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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.

Jun 9: The World Health Organization says it still believes the spread of the coronavirus from people without symptoms is “rare,” despite warnings from numerous experts worldwide that such transmission is more frequent and likely explains why the pandemic has been so hard to contain.

Maria Van Kerkhove, WHO''s technical lead on COVID-19 said at a press briefing on Monday that many countries are reporting cases of spread from people who are asymptomatic, or those with no clinical symptoms.

But when questioned in more detail about these cases, Van Kerkhove said many of them turn out to have mild disease, or unusual symptoms.

Although health officials in countries including Britain, the U.S. and elsewhere have warned that COVID-19 is spreading from people without symptoms, WHO has maintained that this type of spread is not a driver of the pandemic and is probably accounts for about 6 per cent of spread, at most.

Numerous studies have suggested that the virus is spreading from people without symptoms, but many of those are either anecdotal reports or based on modeling.

Van Kerkhove said that based on data from countries, when people with no symptoms of COVID-19 are tracked over a long period to see if they spread the disease, there are very few cases of spread.

“We are constantly looking at this data and we''re trying to get more information from countries to truly answer this question,” she said. “It still appears to be rare that asymptomatic individuals actually transmit onward.”

New York, May 8: An Indian-American father and daughter, both doctors in New Jersey, have died due to the COVID-19, with Governor Phil Murphy describing their demise as “particularly tough" and hailed them for dedicating their lives for others.

Satyender Dev Khanna, 78, was a surgeon who served both on staff and as the head of the surgical departments for multiple hospitals across New Jersey for decades.

Priya Khanna, 43, was a double board-certified in both internal medicine and nephrology. She was Chief of Residents at Union Hospital, now part of RWJ Barnabas Health.

"Dr Satyender Dev Khanna and Dr Priya Khanna were father and daughter. They both dedicated their lives to helping others. This is a family dedicated to health and medicine. Our words cannot amply express our condolences," New Jersey Governor Murphy tweeted on Thursday.

“Both dedicated their lives to helping others and we lost both of them to COVID-19,” Murphy said during a press conference on Thursday, saying their demise is a "particularly tough one.”

Satyender passed away at the Clara Maass Medical Center where he had worked for more than 35 years.

Murphy described him as a "pioneering doctor” who was one of the first surgeons to perform laparoscopic surgery in the state. He is being remembered by colleagues as a “gentle and caring physician."

“And for a doctor, I'm not one, but I would bet, I don't think there could be a more fitting way to be remembered, or a nurse or a healthcare worker of any kind,” Murphy said, adding that the doctor had a passion for bicycling, and he often found peace from the hustle of the hospital in biking along the Jersey Shore.

Priya did all of her medical training in New Jersey and then did her fellowship in nephrology in South Jersey with the Cooper Health System. Like her father, she too worked at Clara Maass, where she died.

She was also Medical Director at two dialysis centres in Essex County and “took pride” in teaching the next generation of doctors, Murphy said, adding that the ICU physician who cared for Priya Khanna was trained and taught by her as well.

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“Priya will be remembered as a caring and selfless person who put others first. And even while in the hospital, fighting her own battle, she continued to check up on her mom and dad and her family,” Murphy said.

“This is a family, by the way, dedicated to health and medicine,” he said.

The governor spoke with Satyender's wife Komlish Khanna, who is a paediatrician. The couple has two more daughters - Sugandha Khanna, an emergency medicine physician and Anisha Khanna, a paediatrician.

“Unbelievable. Our words cannot amply express our condolences nor, I am sure, can they express the pain that the Khanna family is feeling. But I hope that the fact that our entire state mourns with them is some small comfort. And we mourn everyone we have lost. We commit in their memory to saving as many lives as we can,” Murphy said.