There’s light at the end of the tunnel
India has been proactive. Citizens may have immunity. Scientific breakthroughs are possible
W hen I first heard Prime Minister (PM) Narendra Modi’s address to the nation on Friday, carefully, I must confess to feeling a little disappointed. There was no condemnation of the fact that our brave “Covid-19 warriors” — doctors and other health care workers — were being assaulted; and there was no comforting statement about the efforts to overcome the lack of the personal protective equipment (PPE) supplies for the frontline workers. But, then, I heard the speech a second time, and then a third time.
And I realised this was the most positive, encouraging and unifying speech by any leader to a nation. It had been nine days into lockdown when he spoke (it is 12 days now). Citizens have been battling uncertainty, fear, despair, and even depression. There is social fragmentation, the suffering of the poor, and even a growing religious blame game.
In that backdrop, the PM’s address was purposeful — focused on uniting the nation, while maintaining social distancing and selfisolation. It was, importantly, about deploying combined “utsaah” (enthusiasm) as the biggest force in moving from the darkness of the coronavirus pandemic (Covid-19) into the light of victory. The PM’s address would have made the most accomplished psychologist proud and envious.
As someone who has been deeply involved in the Indian health care system, do I see a
“light “at the end of the tunnel? Yes, and here is why.
One, we have been the most proactive nation in the world against Covid-19. Numerous measures by the government — isolating the country; testing of travellers; quarantining, tracing and isolation of suspected cases; public education on hand-washing and social distancing; forced self-quarantine, and, finally, a national lockdown — were instituted even when there were very few cases in the country. This is a fact that has been appreciated and admired by World Health Organization. It has been responsible, to a great extent, for limiting the spread of the virus patients to a manageable number so far, even as Europe and the United States are dealing with hundreds of thousands of patients, overwhelming even their advanced health care systems. The responsibility now lies with the public, we cannot let the strategy down.
Two, while sceptics may argue that the number of Covid-19 cases is low because we are not testing enough, and, therefore, we do not have an accurate figure, the comforting fact is that we, as doctors, know that the emergency areas of our hospitals are not getting flooded with patients with upper respiratory tract infection, pneumonia and deaths. Frontline doctors are the first to sense, witness and face an epidemic, irrespective of testing. Maybe, the worst is still to come over the next two weeks — but maybe not? No one can be any wiser than the other.
It is also remotely possible that public exposure in India to regular and repeated infections, and other viruses, may have developed a protective cross immunity to, at least, prevent serious Covid-19 infections. The encouraging fact is that 80% patients affected in Covid-19 just have minor flu-like illness and get better anyway.
Three, more than a 100 companies around the world working aggressively on finding effective drugs for treatment as well as vaccines for prevention of the Covid-19 infection. New vaccines for prevention could take 12-18 months, but effective treatment for Covid-19 could be a reality in next four weeks. A promising anti-viral drug, Remdesivir, has been put into phase III trials. Chloroquine and hydroxychloroquine, a drug well known to India for the last 60 years for the treatment of malaria, is showing promise for the treatment and prevention of Covid-19 infections.
The Indian Council of Medical Research as well as other scientific bodies globally are engaged in prospective trials on this. In the next two to four weeks, we will have the results to define the role of this inexpensive and readily-available treatment for our population. Serum containing antibodies against the coronavirus from patients who have recovered from Covid-19 infection is in trial to treat serious coronavirus infections. Breakthroughs are around the corner.
Four, there are two preliminary reports, which emerged last week, providing indirect evidence that the BCG vaccine — given for the prevention of tuberculosis — may provide protection against Covid-19. Based on these observations, prospective trials have started in the US and Europe to define the role of the BCG vaccine for prevention of Covid-19 infection. Thankfully, India, unlike other western nations, has had a mandatory BCG vaccination policy at birth, for all its population. We hope that this may also in some way protect us from serious Covid-19 infections and death.
The PM called on the 1.3 billion people in this country to focus and meditate together, as witnessed in the coming together of the nation on Sunday night. It is easy to mock this. But after 30 years of being in the frontline of the medical profession, and pioneering treatments of heart disease, every day, I pray to God to help me save my patients. I prayed to God to save my mother’s life when after six weeks of treating her on a ventilator, the best doctors and best of technology failed.
Thirteen years ago, I organised a scientific symposium on “Do prayers heal and Cure?” And every day, I witness a person demolished by an unfortunate “act of fate” — an accident or an illness that suddenly incapacitated them. Humility helps. And it helps to combine science with spirituality, to provide us with positivity, with hope, with determination if we are to overcome the ravages of the Covid -19 disease.
While there is hope, there is no role for complacency. We need to take all precautions, follow all advisories and be vigilant. We need to appreciate and respect all the efforts being put in by the frontline Covid-19 warriors who are putting their lives at risk to protect us. Though physically separated, we need to be united in spirit and mind. There is light at the end of the tunnel. Dr Ashok Seth is a noted clinical leader and chairman , Fortis Escorts Heart Institute The views expressed are personal