News Excerpt
Recently, a new virus named as novel coronavirus 2019-nCoV belonging to the Coronavirus family has claimed thousands of lives globally. The WHO has declared it a Public Health Emergency of International Concern (global emergency) which was later changed into a Pandemic.

Pre-Connect
●    The “CO” in COVID stands corona, while “VI” is for virus and “D” for disease. The number 19 stands for the year 2019 when the outbreak was first identified.
●    These are named for the crown-like spikes on their surface. “Corona” in Latin means crown.
●    Its manifested symptoms may include fever, cough and shortness of breath.
●    There are four common coronavirus that cause mild to moderate upper-respiratory tract illnesses, like common cold are:
o    229E (alpha coronavirus)
o    NL63 (alpha coronavirus)
o    OC43 (beta coronavirus)
o    HKU1 (beta coronavirus)
●    Coronavirus antibodies are also not effective as a person can catch the virus again in a few months.
●    Coronavirus is a zoonotic disease (i.e. transmitted from animals) in the last few years, in the last few years world has seen various zoonotic diseases such as:
o    Severe Acute Respiratory Syndrome (SARS)
•    SARS coronavirus (SARS-CoV) was identified in 2003. It was first infected humans in the Guangdong province of southern China in 2002.
•    It affected 26 countries and resulted in more than 8000 cases in 2003.
•    It transmits primarily from person to person.
•    It shows symptoms similar to the influenza.
•    No individual symptom or cluster of symptoms has proved to be specific for diagnosis of SARS.
o    Middle East Respiratory Syndrome (MERS)
•    It was first reported in Saudi Arabia in 2012 and has since spread to several other countries.
•    It was caused by a virus known as Middle East Respiratory Syndrome Coronavirus (MERS-CoV).
•    Patients of MERS developed severe respiratory illness with symptoms of fever, cough and shortness of breath.
•    Out of 10 about 3 or 4 patients with MERS reported fatality.
o    Ebola outbreak in Africa: It spread to the humans from wild chimpanzees after those were killed and consumed.

About Novel Coronavirus
⮚    Coronavirus (CoV) are a large family of viruses that cause illness ranging from common cold to MERS and SARS.
⮚    Antibiotics do not work against such viral pneumonia and there are no vaccines against them.
⮚    Further, the virus is contagious even during incubation (even before a patient exhibits any symptoms), thus amplifying its transmissibility.
⮚    However, this claim is refuted by the US scientist and they claim that the main driver of novel coronavirus transmission is people who exhibit overt symptoms. Such people will spread the virus more readily through coughing and sneezing.
⮚    The median incubation period after infection is three days; the incubation period can also last more than three weeks as per one study.
⮚    The antibody test can be used for detecting people infected with novel coronavirus but are asymptomatic or exhibit only mild symptoms. Two different antibody testing platforms (virus neutralization assay and ELISA assay) can be used to confirm past infection.
⮚    Human coronaviruses most commonly spread from an infected person to others through:
o    The air by coughing and sneezing.
o    Close personal contact, such as touching or shaking hands.
o    Touching an object or surface with the virus on it, then touching your mouth, nose, or eyes before washing your hands.
o    Rarely, fecal contamination.
⮚    Mapping the culprit:
o    To counter the virus, the US had produced a 3D atomic scale map of the protein (spike (S) glycoprotein) of the novel coronavirus (SARS-CoV-2) that binds to and infects human cells.
o    This will allow scientists to develop vaccines and antivirals against the virus and even better diagnostics.
o    COVID-19 disease binds to the cellular receptor called angiotensin-converting enzyme 2 (ACE2), which serves as the entry point into human cells with high affinity. This explains the high human-to-human transmissibility of the virus compared with the SARS coronavirus.
⮚    Use of Convalescent plasma to counter COVID-19:
o    Chinese pharma’s are using plasma taken from people who have recovered from the infection to treat critically ill patients.
o    The same method was used when Ebola struck Guinea, Sierra Leone, and Liberia in 2014.
o    The method has been used against measles, chickenpox, and rabies. In the case of rabies, it acts as passive immunization after dog bite and before disease develops.

Is Novel Corona a Man-Made Disaster?
    According to WHO estimates there are millions of deaths occurring every year from zoonoses.
    Some 60% of new emerging infectious diseases globally are zoonoses. Over 30 new human pathogens detected over the last three decades out of which 75% originated in animals.
    This disturbing trend is linked with the close mixing of humans and animals, especially the unregulated handling of blood and other body products. This increases the chances of transmission of a virus from animals to humans.
    Globally, Animal markets are now acting as a breeding grounds as there is free interchange of pathogens between species and mutations.  

Coronavirus in India
    There are multiple cases of the coronavirus reported in India with situations troublesome in Kerala.
    Incidentally, Kerala is also the state which dealt with the outbreak of Nipah virus, another zoonotic disease caused by fruit bat. However, the state machinery in Kerala reacted pro-actively and prevented the spread of the virus and Kerala was declared Nipah-free within a month.
    The screening is a big challenge as infected people do not show symptoms during the incubation period and hence thermal screening at airports and seaports will be unable to detect such cases.

What India needs to do?
    Strengthen the surveillance: The government needs to strengthen the present disease surveillance programme as various infectious diseases including those of the zoonotic variety are on the rise in India. Further, India always had seasonal outbreaks of dengue, malaria and influenza strains.
    Reduce the reliance on NIV (National Institute of Virology):
o    Though NIV is the only lab in India which has a biosafety level-4 (BSL-4) standards, reliance on it must be reduced and more private players be allowed in genome sequencing (it helps in understanding where the virus came from and how it spread) of viruses.
o    A prominent example of this is the Manipal Centre for Virus Research work in the incident of Nipah Virus.
o    The active involvement of private players is possible as due to presence of the latest sequencing equipment in many research labs the cost of sequencing falling, researchers are using genome sequences for genomic epidemiology.
    Capacity Building:  
o    There is need to develop human technical expertise of Indian labs in the field of virology and epidemiology.
o    Also, India requires a comprehensive influenza surveillance system that disseminate surveillance data, and improve early response to influenza viruses with pandemic potential.


Epidemic vs. Pandemic
OUTBREAK: A sudden rise in cases of a disease in a particular place.
EPIDEMIC: A large outbreak, one that spreads among a population or region. Covid-19 in China is considered an epidemic.
PANDEMIC: It is an epidemic that has spread on a more global scale, affecting large numbers of people.  Generally, the WHO is looks out for sustained outbreaks on different continents before declaring an event as Pandemic.

How WHO names a new Disease?
The name of a new disease should consist of a combination of terms. These terms consist of a generic descriptive term based on clinical symptoms (respiratory), physiological processes (diarrhoea), and anatomical or pathological references (cardic). It can refer to specific descriptive terms such as those who are afflicted (infant, juvenile, and maternal), seasonality (summer, winter) and severity (mild, severe). The name can also include other factual elements such as the environment (ocean, river), causal pathogen (coronavirus) and the year the new disease is first detected with or without mentioning the month.

Public Health Emergency of International Concern (PHEIC)
    PHEIC is an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response.
    Such situations are generally:
o    Serious, sudden and unusual
o    Have implications beyond borders
o    Require immediate international action.
    PHEIC lead to boosting of public health measures, funding and resources to prevent and reduce global spread.
    In case of global emergency, all countries should be prepared for containment, including active surveillance, early detection, isolation and case management, contact tracing and prevention of the onward spread of disease, and to share full data with WHO.


Why China?
    China is at centre of Covid-19 but it’s not the first time, it happened earlier in the case of SARS-2002.
    This happens because of Wuhan Wet market which offers wildlife.
    China in 1970s was hit by huge famine owing to which the government gave control over the agricultural commodities.
    Major Agri companies move into rearing of animal which are generally consumed such as pig, cock, etc. but few small farmers started serving wildlife such as snakes, turtle etc. which soon got government backing as it was feeding the people.
    In 1980s, China amended the wildlife protection act and listed wildlife as resources owned by the state. This encouraged domestication of wildlife and also projected it as something human can benefit from.
    Small farms turned into big industry and funneled into wet markets, also with this grew the illegal wildlife trade which included animals like pangolin, tiger etc.
    After the outbreak of SARS which was traced back to Wet market, China banned these markets.
    However, later it was lifted and the industry has grown over the year and now valued at $140 billion.
    The majority of China doesn’t consume wildlife, only minority of rich people consume it.
    China now need to take a firm action on wildlife wet


PEPPER IT WITH
H1N1, KFD, Zoonotic Diseases, SARS, EBOLA, MERS, Epidemic Act 1897

China-Pharma War
    As Coronavirus spreads far and wide there has been shortage of essential drugs to treat the victims of the virus in the European countries as well as in the USA.
    This is primarily due to China being a pharma production giant and to control the spread of virus it closed down the cities.
    The situation has again sparked debate over China being a hoarder of strategic resources and in any event of conflict it might deny access to drugs to its opponents.
    China has already done this by denying Japan access to Rare Earth Elements in backdrop of island dispute (Senkaku Islands / Diaoyudao Islands)
    India, on the other hand, though produce generic drugs is also depended on China for the raw material of those.
    This outbreak is the warning sign for the world to develop basic capability to ensure supply of essential drugs.