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May 30: Warning of the tightrope walk ahead as governments battle the coronavirus crisis, Nobel laureate Peter Charles Doherty has expressed concern about densely populated countries such as India relaxing lockdown norms while also describing a complete shutdown as “an economic and social impossibility”.

The Australian immunologist, who cautioned that the number of COVID-19 cases will rise in the coming days, said the earliest time frame for an effective vaccine “going into large numbers of people” is nine to 12 months.

"If all goes well with testing, we could know if some of the candidate vaccines are both safe and effective as early as September/October. Then, rolling a vaccine out will depend on the type of product and how quickly it can be made, put in vials and so forth," Doherty told PTI in an email interview from Melbourne.

The novel coronavirus, he added, does not change fast like influenza and, from what is known so far, “the same vaccine should work everywhere”.

Doherty, who is with the Department of Microbiology and Immunology at the Doherty Institute, University of Melbourne, won the Nobel Prize for Medicine in 1996 for his discovery of how the body’s immune system distinguishes virus-infected cells from normal ones.

Discussing the lockdown, he said, "If it was purely a matter of hard science, everywhere should stay locked down. But that’s pretty much an economic and social impossibility.”

The expectation, he said, is the numbers will rise and limiting spread will depend on people acting responsibly and the capacity for rapid response and extensive contact testing.

“And in a densely populated country like India I think that it will be very difficult," the scientist said.

Several countries, including India, began relaxing lockdown norms in mid-May despite the WHO’s warning about a second wave. India’s lockdown began on March 25 and has since been extended. The fourth phase ends on Sunday.

Asked whether there are any alternatives to a lockdown, the 79-year-old said, "There is no other option other than closing borders. South Korea, for example, conducted massive, intensive testing and contact tracing in a wealthy country with a very disciplined population. Otherwise, not till we have effective vaccines."

He added that he personally doesn’t see the point of closing borders for people coming in if there’s already a high incidence of disease in the community, “unless it’s to avoid the need to care for them and use scarce hospital beds".

According to Doherty, the coronavirus "is a new virus which has come straight out of nature".

“It (the virus) has moved so rapidly across the world because of people travelling on international planes as well as tourist ships," he added.

The immunologist also warned against the use of hydroxychloroquine to treat COVID-19, and said current and planned trials of the anti-malaria drug should be stopped.

“My understanding is that the use of the drug in severe disease is definitely contra-indicated, but it’s not yet clear whether, if taken under medical supervision, it could have some useful effect if taken early on, or as a preventive. Those trials just haven’t been done properly," Doherty noted.

The Indian Council of Medical Research (ICMR) has backed the use of hydroxychloroquine as a preventive against COVID-19 even after the WHO suspended clinical trials of the drug citing safety concerns.

Asked whether plasma therapy can be an effective treatment for COVID-19, Doherty said, "We lack good properly controlled trials but, especially if the plasma has been tested for antibody levels and there’s evidence of good activity, it could be helpful. If I had the disease and was offered plasma therapy I would certainly accept, but I would not take hydroxychloroquine."

Doherty is also very optimistic about herd immunity developing against the SARS-CoV-2 infection.

"We think that (herd immunity) will cut in and have an obvious effect when, say, 60 per cent of people have been infected. Best hope is to boost herd immunity with a vaccine," he stated.

Herd immunity is a form of indirect protection from infectious disease that occurs when a large percentage of a population has become immune to an infection, whether through vaccination or previous infections.

The number of COVID-19 cases have crossed 5.9 million and the fatalities 3,65,000, according to the Johns Hopkins University on Saturday. 

In India, the death toll has risen to 4,971 and the number of cases to 1,73,763, according to the Union Health Ministry on Saturday.

Several states, including Bihar, Uttar Pradesh, Madhya Pradesh, Jharkhand and Chhattisgarh, have reported a rise in number since lockdown norms were relaxed in early May and migrant workers reached home.

In Uttar Pradesh, for instance, the number of infections rose from around 3,000 on May 4 to 6,532 on May 26. Similarly, Bihar’s numbers increased from around 500 to over 2,700 in the period.

United Nations, May 7: An average of 80,000 COVID-19 cases were reported each day in April to the World Health Organization, the top UN health agency has said, noting that South Asian nations like India and Bangladesh are seeing a spike in the infections while the numbers are declining in regions such as Western Europe.

WHO Director-General Tedros Adhanom Ghebreyesus said on Wednesday that countries must also be able to manage any risk of the disease being imported into their territories, and communities should be fully educated to adjust to what will be a "new norm".

He said as the countries press forward in the common fight against COVID-19, they should also lay the groundwork for resilient health systems globally.

"More than 3.5 million cases of COVID-19 and almost 250,000 deaths have now been reported to the WHO. Since the beginning of April, an average of around 80,000 new cases have been reported to the WHO every day," Ghebreyesus said in Geneva yesterday.

Asserting that the virus cases were not just numbers, he said: "every single case is a mother, a father, a son, a daughter, a brother, sister or friend".

He said while the numbers are declining in Western Europe, more cases are being reported every day from Eastern Europe, Africa, South-East Asia, the Eastern Mediterranean and the Americas. Even within regions and within countries, there are divergent trends, the agency added.

While some countries are reporting an increase in COVID-19 cases over time, many have seen caseloads rise because they have ramped up testing, the WHO official said.

"We've also seen in Europe and Western Europe a fundamental decrease in the number of cases, but we have seen an associated increase in the number of cases reported in places like the Russian Federation. Southeast, the Western Pacific areas are relatively on the downward trend like Korea and others, but then we do see in South Asia, in places like Bangladesh, in India, some trends towards increase.

"So it's very difficult to say that any particular region is improving or (not improving). There are individual countries within each region that are having difficulties getting on top of this disease and I am particularly concerned about those countries that have (an) ongoing humanitarian crisis," WHO's Executive Director Michael Ryan said.

The death toll due to COVID-19 in India rose to 1,783 while the number of cases climbed to 52,952 on Thursday, registering an increase of 89 deaths and 3,561 cases in the last 24 hours, the Union Health Ministry said.

The number of active COVID-19 cases stood at 35,902 while 15,266 people have recovered, it said.

Noting that while seeing an increase in the number of cases is not good in terms of transmission, WHO's Emerging Diseases and Zoonoses Unit head Maria Van Kerkhove said: "but I don't want to equate that with something (being) wrong".

"I want to equate that with countries are working very hard to increase their ability to find the virus, to find people with the virus, to have testing in place to identify who has COVID-19, and putting into place what they need to do to care for those patients," Kerkhove said.

With more countries considering easing restrictions implemented to curb the spread of the coronavirus, the WHO has again reminded the authorities of the need to maintain vigilance.

"The risk of returning to lockdown remains very real if countries do not manage the transition extremely carefully, and in a phased approach," Ghebreyesus said.

He urged countries to consider the UN agency's six criteria for lifting stay-at-home measures.

That advice includes ensuring surveillance is strong, cases are declining and transmission is controlled. Health systems also must be able to detect, isolate, test and treat cases, and to trace all contacts.

Additionally, the risk of outbreak in settings such as health facilities and nursing homes needs to be minimised, while schools, workplaces and other public locations should have preventive measures in place.

"The COVID-19 pandemic will eventually recede, but there can be no going back to business as usual. We cannot continue to rush to fund panic but let preparedness go by the wayside," he said.

He said the crisis has highlighted the importance of strong national health systems as the foundation of global health security: not only against pandemics but also against the multitude of health threats that people across the world face every day.

"If we learn anything from COVID-19, it must be that investing in health now will save lives later," Ghebreyesus said.

While the world currently spends around USD 7.5 trillion on health annually, the WHO believes the best investments are in promoting health and preventing disease.

"Prevention is not only better than cure, it's cheaper, and the smartest thing to do," he said.

The deadly coronavirus, which originated from the Chinese city of Wuhan in December last year, has infected over 3.7 million people and killed 263,831 people globally, according to a tally by Johns Hopkins University.

Beijing, Jan 24: As China stepped up measures to control the spread of coronavirus, locking down Wuhan and Huanggang cities in the Hubei province where several Indians live, the Indian Embassy here has set up hotlines for their assistance.

Chinese officials assured all assistance, including food supply, to the Indians who stayed put in the province, the Indian Embassy here said in a press release on Thursday.

Wuhan and its surrounding area became the epicentre of the coronavirus outbreak as the confirmed cases climbed to over 600 mostly from the city and the province with 17 deaths so far.

China has virtually sealed Wuhan and Huanggang cities, halting all public transport, including flight services, and advised people to stay at home and follow the precautions. The two cities put together have a population of over 17 million people.

Chinese officials said the measures have been taken to prevent the spread of the virus to other cities and the world.

Concerns arose for India too as about 700 Indian students, mostly studying medicine in different Chinese universities, resided in Wuhan and its neighbouring areas.

While many of them were believed to have left home for the Chinese New Year holidays, others remained in the city to complete their academic work. However, the exact number is not yet known.

“The Embassy of India has been receiving queries from Indians in Hubei province as well as their relatives in India in connection with the evolving situation of coronavirus infection in China,” the embassy press release said.

The embassy is in touch with relevant Chinese authorities in Beijing and Wuhan as well as Indians in Hubei Province, especially in Wuhan, it said.

“We are closely monitoring the evolving situation in China, including the advisories issued by the World Health Organisation (WHO),” the embassy said.

According to the embassy, Chinese authorities have assured all assistance to residents of Wuhan, including food supply.

“At present, it is reported that supermarkets (particularly those that are government-run) and e-commerce services, including food delivery, continue to remain operational in Wuhan,” it said.

The embassy has started two hotlines for those who wish to get in touch with the Mission in this regard in the following phone numbers:              +8618612083629 and +8618612083617.

“All are advised to also keep track of the embassy's social media accounts (Twitter:@EoIBeijing; Facebook: India in China) for updates on this evolving situation,” the release said.

Meanwhile, the Chinese Foreign ministry said all assistance would be provided to consular officials of the foreign missions to ensure the safety of the foreigners in the country.

Asked whether China would consider any request from the respective countries to move their citizens out of Wuhan, Chinese Foreign Ministry spokesman Geng Shuang said, “We always help foreign consular officials in China in their official jobs, we offer them all the assistance and convenience necessary and we work to guarantee foreign citizens' legitimate rights and interest in China.”

He said while specific detailed would be provided by local officials, China in principle, has always handled issues according to domestic laws, international laws and bilateral consular agreements.