There is light at the end of the tunnel: analysis
When I first heard Prime Minister (PM) Narendra Modi’s speech to the nation on Friday, carefully, I must confess that I am a little disappointed. The fact that our brave “Covid-19 warriors” – doctors and other health workers – were under attack was not condemned; and there was no comforting statement about efforts to overcome the lack of supplies of personal protective equipment (PPE) for front-line workers. But then I heard the speech a second time, and then a third time.
And I realized that this was the most positive, encouraging, and unifying speech of any leader in a nation. It had been nine days in closing when he spoke (now it’s 12 days). Citizens have been fighting uncertainty, fear, despair, and even depression. There is social fragmentation, suffering of the poor and even a growing game of religious guilt.
In that context, the prime minister’s speech had a purpose: to focus on uniting the nation, while maintaining social distancing and self-isolation. It was, above all, about the combined deployment “utsaah“(Enthusiasm) as the greatest force to move from the darkness of the coronavirus pandemic (Covid-19) to the light of victory. The Prime Minister’s leadership would have made the most experienced psychologist feel proud and envious.
As someone who has been deeply involved in the Indian healthcare system, do I see a “light” at the end of the tunnel? Yes, and here is why.
First, we have been the most proactive nation in the world against Covid-19. Numerous government measures: isolate the country; traveler test; quarantine, location, and isolation of suspected cases; public education on hand washing and social distancing; forced self-quarantine and eventually a national blockade were instituted even when there were very few cases in the country. This is a fact that has been appreciated and admired by the World Health Organization. It has been largely responsible for limiting the spread of virus patients to a manageable number thus far, even when Europe and the United States are dealing with hundreds of thousands of patients, overwhelming even their advanced healthcare systems. The responsibility now falls on the public, we cannot disappoint the strategy.
Two, while skeptics may argue that the number of Covid-19 cases is low because we are not testing enough and therefore do not have an accurate number, the comforting fact is that we as physicians know that Emergency areas of our hospitals are not being inundated with patients with upper respiratory tract infection, pneumonia, and deaths. Frontline doctors are the first to feel, witness, and face an epidemic, regardless of the evidence. Perhaps the worst is yet to come in the next two weeks, but perhaps not? No one can be wiser than the other.
It is also remotely possible that public exposure in India to regular and repeated infections, and other viruses, may have developed protective cross-immunity to at least prevent serious Covid-19 infections. The encouraging fact is that 80% of affected patients in Covid-19 only have mild flu-like illness and get better anyway.
Three, more than 100 companies worldwide work aggressively to find effective medications for treatment, as well as vaccines for the prevention of Covid-19 infection. New vaccines for prevention could take 12-18 months, but effective Covid-19 treatment could be a reality in the next four weeks. A promising antiviral drug, Remdesivir, has been put into phase III trials. Chloroquine and hydroxychloroquine, a medicine well known in India for the past 60 years for the treatment of malaria, shows promise for the treatment and prevention of Covid-19 infections.
The Indian Council for Medical Research, as well as other scientific bodies worldwide, participate in prospective trials on this. In the next two or four weeks, we will have the results to define the role of this cheap and easily available treatment for our population. Serum containing antibodies to the coronavirus from patients who have recovered from Covid-19 infection is being tested to treat severe coronavirus infections. Advances are just around the corner.
Four, there are two preliminary reports, which emerged last week, that provide indirect evidence that the BCG vaccine, administered for the prevention of tuberculosis, can provide protection against Covid-19. Based on these observations, prospective trials have been started in the USA. USA And Europe to define the role of the BCG vaccine for the prevention of Covid-19 infection. Fortunately, India, unlike other Western nations, has had a mandatory BCG vaccination policy at birth for its entire population. We hope this also protects us in some way from serious Covid-19 infections and death.
The prime minister called on the 1.3 billion people in this country to focus and meditate together, as seen at the nation’s gathering on Sunday night. It is easy to make fun of this. But after 30 years of being at the forefront of the medical profession and pioneering the treatment of heart disease, I ask God to help me save my patients. I asked God to save my mother’s life when, after six weeks of treating her with a ventilator, the best doctors and the best technology failed.
Thirteen years ago, I organized a scientific symposium on “Do prayers heal and cure?” And every day, I witness a person demolished by an unfortunate “act of fate”: an accident or illness that suddenly incapacitated them. Humility helps. And it helps to combine science with spirituality, to provide us with positivity, hope and determination to overcome the ravages of Covid’s disease -19.
While there is hope, there is no role for complacency. We need to take all precautions, follow all warnings, and be vigilant. We need to appreciate and respect all the efforts that the frontline Covid-19 warriors put forth that risk their lives to protect us. Although physically separate, we need to be united in spirit and mind. There is light at the end of the tunnel.
Dr. Ashok Seth is a prominent clinical leader and president of the Fortis Escorts Heart Institute.
The opinions expressed are personal.