India reports the lowest COVID-19 cases in 24 hours. The total death rate has been also reduced with 301 new deaths reported in last 24 hours.According to the Health Ministry total recoveries are 96,36,487.
The total number of deaths reported till now after outbreak is 1,46,111 .
Total number of tests – ICMR
The total number of samples tested are 16,31,70,557 for COVID-19 samples up to December 21. The total 10,72,228 samples were tested in last 24 hours.
By Dr Narendra Saini
SARS-CoV-2,Covid 19 Update
Cases : 77,713,003
deaths : 1,708,830
US : Cases : 18,473,716 deaths : 336,772
India : Cases 10,075,422
deaths : 146,145
Brazil : cases 7,264,221 deaths : 187,322
UK : 2,073,511
deaths : 67,616
(worldometer)
Coronaviruses is an RNA virus, and mutations arise naturally as the virus replicates. So it is not unexpected that new variants of SARS-CoV-2 are emerging. Since its detection in Wuhan, China, the SARS-CoV-2 has seen many changes. The strain that’s infecting people now if is compared to the first one that spread in Wuhan. Many mutations have already arisen, but only a very small minority are likely to be important and to change the virus in an appreciable way. COG-UK says that there are currently around 4000 mutations particularity in the spike protein. This is the key, the virus employs to unlock the door to the human body’s cells.
Notably, countries where the new variant has been identified – including the U.K., Denmark, the Netherlands, and Italy – have robust genomic surveillance systems. This is not the case in the vast majority of nations worldwide. This implies that the new different variants could very well already be present in dozens of countries,
The D614G is the first known mutation that is suspected to have occurred in Eastern China in January and later spread through New York City and Europe. Within a few months of the pandemic, this particular variant was found all over the world, as it had successfully replaced its predecessor, which had spread from Wuhan.
Another variant called 20A.EU1, is known to have spread from farmworkers to local populations in Spain in June and July . People then returning from a holiday in Spain most likely playing a key role in spreading the strain across Europe.
The new strain now, dubbed VUI-202012/01,
( “Variant Under Investigation” in December 2020) and according to the preliminary genomic characterisation the present UK variant has an unusually large number of genetic changes ( approximately 23 ), particularly in the spike protein. Changes in spike protein may, in theory, result in the virus becoming more infectious, spreading more easily between people.
There is no evidence at the moment that the new variant causes disease which is different from that caused by previous variants. The variant does seem about 40-70 percent more transmissible however Testing with the already used method should work. Current coronavirus swab tests would detect the new variant.
Even though the mutation in the virus appears to be significant, experts have not found any reason to suggest that the new mutation would affect the vaccination as yet.
At the moment, there is no indication that this new strain would evade treatments.The new variant has mutations to the spike protein that the leading vaccines are targeting. However, vaccines produce antibodies against many regions in the spike protein, so it’s unlikely that these changes would make the vaccine less effective.
However, as more and more people get vaccinated, researchers expect the virus to evolve mutations that will help make it resistant to existing vaccines in the future as happens in seasonal flu
Face coverings (nose &mouth) should be part of new normal
Smoking in any form at this time should be banned in public places as it may increase the spread of virus.Teamwork and Transparency are important in winning this Corona war
A new infectious variant of the coronavirus spreading rapidly in Britain with mutations can infect Children also- unlike previous strains , says Scientists .
According to the news agency Reuters – The U.K government’s New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) who are tracking the variant said, It has swiftly become the dominant strain in the south of Britain and do the same across the country.
The Government of India is soon going to sign a agreement with serum Institute of India (SII) to purchase 5 crore vaccines for procurement before starting vaccination in the month of January.
25 December has been observed as “Good Governance Day” since 2014 to celebrate the birth anniversary of former Prime Minister Atal Bihar Vajpayee. However, this year, if top sources are to be believed, the government is likely to declare some “big news” on the day related to the Covid-19 vaccine.
The Government of India has already prioritized the list of people who will get the vaccine in phase -1.
“After consultation with experts, we’ve prioritized 30-cr people for COVID vaccine. It includes health workers, frontline workers like police, military&sanitation staff, people above 50 yrs &those who are below 50 yrs but are suffering from certain diseases,” said Dr Harsh Vardhan , Union Health Minister
The task force at state , district and block levels are finishing their training for vaccination.
“We’ve formed task forces at state, district & block levels. Thousands of master trainers have been trained across the country. We’ve conducted training at state level & trained over 20,0 00 workers in about 260 districts,”Dr Harsh Vardhan Added
According to sources, vaccinators across the country have received instructions to be “all set” by 25 December and state trainers for the immunisation drive have been asked to finish their training by Friday. “The state trainers have asked to finish the district level training by 25 December,” sources said.
The Family Welfare Department of Uttar Pradesh has cancelled all leaves of officers and employees of the Health Department till 31 January 2021, stating that their cooperation would be required during that period. The employees whose leaves have been cancelled include doctors, nurses, contract workers and daily wage workers.
Meanwhile, Hindustan Syringes and Medical Devices (HMD) have delivered 289.1 lakh syringes for the nationwide immunisation programme and are targeting to deliver 70.07 crore syringes by April.
“We are on track to finish the shipment of the last few batches against an order of 140 million pieces for COVAX by the end of next week. We have space now to allow us to ramp up our production for the Government of India from 9 lakhs per day to 13.5 lakhs per day of 0.5 ml/0.1ml from the coming week,” said Rajiv Nath, CEO of HMD.
He added that the total dispatches in December, which started on 17 December, for 0.5ml AD syringes as per CMSS’s order amount to 57 lakh in Bareilly, 17.8 lakh for Jhansi, 38.90 lakh for Agra, 26.10 lakh for Kanpur, 58 lakh for Lucknow, 46 lakh for Gorakhpur and 48.1 lakhs for Varanasi. “The total number of syringes delivered till 19 December is 289.1 lakh,” he said.
Dr V.K. Paul, a member (health) of NITI Aayog and the head of the Covid-19 taskforce committee, also said in an exclusive interview, “India is lucky to have so many drug-maker companies. Whenever we have a vaccine, India will prove to be the strongest country to end COVID-19. Our vaccine industry is very strong regarding the development and production of vaccines. India’s vaccines are used in low and middle-income countries as well, which is about 60 percent of the world. We may also get vaccines that are being developed by other countries. We have three companies, amongst which, two are from India and one from another country, which have applied for emergency licensure. Indian companies which have applied for emergency authorisation are Serum Institute of India (SII) and Bharat Biotech, and the other is Pfizer from the US. The DCGI is reviewing their data.”
By Dr. Alok Thakar
The COVID-19 epidemic has been noted to be associated with an increase in another type of infection- RhinoOrbitoCerbral Mucormycosis. Rhino Orbito Cerebral Mucormycosis is a dangerous infection of the nose which causes destruction and disfigurement and spreads to the eye, and from the eye of the brain. Infection with mucormycosis usually occurs in patients who have compromised immunity due to some other underlying illness. It is very unusual for the infection to occur in someone who is otherwise healthy and with normal immunity. In our practice previously, such infection with mucormycosis was commonly noted in patients with uncontrolled diabetes, and sometimes in patients receiving immune-suppressing medicines or steroids. In recent months, however, the commonest underlying condition which is noted to be associated with a mucormycosis infection is a Covid-19
infection.
The mucormycosis infection starts in the nose. It causes rapid gangrene of the mucosa of the nose and may also cause darkening and gangrene of the overlying skin and the hard palate. It can spread to the eyes and from the eyes to the brain. Spread is generally along the blood vessels as the fungus which causes the infection is known to have a specific predilection for the blood vessel lining and spreads along it.
An increase in the number of patients with such infection has been noted since April when the Covid-19 epidemic was first manifesting. Since then as the number of Covid19 patients has increased, a proportionate increase is also noted in patients with mucormycosis infection. In many instances, the Covid-19 infection had been asymptomatic and the first illness noted by the patient was the mucormycosis infection in the nose and eye.
COVID -19 can be complicated by many secondary events that predispose to a severe infection such as mucormycosis. Covid-19 has been noted to cause wide fluctuations in the blood sugar levels and may precipitate uncontrolled diabetes. It may lead to an increased tendency of clot formation in the blood vessels of the brain and eye. It is also associated with a decrease in the lymphocyte count and may compromise cell-mediated immunity. All these mechanisms it seems are contributing to immune compromise and leading to the increasing incidence of mucormycosis in these patients. The infection can be very serious, it may lead to blindness and disfigurement and may even be life-threatening. We have had sufficient experience in dealing with this illness in the past many years, but treating the infection in the presence of active COVID-19 infection provides new challenges. Patients need immediate hospitalization, treatment with intravenous antifungal drugs, and often immediate surgery to remove the infection and necrosis so as to clear the fungus and prevent its spread to other areas.
Immediate and active treatment can lead to control of the infection and limit its serious effects.
The writer is Dr. Alok Thakker, HOD, ENT,AIIMS , New Delhi.
The largest vaccine producer in the world has asked the government to indemnify manufacturers against lawsuits. Serum Institute of India CEO Adar Poonawalla has asked the government to protect the vaccine makers from “frivolous lawsuits”. Adar Poonawalla’s comment has come after a volunteer in Chennai alleged that he had suffered from the adverse effects after volunteering for the Oxford vaccine trials.
“We need to have the government indemnify manufacturers, especially vaccine manufacturers, against all lawsuits,” Adar Poonawala said at Global Technology Summit 2020, organised by the Carnegie India with The Print as its digital partner.
The giant British – Swedish multinational drug maker company is likely to get regulatory approval from the UK’s independent regulator MHRA by the end of this year to start a rollout in early 2021, according to the UK media report.
It is expected to authorise the vaccine by December 28 or 29 after the final data is provided on Monday, The Daily Telegraph quoted senior government sources .The Medicines and Healthcare products Regulatory Agency (MHRA) authorisation will give confidence to countries across other countries. India has already manufactured more than 50 million of the AstraZeneca vaccines.
In India, AstraZeneca had a tie-up with Serum Institute of India (SII) whose phase -3 trials have been already started. AstraZeneca is a double-dose vaccine that will be given in 4 weeks of time after the completion of a single dose. It can be stored at a normal temperature in comparison to the Pfizer vaccine.
India has crossed 1 crore Covid-19 reported cases today, but India’s recovery rate is highest in the world the Union Health Minister Dr Harsh Vardhan said “There have been a little over one crore cases of COVID19 in India. Of that, 95 lakh 50 thousand cases have recovered successfully. India has one of the highest recovery rates in the world at 95.46%:Our scientists & health experts have worked on the development of a vaccine by genome sequencing & isolation of the coronavirus & developed an indigenous vaccine.”
” In 6-7 months, we will have the capacity to inoculate about 30 crore people.” he added
India has crossed 1-crore mark of COVID-19 cases. The new infections cases reported in last 24 hours are 25,153.The total number deaths reported from the time of outbreak is 1,45,136 and total number of recovered and active cases are 95,50,712 and 3,08,751 , the data is shared by the Union Ministry of Health and Family welfare.
According to the data from the Ministry of Health, there is an exponential rise in India’s testing that has crossed 16crore.The National Positivity rate has been dropped to 6.25%. “The 15 States and UTs have Positivity Rate less than the national average”, statement from Union Ministry of health
What is in the placebo? Is the recipient of a placebo aware of it? Can a person who has volunteered for the placebo get the Covid vaccine? These are some important questions which are on everyone’s minds as people in certain corners of the world start to receive the Covid vaccine and others hope to do so soon.But now people are in fear to volunteer for a vaccine trials because of hidden doubts in their minds. Dr.Satyajit Rath , Immunologist , IISER,Pune responds to all these anwers.
1. How a volunteer would know whether he has taken a placebo or a vaccine for COVID-19?
No, they will not know. In fact, not even the people giving the injection will know, in all likelihood. That is why these are called ‘blinded’ trials; the people taking the experimental vaccine (or ‘candidate vaccine’) and the people monitoring it will not know who has got the ‘vaccine’ and who has got the ‘dummy vaccine’ or ‘placebo’ (so they are ‘bind’ to that information!). That way, that knowledge will not affect what they do and how they behave, which will reduce the possibility of bias in the study.
2. What is the difference between placebo and Vaccine?
A ‘placebo’ is a ‘dummy vaccine’, in the sense that it looks like the ‘vaccine’, but does not have any of the active ingredients of the ‘vaccine’. So the ‘placebo’ would have no real effect at all. Placebos are used so as to have a group to compare the ‘vaccinated’ group with, in order to see if the vaccine ‘works’. It is, effectively, an ‘unvaccinated’ group, except that group is getting a ‘pretend vaccine’ so as to maintain ‘blinding’ in the trial.
3. Do you think if a person takes a placebo then he/she can’t take a vaccine? if no then why?
No no; of course, people taking placebos in a vaccine trial can, should and will get the actual vaccine if and when the trial is successful and the vaccine is seen to work!
4. What test can be done to know about the safety and effectiveness of a vaccine?
The safety and effectiveness of an experimental vaccine cannot be tested by anyone ‘test’. It is a structured process of first ‘pre-clinical’ testing in experimental animals in which safety and the ability to generate a useful immune response are tested, and then the three phases of trials in humans, in which safety is tested (phase 1), the ability to generate an immune response is tested (phase 2), and then the actual ability to protect against the disease is tested (phase 3). All of these have been and are being done for all COVID-19 vaccine candidates.