Since early March, our war against COVID-19 has been making steady progress in India. This has involved detection, protection, prevention, prescription and participation. Purposefully, private groups, industries, medical fraternity, scientists and technologists have joined hands together with the government in this war, both through financial contributions and participation by involving their R&D expertise. Government agencies such as DST, DBT (and its BIRAC), SERB, CSIR, ICMR, DMR, MHFW, DRDO, and others have announced several grants focusing on specific aspects related to this war, while the Tata Trust, WIPRO, Mahindra, the Wellcome Trust India Alliance and several multinational pharma companies have come forward in this joint effort.
Detection, prevention, protection
The first thing is to detect whether a person has been infected by the virus. Since COVID-19 spreads within the moist part of the inner nose and throat, one measures the temperature of the individual around his nose and face, using a thermo-screening device (as used with arriving passengers in airports, or entering buildings and factories). Better devices of greater speed, detail and accuracy, such as whole-body scanners which depict body temperatures with colour codes on a computer monitor have come about from abroad. The National Disaster Management Authority (NDMA) has been offered 1,000 digital thermometers for screening, and 100 full-body scanners.
Clearly India needs these by the thousands. This need has triggered some computer industry people in India to make such body scanners here at home, a positive step. We hope these can come about at the soonest.
Once an individual is tested positive this way, it needs to be confirmed by doing a biological test to make sure that it is coronaviral infection. Until a month ago, we needed to import kits to do this. Today, more than a dozen Indian companies (most notably by the MyLab-Serum Inst.duo which can make several lakhs of these kits a week) have made them, each certified by the national body. This has rapidly expanded the scale of reliable testing rapidly across the country. Once tested positive, the patient has to be isolated and quarantined in appropriate centres. This has been done with remarkable speed and reliability, as mentioned below.
An important way to protect oneself against the invasion by the virus is to wear a mask. We constantly hear about how these are not available or sold at exorbitant cost. The notion that it is not always necessary is wrong. As the well known infection expert Dr. Jacob John of Vellore clarifies ( The Hindu, April 2), it is vital that we mask ourselves as we move about in streets, since the virus is also airborne. Towards this, even as many entrepreneurs and firms across India have started making these at affordable costs, social media such as WhatsApp show the typical jugaad ways of using a baby diaper (unused!), male banian (unused!), the pallu of a saari, or dupatta and such. Happily enough, after the government clarifications and advice on this matter, more and more people are now seen to mask themselves. TV channels are also doing a useful service by inviting experts and asking them to offer relevant advice to people who have specific questions and doubts about protection in specific individual instances.
In this connection, a very recent piece of advice on protection has been given to people wearing glasses, (and also to eye doctors whom they consult) by my colleague Dr. Muralidhar Ramappa of the L V Prasad Eye Institute, Hyderabad. He says: (1) If you wear contact lenses, switch to glasses for a while. (2) Wearing glasses may provide a layer of protection. (3) Do not skip your eye exam, but take precautions. (4) Your eye doctor may recommend some more precautions. (5) Stock up your prescribed eye medicines, if you can and (6) avoid rubbing your eyes.
In addition to what the Central and State governments and notable private hospitals (for example, Apollo, Medanta and others) have set up as isolation and quarantine centres, several private agencies have helped set up these in Hyderabad, Bengaluru, Haryana, West Bengal, and helped equip them (for example, Infosys Foundation, Cyient, Skoda, Mercedez Benz, and Mahindra). These are some examples of how governments and private agencies have joined hands — as they say: We are all in this together.
Another exciting advance towards protection (and prevention of spread) has been the large scale production of incubators, ventilators and devices to monitor the individuals who have been placed in such quarantine centres. Mahindra has successfully made ventilators in large scale at affordable prices, and DRDO has come up with a special kind of tape in order to make patient protection gowns for clinicians, nurses and paramedics.
Can India offer drugs?
While the possibility of a preventive vaccine for large scale use in India is at least a year away, we need to turn to molecular and drug-based approaches, in which India has great internal expertise and teams of excellent organic and biological scientists. Rightly, the government and some drug companies have turned to them to locally prepare and use several drugs (favilavir, remdesavir, avigen and such), and also modify them using well-known methods. Indeed, the CSIR has already roped in organic chemists and bioinformatics experts who can predict the 3D structures of proteins, so as to look for potential areas on their surface to which molecules can fit (lock and key approach). I have every hope that with such team efforts, India will come out with ‘made in India’ drug molecules to overcome this killing virus. Yes, we can.
Despite their full knowledge that millions of people have settled in cities and large towns, as daily wage labourers, far away from their families in villages, State and Central governments did not plan ahead for them, nor did they plan to reimburse their wages during the lockdown which blocked their getting back home. This led to a toss of social distancing and possible community spread. Social distancing is, alas, not in Indian culture, while herd mentality is. This could have been thought of by the social scientist advisors to the governments, and could have been avoided.
(Disclosure: it is important to note that I have chosen to highlight only some examples here. There are several more ‘unsung heroes’ across the states and the nation. I hope they will not be offended that I have ignored them.)
dbala@lvpei.org
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