An utter disregard to pandemic-associated security measures is reaching unsafe proportions in India and practically appears symptomatic of a new devil-may perhaps-care attitude exactly where even a record viral caseload is not creating people today transform their behaviour. Picture the new virus variants landing into the nation, new mutations emerging locally and set them against the pictures of big gatherings for religious events, elections, cricket matches and social functions and it is a no brainer why India is seeing record COVID-19 situations each and every day. But with new situations now at more than 2 lakh a day for 3 straight days, issues more than what is in-shop tomorrow are acquiring difficult to ignore.
At one finish, there are worries about the injections – the availability of vaccine doses, the forms of new vaccines, their security and their capability to deal with the new variants. On the other finish, there are issues about the infection and the manner in which it is unfolding – the altering nature of the virus, its probably resistance to vaccines, and the transmissibility versus the virulence of the virus strains.
Let us attempt and get answers to some of the significant inquiries:
How secure and helpful are the vaccines?
How significantly must we be concerned about the virus variants and the capability of the vaccines to deal with them? Based on research accomplished abroad, Dr Gagandeep Kang, India’s major vaccine scientist and professor at the Christian Medical College, Vellore, tells TheSpuzz Online: “Of all the strains that we see, we do not need to worry too much.” Among all the variants, there are more issues about the South African variant – that vaccine professionals refer to as B.1.351. It is also identified in India as are the other variants – B.1.1.7 (the UK variant) and P.1 (the Brazilian strain) apart from the double mutations observed in India and in other nations. “I don’t think we know for sure that all the vaccines are not working even against the South African variant – which is regarded as the worst of the lot variants in terms of immune escape. However, these kinds of studies need to be done in India also,” says Dr Kang.
Dr Soumya Swaminathan, the chief scientist at the World Health Organisation and the former director-common at the Indian Council of Medical Research (ICMR) says: “All the currently approved vaccines in India and those which have received emergency use listing by the WHO and other stringent regulatory authorities and will also eventually get to India are all very effective in preventing severe disease and death.” She feels “most will probably work against the variants noticed in India also (B.1.1.7, B.1.351, P.1 apart from the double mutations) though more studies are needed on the vaccine efficacy against the different variants.”
Agreeing with the view on the working of the vaccines, Rakesh Kumar Mishra, director of the Centre for Cellular and Molecular Biology (CCMB), a premier Indian study organization based in Hyderabad and focused in the frontier regions of contemporary biology, says: “because we are not finding any unusually high level of re-infection, it means people who got infected have developed the immunity and are able to resist the infection. Therefore, he sees reason to believe the vaccines are also working and therefore “those who get vaccinated will also get the protection.”
CCMB (and probably a couple of other scientific institutions), he says, is presently conducting the in-vitro neutralizing assay to recognize the response of vaccines to the double mutations and he feels in a different 10 days to a fortnight more clearer image must emerge on the efficacy of the vaccines on the double mutations.
What facts are nevertheless missing?
But then, when we have to have to do the research in India, the issues that have to have to be cleared are about the vaccines that are acquiring authorized. In the Sputnik vaccine, no one knows till date which of the two presentations – the frozen one or the lyophilized one – has been authorized by the Indian drug regulator. For instance, K V Balasubramaniam, an independent consultant and the former managing director of Indian Immunologicals Ltd, explains: “the frozen one needs to be stored at minus 20 degrees centigrade and therefore likely to pose a logistical challenge whereas the lyophilized (for freeze-dried) one can be stored like many other vaccines at between 2 and 8 degrees centigrade, there could be challenges of apparently a short window available for administering the vaccine after the vial has been opened.”
Then, on the other significant vaccine in India – Covaxin created by Bharat Biotech and now also by the Maharashtra government undertaking Haffkine Biopharmaceutical Corporation by means of technologies transfer from Bharat Biotech. Vaccine professionals point out that the final efficacy study information is nevertheless to be shared and that they are all even today basing all their views on only the interim study findings shared so far. Many hope it will be announced quickly.
What is the vaccination program?
Given the increasing caseload and the reality that vaccines are the only readily available defence, the crucial concern, as a result, is the have to have for clarity on what the government’s proposed inoculation method is: For instance, the crucial query every person desires to know is how numerous people today does the government basically want to vaccinate and based on that its assessment of the vaccine doses necessary and the extent to which the procurement plans for these are in location and the resource allocation created.
How to verify transmission?
The notion is to recognize, which is the target segment of the population the government is seeking at. If the purpose is to verify the transmission then 45 years and above is not the target population since transmission is more by means of younger people today. However, if the purpose is the prevention of extreme illness and death then the argument of 45 years and above can hold.
While, ideally, anyone above the age of 18 – at least going by the readily available vaccines and the applicability based on age presently – must be permitted a vaccine and subsequently, even get to the kids also since as the illness settles down, professionals say, kids could unwittingly come to be the key modes of transmission.
Why the outcry for Remdesivir is flawed?
Talk to patients acquiring treated for COVID and in reality, a colleague of this writer is presently in a hospital in Delhi coping with COVID and desperately in have to have of Remdesivir. Elsewhere in Chennai, there is a patient that has a extended list of prescription from a physician and this incorporates antibiotics, asthma drugs, paracetamol and even a CT scan. How significantly of all these medicines is justified, we asked Dr Swaminathan and this is what she says: “Unnecessary use of antibiotics or antivirals (including Remdesivir) is not warranted in all cases of COVID-19.” She says, “we have learnt a lot about the clinical management of COVID-19 and it is important that all physicians and hospitals follow evidence-based clinical care guidelines and stick to standard protocols.” The WHO, she says, “has guidelines on the treatment of COVID-19 which are regularly updated based on emerging evidence.” Though she also feels “more research is needed in India and globally on outpatient treatment of patients with drugs like inhaled corticosteroids and nitric oxide, both of which have shown promising early results and need further validation.”
The answer, Dr Gagandeep Kang, feels is getting in location a suitable protocol that is standardized that each private and public systems adhere to and provide proof-based care and not a random set of treatment options that are decided with, in some situations, just with an eye on earnings. CMC Vellore, for instance, she points out, has a protocol in location for COVID patients created by a group that appears at the proof.