Those top judges shouldn’t have brought the issue to the public, says Santosh Hegde

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/Udupi, Jul 26: Karnataka’s twin coastal districts of Dakshina Kannada and Udupi have recorded 369 new coronavirus positive cases and 10 more deaths related to the covid-19 in past 24 hours. 

Dakshina Kannada

With 199 new covid-19 cases, DK’s covid toll mounted to 4,811. The district also recorded eight new covid-related deaths. The death toll mounted to 123. 

Among the 199 new cases are 31 primary contacts, 73 with influenza-like illness (ILI), and 10 with severe acute respiratory illness (SARI). As many as 83 cases are under investigation. Two of the patients have international travel history.

Eight deaths:

A 71-year-old man from Mangaluru, who was admitted to a private hospital on July 19, passed away on July 23. He was diagnosed with ARDS/multiorgan dysfunction, chronic renal disease, diabetes, and hypertension. His throat swabs tested positive for covid-19. 

A 70-year-old man from Mangaluru, who was admitted to a private hospital on July 20, passed away on July 24. He had developed sepsis, chronic kidney disease, lower respiratory tract infection, and other ailments. 

A 55-year-old man from Puttur was admitted to a private hospital on July 23, and passed away a day later. He was diagnosed with septic shock with acute kidney injury with severe metaboic acidosis. 

A 56-year-old man from Mangaluru who was admitted to a private hospital on July 20 passed away on July 24. He was suffering from acute respiratory distress syndrome, multi-organ dysfunction syndrome and ischemic heart disease.

A 72-year-old man from Mangaluru who was admitted to a private hospital on July 18 passed away on July 24. He was suffering from refractory hypoxemia/refractory ARDS, septic shock, secondary bacterial infection, renal failure, acute coronary event, and other ailments. 

A 45-year-old woman from Mangaluru who was admitted to a private hospital on July 24 passed away the same day. She had been diagnosed with metastatic carcinoma of right lung and pneumonia. 

A 55-year-old man from Mangaluru who was admitted to a private hospital on July 21 and passed away on July 24. As per the district bulletin, he was suffering from refractory hypoxemia/refractory ARDS, septic shock, secondary bacterial infection, renal failure, acute coronary event, and other ailments.

A 70-year-old man from Mangaluru suffering from severe pneumonia with ARDS, multiorgan dysfunction, sepsis, chronic kidney disease and hypothyroidism was admitted to a private hospital on July 24 and passed away the same day.

Though the above patients contracted coronavirus, the exact cause of their deaths is being investigated by a team of experts and their report is awaited.

Udupi

The district recorded 170 new covid-19 cases and the total confirmed cases mounted to 3,388. Among the new cases, 86 are in Udupi, 31 in Kundapur, and 52 in Karkala. They include 106 male and 63 women. As many as 2,133 patients have been discharged so far, and 1,241 cases are currently active. 

The district also recorded two covid-19 related deaths – a woman and a man. One is a 63-year-old resident of Byndoor and the other is from Udupi's Indiranagar area. Both had been admitted to the ICU of a private hospital. 

Byndoor resident passed away on the night of Saturday July 26, the Udupi resident died on Sunday. The last rites of both the deceased were conducted as per protocol.