Corona Corona the fight against Corona
Novel corona virus has been something which has been a great leveller to mankind. A virus that has infected and killed irrespective of race class religion gender. All the divides that have been used by politicians to get votes and manipulate people across countries have all been breached. Royalty of every kind, literally like Prince Charles, of movies like Big B and Tom Hanks, of sports like CR7 and Usain Bolt, of politics like Amit Shah and Justin Treaudeu have been affected by this virus just as the homeless and poor down trodden have been affected. Countries of all the world whether they be the white western, black African, middle east Asian south Asian or oriental, every one has been affected. Religion hasn’t been spar ed as corona has shown that it doesn’t chose, whether you don’t pray or pray to Ram Rahim or Jehovah. Corona has shown that it believes in random selection and not natural selection.
But now that corona is here and as per many experts here to stay, we need to build up a strategy as to how to overcome this. Like all such illnesses we have to fix our strategy on prevention containment and treatment both in the short and long term. Since childhood we have been told that prevention is better than cure, and that holds very true for this disease. Once the disease enters you whether you display symptoms or are asymptomatic, the disease has to be contained within the carrier and treated till the patient ceases to be a threat to spreading the infection. The next important step is to identify a means of making the disease ineffective in the long term through development of immunity against the disease either through administering a vaccine or acquiring Herd immunity.
Prevention is the greatest tool in this fight and social distancing the most potent weapon for this fight. The disease being spread through contact, cutting down that means of contact is the biggest way to break the chain. It’s like removing a domino from a stack of falling dominoes so that the pending stack doesn’t fall. Setting up barriers like use of masks, face shields, gloves to stop the access of these viruses to your susceptible areas like nose, mouth, eyes through which the virus enters the body easily are sure fire ways of breaking this chain. However careful we are in these barriers that we create, the contagion is so virulent that we still might pick it up or have it on various surfaces we come in contact with in our every day life. There in comes our second line of defence in the form of personal hygiene, use of hand washing, hand sanitisers and surface disinfectants, to get rid of the contagions that have seeped through our first line of defence. Use of a sanitising agent on every surface that can be exposed to the contagion, like door ways, doorbells, knobs and handles, currency, items shopped or delivered, vegetables and fruits are essential to break this chain.
Once the disease has entered you irrespective of the various checks and measures put up the next most important thing is containment. Testing tracing and containment is the three-pronged action plan to detect and contain the disease and prevent a spread that cannot be controlled. It’s like having a bush fire that is spreading cut off from the bigger area by identifying what are the hot spots and cutting its access from the bigger forest till it dies out. Various countries have worked out various protocol for testing. However, everyone is in unanimity that testing is the cornerstone of this fight against corona. Testing followed by tracing and containment or isolation, quarantine howsoever you name it. India has been ramping up testing facilities and introducing techniques like pooled testing, where about 5 people’s samples have been pooled together and tested to increase the reach of the testing. Recently we hit the 10 million mark and the numbers keep climbing. While that has exposed more infected especially the asymptomatic, it also is leading us to treat them and help increase herd immunity.
Once the infection has hit you, treatment is the way forward. To most positive patients who are asymptomatic or afflicted with mild symptoms very little needs to be done, beyond a protocol of antiviral and a high protein rich diet along with some vitamins to strengthen up immunity. Hydroxychloroquine and Remdesivir have gained popularity as medicines to treat covid 19 affected. Although there is no fixed protocol even now. Some critical considerations for this treatment is the determination of existing conditions of comorbidity and the management of such conditions. Conditions of comorbidity are those which could flare up under the cytokinin storm that this disease will generate or could fan its flare up. Conditions like diabetes fan any infection, while cardio vascular condition gets flared up when an infection is there in the system. Conditions like tuberculosis and cancer have also been found to be detrimental in a covid attack. Covid is like many of its predecessors such as SARS and MERs a respiratory disorder, in fact it is often referred to as SARI or Severe and Acute Respiratory Infection. Consequently, lungs and the respiratory system is the most affected by this disease. The prime challenge that the covid warriors are facing are in maintaining oxygen saturation. In fact, mortality is happening due to either of two things, the patient succumbing to a comorbidity or respiratory stress leading to hypoxia in essential organs leading to organ failure and hence death. This is where the criticality of ventilators has come in place for most health care units.
While the world has been battling with this disease, there is basically two thought processes evolving out in this battle towards a long-term battle plan. One school of thought is based on the community generating a herd immunity towards the contagion, as more and more people are exposed to the virus so that we are able to resist the disease without external intervention. Our body recognising the virus as an antigen for which the system develops a set of antibodies to be let loose to fight it in case of an infection. The other school of thought is based on the development of a vaccine. The mortality cost before a critical mass of the population is exposed to the virus for suitable herd immunity to develop is huge. If we take India as a case study, on a base line of 130 cr population, if herd immunity is achieved at say 60% infection rate, that means a whopping 78 cr people will need to be infected. At the associated mortality rate of 2%, it means a death toll of 1.56 cr. Our country would also not have the infrastructure to combat such a huge number of infections and hence the mortality rate could also spike leading to an even higher death toll. And this is just in india, globally the numbers would be devastating. In this backdrop developing a vaccine to fight this disease seems most appropriate. With a base molecule developed even with mutations of the virus we can continue to fight the disease with suitable tweaking. With 7 possible candidates already in phase 3 clinical trials right now, the hunt for a vaccine doesn’t seem very distant with major governments willing to fund and support the sponsoring organisations in fast tracking the vaccine development program. Organisations like the Serum Institute are willing to lock in funds towards development of a vaccine that has as yet not passed clinical trials, the gap between approval and go live in the market could be shortened.
As the case maybe, with a vaccine still a few months away our destiny is still in our hands, in the form of our first line of defence, of social distancing and avoiding contact. This is the safest way for us to avoid the disease, as simple steps of using a mask, gloves, and avoiding of physical contact as much as possible is the best way to keep the disease from entering our homes. If it enters, isolation is the best way forward to keep it in check. Testing and tracing has to be supported by us just as social distancing has to be adopted in our life style for now. Mask and sanitisers need to be essential items for us. Till the vaccine comes our safety is our responsibility.
