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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.

Shanghai, Jan 27: The death toll from a coronavirus outbreak in China rose to 81 on Monday, as the government extended the Lunar New Year holiday and more big businesses shut down or told staff to work from home in an effort to curb the spread.

Chinese Premier Li Keqiang visited the central city of Wuhan, the epicenter of the outbreak, as the government sought to signal it was responding seriously to the crisis.

The total number of confirmed cases in China rose about 30% to 2,744, about half of them in Hubei province, whose capital is Wuhan.

As worries grew around the world, Chinese-ruled Hong Kong, which has had eight confirmed cases, banned entry to people who had visited Hubei in the past 14 days. The ban did not cover Hong Kong residents.

The number of deaths from the flu-like virus in Hubei climbed to 76 from 56, health officials said, with five deaths elsewhere in China, including the southern island province of Hainan, which reported its first fatality on Monday.

While a small number of cases have been confirmed in more than 10 countries, linked to people who traveled from Wuhan, no deaths have been reported elsewhere.

Li is the most senior leader to visit Wuhan since the outbreak began. Clad in a blue protective suit and mask, he inspected efforts to contain the epidemic and spoke to patients and medical staff, the government said.

The government is extending the week-long Lunar New Year holiday by three days to February 2, in a bid to slow the spread of the virus. The Lunar New Year is usually a time for millions of people to travel, but many have had to cancel their plans because of travel curbs over the virus.

Incubation

Wuhan is already in virtual lockdown and severe limits on movement are in place in several other Chinese cities.

The city of 11 million clamped down further on Monday, announcing the suspension of visa and passport services until January 30.

Despite the curbs, the mayor of Wuhan said on Sunday that five million people had left the city for holidays and other reasons.

Images from Wuhan showing hospital corridors packed with people seeking treatment have circulated on social media, along with complaints of soaring prices for essentials such as vegetables.

Chinese leaders have urged transparency in the crisis, after public trust was eroded by the cover-up of the spread of Severe Acute Respiratory Syndrome (SARS), a coronavirus that originated in China and killed nearly 800 people globally in 2002 and 2003.

Much is not known about the newly identified coronavirus, including how easily it spreads and just how dangerous it is. It can cause pneumonia, which has been deadly in some cases.

National Health Commission minister Ma Xiaowei said on Sunday the incubation period could range from one to 14 days, and the virus was infectious during incubation, unlike SARS.

That compares with a World Health Organization (WHO) estimate of two to 10 days for the incubation period.

“Understanding the time when infected patients may transmit the virus to others is critical for control efforts,” the WHO said.

The virus is believed to have originated late last year in a Wuhan market illegally selling wildlife. It has spread to other cities, including Beijing and Shanghai, as well as more than 10 countries including France, Japan and the United States.

‘Overwhelmed’

Australia confirmed its fifth case on Monday involving a woman on the last flight out of Wuhan to Sydney before China’s travel ban.

Health minister Greg Hunt told the Australian Broadcasting Corporation (ABC) authorities aimed to get about 100 Australian children and young people out of Wuhan.

One father of two, Nathan Wang, told the ABC his wife was stuck in Wuhan with the children. “We absolutely want the children to come back, because hospitals in Wuhan are overwhelmed,” he said.

Airports around the world have stepped up screening of passengers from China, although some health experts have questioned its effectiveness.

Last week the WHO stopped short of calling the outbreak a global health emergency, but some health experts question whether China can contain the epidemic.

WHO Director-General Tedros Adhanom Ghebreyesus is due to travel to Beijing to meet officials and health experts.

Australia, France, Italy, Japan and the United States have all said they are working to evacuate citizens from Wuhan.

Some of China’s biggest companies have been affected, with hotpot restaurant chain Haidilao International Holding shutting branches nationwide from Sunday until Friday.

Gaming giant Tencent Holdings Ltd advised staff to work from home until February 7, and e-commerce firm Alibaba removed vendors’ offers of overpriced face masks from its online Taobao marketplace as prices surged.