China tacitly acknowledges withdrawal of troops from Ladakh

New Delhi, May 23: The nationwide lockdown will no longer help India in its fight against COVID-19, and in its place community-driven containment, isolation and quarantine strategies have to be brought into play, leading virologist Shahid Jameel said.

The recipient of Shanti Swarup Bhatnagar Prize for Science and Technology also stressed that testing should be carried out vigorously to identify coronavirus hotspots and isolate those areas.

"Our current testing rate at 1,744 tests per million population is one of the lowest in the world. We should deploy both antibody tests and confirmatory PCR tests. This will tell us about pockets of ongoing infection and past (recovered) infection. This will provide data to open up gradually and let economic activity resume," Jameel told PTI in an interview.

He stressed that testing has to be dynamic to continuously monitor red, orange and green zones and change these based on that data.

About community transmission of COVID-19 in India, Jameel said the country reached that stage long ago.

"We reached community transmission a long time ago. It's just that the health authorities are not admitting it. Even ICMR's own study of SARI (severe acute respiratory illness) showed that about 40 per cent of those who tested positive for SARS-CoV-2 did not have any history of overseas travel or contact to a known case. If this is not community transmission, then what is?" he posed.

Lockdown bought India time in its fight against coronavirus, but continuing it is unlikely to yield any further dividend, Jameel said.

"Instead, community-driven local lockdowns, isolations and quarantines have to come into play. Building trust is most important so that people follow rules. A public health problem cannot be dealt with as a law-and-order problem."

The nationwide lockdown, initially imposed from March 25 to April 14, has been extended thrice and will continue at least till May 31. The virus has claimed 3,720 lives and infected over 1.25 lakh people in the country so far.

Jameel has expertise in the fields of molecular biology, infectious diseases, and biotechnology. He is the CEO of Wellcome Trust/Department of Biotechnology's India Alliance and is best known for extensive research in Hepatitis E virus and HIV.

He said COVID-19 will eventually be controlled through herd immunity, which is acquired in two ways – when a sufficient fraction of the population gets infected and recovers, and with vaccination.

"It is estimated that for SARS-CoV-2 at least 60 per cent of the population would have to be infected and recovered, or vaccinated. This will happen over the course of the next few years," Jameel said.

Herd immunity is reached when the majority of a population becomes immune to an infectious disease, either because they have become infected and recovered, or through vaccination. When that happens, the disease is less likely to spread to people who aren't immune, because there just aren't enough infectious carriers.

"India has 1.38 billion people, a population density of about 400/sq km and a healthcare system ranked at 143 in the world. If we allow 60 per cent people to get infected quickly in the hopes of herd immunity, that would mean 830 million infections," Jameel said.

"If 15 per cent need hospitalization that means about 125 million isolation beds (we have 0.3 million). If five per cent need oxygen and ventilatory support, this amounts to about 42 million oxygen support and ICU beds; we have 0.1 million oxygen support beds and 34,000 ICU beds. This would overwhelm the healthcare system causing mayhem," he said.

Jameel said if the population level mortality is 0.5 per cent that would mean 40 lakh deaths. "Are we prepared to pay this price for herd immunity in the short term? Clearly not," he said.

He said it is unlikely that a vaccine would be available by the end of the year.

"Even then, we don't know yet how long it would give protection – weeks, months, one year, a few years? I don't think we will return to pre-coronavirus days for at least the next 3-5 years. This is also a chance to evaluate if we want to return to those unsustainable, environment-damaging ways. COVID-19 is a timely warning to reform our way of living," he said.

Jameel said it is hard to predict but plausible that COVID-19 would return in second or third wave.

"Later waves come when we don't understand the disease and become lax. A comparison to Spanish Flu is not entirely valid because in 1918 no one knew what caused it. No one had seen a virus till the mid-1930s as the electron microscope needed to view those was invented in 1931," he said.

"Today we know a lot more about the pathogen, its genetic makeup, how it transmits and how to prevent it. We need to be sensible and follow expert advice," he said.

If there is any scientific evidence linking deforestation, rapid urbanisation, climate change with pandemics like COVID-19, he said zoonotic viruses -- those that jump from animals to humans -- happen so when wild animal–human contacts increase.

"Deforestation destroys animal habitats bringing them closer to humans. When you cut forests, bats come to roost on trees closer to human habitations. Their viruses in secretions/stool get transmitted to domestic animals and on to humans. This happened clearly with Nipah virus outbreak in Malaysia in 1997-98 from fruit bats to pigs to humans," he said.

"COVID-19 possibly arose in wet animal markets due to dietary habits that bring all kinds of live and dead wild animals in close contact with humans," Jameel added.

United Nations, Jun 30: India accounts for 45.8 million of the world's 142.6 million "missing females" over the past 50 years, a report by the United Nations said on Tuesday, noting that the country along with China form the majority of such women globally.

The State of World Population 2020 report released on Tuesday by the United Nations Population Fund (UNFPA), the world organisation's sexual and reproductive health agency, said that the number of missing women has more than doubled over the past 50 years - from 61 million in 1970 to a cumulative 142.6 million in 2020.

Of this global figure, India accounted for 45.8 million missing females as of 2020 and China accounted for 72.3 million.

Missing females are women missing from the population at given dates due to the cumulative effect of postnatal and prenatal sex selection in the past, the agency said.

Between 2013 and 2017, about 460,000 girls in India were missing' at birth each year. According to one analysis, gender-biased sex selection accounts for about two-thirds of the total missing girls, and post-birth female mortality accounts for about one-third, the report said.

Citing data by experts, it said that China and India together account for about 90-95 per cent of the estimated 1.2 million to 1.5 million missing female births annually worldwide due to gender-biased (prenatal) sex selection.

The two countries also account for the largest number of births each year, it said.

The report cites data by Alkema, Leontine and others, 2014 National, Regional, and Global Sex Ratios of Infant, Child, and under-5 Mortality and Identification of Countries with Outlying Ratios: A Systematic Assessment' from The Lancet Global Health.

According to their analysis, India has the highest rate of excess female deaths, 13.5 per 1,000 female births, which suggests that an estimated one in nine deaths of females below the age of 5 may be attributed to postnatal sex selection.

The report notes that governments have also taken action to address the root causes of sex selection. India and Vietnam have included campaigns that target gender stereotypes to change attitudes and open the door to new norms and behaviours.

They spotlight the importance of daughters and highlight how girls and women have changed society for the better. Campaigns that celebrate women's progress and achievements may resonate more where daughter-only families can be shown to be prospering, it said.

The report said that successful education-related interventions include the provision of cash transfers conditional on school attendance; or support to cover the costs of school fees, books, uniforms and supplies, taking note of successful cash-transfer initiatives such as Apni Beti Apna Dhan' in India.

It said that preference for a male child manifested in sex selection has led to dramatic, long-term shifts in the proportions of women and men in the populations of some countries.

This demographic imbalance will have an inevitable impact on marriage systems. In countries where marriage is nearly universal, many men may need to delay or forego marriage because they will be unable to find a spouse, the report said.

This so-called "marriage squeeze", where prospective grooms outnumber prospective brides, has already been observed in some countries and affects mostly young men from lower economic strata.

"At the same time, the marriage squeeze could result in more child marriages, the report said citing experts.

Some studies suggest that the marriage squeeze will peak in India in 2055. The proportion of men who are still single at the age of 50 is forecast to rise after 2050 in India to 10 per cent, it said.

The UN report said that every year, millions of girls globally are subjected to practices that harm them physically and emotionally, with the full knowledge and consent of their families, friends and communities.

At least 19 harmful practices, ranging from breast ironing to virginity testing, are considered human rights violations, according to the UNFPA report, which focuses on the three most prevalent ones: female genital mutilation, child marriage, and extreme bias against daughters in favour of sons.

Harmful practices against girls cause profound and lasting trauma, robbing them of their right to reach their full potential, says UNFPA Executive Director Dr. Natalia Kanem.

This year, an estimated 4.1 million girls will be subjected to female genital mutilation. Today, 33,000 girls under age 18 will be forced into marriages, usually to much older men and an extreme preference for sons over daughters in some countries has fuelled gender-biased sex selection or extreme neglect that leads to their death as children, resulting in the 140 million missing females.

The report said that ending child marriage and female genital mutilation worldwide is possible within 10 years by scaling up efforts to keep girls in school longer and teach them life skills and to engage men and boys in social change.

Investments totalling USD 3.4 billion a year through 2030 would end these two harmful practices and end the suffering of an estimated 84 million girls, it said.

A recent analysis revealed that if services and programmes remain shuttered for six months due to the COVID-19 pandemic, an additional 13 million girls may be forced into marriage and 2 million more girls may be subjected to female genital mutilation between now and 2030.

The pandemic both makes our job harder and more urgent as so many more girls are now at risk, Kanem said.

New Delhi, Jul 6: The Indian Academy of Sciences, a Bengaluru-based body of scientists, has said the Indian Council for Medical Research's (ICMR) target to launch a coronavirus vaccine by August 15 is "unfeasible" and "unrealistic".

The IASc said while there is an unquestioned urgent need, vaccine development for use in humans requires scientifically executed clinical trials in a phased manner.

While administrative approvals can be expedited, the "scientific processes of experimentation and data collection have a natural time span that cannot be hastened without compromising standards of scientific rigour", the IASc said in a statement.

In its statement, the IASc referred to the ICMR's letter which states that "it is envisaged to launch the vaccine for public health use latest by 15th August 2020 after completion of all clinical trials".

The ICMR and Bharat Biotech India Limited, a private pharmaceutical company, are jointly developing the vaccine against the novel coronavirus -- SARS-CoV-2.

The IASc welcomes the exciting development of a candidate vaccine and wishes that the vaccine is quickly made available for public use, the statement said.

"However, as a body of scientists including many who are engaged in vaccine development IASc strongly believes that the announced timeline is unfeasible. This timeline has raised unrealistic hope and expectations in the minds of our citizens," it said.

Aiming to launch an indigenous COVID-19 vaccine by August 15, the ICMR had written to select medical institutions and hospitals to fast-track clinical trial approvals for the vaccine candidate, COVAXIN.

Experts have also cautioned against rushing the process for developing a COVID-19 vaccine and stressed that it is not in accordance with the globally accepted norms to fast-track vaccine development for diseases of pandemic potential.

The IASc said trials for a vaccine involve evaluation of safety (Phase 1 trial), efficacy and side effects at different dose levels (Phase 2 trial), and confirmation of safety and efficacy in thousands of healthy people (Phase 3 trial) before its release for public use.

Clinical trials for a candidate vaccine require participation of healthy human volunteers. Therefore, many ethical and regulatory approvals need to be obtained prior to the initiation of the trials, it added.

The IASc said the immune responses usually take several weeks to develop and relevant data should not be collected earlier.

"Moreover, data collected in one phase must be adequately analysed before the next phase can be initiated. If the data of any phase are unacceptable then the clinical trial is required to be immediately aborted," it said.

For example, if the data collected from Phase 1 of the clinical trial show that the vaccine is not adequately safe, then Phase 2 cannot be initiated and the candidate vaccine must be discarded.

For these reasons, the Indian Academy of Sciences believes that the announced timeline is "unreasonable and without precedent", the statement said.

"The Academy strongly believes that any hasty solution that may compromise rigorous scientific processes and standards will likely have long-term adverse impacts of unforeseen magnitude on citizens of India," it said.