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INDIA'S STRUGGLE WITH COVID-19: REACHING THE POINT WHERE WE STAND TODAY

INDIA'S STRUGGLE WITH COVID-19: REACHING THE POINT WHERE WE STAND TODAY

Before I write any further on the topic of Corona, I would like to express my grief at the plight of doctors from the 900hundred bedded Hindu Rao Hospital-a Covid-19 dedicated centre run by North Delhi Municipal Corporation (NDMC).

The non-payment of their salaries for more than 3months and a crossfire of blames and counter blames between (NDMC) and Delhi government is an unfortunate situation, to say the least. This crisis of unbearable financial stress to the team leaders of the frontline workers in the prevailing emergency situations of the pandemic should be sorted out at the earliest possible as it carries the potential of causing a complete breakdown of the system.

It is now around 10months since Covid-19 virus made its gatecrash entry into almost every corner of the earth, affecting each & every sphere of human existence. India has borne the brunt of this attack both as a part of the rest of the world and as a unique nation of 1300million people , majority of whom were living below the internationally drawn poverty line even before the spread of this disease, as a nation practising all major religions of the world,, having 26 different official languages, a landscape varying from the mighty Himalayas to Rajasthan's Thar desert of 200lakh square kms, a mainland coastline of 5422.6kms, sharing its northern borders on both Eastern & Western sides with hostile countries. Each of these factors hold a moulding effect on the planning and execution of a fight against a disease which has a power of spreading like wildfire anywhere and everywhere. The health delivery system in this adverse situation could evidently not have been self sufficient or one of the best in the world, yet the country's fight for survival has been remarkably bold, result oriented & scientifically based.

Circumstances like these in any other part of the world would have led to a complete crackdown in the official and unofficial machinery which runs a nation, but India has not given any evidence of surrender to the Doom's day predictions about the pandemic.

The earliest days of the pandemic brought forward a depressing picture of millions of migrant labourers, literally walking down 1000s of kms back home after losing their meagre livelihoods, carrying their children & heavy baggage on frail shoulders, which more often than not belonged to ladies, running hungry for days, getting crushed under trains and buses, but continuing their march till they reached their destinations. Many died on the way but the country survived with the strength they imparted to it.

The complete lockdown stretching over months led, as we all are painfully aware, to a halt of all human activity; businesses and markets were closed, educational institutions were shut sine die, all means of transport were stopped from running, roads wore the bare empty look which no eyes had seen before, visit to religious places & cinema houses, sports, cultural events were all stopped and cancelled. This last part of the scenario was the only thing India shared with the world-the rest of the story being totally different for our land of miracles and awe.

The first confirmed case of Covid-19 was recorded in Kerela's, Thissur district on 30th January'2020, the country has come a long way from this Wuhan exported case, reaching 75,49,162 number of the total affected individuals & 1,14,623 national death figure as of today the 19th October'2020. Till mid-May we were nowhere in the list of 10 most affected nations, but from then on we steadily climbed this chart to reach our present 2nd position in it & are stuck there for more than a month now; 8th September'2020 is the date of reaching this world record when our numbers exceeded those of Brazil and remained less compared to only one country, USA.

Our consolidated efforts to fight the disease have been inundated by (1) the wreckage caused from repeated sea storms at the Eastern as well as the Western coasts, (2) a locust invasion on the north western states, (3) military scuffles with China, continued irritants from Pakistan, and even Nepal, which till date had been a friendly nation, (4) serious social disruptive incidents occurring as a result of religious intolerance, (5) state level elections and by elections & Rajya Sabha elections-to name a few of these factors, which also included (6) protests against various constitutional amendments, and (7) our multitude of festivals and finally last but not the least (8) especially in the NCR the return of the pollution problem, which in itself can be a cause of an epidemic of allergic respiratory diseases.

In this chaotic social scene, a scientific thought, leave alone a scientific action of such mass scale connotations would seem unimagineable, but India is India and we have done it!! Behind this grim facade of a hazy cover, a probe into the reality of the results of our struggle against the disease would read as a big success story.

Much before the actual declaration of the pandemic being made at the UN level and almost coinciding with WHO's declaration on 12th January'2020 that a novel Coronavirus was causing a respiratory illness in a cluster of people in the Wuhan city of district Hubei in China, India began thermal screening of passengers arriving from China and a few other countries on 21st January'2020. This exercise was initially carried out at 7 airports and by the end of January was extended to 20 airports. The countries from where arrivals were being screened initially included China, Thailand, Hong Kong, Singapore, Japan and South Korea- this was in the earlier part of February'2020, by the end of February Nepal, Vietnam, Malaysia, & Indonasia were also included in the list. However, in February only, the ICMR admitted that airport screening alone was insufficient to control the impending threat.

The actual plans to deal with a worsening of the pandemic in the country were only drawn in mid-March for which seven ministries were roped in to set up additional quarantine and treatment facilities. While spreading information about these plans care was taken to caution all concerned to avoid a panic-like situation. I believe that this small step provided a big boost to the morale of the workers at all levels. Social distancing advice to be announced by all states was issued on 17th March and was the first step of the preventive strategy to which later wearing masks and frequent hand washing for 20seconds and use of sanitizers were soon added.

Countrywide lockdown for 21days was declared by the PM from 25th March & was preceded on 22nd March by a single day exercise of similar nature in 82 districts of 22 states and union territories, where confirmed cases had been reported. This was followed by barring of interstate travel and sealing of state borders. The positive effect of this measure was that the doubling time for the number of cases increased from the earlier three to six days. A complete lockdown of the entire nation was thus in place from 25th March till 31st May, but declarations to this effect were made in steps and phases. For the red zones or the containment areas this situation was to prevail till 30th June. This essential step of locking down the entire nation for a prolonged 2 & 1/2 month period made every single citizen of the country aware of risk factors associated with the illness and thus comply with the instructions and government advisories.

Under the WHO guidelines, the country adopted an epidemiological approach involving mass scale detection-covering maximum population, adequate testing for the disease, isolation of the affected individuals, care for every positive case and sincere tracing of contacts. (Please refer to my previous article "Making Sense of World Corona Figures-Chapter20-WHO on Corona" dated 13th October'2020)

With these dedicated efforts we have reached today's date of 19th October when 5days back on 14-10-2020 the total samples tested were '9 crore 90 thousand 122' of which those who tested positive numbered 72 lakhs 39 thousand and 389, this was equivalent to a (test/million figure of of 65,289 & a positively percentage of 8.04). The union health ministry has set up a war room from where the policy making team with members from different government organisations work to decide about the policies to be adopted to tackle the prevention and spread of coronavirus.

The National Institute of Virology has been providing leadership and guidance under which the initial 15 labs, as on 17th March, increased to 65 labs for testing of the virus. The visionary decision taken in mid-March to allow the NABL accreditation attained private labs to conduct tests on suspected individuals has helped the workers cover a population of roughly ten crores for Covid-19 tests.

Rapid antibody tests, pool testing which are capable of handling around 90 tests at a time, RT-PCR tests, low cost paper strip tests developed by the Institute of Genomics & Integrative Biology of Delhi are the various types of tests being used for detection of the affected individuals. At this point it might be imperative to mention the ridiculous experience with the Chinese test kits, 6,50,000 of which arrived in India on the 16th April'2020. Over 2 million more were to be delivered within the next 15 days. These were rapid antibody tests and RNA extraction kits which were distributed by ICMR & NICED to various states for their use. On 21st April the health department of West Bengal alleged that these kits were yielding inconclusive results and a low accuracy of 5.4% as compared to the expected 90% was found in relation to these kits, so the ICMR stopped their uses all over the country and cancelled orders for the remaining kits.

Another very important achievement of the scientists of this nation, was the isolation, as early as on 14th March, of a strain of the novel Coronavirus. By doing this India became the 5th country to isolate a pure sample of this virus after China, Japan, USA & Thailand.

India has played an important role in the treatment and research aspects of the global Covid-19 control programs too. Hydroxychloroquine-sulfate a refined form of the 400 year old antimalarial drug chloroquine, is a part of four drugs Solidarity Trial for Covid-19 treatment, initiated by WHO and India participated in it by sending it in bulk to USA and other countries where malaria had long since been eradicated. The other three drugs in this scheme are Remdesivir, Lapinavir & the interferon.

India's experiment with convalescent plasma therapy wherein a recovered patient who has developed IgG antibodies in his blood, donates his plasma to a Corona ill patient, has also been tried elsewhere and is slowly gaining popularity after the four preconditions which ensure its success have been discovered.

As for the anti-corona vaccine, a latest advisory on it has been released from the PM's office which has emphasised on 17th October'2020, after Mr Narender Modi chaired a special meeting on the subject. that (a) no intranasal Covid-19 vaccine is under clinical trial in India, today (b) 3 indigenous vaccine candidates are in advanced stages of development out of which two are in stage (ii) and one is in stage (iii) and (c) that the country's health delivery system has to gear up its preparedness for vaccine administration by ensuring advanced planning for (i) cold storage chains for the vaccines (ii) distribution network (iii) monitoring mechanism and (iv) advance assessment & preparation of ancillary equipment required such as vials & syringes. Detailed blueprint for this plan was presented in that meeting which was attended by the Union Health Minister Dr Harsh Vardhan, & NITI aayog's principal scientific advisor besides senior officers from various concerned agencies.

It was further said here that Indian scientists & research teams were collaborating and strengthening the research capacities in neighbouring countries such as Afghanistan, Bangladesh, Bhutan, Maldives, Mauritius, Nepal, and Srilanka. Besides this, Myanmar, Bangladesh, Qatar, & Bhutan have requested India to help in the clinical trials in their respective countries.

It is a result of such hard work and team efforts that today, the leading daily newspaper Hindustan Times carried these two headlines on its front page, "Covid could be under control by February" as a quote from a panel of experts appointed by the government, and WHO has welcomed India's stance against vaccine nationalism.

The above mentioned applause from WHO has come our way because of our strategy on anti-corona vaccine, wherein, besides promoting and fully utilising our own products in this capacity we have accepted proposals from many of the foreign companies to allow the use of their products too in our country.

INDIA'S STRUGGLE WITH COVID-19: REACHING THE POINT WHERE WE STAND TODAY

INDIA'S STRUGGLE WITH COVID-19: REACHING THE POINT WHERE WE STAND TODAY

Before I write any further on the topic of Corona, I would like to express my grief at the plight of doctors from the 900hundred bedded Hindu Rao Hospital-a Covid-19 dedicated centre run by North Delhi Municipal Corporation (NDMC).

The non-payment of their salaries for more than 3months and a crossfire of blames and counter blames between (NDMC) and Delhi government is an unfortunate situation, to say the least. This crisis of unbearable financial stress to the team leaders of the frontline workers in the prevailing emergency situations of the pandemic should be sorted out at the earliest possible as it carries the potential of causing a complete breakdown of the system.

It is now around 10months since Covid-19 virus made its gatecrash entry into almost every corner of the earth, affecting each & every sphere of human existence. India has borne the brunt of this attack both as a part of the rest of the world and as a unique nation of 1300million people , majority of whom were living below the internationally drawn poverty line even before the spread of this disease, as a nation practising all major religions of the world,, having 26 different official languages, a landscape varying from the mighty Himalayas to Rajasthan's Thar desert of 200lakh square kms, a mainland coastline of 5422.6kms, sharing its northern borders on both Eastern & Western sides with hostile countries. Each of these factors hold a moulding effect on the planning and execution of a fight against a disease which has a power of spreading like wildfire anywhere and everywhere. The health delivery system in this adverse situation could evidently not have been self sufficient or one of the best in the world, yet the country's fight for survival has been remarkably bold, result oriented & scientifically based.

Circumstances like these in any other part of the world would have led to a complete crackdown in the official and unofficial machinery which runs a nation, but India has not given any evidence of surrender to the Doom's day predictions about the pandemic.

The earliest days of the pandemic brought forward a depressing picture of millions of migrant labourers, literally walking down 1000s of kms back home after losing their meagre livelihoods, carrying their children & heavy baggage on frail shoulders, which more often than not belonged to ladies, running hungry for days, getting crushed under trains and buses, but continuing their march till they reached their destinations. Many died on the way but the country survived with the strength they imparted to it.

The complete lockdown stretching over months led, as we all are painfully aware, to a halt of all human activity; businesses and markets were closed, educational institutions were shut sine die, all means of transport were stopped from running, roads wore the bare empty look which no eyes had seen before, visit to religious places & cinema houses, sports, cultural events were all stopped and cancelled. This last part of the scenario was the only thing India shared with the world-the rest of the story being totally different for our land of miracles and awe.

The first confirmed case of Covid-19 was recorded in Kerela's, Thissur district on 30th January'2020, the country has come a long way from this Wuhan exported case, reaching 75,49,162 number of the total affected individuals & 1,14,623 national death figure as of today the 19th October'2020. Till mid-May we were nowhere in the list of 10 most affected nations, but from then on we steadily climbed this chart to reach our present 2nd position in it & are stuck there for more than a month now; 8th September'2020 is the date of reaching this world record when our numbers exceeded those of Brazil and remained less compared to only one country, USA.

Our consolidated efforts to fight the disease have been inundated by (1) the wreckage caused from repeated sea storms at the Eastern as well as the Western coasts, (2) a locust invasion on the north western states, (3) military scuffles with China, continued irritants from Pakistan, and even Nepal, which till date had been a friendly nation, (4) serious social disruptive incidents occurring as a result of religious intolerance, (5) state level elections and by elections & Rajya Sabha elections-to name a few of these factors, which also included (6) protests against various constitutional amendments, and (7) our multitude of festivals and finally last but not the least (8) especially in the NCR the return of the pollution problem, which in itself can be a cause of an epidemic of allergic respiratory diseases.

In this chaotic social scene, a scientific thought, leave alone a scientific action of such mass scale connotations would seem unimagineable, but India is India and we have done it!! Behind this grim facade of a hazy cover, a probe into the reality of the results of our struggle against the disease would read as a big success story.

Much before the actual declaration of the pandemic being made at the UN level and almost coinciding with WHO's declaration on 12th January'2020 that a novel Coronavirus was causing a respiratory illness in a cluster of people in the Wuhan city of district Hubei in China, India began thermal screening of passengers arriving from China and a few other countries on 21st January'2020. This exercise was initially carried out at 7 airports and by the end of January was extended to 20 airports. The countries from where arrivals were being screened initially included China, Thailand, Hong Kong, Singapore, Japan and South Korea- this was in the earlier part of February'2020, by the end of February Nepal, Vietnam, Malaysia, & Indonasia were also included in the list. However, in February only, the ICMR admitted that airport screening alone was insufficient to control the impending threat.

The actual plans to deal with a worsening of the pandemic in the country were only drawn in mid-March for which seven ministries were roped in to set up additional quarantine and treatment facilities. While spreading information about these plans care was taken to caution all concerned to avoid a panic-like situation. I believe that this small step provided a big boost to the morale of the workers at all levels. Social distancing advice to be announced by all states was issued on 17th March and was the first step of the preventive strategy to which later wearing masks and frequent hand washing for 20seconds and use of sanitizers were soon added.

Countrywide lockdown for 21days was declared by the PM from 25th March & was preceded on 22nd March by a single day exercise of similar nature in 82 districts of 22 states and union territories, where confirmed cases had been reported. This was followed by barring of interstate travel and sealing of state borders. The positive effect of this measure was that the doubling time for the number of cases increased from the earlier three to six days. A complete lockdown of the entire nation was thus in place from 25th March till 31st May, but declarations to this effect were made in steps and phases. For the red zones or the containment areas this situation was to prevail till 30th June. This essential step of locking down the entire nation for a prolonged 2 & 1/2 month period made every single citizen of the country aware of risk factors associated with the illness and thus comply with the instructions and government advisories.

Under the WHO guidelines, the country adopted an epidemiological approach involving mass scale detection-covering maximum population, adequate testing for the disease, isolation of the affected individuals, care for every positive case and sincere tracing of contacts. (Please refer to my previous article "Making Sense of World Corona Figures-Chapter20-WHO on Corona" dated 13th October'2020)

With these dedicated efforts we have reached today's date of 19th October when 5days back on 14-10-2020 the total samples tested were '9 crore 90 thousand 122' of which those who tested positive numbered 72 lakhs 39 thousand and 389, this was equivalent to a (test/million figure of of 65,289 & a positively percentage of 8.04). The union health ministry has set up a war room from where the policy making team with members from different government organisations work to decide about the policies to be adopted to tackle the prevention and spread of coronavirus.

The National Institute of Virology has been providing leadership and guidance under which the initial 15 labs, as on 17th March, increased to 65 labs for testing of the virus. The visionary decision taken in mid-March to allow the NABL accreditation attained private labs to conduct tests on suspected individuals has helped the workers cover a population of roughly ten crores for Covid-19 tests.

Rapid antibody tests, pool testing which are capable of handling around 90 tests at a time, RT-PCR tests, low cost paper strip tests developed by the Institute of Genomics & Integrative Biology of Delhi are the various types of tests being used for detection of the affected individuals. At this point it might be imperative to mention the ridiculous experience with the Chinese test kits, 6,50,000 of which arrived in India on the 16th April'2020. Over 2 million more were to be delivered within the next 15 days. These were rapid antibody tests and RNA extraction kits which were distributed by ICMR & NICED to various states for their use. On 21st April the health department of West Bengal alleged that these kits were yielding inconclusive results and a low accuracy of 5.4% as compared to the expected 90% was found in relation to these kits, so the ICMR stopped their uses all over the country and cancelled orders for the remaining kits.

Another very important achievement of the scientists of this nation, was the isolation, as early as on 14th March, of a strain of the novel Coronavirus. By doing this India became the 5th country to isolate a pure sample of this virus after China, Japan, USA & Thailand.

India has played an important role in the treatment and research aspects of the global Covid-19 control programs too. Hydroxychloroquine-sulfate a refined form of the 400 year old antimalarial drug chloroquine, is a part of four drugs Solidarity Trial for Covid-19 treatment, initiated by WHO and India participated in it by sending it in bulk to USA and other countries where malaria had long since been eradicated. The other three drugs in this scheme are Remdesivir, Lapinavir & the interferon.

India's experiment with convalescent plasma therapy wherein a recovered patient who has developed IgG antibodies in his blood, donates his plasma to a Corona ill patient, has also been tried elsewhere and is slowly gaining popularity after the four preconditions which ensure its success have been discovered.

As for the anti-corona vaccine, a latest advisory on it has been released from the PM's office which has emphasised on 17th October'2020, after Mr Narender Modi chaired a special meeting on the subject. that (a) no intranasal Covid-19 vaccine is under clinical trial in India, today (b) 3 indigenous vaccine candidates are in advanced stages of development out of which two are in stage (ii) and one is in stage (iii) and (c) that the country's health delivery system has to gear up its preparedness for vaccine administration by ensuring advanced planning for (i) cold storage chains for the vaccines (ii) distribution network (iii) monitoring mechanism and (iv) advance assessment & preparation of ancillary equipment required such as vials & syringes. Detailed blueprint for this plan was presented in that meeting which was attended by the Union Health Minister Dr Harsh Vardhan, & NITI aayog's principal scientific advisor besides senior officers from various concerned agencies.

It was further said here that Indian scientists & research teams were collaborating and strengthening the research capacities in neighbouring countries such as Afghanistan, Bangladesh, Bhutan, Maldives, Mauritius, Nepal, and Srilanka. Besides this, Myanmar, Bangladesh, Qatar, & Bhutan have requested India to help in the clinical trials in their respective countries.

It is a result of such hard work and team efforts that today, the leading daily newspaper Hindustan Times carried these two headlines on its front page, "Covid could be under control by February" as a quote from a panel of experts appointed by the government, and WHO has welcomed India's stance against vaccine nationalism.

The above mentioned applause from WHO has come our way because of our strategy on anti-corona vaccine, wherein, besides promoting and fully utilising our own products in this capacity we have accepted proposals from many of the foreign companies to allow the use of their products too in our country.

INDIA'S STRUGGLE WITH COVID-19: REACHING THE POINT WHERE WE STAND TODAY

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