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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.

Up to 2,241 new cases of COVID-19 have been reported across the globe as of Thursday, bringing the total count to 95,333, according to the latest official data by the World Health Organization (WHO).

Five countries, territories and areas reported COVID-19 cases for the first time in the past 24 hours, the Xinhua news agency reported.

WHO Director-General Tedros Adhanom Ghebreyesus emphasised the importance of implementing a comprehensive approach to mitigate the impact of the virus in a briefing on Wednesday.

The ILO has warned that if another Covid-19 wave hits in the second half of 2020, there would be global working-hour loss of 11.9 percent - equivalent to the loss of 340 million full-time jobs.

According to the 5th edition of International Labour Organisation (ILO) Monitor: Covid-19 and the world of work, the recovery in the global labour market for the rest of the year will be uncertain and incomplete.

The report said that there was a 14 percent drop in global working hours during the second quarter of 2020, equivalent to the loss of 400 million full-time jobs.

The number of working hours lost across the world in the first half of 2020 was significantly worse than previously estimated. The highly uncertain recovery in the second half of the year will not be enough to go back to pre-pandemic levels even in the best scenario, the agency warned.

The baseline model – which assumes a rebound in economic activity in line with existing forecasts, the lifting of workplace restrictions and a recovery in consumption and investment – projects a decrease in working hours of 4.9 percent (equivalent to 140 million full-time jobs) compared to last quarter of 2019.

It says that in the pessimistic scenario, the situation in the second half of 2020 would remain almost as challenging as in the second quarter.

“Even if one assumes better-tailored policy responses – thanks to the lessons learned throughout the first half of the year – there would still be a global working-hour loss of 11.9 per cent at the end of 2020, or 340 million full-time jobs, relative to the fourth quarter of 2019,” it said.

The pessimistic scenario assumes a second pandemic wave and the return of restrictions that would significantly slow recovery. The optimistic scenario assumes that workers’ activities resume quickly, significantly boosting aggregate demand and job creation. With this exceptionally fast recovery, the global loss of working hours would fall to 1.2 per cent (34 million full-time jobs).

The agency said that under the three possible scenarios for recovery in the next six months, “none” sees the global job situation in better shape than it was before lockdown measures began.

“This is why we talk of an uncertain but incomplete recovery even in the best of scenarios for the second half of this year. So there is not going to be a simple or quick recovery,” ILO Director-General Guy Ryder said.

The new figures reflect the worsening situation in many regions over the past weeks, especially in developing economies. Regionally, working time losses for the second quarter were: Americas (18.3 percent), Europe and Central Asia (13.9 percent), Asia and the Pacific (13.5 percent), Arab States (13.2 percent), and Africa (12.1 percent).

The vast majority of the world’s workers (93 per cent) continue to live in countries with some sort of workplace closures, with the Americas experiencing the greatest restrictions.

During the first quarter of the year, an estimated 5.4 percent of global working hours (equivalent to 155 million full-time jobs) were lost relative to the fourth quarter of 2019. Working- hour losses for the second quarter of 2020 relative to the last quarter of 2019 are estimated to reach 14 per cent worldwide (equivalent to 400 million full-time jobs), with the largest reduction (18.3 per cent) occurring in the Americas.

The ILO Monitor also found that women workers have been disproportionately affected by the pandemic, creating a risk that some of the modest progress on gender equality made in recent decades will be lost, and that work-related gender inequality will be exacerbated.

The severe impact of Covid-19 on women workers relates to their over-representation in some of the economic sectors worst affected by the crisis, such as accommodation, food, sales and manufacturing.

Globally, almost 510 million or 40 percent of all employed women work in the four most affected sectors, compared to 36.6 percent of men, it said.

The report said that women also dominate in the domestic work and health and social care work sectors, where they are at greater risk of losing their income and of infection and transmission and are also less likely to have social protection.

The pre-pandemic unequal distribution of unpaid care work has also worsened during the crisis, exacerbated by the closure of schools and care services.

Even as countries have adopted policy measures with unprecedented speed and scope, the ILO Monitor highlights some key challenges ahead, including finding the right balance and sequencing of health, economic and social and policy interventions to produce optimal sustainable labour market outcomes; implementing and sustaining policy interventions at the necessary scale when resources are likely to be increasingly constrained and protecting and promoting the conditions of vulnerable, disadvantaged and hard-hit groups to make labour markets fairer and more equitable.

“The decisions we adopt now will echo in the years to come and beyond 2030. Although countries are at different stages of the pandemic and a lot has been done, we need to redouble our efforts if we want to come out of this crisis in a better shape than when it started,” Ryder said.