M A Gafoor is new chief of Karnataka Minorities Development Corporation

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. 

Bangalore, Feb 1: Following the Directions from department of Health and Family Welfare, Govt of Karnataka, to set up Isolation ward for the admission and treatment of the Novel Coronavirus infected patients, Fortis Hospital, Bangalore has allocated 5 isolation beds, 4 at its Bannergatta unit and 1 at Cunningham Road Unit.

According to a statement issued here on Friday, Dr A Nagasubramaniam, Medical Director, Fortis BG unit said, “We are following the guidelines and protocols as suggested by Department of Health and family welfare and Rajiv Gandhi Institute of Chest Diseases in line with WHO guidelines for managing any suspected case. We will accordingly notify the health authorities.”

The management has been educating the hospital staff members, visitors and patients about the virus and the precautionary measures on a timely basis. A health advisory on Coronavirus has also been put up at the lobby and the canteen to educate the patient attenders, nurses and staff members, the statement added.

The unexpected lockdown to prevent spread of covid–19 has caused a serious damage to the lives of Indian expatriates irrespective of laborers and entrepreneurs in Kingdom of Saudi Arabia. Different stories of expatriates' ordeals are emerging from the region. 

Abdul Razaq, hailing from Udupi in Karnataka has been running small scale business at Jeddah, Saudi Arabia, based on oil refinery projects of the government. He was undergoing medical treatment for his cancer which is in fist stage. He explaines his ordeals caused by lockdown and stopping the flight facility. 

“I was regularly visiting home country for the treatment of cancer. Now I cannot go as international flight service has been stopped. I expect that government will hear problems of expatriates and will arrange facilities to take us back to home”, he said.

Mubeen from Bengaluru was working on temporary basis  for a company in Jubail. He had lost his jobs like some of his colleagues due to the lockdown.

“As everything was alright, I had brought my parents recently to Saudi Arabia on a visit visa. Things changed drastically with covid-19 attack. Continuous lockdown caused burden over the company and they removed temporary employees like me to control possible losses” he said.

“Now owner of the flat has been harassing me for the rent. I do not have money either to pay rent or to cover daily family expenses. I do not know what to do further”, he added. 

Iqbal from Mangaluru left for Saudi Arabia to help his family. He got a job in a juce centre in Dammam recently. Corona lockdown made his life difficult. He is eager to return his home country. 

“I came to Saudi Arbia because of financial difficulties as I had not found any job with good salary there. I thought I can earn well by going to Saudi Arabia. However, here too the salary was not so good. Now juice center is closed due to lockdown and sponsor is giving very small amount of money as salary through which we cannot afford our expenses and our families back in home,” he said.

“Here It is not easy get help of fellow Indians since most of them have their own ordeals. I would like to return home country; there however we can manage to get help of friends and relatives. I am looking forward the help of Indian government to start air facility for stranded NRIs,” he said. 

Mohsin from Mysuru is a taxi driver in Dammam, Saudi Arabia. He was earning on commission basis. Now Saudi government banned movement of taxis in the region, which pushed him and his fellow taxi drivers into trouble.

“We were earning commissions daily on the basis of trips. Now we cannot move outside with taxi since it may cause us to pay the fine of SR.10000. How can I manage my expenses and family members in home?”, he asked.

There are cases of pregnant women who have to return India for delivery. Those who brought family here on visit visa will not have insurance. Delivery charges and any kind of medical facilities without insurance in Saudi Arabia is very expensive. Expatriate Indians with such problems are awaiting government's help.

“I had brought my wife on one year visit visa. Now she is pregnant and I have to send her back to home for delivery. If lockdown continues, it is difficult to send back and we have to spend big amounts for delivery without insurance. It is a big burden to me as I work for small salary in a company”, said Yunus from Hyderabad, who is living in Jeddah, Saudi Arabia.

Lockdown is haunting even entrepreneurs in Saudi Arabia. Most of expatriates in the industrial hub of Jubail are doing business based on Saudi Government’s oil refinery projects. Saudi Arabia temporarily stopped most of the projects as part of public health safety measures to maintain social distance. 

“We are doing business based on oil refinery projects. Now projects are stopped. We brought around 1100 people on work permit visa on temporary basis. And also, we have around 1200 permanent workers. It is a big burden to provide them with food, accommodation and salary. It may cause a big loss for our company”, said owner of expatriates company, Sheikh Mohammed.

Saudi Arabia had reported first corona virus affected case in March 2, 2020. At the end of March, it was 1600 and now it already corssed 6000. Saudi Health ministry has cautioned the number of affected people may rise 10000 to 200,000 and directed for more precautionary measures. In such case, the Indian expatriates may have to face crisis in the region. 

Indian expatriate organizations are demanding for immediate intervention of Indian government to ensure better quarantine facility and treatment of NRIs in Saudi Arabia as the cases are increasing rapidly. The condition of laborers in some of the camps are such that seven to eight people should share a single bed room. 

“Normally if there is a flat, it will consist three to four bed rooms. In single bedroom companies will provide three four bunk beds and six to eight people should share the room. In such cases, if a person affected with virus it will spread quickly to others. Thus, Indian government should ensure quarantine facility for NRIs”, says Wasim Rabbani, president of Indian Social Forum, Eastern Region, Saudi Arabia. 

President of Karnataka Non Residential Indians, A forum for the NRI organizations of Karnataka, Zakaria Muzain says Indian Government should immediately interfere to bring back those stranded NRIs who wish to return home. Government should intervene to pressure Indian embassy to take the issues of troubled expatriates. 

“Government should make special flight arrangement for such NRIs in trouble. It should also arrange quarantine facility for those who return to India. Already there are many Non-Governmental charity organization which have come forward to give their facilities for NRIs”, he said. 

NRIs from all categories are looking forward for the help of Indian government. It is important to Indian government to take quick action as the problem is increasing in Saudi Arabia.