigation was underway.

Andhra Pradesh – Hindu extremists on Oct. 13 stopped construction of a Methodist church building and verbally abused Pastor M. Gabriel in Nizamabad. The All India Christian Council (AICC) reported that the Hindu extremists along with the village head, Vital Reddy, were responsible for the hostilities. The pastor filed a police complaint charging harassment and contacted the district collector and superintendent of police, but no action had been taken at press time. An AICC representative told Compass that the pastor has stopped church construction to avoid further disturbances.

Karnataka – State police on Oct. 10 arrested Christians on false charges of forcible conversion in Gowdigere village, Hubli, Dharwad district. The Global Council of Indian Christians (GCIC) reported that at 9 a.m. about 30 local Hindu nationalists barged into the house of a Christian woman identified only as Venkatamma just after the end of a prayer service. The extremists falsely accused Friends Missionary Prayer Band Mission Pastor Murthy Nayak Ganesh and evangelist Chandrakanth Gopanna Lambani of fraudulently luring people to Christianity. Later the extremists forced the Christians to the village temple, and then telephoned Kundugol police who came to the temple and took the Christians to the station, charging them “punishment of criminal conspiracy,” among others. With GCIC intervention, the pastors were released on Oct. 12, but it was not clear at press time whether charges were still pending.

Punjab – Hindu extremists in Samral Chowk, Ludhiana on Oct. 6 severely beat and stabbed a Christian worker, according to the Evangelical Fellowship of India (EFI). At About 7:30 a.m. Vijay Kumar, an Indian Pentecostal Church worker and a former student of Punjab Bible College, was distributing gospel tracts when five Hindu extremists arrived in a vehicle with a non-numbered license plate and forced him into it. Beating and stabbing him with a knife in his chest and leg while taking him to different sites, they questioned him about how much money he had received to become a Christian and asked with which Christian groups he was associated, EFI reported. They later took him to a jungle and continued torturing him. A Christian search team began looking for Kumar at 7:30 p.m., and at 2 a.m. that night they received a phone call from him saying the assailants had taken him back to his village and thrown him from the running vehicle. He was taken to Christian Medical College with severe injuries but was recovering well. A complaint was filed at Shingaar police station, but no arrests had been made at press time.

Chhattisgarh – Hindu extremists attacked a pastor and his family and later accused them of forced conversion and other false charges in Jyotipur village, Bilaspur district. Pastor Markus Das of the Assembly of God Church on Oct. 4 went to visit a family in Sadwani village along with his wife and children. On their way back their van had a flat tire, and as his friend Atul Arthur gave them a ride home, a group of people from the Rathore community – closely aligned with the Hindu extremist Bajrang Dal – attacked them. They accused Pastor Das of forcible conversion and tried to drag him and others out of the vehicle, causing minor injuries. They damaged the vehicle, smashing the windows. Pastor Das and his family managed to escape, but the next morning when he went back to pick up his van, he was told that the forest department had confiscated his vehicle after allegedly finding illegal wood in it. Pastor Das said the Rathore community set a trap. “They broke the front windshield of my car and planted the wood in my car when I was away,” he said. A First Information Report has been filed against Pastor Das indicting him for forced conversion and carrying illegal wood, and the pastor has filed an FIR against members of the Rathore Community in the Gorala police station.

Chhattisgarh – Hindu extremists in Raipur on Oct. 3 tried to pressure a Christian family into giving up their faith. The extremists also threatened to publicly dishonor Pastor Kamlakar Roa Bokade by filing charges of forcible conversion against him if he did not stop visiting the family of Modichandan Sahu, a convert who has regularly attended worship services for the past 15 years. Modichandan Sahu’s two daughters had married non-Christians under social pressure, and one of her sons-in-law, Bhuwan Sahu, a member of the Hindu extremist Bharatiya Janata Party, cut off relations with his in-laws several years ago because of his opposition to Christianity. Hindu extremists led by Bhuwan Sahu on Oct. 3 stormed Motichandan’s house, pressured her to give up her faith and tried to force her into Hindu ceremonies and ritual. The next day he began threatening Pastor Bokade, telling him by cell phone that they would frame him for forceful conversion. The Chhattisgarh Christian Forum has notified police of the harassment.

Kerala – Hindu extremist Bharatiya Janata Party newspaper The Janmabhumi Daily forced sub-editor Sredevi Nair to resign from her job on Oct. 1 after management learned that she had received Jesus Christ. Nair resigned two days before her baptism, reported The Indian Catholic. The managing editor of the Janmabhumi daily, Kummanam Rajasekharan, reportedly called her during work hours and said it was not possible for a convert to continue with the newspaper. The Indian Catholic reported that Rajasekharan urged Nair to convert her Christian husband to Hinduism and have a marriage ceremony at a Hindu temple. The Indian Express quoted Janmabhumi Editor Leela Menon as saying that that she was against conversion, and that Nair was trying to malign the newspaper after her resignation.

Madhya Pradesh – Members of the Hindu extremist Abhinav Bharat on Sept. 28 stormed into a house church in Adhartal, on the outskirts of Jabalpur. The Global Council of Indian Christians (GCIC) reported that at 12:30 p.m. about 15 of the intolerant Hindus arrived on motorcycles and broke into the house church meeting shouting “Jai Sri Ram [Hail to Lord Ram)” and vandalized the property, including damaging the cross at the entrance. The Hindu extremists threatened 51-year-old Pastor Peter Johnson with further attacks. Pastor Johnson filed a complaint with Adhartal police station in Jabalpur, and police have reportedly forwarded it to the City Superintendent of Police and Collector. GCIC reported that police assured a speedy investigation. The Abhinav Bharat is already under the government scanner for anti-Muslim bomb blasts, and some of their leaders holding government posts are in custody and on trial.

Madhya Pradesh – For the third time, radicals from the minority Jains religion on Sept. 27 attacked and threatened the church of Pastor Mukesh Pal of Rajgarh, Dhar district. About a dozen of the Jains, all members of the Hindu nationalist Bharatiya Janata Party, interrupted a worship service of some 500 mainly tribal people and cursed, criticized and accused Christians of fraudulent conversion, eating cow meat and mixing harmful chemicals into anointing oil used for prayers for the sick. The Jains religion advocates non-violence and vegetarianism. After those attending the church service argued with the radicals, the extremists left but returned with five policemen. A doctor was called on the spot to test the prayer oil, and he certified it as chemical-free. Nevertheless, police arrested Pastor Mukesh Pal and Ganpat Goyal, and many from the church followed and stood outside the police station demanding the release of the two Christians. After calls from Christian friends, high-ranking officers ensured that police release the two Christians. Pastor Pal told Compass that the radicals attacked their prayer hall in June 2006, badly damaging it. They arrived again in August 2006, warning the Christians not to hold more services and accusing them of forcible conversion, although they did no physical harm.

Andhra Pradesh – Hindu extremists led by Venkat Reddy attacked a Christian identified only as Abhishek, from Hebron Church, and accused him of forceful conversion on Sept. 25 in Ranga Reddy. The All Indian Christian Council (AICC) reported that the extremists attacked the Christian while he was conducting a Bible school class at Hamamguda, mercilessly beating him and accusing him of organizing the study program to forcibly convert children to Christianity. Abhishek received treatment at Apollo Santoshnagar Hospital, reported AICC. The extremists filed a police complaint against the Christian, but later forced the Christian to agree to stop the Bible program.

Report from Compass Direct News