College student dies as reckless garbage truck hits her scooter

Bengaluru, Mar 28: Sun Tsu, in 'The Art of War' speaks of a skilful general who can subdue his enemy without any fighting. This constitutes the ultimate triumph which is referred to as stratagem. Today, we would need one such when we are faced with the '21-day corona challenge' for India.
Nearly four weeks back, Dr Jyothsna Rao, Dr Gururaj Rao and I sat across the OPD in the afternoon at HCG Bengaluru discussing our ongoing cancer immunology research. While on this topic, we drifted into the discussion on the coronavirus. During this engaging discussion, we wondered the similarity of the enigma between the virus and cancer. I paused to ask Dr Jyothsna and Dr Guru - how we wish we could do something against this virus.
Dr Jyothsna is a PhD from NCBS and had worked under Dr Ralph Steinman, physician and researcher from Rockefeller University, who won the Nobel Prize for his discovery of the dendritic cell and its role in adaptive immunity in 2011. Dr Gururaj is a molecular and cell biologist who did his PhD at the Chapel Hill, University of North Carolina and is the Director of iCrest.
Jyothsna while hearing our perplexing conversation on the covid intervened, "Yes, surely. I think we should take a break from cancer and focus on the innate and adaptive immunity role in COVID-19."
Thus began this sincere attempt to relook the human immune system from the eyes of the COVID-19.
We have 10 types of immune cells at the least which are widely dispersed in millions across the body. When our body is invaded by a foreign organism (bacteria, fungi or virus), these cells work with each other to destroy the invader.
Now, the question is - how do the immune cells talk to each other? They use small-molecule substances called cytokines (cyto means cells; kine means movement). There are many cytokines that are involved in work on the immune system. The most relevant for viruses are interferons.
Interferons (IFN) as the name reflects have an ability to interfere with the viral activity and stop their multiplication. These specialised signal proteins are released by our cells in response to a viral attack to forewarn other cells. They help build the antiviral proteins within the cells to kill the virus as it tries to invade the new cells.
Historically, interferons are a group of cytokines known to be potent antiviral agents against viruses and a hallmark cytokine induced by the host upon viral infections. Interferons possess unique immunoregulatory activities and are signature cytokines released by (TH1) T immune cells, which are crucial in viral infections.
As the outbreak of COVID-19 grapples us, an urgent need for finding strategies to combat the virus is growing. Coronaviruses (CoVs) are a group of RNA viruses. In patients infected with coronavirus, it was indicated that the activation of the IFN does not occur until 48 hours post-infection. Thus the delayed IFN-related antiviral response by the healthy cells leads to coronavirus evade the immune response.
Numerous studies have presented the success in defeating CoVs by the direct administration of IFNs. In a combination as a concoction, it was shown to synergistically inhibit the virus replication in vitro.
Moreover, it is understood that the earlier induction of IFNs in children although they have a less developed immune system could be the reason behind the children being least affected.
The key to success in reducing the disease fatality might be the stimulation of the immune responses to trigger IFN production at the very early stages of the disease, which might be done through the administration of IFN. Despite the evidence for the efficacy of IFNs in treating CoV-induced infections, the proper dosing and ideal timing for such interventions needs to be verified in clinical trials.
For the later stages of the diseases in advance stages where patients are on ventilator and have developed respiratory distress, we propose to utilise the mesenchymal cells derived from donor bone marrow that have been known to treat acute respiratory syndrome. Mesenchymal cells are known to possess anti-inflammatory activity and thus used often in autoimmune diseases.
With this scientific background, we have activated T cells from healthy donors, in a cGMP facility at iCrest - HCG hospital with an enriched cocktail of cytokines rich in Interferons. Injections of this cocktail we believe will result in a surge of cytokines in the body of the infected person and will boost his ability to fight the virus in the early phases. We are in the initial phases of this study and hope to be ready in the coming weeks with meaningful data on its potential utility.
Currently, it awaits government approvals (Union and state) and we have applied to central drugs authority for their initial evaluation and further directions.
As my Guru often expounded the philosophy of 'Seva' - the goal of education is knowledge, the end goal of knowledge is service. In this attempt to serve our fellow humans at this brink of unprecedented crisis, medical fraternity stands with you and promises to do our best for your safety.
We assure to exhaust every bit of our spirit in this fight against coronavirus. We have lost the sight of shores and travelled thus far, but that is the mandatory first step to cross the ocean. Are we going to succeed in this battle, is something only time will answer. 

Kottayam, Apr 6: "I will leave this room within a week after defeating you," the braveheart nurse had vowed after contracting the deadly coronavirus while attending to India's oldest COVID-19 survior, expressing unflinching faith in Kerala's health care system.

Last Friday, 32-year old Reshma Mohandas lived up to her promise and walked out holding her head high to her home, where she is now placed under 14-day quarantine, after she and the elderly man and his wife were discharged from the Medical College Hospital here on being cured of th e disease.

Soon after 93-year-old Thomas Abraham, whose recovery has been dubbed as a 'miracle cure' by the medical community, and 88-year old Mariyamma left the hospital, Reshma too headed home but with the resolve to come back and serve the patients after the mandatory two weeks quarantine.

"I will leave this room within a week after defeating you (coronavirus)", Reshma had posted in a WhatsApp group of her friends and colleagues while undergoing treatment in isolation at the hospital.

"I posted that message in the WhatsApp group because I have full faith in Kerala's health system. It is world class," Reshma told reporters from her home.

The nurse, who took care Thomas and Mariyamma since March 12, believes she contracted the disease as she was in close contact with and often talked to the couple, who did not wear masks as it made them uncomfortable.

She said she loved taking care of all their needs.

"I was not tensed at all. I love taking care of elderly people. We used to talk a lot (in the ICU)", she said.

Reshma, who was earlier working in the operating theatre of another section, said she used work for four hours in the ICU before she contracted the virus and was admitted to the same wing as a patient.

"I had close contact with them in the ICU because I paid attention to address their every needs," she said. The first warning sign came on March 23 morning when she had a throat infection.

Reshma immediately alerted the head nurse, who in turn informed the doctors.

She was asked to visit the fever clinic at the Medical College and was later referred to the isolation facility where she took care of elderly novel coronavirus patients.

Some 20 nurses who had come into contact with her were sent to home quarantine.

On March 24, she tested positive.

"I did not have any other complications, barring headache and body pain", she said.

Reshma said she was ready to serve in the isolation facility for COVID-19 patients after 14 days of mandatory home quarantine.

"I am ready to work again in the isolation facility when I return," the feisty nurse, whose husband is an engineer, said.

She was all the more happy that proper medical care at the hospital led to recovery of Abraham and Mariyamma.

Kerala Health minister K K Shailaja telephoned Reshma to express her happiness over her recovery.

The Minister said the news about a health professional contracting the coronavirus was a matter of concern for the state.

In a statement, she hailed Reshma's dedication as a professional and said she had treated elderly patients like her parents, attending to their every need.

The elderly couple, hailing from Ranni village in Pathanamthitta district had contracted the virus from their son, daughter-in-law and grandson who returned from Italy last month, all of whom have also recovered.