Islamic organisation activists clean flood-hit temples in Chennai

Riyadh, Jun 17: Saudi Arabia is expected to scale back or call off this year's hajj pilgrimage for the first time in its modern history, observers say, a perilous decision as coronavirus cases spike.

Muslim nations are pressing Riyadh to give its much-delayed decision on whether the annual ritual will go ahead as scheduled in late July.

But as the kingdom negotiates a call fraught with political and economic risks in a tinderbox region, time is running out to organise logistics for one of the world's largest mass gatherings.

A full-scale hajj, which last year drew about 2.5 million pilgrims, appears increasingly unlikely after authorities advised Muslims in late March to defer preparations due to the fast-spreading disease.

"It's a toss-up between holding a nominal hajj and scrapping it entirely," a South Asian official in contact with Saudi hajj authorities said.

A Saudi official said: "The decision will soon be made and announced."

Indonesia, the world's most populous Muslim nation, withdrew from the pilgrimage this month after pressing Riyadh for clarity, with a minister calling it a "very bitter and difficult decision".

Malaysia, Senegal and Singapore followed suit with similar announcements.

Many other countries with Muslim populations -- from Egypt and Morocco to Turkey, Lebanon and Bulgaria -- have said they are still awaiting Riyadh's decision.

In countries like France, faith leaders have urged Muslims to "postpone" their pilgrimage plans until next year due to the prevailing risks.

The hajj, a must for able-bodied Muslims at least once in their lifetime, represents a major potential source of contagion as it packs millions of pilgrims into congested religious sites.

But any decision to limit or cancel the event risks annoying Muslim hardliners for whom religion trumps health concerns.

It could also trigger renewed scrutiny of the Saudi custodianship of Islam's holiest sites -- the kingdom's most powerful source of political legitimacy.

A series of deadly disasters over the years, including a 2015 stampede that killed up to 2,300 worshippers, has prompted criticism of the kingdom's management of the hajj.

"Saudi Arabia is caught between the devil and the deep blue sea," Umar Karim, a visiting fellow at the Royal United Services Institute in London, told AFP.

"The delay in announcing its decision shows it understands the political consequences of cancelling the hajj or reducing its scale."

"Buying time"

The kingdom is "buying time" as it treads cautiously, the South Asian official said.

"At the last minute if Saudi says 'we are ready to do a full hajj', (logistically) many countries will not be in a position" to participate, he said.

Amid an ongoing suspension of international flights, a reduced hajj with only local residents is a likely scenario, the official added.

A decision to cancel the hajj would be a first since the kingdom was founded in 1932.

Saudi Arabia managed to hold the pilgrimage during previous outbreaks of Ebola and MERS.

But it is struggling to contain the virus amid a serious spike in daily cases and deaths since authorities began easing a nationwide lockdown in late May.

In Saudi hospitals, sources say intensive care beds are fast filling up and a growing number of health workers are contracting the virus as the total number of cases has topped 130,000. Deaths surpassed 1,000 on Monday.

To counter the spike, authorities this month tightened lockdown restrictions in the city of Jeddah, gateway to the pilgrimage city of Mecca.

"Heartbroken"

"The hajj is the most important spiritual journey in the life of any Muslim, but if Saudi Arabia proceeds in this scenario it will not only exert pressure on its own health system," said Yasmine Farouk from the Carnegie Endowment for International Peace.

"It could also be widely held responsible for fanning the pandemic."

A cancelled or watered-down hajj would represent a major loss of revenue for the kingdom, which is already reeling from the twin shocks of the virus-induced slowdown and a plunge in oil prices.

The smaller year-round umrah pilgrimage was already suspended in March.

Together, they add $12 billion to the Saudi economy every year, according to government figures.

A negative decision would likely disappoint millions of Muslim pilgrims around the world who often invest their life savings and endure long waiting lists to make the trip.

"I can't help but be heartbroken -- I've been waiting for years," Indonesian civil servant Ria Taurisnawati, 37, told AFP as she sobbed.

"All my preparations were done, the clothes were ready and I got the necessary vaccination. But God has another plan."

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. 

Mangaluru, May 11: The first evocation flight from Dubai to Mangaluru amidst corona crisis is expected to bring back 177 stranded Kannadigas, mainly residents of coastal Karnataka, on Tuesday, May 12.

All the international passengers have to undergo three mandatory upon their arrival at Mangaluru International Airport - the thermal test, pulse oximetry reading and swab test.

They will be categorised based on their health condition and sent to institutional quarantine, said Sindhu B Rupesh, deputy commissioner, Dakshina Kannada.

“Those with some health issues on arrival (Category A) will be ferried through ambulances to quarantine facilities and rest in buses,” she said.

Arriving passengers will be given the option to choose their quarantine home (lodge, hostel and service apartment) based on their budget and preference.

It is learnt that Dakshina Kannada district administration has kept ready close to 1,000 rooms. The tariff for quarantine facilities is between Rs 1,200 and Rs 4,500 (including food) per day.

As per the Karnataka government, as on May 6, about 10,823 stranded expatriates are expected to return home.

The CISF, airport authorities, health and police departments will make arrangements for the arriving repatriates at MIA.

Sindhu said that the district administration has no personal information about the arriving passengers and there is high probability that they may belong to other districts or the neighbouring Kerala.

“So far, the district administration has received the missive that 177 passengers will be landing on May 12. If we are given advance details about the expats from other districts/state, the district administration will alert them to make necessary arrangements,” she said.