Is making hay while it shines, unethical?

So much is talked about pharma giants making ‘a kill’ in the pandemic ‘tsunami’. Is it immoral? Who is competent to decide what is morality in the first place? Anybody could have done the needed research and found the elixir! It is a free world. At the beginning of the game itself it is known the winner would take it all. They have won and get their fair return for their success. Period.

There is shrill cry that though the pharma companies have got state funding for the research, the price of the vaccines which are products of the research, is disproportionately high. But, after all, the state also knows it is betting on a winning horse; it has in fact tied (unethically) all the supplies on priority exclusively for its own use. Any other tags could also have been tied to the recipient of the grant.. but having agreed, now crying foul is anarchism.

One would then argue that in any State sponsored research, the fruits of the efforts should accrue to the society since it is public money. But, ethically, to promote research state should fund such researches in public interest without tying the funding for its own benefit. After all the knowledge generated is not the exclusive domain of the state but of the scientists whose free will play a major role. Even then, the state in its wisdom desires to stake a claim, it is free to incorporate such a clause in the contract while awarding the grant. If not, there is no binding. Play as per rules of the game – don’t change rules retrospectively just because you are empowered! But be a referee and ensure fair playing field.

Should in all state funded research programs, state must have a share? Can the public rightfully demand a stake always in the product, even without such a contractual binding? It is akin to binding all the students graduated as subordinates to the state as they have indirectly got the state funding! What would be the responsibility of those who graduate with state scholarship? To what extent are they subordinate to the state?

This sort of allegations of exploitation, making huge profits and demands to cut down the price, throttle motivation to innovate in scientific arena where the success rates are low and opportunity costs are the norms! Who pays for failed research anyway? If the vaccines had fizzled out, would the market even whisper? No way….

Compared to the US model of Pfizer, Moderna funding or UK’s Astra Zeneca for that matter, is far different from that of India’s handholding strategy at every step of the development of vaccine: Covaxin is a Codeveloped product with the public-private cooperation. Covishield production capacity was funded with advance purchase agreements. These models largely helped in keeping the prices in check and affordable. The agreements are transparent compared to that of Pfizer’s! Why the west succumbed to the conditions of contract, the terms were kept secret, could be due to the eagerness of securing the scarce supplies on priority, ‘at any cost’, in common parlance. Now, on looking back, the west might contemplate on the unnecessary urgency and the trap it fell into. But that is a different story altogether. They have missed the bus!

Arm twisting the companies at this point of time, citing their profit margins, is unethical. At best, you take it or leave it at your peril. These strategies get support only with those having ‘collectivist’ mindset: only a few would toil to generate knowledge and wealth while every one in the society would share equally. This communist philosophy cannot sustain.

Don’t expect a free lunch without a sweat!

Science-ethics dichotomy

Many of the scientists who were architects of the Manhattan Project, including the one who headed the program to make the deadly weapon of mass destruction, Robert J Oppenheimer, never dreamt its immense potential. But were positive it would win them war. Yes, it won the war but nevertheless caused immense loss of life. They were pained to see that it actually become part of the world’s most deadly military arsenal. The only motivation and dedication of many scientists in the project was the mortal fear of nazi Germany Hitler’s win in the ongoing Second World War as German scientists were also working on a similar pursuit; they would have preferred it, may be more as a deterrent, than as a regular military arsenal! After all most of the scientists love humanity! Most of them returned to academia – never wanted to continue the exciting research.

The conscious, self upright, The Times’ man of the year, Oppenheimer met the then American president to dissuade him from pursuing the more deadly H-Bomb told, “I feel I have blood on my hands”. This was unacceptable to Truman, who retorted, “that was no concern of Oppenheimer’s, and that if anyone had bloody hands, it was the president”. The politicians primarily averse to communist Russia taking a lead did not want to derail the H-bomb project; eventually they succeeded in indicting the much acclaimed scientist – he was pronounced not trust worthy anymore with state’s nuclear secrets! Oppenheimer, who has had in his head for years every secret about the atomic bomb and even discovered some of them, was tagged “untrustworthy”! It is to the politicians, who had no iota of this knowledge, that science was pledged! Oppenheimer lost the battle and died a lunatic! The country realised the insults to this extraordinary man much later after his death, corrected the historical blunder and restored his lost glory, is a different story!

Could a scientist destroy the knowledge that he has created, if driven to its being wrongly exploited? Howard Roark, the fictional architect envisioned by Ayn Rand in The Fountainhead, defends his right to dynamite a building, his own creation, because it wasn’t made the way he wanted. “I destroyed it because I did not choose to let it exist,” declares Roark. At best, this is like a kid throwing a tantrum and smashing his toy blocks. At worst, it’s terrorism masquerading as free speech. Does scientist have such a liberty?

Can a professional soldier accept a job with Murder, Inc. and claim he is merely practicing his trade, that it is not his responsibility to know for what his services being used? Would the predicament of the scientist be same as that of ‘that soldier’? What should a scientist do, if he comes to know that his knowledge is being exploited by the powers that be? Does he have the right to destroy the knowledge?

There could be many examples where self conscious scientists could be at logger heads with their own conscience. Let me assure you that this narrative is not to bring out any similarity to the controversial genetic experiments in the Wuhan lab by the ‘bat lady’ with possible CDC funding! Or the scientists, who pioneered the mRNA vaccines to defeat the virus, could feel guilty of windfall gains that their corporates are making, repenting a little on their being out of reach to many poor nations!

No doubt science has won many a wars in the recent centuries, but it has been defeated in the ethical battle, hands down!

Future shock

Things are changing faster than one can imagine! Most of what was predicted by Alwin Toffler in ‘Future Shock’ and Noah Harari’s ‘21 lessens for the 21st century’ could even be overwhelmed!

Take for example, the automobile industry: Electric cars will become mainstream by about 2030. Smart major auto manufacturers have already earmarked money to start building new plants that only build electric cars. Most traditional car companies will doubtless become bankrupt. They will try the evolutionary approach and just build a better car, while tech companies (Tesla, Apple, Google) will do the revolutionary approach and build a computer on wheels. Look at what Volvo is doing right now; no more internal combustion engines in their vehicles starting with 2019 models, using all electric or hybrid only, with the intent of phasing out hybrid models. Many engineers from Volkswagen and Audi are completely terrified of Tesla and they should be. Look at all these auto majors are already offering electric vehicles. That was unheard of only a few years ago.

Auto repair shops will disappear. A petrol/diesel engine has 20,000 individual parts while an electrical motor has just 20. Electric cars are sold with lifetime guarantees and are only repaired by dealers. It takes only 10 minutes to remove and replace an electric motor. Faulty electric motors are not repaired in the dealership but are sent to a regional repair shop that repairs them with robots. Your electric motor malfunction light goes on, so you drive up to what looks like a car wash, and your car is towed through while you have a cup of coffee and out comes your car with a new electric motor!

Petrol pumps will soon go away. Street corners will have meters that dispense electricity. Companies will install electrical recharging stations; in fact, they’ve already started in the developed world.

Only in 2018 the first self-driving cars appeared. In the next 2 years, the entire industry got disrupted. You won’t want to own a car anymore as you will call a car with your phone, it will show up at your location and drive you to your destination.

The very young children of today will never get a driver’s license and will never own a car. This will change our cities, because we will need 90-95% fewer cars. We can transform former parking spaces into green parks.

About 1.2 million people die each year in car accidents worldwide including distracted or drunk driving. We now have one accident every 60,000 miles; with autonomous driving that will drop to 1 accident in 6 million miles. That will save a million lives plus worldwide each year. Insurance companies will have massive trouble because, without accidents, the costs will become cheaper. Their car insurance business model will disappear.

Cities will be less noisy because all new cars will run on electricity. Cities will have much cleaner air as well. Since automobile industry is the energy guzzler, there would be sea change in the energy industry:

Electricity will soon become incredibly cheap and clean. Solar production has been on an exponential curve for 30 years, but you can now see the burgeoning impact. And it’s just getting ramped up. Homes will produce and store more electrical energy during the day and then they use and will sell it back to the grid. The grid stores it and dispenses it to industries that are high electricity users. Has anybody seen the Tesla roof? Fossil energy companies are desperately trying to limit access to the grid to prevent competition from home solar installations, but that simply cannot continue – technology will take care of that strategy.

Coal industries will go away. Gasoline/oil companies will go away. Drilling for oil will stop. They may have to survive on petrochemical industries. So OPEC can’t dictate terms. The middle-east is in trouble.

Children born today would be surprised to know the present ‘chaotic world’ when they grow up – Energy and automobile sector is just one of them. There are many more to come in the health and entertainment industries. Welcome to Tomorrow.

Murky Saga of Covid Vaccines

Covid-19 virus had provided immense opportunity to exploit the ‘do or die’ situation the world faced. Richer nations cornered the supplies! Vax manufacturers used the situation ‘make hay while the sun shines’ to the hilt.

Covid vaccines may be life saving, but their business is extremely murky! Their contracts are secret that enable unethical business practices apart from profiteering! Here are a few from that list.

1. Lobbying for patent protection rights: Governments Helped Create Vaccines But Companies Keep the Patents. Big Pharma companies launch campaign against Biden over Covid vaccine patent waiver mooted by India and South Africa.

2. Double Yammy – Federal funding and monopoly in selling: They get government funding but without any preferential pricing. For example, US vaccine manufacturer, Moderna not only used government-developed technology as the foundation of its vaccine, it also received about $1 billion in government grants to develop the drug. In August, the government placed an initial order for the vaccine for $1.5 billion.

3. No disclosure of pricing: By insisting that their pricing remains confidential, the drug makers have the upper hand over government negotiators who do not know what other countries are paying. The European Commission paid $2.19 for every dose of the vaccine developed by the University of Oxford and AstraZeneca, while South Africa paid more than twice as much, $5.25. United States taxpayers were paying $19.50 per dose for the Pfizer vaccine, while Europeans paid $14.70. It is rumoured that the deposed Israel president, Netanyahu, paid nearly $28 per Pfizer shot to get on priority! Brazil canceled its order to covaxin over bribes in the deal!

4. Monopolistic sale policy: The contracts also prohibit their resale, donation etc., literally blocking their use to the poorer nations!

5. Companies Get Liability Protection: In the United States, drug companies are shielded from nearly all liability if their vaccines don’t work or cause serious side effects. The government covered Covid-19 drug makers under the PREP Act, a 2005 law intended to speed up access to medicine during health emergencies. That means that people cannot sue the companies, even in cases of negligence or recklessness. The only exceptions are cases of proven, “willful misconduct.” Drug companies are seeking similar liability waivers in negotiations with other countries. European negotiators have balked at such requests. Covax also insists that countries accept all liability as part of its contracts. The CureVac-E.U. contract does shield the company from significant liability, but with exceptions. Those exceptions are redacted, meaning censor or obscure (part of a text) for legal or security purposes!

5. US plans to donate its unused excess stock of vaccines to third world, lest they would expire! Would get Good Samaritan tag!

6. Pfizer recommends third booster shot to pep up the lowering of antibody counts, even before its studies are published. Would CDC recommend or wait till the results are peer reviewed?

7. Strong arm tactics: The Indian government had earlier announced that vaccines that are already recognised by WHO and similar other authorities of other countries won’t have to undergo local trials. Moderna applied for permission to the Drug Controller General of India which was granted but Pfizer and J&J did not yet apply. The Indian government’s stated position is that it cannot give indemnity to anyone. The government is saying domestic companies can give indemnity on behalf of their foreign partners. Moderana’s Indian partner Cipla had offered to shoulder some legal responsibilities which Moderna rejected.

Credits:

1. https://www.cnbc.com/2021/06/01/big-pharma-launches-campaign-against-biden-over-covid-vaccine-patent-waiver.html

2. Governments Sign Secret Vaccine Deals – Here’s What They Hide: https://www.nytimes.com/2021/01/28/world/europe/vaccine-secret-contracts-prices.html?referringSource=articleShare

Soft Suppression – Covid Resilient Pandemic Management

Would the strategy to get ‘zero’ covid infection for a safe living be practical? Or living with the virus like the ‘seasonal flu’ be viable? The authorities in countries, such as Australia, New Zealand, South Korea and Singapore, aspire for zero virus approach, while Israel, UK, US and European countries have ventured into trying an alternate option, called, ‘soft suppression [1]’.

What is soft suppression? Adjust its safe management measures in stages, subject to trends in serious cases. This could mean fewer restrictions on social gatherings, larger dine-in groups and lower requirements and higher capacity for events. Vaccinated individuals will be able to engage in a wider range of social activities and in larger groups, while unvaccinated individuals may only do so with negative pre-event testing results. Practically all social and workplace restrictions can be lifted, although some critical measures, such as mask-wearing and precautions for large events may remain.

If the incidence of severe illness from COVID-19 remains low despite clusters emerging from time to time, one would eventually be able to arrive at a truly endemic state. This would be the roadmap of transitioning to a “Covid-resilient” society in which the virus is part of daily life.

Israel is the first country to embark publicly on this new strategy, ‘soft suppression’ for life in the era of coronavirus, based on the assumption that the pandemic is here to stay but can be managed with minimal damage to the economy. This involves issuing ‘green pass’ to those vaccinated or with negative RT- PCR for any indoor gathering or immigration into the country! Knowing that the virus has an incubation period of at least a week, is it not a risk to allow passive carriers that could potentially initiate super spreader events? Yes.. but it is a calculated risk! How?

Not that it would be zero cases! But the cases would not raise very much and would be within manageable limits. This is based on the fact that the world is no more the same like the one last year at the peak of the pandemic when the cases rose exponentially sharply. Now there would be many around who had developed immunity due to infection and many more with vaccination! Is it not a safer world now? If a large population have antibodies, the chances of spreading the infection is that much less! This can be achieved either by vaccination or by natural infection. Sero survey is a cost effective method to assess the fraction having antibodies. The assessment is done by identifying presence of covid-19 antibodies in the blood samples. Those who are sero positives, even if they are exposed to infection would not be infected. If a large fraction is a community are sero positives, the infection not only would not spread but ultimately would die out. A quantitative number to achieve this state is not yet available for covid, though it is expected to be higher than 75%.

For example, a sero survey conducted in June in Ahmedabad city municipal corporation (AMC) in India, with a population of 7.5 million, showed 81% sero positivity [2]! Even though, when the survey was done it had hardly vaccinated less than half its population even once. The presence of antibodies in such high fraction could only be explained by massive natural infection in the second wave in late March- April.

It has also been reported that these antibodies detected in sero surveys wane over time but the resistance to the infection is sustained with the cell mediated immunity; studies have shown such protection could even last for one’s life time [3]. Studies indicate that the adeno type vaccines, such as Asteazenica, JJ and Sputnik, would provoke stronger cell mediated responses than the novel mRNA type vaccines!

In the case of AMC, it was found around 30% of those who had past infection did not show antibodies in earlier surveys. Thus the fraction with cell mediated immunity could easily add an additional 10 to 15% to those detected to be having antibodies in the present survey, making the total up to even 95%! It does reflect in the daily number of new cases which has fallen steeply from a peak of 5500 in late April to double digit by June itself and to a single digit soon thereafter! There is no lockdown in this city presently. Not even 60% of the population have received the jab even once as of today! The city has been logging in single digit daily cases for over a month indicating ‘herd immunity’!

In contrast, those states that have lower sero positivities are struggling to bring down the case numbers: for example, in another Indian state, Kerala, only around 45 per cent people have developed antibodies against the national average of 67% in a survey conducted in late June [4]! Only around 40% have received at least one jab in this state till now. Even then, test positivities continue to hover over 10% for over a month even now. Kerala pursued aggressive contact tracing policy through which it could bring down the daily case numbers during the peak of infection but the flattening has been found counterproductive as it has dragged the duration of the menace! A state which was patted for effective management of the infection last year, is paradoxically the only Indian state, that is struggling to bring down the cases!

Obviously the lesson, to those countries trying to drive away the virus by draconian lockouts, is to adopt ‘soft suppression’ and get on to live with the virus! Especially when vaccination is aggressively being pursued and are with over 70% sero positives. Singapore would soon embark on this strategy given its high vax compliance [5].

Credits:

1. https://www.timesofisrael.com/new-government-said-to-unroll-soft-suppression-strategy-on-resurgent-pandemic/

2. https://www.thehindu.com/opinion/lead/a-serosurvey-template-for-the-whole-of-india/article35499672.ece

3. https://www.nature.com/articles/s41590-021-00969-3.pdf?fbclid=IwAR3qvHT2wM6JU2bQPWtZAYFS9QOAfiNSmwD9SoUy2YBtJecn1D06CKzc1yQ

4. https://www.onmanorama.com/news/kerala/2021/07/23/sero-survey-kerala-45-percent-have-covid-antibodies.html

5. https://www.livemint.com/news/world/singapore-will-progressively-open-international-travel-amid-covid-minister-11627294725024.html

Covid vaccination – Should Personal Liberty Trump Public Good?

The success of immunisation through vaccination over the years has been mind boggling. That the childhood diseases could be largely circumvented, enthused many countries to make childhood vax compulsory.

With some vaccines, the goal of vaccination is to eradicate the disease – disappear it from Earth altogether. The World Health Organisation (WHO) coordinated the effort to eradicate smallpox globally through vaccination, the last naturally occurring case of smallpox was in Somalia in 1977. Endemic measles, mumps and rubella have been eliminated through vaccination in Finland. On 14 October 2010, the UN Food and Agriculture Organisation declared that rinderpest had been eradicated. The WHO is currently working to eradicate polio, which was eradicated in Africa in August 2020 and remained only in Pakistan and Afghanistan at the time.

Though many infectious diseases have been by and large conquered by the scientific understanding, knowledge on the viruses and bacteria, there is reluctance. Why? Common objections included the argument that governments should not infringe on an individual’s freedom to make medical decisions for themselves or their children, or claims that proposed vaccinations were dangerous. Many modern vaccination policies allow exemptions for people with compromised immune systems, allergies to vaccination components, or strongly held objections. It has also been argued that for vaccination to effectively prevent disease, there must be not only available vaccines and a population willing to immunize, but also sufficient ability to decline vaccination on grounds of personal belief.

Also, can anyone vouch vaccines are absolutely safe? No.. All claims so far have been that the “benefits far outweigh the risks”. Especially when vaccines for Covid-19 are approved through the unconventional “Emegency Use Authorisation” route, many have become sceptical. And there is no compensation for the possible damages of the vaccinated! You vaccinate at your risk to save the public at large! Strange logic, isn’t it?

On the other hand, should personal freedom override societal good? An infectious disease as lethal as the Covid-19, definitely calls for measures that have not been in vogue so far in the human history. When social distancing and masking were prescribed as the counter measures by the epidemiologists, there was resistance. When the governments clamped locked downs, there was a furore in many countries as it would curtail the livelihood of common public. Now it is vaccination time. Should it be made compulsory as the virus mutates in non-immunised becoming deadlier menace. But yet, no country, including the authoritarian ones, has yet been able to make it mandatory!

Should the Liberty be allowed to trump public good? Even the much debated land acquisition law in India, for example, only when 80% of the title holders voluntarily accept to sell their lands to government, the rest can be coerced to comply. Would there not be a similar argument as the goal is to reach only the herd immunity for which only +70% need to be jabbed, why compel everyone to take? It is not like the Second World War time where some in London have to be forced to switch off their electric lights against their wish in their homes, to avoid bombing by Germans. Liberty is admittedly curtailed for right reasons. But anti-vaccine mentality cannot be compared to that.

Till then, would it become a notorious case as in the anecdote – wherein milk was requested for performing a ritual for a deity from the public, some thought why not just give water as it would get unnoticed with all others adding milk? Don’t be surprised that there would be many justifying their ‘rights’ to add water!

No amount of ‘carrot and stick’ strategy would enable overcoming the vaccine reluctancy. People will see that their friends, their colleagues, and their loved ones have been vaccinated, and have been okay, the levels of hesitancy probably will go down.

Credits

1. https://www.bmj.com/content/373/bmj.n1645

2. https://nattuspage.home.blog/2020/11/24

Self styled cyber miners bust the Chinese virus?

A group of 24 people that calls itself DRASTIC, or Decentralized Radical Autonomous Search Team Investigating COVID-19, began looking into clues from Chinese scientific databases shortly after the pandemic began. This “Twitter detectives” also includes “China experts and scientists” who are working anonymously to ensure their “privacy and security”. One of the members is an Indian in his late-20s, residing in the eastern part of the country (possibly in Bhubaneswar) and working under the moniker ‘The Seeker’. The team combed through thousands of documents and Chinese scientific papers to find that researchers had discovered a family of SARS viruses in a mineshaft in Mojiang village in Yunnan province in 2012. By early 2021, DRASTIC had produced so much information that it launched their own website as a repository. The site contains science papers, Twitter threads, translations of Chinese documents and links to articles.

In May 2020, The Seeker found a 60-page master’s thesis written by a student at Kunming Medical University in 2013 titled “The Analysis of 6 Patients with Severe Pneumonia Caused by Unknown Viruses.” The thesis described in exhaustive detail the conditions and step-by-step treatment of the miners who got sick in 2012. The suspected culprit? SARS-like [coronavirus] from the Chinese horseshoe bat or other bats, noted the thesis. The Seeker then found a second thesis from a PhD student at the Chinese CDC confirming the above information. Four of the miners had tested positive for antibodies from a SARS-like infection, and the WIV, Wuhan Institute of Virus, was involved in testing samples from the patients. Shortly after The Seeker posted these theses, China reportedly changed the access controls on CNKI, the Chinese data base, so no one could do a similar search again.

In a paper published in the journal Frontiers in Public Health in October 2020, Monali Rahalkar and Rahul Bahulikar of the MACS Agharkar Research Institute and BAIF Development Research Foundation, respectively, wrote: “The Master’s thesis (in the Chinese language) found on the cnki.net website concluded that a SARS-like CoV originating from Chinese horseshoe bats (Rhinolophus) was the predicted causative agent in the miners’ illness. It was also found that the gene, RaTG13/CoV4991 was collected from the mineshaft in 2013. RATG13 is supposed to be the closest known relative of the SARS-CoV-2 virus. One of the differences between RATG13 and SARS-CoV-2 genes is the Furin cleavage site.”

‘Furin cleavage site’ mystery is the one that needs to be resolved as this makes the covid-19 virus more infectious. Virologists opine, “It would take many decades for this sort of modification in the gene to naturally evolve”. Was ‘gain of function’ experiments in WIV lab pursued in search of a vaccine responsible for introduction of these changes in this ‘man-made’ virus? Is it true that as early as in Nov 2019, there were a few cases of infection of WIV technicians with Covid-19 symptoms?

Is this strain genetically engineered in WIV, is the moot question! The search for evidence for a lab role is difficult, as is the hunt for a motive if the origin of the pandemic indeed lies in a lab! Would it be unreasonable, after such a mayhem, to demand a detailed review of the activities of the lab and the notorious ‘bat lady’ Shi Zhengli who led this research?

Credits:

1. https://theprint.in/science/wuhan-labs-deleted-data-unreported-pneumonia-cases-challenges-to-natural-origins-of-covid/671984/

2. https://timesofindia.indiatimes.com/india/toi-finds-the-seeker-who-made-the-world-rethink-covids-origins/articleshow/83268958.cms

3. http://www.opindia.com/2021/06/the-seeker-covid-19-lab-leak-hypothesis-interview/

4. https://swarajyamag.com/news-brief/explained-how-a-persistent-young-indian-brought-covid-19-lab-leak-theory-to-the-fore-battling-mainstream-media-bias

Why Indemnify Covid Vaccination Business?

Does covid vaccines belong to a super class of drugs? Why should this community be indemnified for possible lapses? Or it is due to this emergency use authorisation, EUA, that genuinely calls for such waiver since the scientific studies could not be completed? Fair enough!

India held its ground that no waiver can be given to SII & BB while giving EUA. But yielding to Pfizer’s demand now is a clear case of discrimination. No doubt India needs to counter its deadly second surge! Pfizer is promising 5 crore vaccine delivery only if Indian government indemnifies the supply. Had enough quantities of other vax been available govt would not have yielded? I Indian government could have included a clause that the indemnification is for a limited period only! Say up to the distress period – till December when supply to improve thereafter? That may sound logical! Compelling Indian suppliers alone is unethical!

There are many cases, where manufacturers of some drugs were held liable for such risks and have paid huge compensation down the line in the lifetime of the drugs. In this case, the vax giant says take it or leave it!

Another point of view is vaccinating 12-18 years old kids. Only Pfizer has the approval and no one else. Would the GoI reserve the Pfizer’s supply to this segment? BB and zydus cadila have just started clinical trials but it might take two to three months for the results! Pfizer might fill in the gap!

Pfizer knows the ways of the world and they buy and takeover everything in sight! They buy politicians, media and now armtwisting the Govt which is already under pressure from opposition, which has already been ” lined” up by pfizer. The opposition wanted states to have freedom to buy and now Pfizer has twisted them to ask the centre to negotiate. In the case of vaccine, judiciary too fired the Govt for going slow on vax prucurement citing procedural delays. The Govt is being cornered. But hmm… Pfizer US giant… life of kids.. social media.. government is terrified.. they want to weather the storm before it even starts…

Everywhere else it is the respective government that has accepted such liability and procured vax in the larger interest of the public. The international Covax program is governed by WHO global insurance. But, GoI does not have an insurance plan to cover any damages of either the Indian or other vaccines. It may not be possible by the manufacturer to cover the risk as it would not be a sound commercial proposition, is a different matter altogether!

It is a bitter pill to swallow..

Indian Nuclear liability act framed in the aftermath of Fukushima accident was such catch-22 situation! The Nuclear power plant (NPP) and suppliers of its accessories refused to supply to india under the act. The Indian NPP program was derailed even after international nuclear trade was permitted with India. Now a comprehensive insurance plan by a consortium of Indian insurance companies is the rescue plan!

I am sure there would be debates in public forums.

Purists and Pragmatists

Ramdev’s acrimonious encounter (1) with Indian Medical Association: is there a need to deride other systems of medicines than the one you are trained? Yes, only to those practitioners who are threatened of their livelihood by the competitors and would thus wish to scuttle their business by sullying them; But for those, who suffer from ailments, it does not matter who cures, the ones that ‘would’ cure is the most sought after!

Many a times, it is by the word of mouth (and now social media) that picks up the better ones. How else can one explain the crowd that thronged (2) in ‘krishnapatnam’ village near Nellore district in AP, hearing a wonder cure ‘eye drops’ for covid? There were many, reportedly even with oxygen support, waiting in ambulances, leaving their ICUs, among the thousands that swarmed to get this ‘traditional’ preparation! Does it not show the extreme distress? People are driven from pillar to post with the sole objective of ‘எத்தைத்தின்னால் பித்தம் குறையும்’ syndrome!

Being an ardent follower of Homoeopathy over three decades, I am witness to many wonder cures for melodies such as jaundice, shrilling cries and tantrums of babies, mental depression, etc., that allopathy could not alleviate! There are countless cases of reliefs using Ayurvedic treatment, like the one for joint pains. My chronic Achilles tendonitis, of heel for which I was advised surgical procedure as the possible cure, could get relieved with Chinese foot massaging! I would only advocate an open mind for any ailment! Human body has evolved over eons with checks and balances, which is difficult to decipher by any one completely as yet!

Unlike the west, the east and far eastern civilisations, that dates back to centuries, have a host of concoctions to offer for any ailment. Many a times, it is wholistic unlike the ‘modern’ system that primarily relies on ‘signs and symptoms’! Though these old systems have survived centuries with unrecorded successes, acrimonious challenge by the evidence based allopathy, continue to bewilder the empirical evidences by the legions of these traditional medicines. I do not know, why?

With seemingly a large understanding of the genes in the recent times, people tend to arrogantly believe, there is cure for any melody; they can even deliver ‘designer babies’ meeting the required ‘specifications’! I would not be surprised if one day we end up in ‘Frankensteins’ through this genetic engineering, that has entered into therapeutics; fortunately this research is either banned or restricted in many ‘saner’ countries! Who knows – even covid virus might have been an outcome of one such research!

The audacious front line researchers of the cutting edge research apart, there are a still quite a few medical practitioners who understand the limitations of their own system and do not mind advising the “goods” in the other; leave alone some of them even furtively ‘cross’ prescribing, though it may be a ‘bitter pill’ to swallow for the ‘purists’!

This puddled topic reminds me of a sanskrit satirical verse by Neelakanta Dhikshidar who lived in the 17th century, in his ‘kalividambana’ on doctors:

that translates roughly into: ‘A doctor can treat a patient as he likes but he should prescribe strict diet restrictions. If restored to health, the credit goes to the treatment and if otherwise, the blame can be passed on to non adherence of dietary regimen’. To be precise, you can continue to be a successful doctor, once you know how to coverup the failures!

Is this not true even today? Does this not depict the present dilemma of the society?

Credits:

1. https://youtu.be/tIxlH0JOoUA

2. https://youtu.be/CcZE0ofp7R4

Can the world be the same ever again?

A few small countries have claimed near normalcy while a few bigger ones have feigned the same by unmasking, even-though the infection has not really abated. As per WHO guidelines, a country is considered infection free only when, no single case of new infection is reported for two incubation periods. That is, zero case for a month or so. This must be when no external constraints are in force for mobility and social gatherings. It doesn’t appear so anywhere in the near future.

Festivals, travels and elections are common activities of any free country in today’s world. Majority of the population engage in these activities in normal life, but these routines do not appear to be in the horizon.

For example, consider some of the recent election exercises: US had one to choose its president in the fag end of 2020. Neither the pandemic nor elections deter with the presence of each other. USA never had a relapse from infection ever since its onset in early 2020 is another story. Elections too were held in the four major states in the more populous India in April 2021. While the numbers in India were indeed quite low in March 2021- real bottom of the wave at less than 10000 cases a day, 10% of the September, 2021 peak! TPR, the test positivity rate, also was quite low, at less than a few percentage. In April 2021, it had a phenomenal raise during the busy the multiphase schedule. The election mela ended in 2nd May; the peak of the second wave in the country was on 13th May, after a typical ten day incubation period of this virus. Look at the numbers today when many states are still under lockdown: 70% of the daily infection of the country’s 220 K, is from six states, three of the four states that had elections are in the list. Only Karnataka, Maharashtra and AP being outliers – Have they paid the price for being close neighbours?

Now take the case of festivals: How come the kumbmela states, UP, Uttarakhand are out of the woods so quickly ? The congregation should have contributed to the infection as much as election bound states – but didn’t.. why? would it have been the large scale testing that could have led to scuttling of the menace? could be! UP tests over 3.2 lakhs a day even today and it’s positivity (TPR) is less than just 1%. Even at its peak of infection the TPR was not above 18%. Uttarakhand Could keep its positivity at its peak below 24%; today it is at less than 8%. Both the states had peaks around 10 days after the festival time.

Why the election bound states could not manage well? Poor testing? For strange reasons, the authorities did not comply to the warnings to ramp up the testing in TN, Kerala, WB and are paying a heavy price now. TPRs were all above 25% and sometimes dangerously even close to 30%? WB even today continues to be well above 25% while others are just less than 20%!

Conclusion is any congregation would contribute to a wave; no doubt! As long as there is any remnant of live virus around, there is a looming threat! From the experience of Mar-May 2021 period, it can be safely concluded that even a TPR of less than 1% in random testing would not guarantee a threat free world! Till immunisation of the whole public is done like in small pox, the threat would continue: virus would not only thrive, but mutate and can potentially become resistant to the existing immunity!