By Dr. George Jacob

Kochi, Sept 24, 2020: It has been nine months since first cases of Covid-19 were reported from China’s Wuhan. The onslaught of SARS Co-V-2 on mankind has been relentless. Globally 31.6 million has been infected, and 971,000 killed. India’s share of ‘viral bashing’ reads 31.6 million infected and 791,000 lost. India testing nearly a lakh positive daily is second in ‘COVID-19 ranking’ globally.

This wasn’t unexpected in a nation with population density of 646 per square kilometer. Early days of the pandemic saw India and other nations lock up citizens behind closed doors. World economy nosedived. Bankrupt migrants desperate to reach home during the lockdown perished like flies on Indian thoroughfares.

From those early days, the world and the nation have moved on. Moved on by concurrently making earnest attempts to tame the virus. This however has largely remained futile. The futility can be attributed to characteristics of the host, causative agent and treatment factors-the usual factors that determine the course of infectious diseases.

Host characteristics

Those vulnerable to infection and more relevantly, succumbing to the infection have largely been from those in extremes of age, and those with comorbidities viz; heart, lung and renal ailments, diabetes, hypertension, cancer , those on immunosuppressants, and the pregnant.

Causative agent

Bats form the reservoir of coronaviruses including SARS-Co-V-2, the causative agent of Covid-19. The virus must have made an inter-species somersault in the wet-markets of Wuhan back in December 2019 when the Chinese must have consumed bats. Much in keeping with the Chinese’ weird food habits.

It took quite a while for scientists to unravel the characteristics of the virus. Especially its pathogenicity. By then the virus had clambered the Great Wall, crossed oceans, and turned pandemic. The favorite pastime of the virus has been to mutate, mutate and to mutate, flummoxing the scientific world and rendering development of a vaccine a tightrope walk.

And displaying wide-ranging pattern of morbidity and mortality across the globe. Governments that had given up the fight against the virus or have had to encounter late resurgence of cases like Italy at a time and Kerala, the Indian state now, respectively reported ‘different strains’ of the virus to blame for its marauding capability. While natural history and pathogenicity of the virus has more or less been uniform globally, the numbers that were infected and had perished ranged widely between nations.

Treatment factors

The men and women in the white coat haven’t categorically been able to treat the virus convincingly. At least not yet. Drugs that have been tried or decorated as ‘being effective fighters’ would fill up a pharmacy shelf. Basic vitamins and minerals like zinc have been shown to render immunity against the virus.

But those that claimed to have the virus wave the white flag ranged from steroids, antimalarial hydroxychloroquin (with which India played ‘a friend in need’ to a United States on her knees, fresh from the Modi-Trump drama of pretended bonhomie and make-believe bilateral coziness),anticoagulants, antivirals singly and/ or in combination, Convalescent Plasma Therapy, and even measures that seemed like good old grandma’s ‘home-treatment’ tricks like ingestion of warm fluids and consumption of nutritious diet. Nothing seems to have worked convincingly. Till date.

The crafty virus has had Physicians resemble blind men throwing stones at the mango tree with mangoes hit by fluke than skilled aim! With an effective treatment modality evading medical scientists, the loud and expected shout for a vaccine has risen from humanity in trouble. Nations made a beeline claiming success in development of a vaccine including India. Claims remain claims. The vaccine resembles that last treasure in a treasure hunt game. As elusive. And as reluctant to emerge from the dark.

Nations have taken to ‘vaccine nationalism’ forgetting to realize that it takes time for a vaccine to emerge. It takes an average of 10.7 years for a vaccine to emerge against infectious diseases. The following shows diseases and time in years it took for a vaccine to emerge against them in parenthesis; polio (7), measles (9), Chicken pox (34), Mumps (4), Human Papilloma Virus (15), HIV (36 and counting).

That being the case, nations which had citizens locked up behind closed doors, and have since let them free to adopt the inevitable option of ‘living with the virus’ by adopting ‘new normals’, are now hoping for the ‘ultimate messiah’ in herd immunity.

New Delhi and Mumbai in India have reported to have acquired herd immunity by 29.1 and 57 percent respectively.

That’s where we are, nine months on, since this virus has embarked on its dark crusade of pandemical proportion.

Convincing treatment and vaccine-led primary prevention have evaded us thus far. All is not lost though. The dictum ‘that which cannot be treated must be prevented’ holds true for Covid-19. Sensible and effective steps to prevent the virus from infecting man have emerged. They have stood the test of more than ¾ of a year. New Zealand, South Korea and Asia’s largest slum, Dharavi in Mumbai stand testimony to effectiveness of these simple instructions, which can be gathered under a mnemonic code- SMS!

The idea is to that keep the virus well away from man

S-Social distancing; maintaining a distance of at least a meter between people.

M-wearing Masks properly covering the nose and mouth to minimize the infecting viral load, and to prevent transmission of the virus by the infected.

S- Use of Sanitizers or thorough washing of hands to limit fomite transmission.