December 30, 2020

Highly infectious, not more lethal


 https://epaper.tribuneindia.com/c/57385013

Vaccination dry run


https://epaper.tribuneindia.com/2941688/Haryana-Edition/HR-30-December-2020#clip/57372919/cbc6d46a-8fa5-4493-9d48-c87dc91260fd/549.7142857142858:806.9039443155452


 

The new variant: What we know so far


 https://epaper.hindustantimes.com/Home/ArticleView

December 01, 2020

Moderna asks US, Europe for emergency approval of vaccine


Indian Express

 

Covid curfew's impact


https://epaper.tribuneindia.com/2908215/Haryana-Edition/HR-01-December-2020#clip/56706614/b11f6107-70a6-4452-9e42-e603fdffca8e/571.4285714285714:701.7549883990719

 

November 16, 2020

For 9th consecutive day, below-50,000 fresh Covid cases reported 435 more fatalities push the death toll to 1, 30,070

India’s COVID-19 caseload mounted to 88,45,127 with 30,548 infections being reported in a

day while the number of people who have recuperated from the disease surged to 82,49,579,

according to data updated by the Union health ministry on Monday.

The coronavirus death toll climbed to 1,30,070 with 435 new fatalities, the data updated at 8

am showed.

The number of active cases remained below five lakh for the sixth consecutive day.

There are 4,65,478 active cases of coronavirus infection in the country as on date which

comprise 5.26 per cent of the total caseload, the data stated.

The total number of recoveries has surged to 82,49,579, pushing the national recovery rate to

93.27 per cent. The COVID-19 case fatality rate stands at 1.47 per cent.

India’s COVID-19 tally had crossed the 20-lakh mark on August 7, 30 lakh on August 23 and

40 lakh on September 5. It went past 50 lakh on September 16, 60 lakh on September 28, 70

lakh on October 11 and crossed 80 lakh on October 29.

According to the Indian Council of Medical Research (ICMR), a total of 12,56,98,525 samples

have been tested up to November 15 with 8,61,706 being tested on Sunday.

The 435 new fatalities include 95 from Delhi, 60 from Maharashtra, 51 from West Bengal, 30

from Punjab, and 21 each from Karnataka and Kerala.

The total 1,30,070 deaths reported so far in the country include 45,974 from Maharashtra,

followed by 11,529 from Karnataka, 11,478 from Tamil Nadu, 7,661 from West Bengal, 7,614

from Delhi, 7,372 from Uttar Pradesh, 6,868 from Andhra Pradesh, 4,458 from Punjab and

3,803 from Gujarat.

The Health Ministry stressed that more than 70 per cent of the deaths occurred due to

comorbidities.

“Our figures are being reconciled with the Indian Council of Medical Research,” the Ministry

said on its website, adding that state-wise distribution of figures was subject to further

verification and reconciliation.


https://www.tribuneindia.com/news/nation/for-9th-consecutive-day-below-50-000-freshcovid-

cases-reported-171067

First batch of Sputnik V vaccine to arrive in Kanpur medical college

Human clinical trials of the vaccine to start from next week 

The first batch of Russia's Sputnik V vaccine for COVID-19 is likely to reach Kanpur's Ganesh

Shankar Vidyarthi Medical College by next week wherein the vaccine's Phase 2 and Phase 3

human clinical trials will be conducted.

The decision to conduct the human clinical trials of the vaccine was taken after Dr Reddy's

Laboratories got approval from the Drugs Controller General of India (DCGI) in this regard,

an official said.

Speaking to PTI, college principal R B Kamal said the human clinical trials of the vaccine will

start from next week.

"As many as 180 volunteers have registered for the trials. Head of the research Saurabh

Agarwal will determine the dosage of the vaccine to be administered. One dose will be

administered and the condition of volunteers will be monitored to determine whether they need

further doses or not," he said.

Kamal said the volunteers' vitals and condition will be checked periodically and the data will

be analysed to determine whether the vaccine is a success or not.

He said the effect of the vaccine on the volunteers will be studied for seven months after the

same is administered once, twice or thrice within an interval of 21 days.

After observing the effects of the vaccine for a month, authorities will be apprised of the results

of the trial, and they will then make a decision accordingly.

The Ethics Committee of the college has also given permission for the trails, he said.

The vaccine has to be kept at a temperature of -20 to -70 degrees Celsius.

In September, Dr Reddy's and the Russian Direct Investment Fund (RDIF), Russia's sovereign

wealth fund, entered into a partnership to conduct clinical trials of Sputnik V vaccine and its

distribution in India.

As part of the partnership, RDIF shall supply 100 million doses of the vaccine to Dr Reddy's

upon regulatory approval in India.

On August 11, the Sputnik V vaccine was registered by the Ministry of Health of Russia and

became the world's first registered vaccine against COVID-19 based on the human adenoviral

vector platform.


https://www.tribuneindia.com/news/health/first-batch-of-sputnik-v-vaccine-to-arrive-inkanpur-

medical-college-170672

J&J starts two-dose trial of its COVID-19 vaccine candidate

Rival drugmakers Pfizer and BioNtech said last week that their potential

COVID-19 shot showed more than 90%efficacy

The U.S. drugmaker plans to enrol up to 30,000 participants for the study. Reuters photo.

Johnson & Johnson launched a new large-scale late-stage trial on Monday to test a two-dose

regimen of its experimental COVID-19 vaccine and evaluate potential incremental benefits for

the duration of protection with a second dose.

The U.S. drugmaker plans to enrol up to 30,000 participants for the study and run it in parallel

with a one-dose trial with as many as 60,000 volunteers that began in September.

The UK arm of the study is aiming to recruit 6,000 participants and the rest will join from other

countries with a high incidence of COVID-19 cases such as the United States, Belgium,

Colombia, France, Germany, the Philippines, South Africa and Spain, it said.

They will be given the first dose of either a placebo or the experimental shot, currently called

Ad26COV2, followed by a second dose or placebo 57 days later, said Saul Faust, a professor

of paediatric immunology and infectious diseases who is co-leading the trial at University

Hospital Southampton.

The trial follows positive interim results from the company's ongoing early to mid-stage

clinical study that showed a single dose of its vaccine candidate induced a robust immune

response and was generally well-tolerated.

"The study will assess efficacy of the investigational vaccine after both the first and second

dose to evaluate protection against the virus and potential incremental benefits for duration of

protection with a second dose," J&J said in a statement.

Rival drugmakers Pfizer and BioNtech said last week that their potential COVID-19 shot

showed more than 90% efficacy in interim data from a late-stage trial, boosting hopes that

vaccines against the pandemic disease may be ready for use soon.

While the Pfizer-BioNtech vaccine uses a new technology known as messenger RNA, J&J's

uses a cold virus to deliver genetic material from the coronavirus into the body to prompt an

immune response.

The platform, called AdVac, is also used in an Ebola vaccine that was approved earlier this

year.

"It's really important that we pursue trials of many different vaccines from many different

manufacturers and be able then to ensure the supply both to the UK and global population,"

Faust told reporters at a briefing.

Recruitment into the study will complete inMarch 2021 and the trial will last for 12 months.


https://www.tribuneindia.com/news/health/jj-starts-two-dose-trial-of-its-covid-19-vaccinecandidate-

171083

Steroid treatment should be reserved for sickest COVID-19 patients, say scientists

While dexamethasone and other steroids are prescribed to treat cytokine

storms, scientists say these drugs can backfire in patients whose immune

response is already suppressed.

Most adults with moderate-to-severe COVID-19 have a suppressed immune response against

the novel coronavirus rather than life-threatening hyper-inflammation, according to a study

which suggests steroids such as dexamethasone should be reserved for the sickest patients.

Scientists, including those from St Jude Children’s Research Hospital in the US, assessed the

levels of the immune system protein cytokines and other health markers in 168 adults with

COVID-19, 26 adults with flu and 16 healthy volunteers.

They said more than 90 per cent of the COVID-19 patients were hospitalised and about half in

the intensive care unit (ICU) while more than half of flu patients were admitted for treatment

and 35 per cent were in the ICU.

According to the research, published in the journal Science Advances, fewer than 5 per cent of

the COVID-19 patients, including some of the sickest individuals, had the life-threatening,

hyperinflammatory immune response known as the cytokine storm syndrome.

The researchers explained that cytokine storms develop when excess or abnormally regulated

levels of cytokine proteins in the body lead to hyperinflammation and tissue damage.

While dexamethasone and other steroids are prescribed to treat cytokine storms, they said these

drugs could backfire in patients whose immune response was already suppressed.

“We did identify a subset of COVID-19 patients with the broadly upregulated array of

cytokines. But, overall, the average person with COVID-19 had less inflammation than the

average person with flu,” said study co-author Paul Thomas from St. Jude Children’s Research

Hospital.

Based on the findings, the scientists said treatment suppressing inflammation might only be

effective in a minority of patients with the hyperinflammatory profile.

They believe the need of the hour is a fast, reliable, and inexpensive test to measure cytokines

and identify patients who are most likely to benefit from dexamethasone treatment.

“Directing immunosuppressive therapies to the small subset of COVID-19 patients who have

an overactive immune response is the only way to know if these approaches are ultimately

helpful,” said Philip Mudd, another co-author of the study from the Washington University

School of Medicine in the US.


https://www.tribuneindia.com/news/health/steroid-treatment-should-be-reserved-for-sickestcovid-

19-patients-say-scientists-170671

New compounds to potentially treat novel coronavirus identified'

They said the compounds can disrupt the SKI protein complex in the human body.

Researchers have discovered new drug compounds that target a protein which enables the novel

coronavirus and other viruses with the pandemic potential to replicate in human cells.

Researchers have discovered new drug compounds that target a protein which enables the novel

coronavirus and other viruses with the pandemic potential to replicate in human cells, an

advance that may lead to new therapeutics for COVID-19.

According to the researchers, including those from the University of Maryland in the US, these

compounds disrupt the functioning of a protein complex inside human cells that are critical for

the replication and survival of coronaviruses, including the one that causes COVID-19.

The scientists believe the findings, published in the journal PNAS, could lead to the

development of new broad-spectrum antiviral drugs that target viruses such as influenza, Ebola

and coronaviruses like SARS-CoV-2.

They said the compounds can disrupt the SKI protein complex in the human body which

regulates various aspects of the functioning of a cell.

In the current study, the researchers discovered that this complex also plays a crucial role in

helping a virus replicate its genetic material, RNA, within the cells it infects.

"We determined that disrupting the SKI complex keeps the virus from copying itself, which

essentially destroys it," said study co-author Matthew Frieman from the University of

Maryland.

"We also identified compounds that targeted the SKI complex, not only inhibiting

coronaviruses but also influenza viruses and filoviruses, such as the one that causes Ebola,"

Frieman said.

Using computer modelling, the researchers identified a binding site on the SKI complex and

identified chemical compounds that could attach to this site.

From further experimental analysis, they showed that these compounds have antiviral activity

against coronaviruses, influenza viruses, and filoviruses such as Ebola.

"These findings present an important first step in identifying potential new antivirals that could

be used to treat a broad number of deadly infectious diseases," said study lead author Stuart

Weston, also from the University of Maryland.

Such drugs have the potential to treat infectious disease associated with future pandemics, the

scientists added.


https://www.tribuneindia.com/news/health/new-compounds-to-potentially-treat-novelcoronavirus-

identified-170655

Radiology holds the key in detection of coronavirus

Contribution of radiologists has become more pronounced during pandemic

Radiology has assumed enormous significance in diagnosis and prognostication during the

COVID-19 pandemic and lakhs of people are slowly but surely becoming aware of HRCT

Scan, a diagnostic test conducted by the radiology department.

Although people seldom interact directly with the radiologists, the role that the latter plays

before COVID-19 is confirmed as well as during treatment post recovery is undeniable. Their

contribution has become more pronounced during the pandemic.

In case of emergency cases such as severe head injury in road accidents, surgeries are taken up

after assessment by radiologists using CT Scan or any other radiological investigations. When

a person enters a diagnosis room, they usually interact with radiographers or technologists, or

supporting staff. The radiographers conduct the process ofmaking a patient or a person undergo

the scanning procedure under guidance of the specialists.

“The radiographers or technologists send us images of CT Scan or MRI Scan and other

radiological investigation reports.We read the images and note down the observations. In case

of emergency cases, if a patient needs immediate surgery or other treatment, we immediately

call the surgeon or physician after going through the scanning images,” said Ravuri Power,

general secretary of Indian Radiological and Imaging Association-Telangana chapter. The

World Radiology Day was observed on November 8.

Immediate assessment

Usually, for immediate assessment, the radiology department is placed next to the emergency

or casualty ward of a hospital.

When COVID-19 cases started to increase in March and a few months thereafter, undergoing

tests was a challenge in the State. Private labs were allowed to conduct tests to detect presence

of the virus from mid-June. Until then, doctors in private hospitals heavily relied on High

Resolution Computed Tomography (HRCT) Scan reports to assess if a suspected patient had

the virus.

Apart from HRCT Scan, radiological investigations used for diagnosing COVID are chest

radiograph (X-Ray) and ultra sonography.

Dr Ravuri said that COVID has a specific Computed Tomography (CT) imaging finding which

helps them in accurate diagnosis of the infectious disease. “Hence, it is useful for excluding

other infections based on specific chest imaging findings. Besides, physicians manage

treatment protocols based on report from radiologists,” he said.

During the treatment too, CT scanning can detect Pulmonary Thrombo Embolism or Cerebral

Venous Thrombosis which are blood clots in major blood vessels of the lungs and brain

respectively. “These COVID-associated complications have high rate of morbidity and, at

times, mortality,” Dr Ravuri said.


https://www.thehindu.com/news/cities/Hyderabad/radiology-holds-the-key-in-detection-ofcoronavirus/

article33061659.ece

November 06, 2020

Smaller cough droplets may travel over 6 metres: study

These findings are also greatly dependent on the environmental conditions, such as wind

speed, humidity levels, and ambient air temperature

Scientists have analysed the dispersion of coughs using air flow simulation and found that

some smaller droplets, which are easily carried by the wind, travel up to 6.6 metres and even

further under dry air conditions.

The COVID-19 pandemic has led many researchers to study airborne droplet transmission in

different conditions and environments.

Scientists from A-STAR’s Institute of High Performance Computing in Singapore conducted

a numerical study on droplet dispersion using high fidelity air flow simulation.

The research, published in the journal Physics of Fluids, found that a single 100-micrometre

cough droplet under wind speed of 2 metres per second can travel up to 6.6 metres and even

further under dry air conditions due to droplet evaporation.

“In addition to wearing a mask, we found social distancing to be generally effective, as

droplet deposition is shown to be reduced on a person who is at least 1 meter from the

cough,” said study author Fong Yew Leong.

The researchers used computational tools to solve complex mathematical formulations

representing air flow and the airborne cough droplets around human bodies at various wind

speeds and when impacted by other environmental factors.

They also assessed the deposition profile on a person at a certain proximity. A typical cough

emits thousands of droplets across a wide size range. The scientists found large droplets

settled on the ground quickly due to gravity but could be projected 1 metre by the cough jet

even without wind.

Medium-sized droplets could evaporate into smaller droplets, which are lighter and more

easily borne by the wind, and these travelled further, they said.

The researchers offer a more detailed picture of droplet dispersion as they incorporated the

biological considerations of the virus, such as the non-volatile content in droplet evaporation,

into the modelling of the airborne dispersion of droplets.

“An evaporating droplet retains the non-volatile viral content, so the viral loading is

effectively increased,” said study author Hongying Li. “This means that evaporated droplets

that become aerosols are more susceptible to be inhaled deep into the lung, which causes

infection lower down the respiratory tract, than larger unevaporated droplets.”

These findings are also greatly dependent on the environmental conditions, such as wind

speed, humidity levels, and ambient air temperature, and based on assumptions made from

existing scientific literature on the viability of the COVID-19 virus, the researchers said.

The findings could be applied to designing environments that optimise comfort and safety,

such as hospital rooms that account for indoor airflow and airborne pathogen transmission.


https://www.thehindu.com/sci-tech/science/smaller-cough-droplets-may-travel-over-6-

metres-study/article33021701.ece?homepage=true

Artificial intelligence helps better predict mouth cancer risk

Oral cancer is often detected late which means that the patient survival rates are poor.

Artificial intelligence (AI) may help doctors better predict the risk of patients developing oral

cancer by ensuring accuracy, consistency and objectivity, according to researchers from the

University of Sheffield in the U.K.

The researchers are examining the use of AI and machine learning — the study of computer

algorithms that improve automatically through experience — to assist pathologists and

improve the early detection of oral cancer.

The rate of people being diagnosed with oral cancers including mouth, tongue, tonsil and

oropharyngeal cancer, has increased by almost 60% in the last 10 years, the researchers said

in a statement.

Evidence suggests tobacco and alcohol consumption, viruses, old age as well as not eating

enough fruit and vegetables can increase the risk of developing the disease, they said.

Oral cancer is often detected late which means that the patient survival rates are poor.

Currently, doctors must predict the likelihood of pre-cancerous changes, known as oral

epithelial dysplasia (OED), developing into cancer by assessing a patient’s biopsy on 15

different criteria to establish a score. This score then determines whether action is needed and

what treatment pathway should be taken. However, this score is subjective, which means

there are often huge variations in how patients with similar biopsy results are treated.

For example, one patient may be advised to undergo surgery and intensive treatment, while

another patient may be monitored for further changes.

The precise grading of OED is a huge diagnostic challenge, even for experienced

pathologists, as it is so subjective, said Dr. Ali Khurram, Senior Clinical Lecturer at the

University of Sheffield’s School of Clinical Dentistry.

“At the moment, a biopsy may be graded differently by different pathologists. The same

pathologist may even grade the same biopsy differently on a different day, Khurram noted.

He said correct grading is vital in early oral cancer detection to inform treatment decisions,

enabling a surgeon to determine whether a lesion should be monitored or surgically removed.

“Machine learning and AI can aid tissue diagnostics by removing subjectivity, using

automation and quantification to guide diagnosis and treatment,” Khurram said. “Until now

this hasn’t been investigated, but AI has the potential to revolutionise oral cancer diagnosis

and management by ensuring accuracy, consistency and objectivity.”

Samples of archived OED tissue samples with at least five years of follow up data will be

used in order to train AI algorithms and learn the statistical correlations between certain

classifiers and survival rates. These algorithms will aid pathologists in their assessment of

biopsies helping them to make a more informed and unbiased decision about the grading of

the cells and the patient’s treatment pathway.

The proposed algorithms have a strong translational angle and a potential to be rapidly

deployed as an aid to clinical and diagnostic practice worldwide.

“People often feel threatened by AI, however rather than replacing a doctor’s expertise,

exceptionally high-level of training and experience, the technology can help to assist their

decision-making and compliment their skills,” said Khurram. “This will help them to give a

more accurate assessment and enable them to recommend the most beneficial treatment

pathway for individual patients which we hope will help to improve survival rates.”

According to Professor Nasir Rajpoot, from the University of Warwick in the U.K., the pilot

project will pave the way towards the development of a tool that can help identify premalignant

changes in oral dysplasia, which is crucial for the early detection of oral cancer.

“Successful completion of this project carries significant potential for saving lives and

improving patient healthcare provision, said Rajpoot, one of the researchers.


https://www.thehindu.com/sci-tech/health/artificial-intelligence-helps-better-predict-mouthcancer-

risk/article33028342.ece?homepage=true

November 05, 2020

Scientists identify COVID-19 patients who recover quickly, sustain antibodies

Five of the individuals were hospitalised but all others recovered at home,

the study noted. 

Scientists identify COVID-19 patients who recover quickly, sustain antibodies

Researchers have found that a subset of COVID-19 patients who recover faster have a

persistent antibody response against the novel coronavirus, an advance which sheds more light

on the functioning of the immune system and may aid in the development of vaccines against

the disease.

The scientists, including those from Brigham and Women's Hospital in the US, examined

patients who had recovered from mild to moderate COVID-19 and found that while antibodies

against the virus declined in most people over time, some individuals sustained their production

several months following infection.

According to the researchers, previous studies had provided conflicting accounts about whether

people recovering quickly from the viral infection can sustain potentially-protective antibodies

or not.

The results of the current study, published in the journal Cell, noted that these antibody

"sustainers" had a shorter course of symptoms, suggesting that some individuals who recover

from COVID-19 faster may be mounting a more effective and durable immune response to the

virus.

"We've found a subset of individuals that heal quickly while sustaining virus-specific antibody

levels after COVID-19," said Duane Wesemann, a co-author of the study from Brigham and

Women's Hospital.

In the research, the scientists recruited and enrolled 92 people in the Boston area in the US who

had recovered from COVID-19 between March and June of 2020.

Five of the individuals were hospitalised but all others recovered at home, the study noted.

The researchers collected and analysed blood samples monthly, measuring a range of

antibodies, including immunoglobulin-G (IgG), against the novel coronavirus.

They split the cohort into two groups -- those that sustain virus-specific IgG levels over several

weeks, and those that lose them -- and analysed these groups and potential connections they

had to the clinical data.

The study found that IgG levels against the virus tended to decline substantially in most

individuals over the course of three to four months.

However, the antibody production remained stable or enhanced in about 20 per cent of

individuals over the same time period.

According to the scientists, these "sustainers" had symptoms for a significantly shorter period

of time compared to "decayers"—average of 10 days versus 16 days.

They said the sustainers also had differences in memory T cell populations and B cells—two

types of immune cells that can play a key role in immune memory and protection.

"The data point to a type of immune response that's not only adept at handling viral disease by

leading to a swift resolution of symptoms, but also better at producing cells that can commit to

longer term production of anti-virus IgG antibodies," Wesemann said.

"Figuring out how these individuals are able to support longer-term antibody production is

relevant to COVID-19, and will also have important implications for our understanding of the

immune system in general," he added.


https://www.tribuneindia.com/news/health/scientists-identify-covid-19-patients-who-recoverquickly-

sustain-antibodies-165913

COVID-19 lung damage caused by persistence of 'abnormal cells', say scientist

The research also showed the long-term persistence of the viral genome in

respiratory cells and in cells lining the blood vessels, along with the infected

cell syncytia.

COVID-19 lung damage caused by persistence of 'abnormal cells', say scientists

Photo for representation only. Source: iStock.

Scientists have analysed organ samples from deceased COVID-19 patients and found extensive

lung damage in most cases caused by the persistence of abnormal "fused cells," an advance

which sheds more light on the progression of the disease.

The researchers, including those from King's College London in the UK, examined lung, heart,

liver, and kidney samples of 41 patients who died of COVID-19 to examine the behaviour of

the novel coronavirus SARS-CoV-2.

In the study, published in the journal eBioMedicine, they revealed the unique characteristics of

the virus that may explain why some patients experience disease symptoms for months --

known as 'long COVID'—with a feeling of fatigue and lack of breath.

The findings show extensive lung damage in most cases, with patients experiencing profound

disruption of the normal lung structure and the transformation of respiratory tissue into fibrotic

material.

According to the scientists, nearly 90 per cent of the patients showed additional characteristics

that were quite unique to COVID-19 compared to other forms of pneumonia.

They said there was extensive blood clotting of the lung arteries and veins, and several lung

cells were abnormally large with many nuclei, resulting from the fusion of different cells into

single large cells.

The researchers noted that this formation of fused cells—syncytia—is due to the viral spike

protein, which the virus uses to enter the cell.

When the protein is present on the surface of cells infected by the COVID-19 virus, the study

noted that it stimulates their fusion with other normal lung cells, which can be a cause for

inflammation and thrombosis.

The research also showed the long-term persistence of the viral genome in respiratory cells and

in cells lining the blood vessels, along with the infected cell syncytia.

According to the researchers, the presence of these infected cells can cause the major structural

changes observed in lungs, which can persist for several weeks or months, and could eventually

explain 'long COVID'.

"The findings indicate that COVID-19 is not simply a disease caused by the death of virusinfected

cells but is likely the consequence of these abnormal cells persisting for long periods

inside the lungs," said Mauro Giacca, a co-author of the study from King's College London


https://www.tribuneindia.com/news/health/covid-19-lung-damage-caused-by-persistence-ofabnormal-

cells-say-scientists-165949

Oxford COVID-19 vaccine results due next month, raising hopes of 2021 rollout

Unclear if vaccine will be rolled out before Christmas 

UK expects Oxford, Pfizer data in early December

The University of Oxford hopes to present late-stage trial results on its COVID-19 vaccine

candidate this year, raising hopes that Britain could start to roll out a successful vaccine in late

December or early 2021.

A vaccine that works is seen as a game-changer in the battle against the coronavirus, which has

killed more than 1.2 million people worldwide, shuttered swathes of the global economy and

turned normal life upside down for billions of people.

"I'm optimistic that we could reach that point before the end of this year," Oxford Vaccine Trial

Chief Investigator Andrew Pollard told British lawmakers of presenting trial results this year.

Pollard said working out whether or not the vaccine worked would likely come this year, after

which the data would have to be carefully reviewed by regulators and then a political decision

made on who should get the vaccine.

"Our bit - we are getting closer to but we are not there yet," Pollard, director of the Oxford

Vaccine Group, said.

Asked if he expected the vaccine would start to be deployed before Christmas, he said: "There

is a small chance of that being possible but I just don't know."

The Oxford/AstraZeneca vaccine is expected to be one of the first from big pharma to be

submitted for regulatory approval, along with Pfizer and BioNTech's candidate.

"If I put on my rose-tinted specs, I would hope that we will see positive interim data from both

Oxford and from Pfizer/BioNTech in early December and if we get that then I think we have

got the possibility of deploying by the year end," Kate Bingham, the chair of the UK Vaccine

Taskforce, told lawmakers.

Prime Minister Boris Johnson said there was the prospect of a vaccine in the first quarter of

2021.

‘Game changer’

Work began on the Oxford vaccine in January. Called AZD1222, or ChAdOx1 nCoV-19, the

viral vector vaccine is made from a weakened version of a common cold virus that causes

infections in chimpanzees.

The chimpanzee cold virus has been genetically changed to include the genetic sequence of the

so-called spike protein which the coronavirus uses to gain entry to human cells. The hope is

that the human body will then attack the novel coronavirus if it sees it again.

If Oxford's vaccine works, it would eventually allow the world to return to some measure of

normality after the tumult of the pandemic.

Asked what success looked like, he said: "I think good is having vaccines that have significant

efficacy - so whether, I mean, that is 50, 60, 70, 80 per cent, whatever the figure is - is an

enormous achievement.

"It means from a health system point of view, there are fewer people with COVID going into

hospital, that people who develop cancer can have their operations of chemotherapy – it’s a

complete game changer and a success if we meet those efficacy end points."

But Pollard, one of the world's top experts on immunology, said the world might not return to

normal immediately.

"...It takes time to roll out vaccines. Not everyone will take them," he said. "We will still have

people getting this virus because it is just too good at transmitting.


https://www.tribuneindia.com/news/health/oxford-covid-19-vaccine-results-due-next-monthraising-

hopes-of-2021-rollout-165957

October 29, 2020

UK expert says first set of Covid vaccines likely to be "imperfect"


The Indian Express

 

Dr Reddy's looks to complete late stage trials of Sputnik V by mid-May next year


The Indian Express

 

Study finds 80 percent Covid patients deficient in vitamin D


 


The Indian Express

Scientists find brain abnormalities in COVID-19 patients

They said some of the EEG alterations found in COVID-19 patients may indicate damage to the brain that might not be repaired after recovering from the disease Scientists find brain abnormalities in COVID-19 patients An analysis of more than 80 studies reporting complications experienced by COVID-19 patients has revealed that about one-third of them have abnormalities in the frontal lobe of the brain, findings which shed light on the neurological symptoms of the disease. The review of studies, published in Seizure: European Journal of Epilepsy, focused on abnormalities detected using electroencephalogram (EEG) scans, which are used to evaluate the electrical activity in the brain. "We found more than 600 patients that were affected in this way. Before, when we saw this in small groups we weren't sure if this was just a coincidence, but now we can confidently say there is a connection," said Zulfi Haneef, assistant professor of neurology at Baylor College of Medicine in the US. The scientists explained that patients are recommended an EEG test when they have a slowed reaction to stimuli, followed by seizure-like events, speech issues, confusion, or an inability to wake up after sedation. From the review of studies, the researchers said the most common findings from the EEG were slowing or abnormal electrical discharge, mostly in the frontal lobe of the patients. They said some of the EEG alterations found in COVID-19 patients may indicate damage to the brain that might not be repaired after recovering from the disease. Since the brain cannot regenerate, Haneef cautioned that any damage to the organ will more than likely be permanent. "We know that the most likely entry point for the virus is the nose, so there seems to be a connection between the part of the brain that is located directly next to that entry point," he said. "Another interesting observation was that the average age of those affected was 61, one-third were female and two-thirds were males. This suggests that brain involvement in COVID-19 could be more common in older males," Haneef added. However, the scientists believe more studies are needed to validate the conclusions drawn in the review research. According to Haneef, the virus may not be directly causing the abnormal EEG readings in the brain. He said alterations in oxygen intake, heart problems related to COVID-19, or other side effects may also be involved. "These findings tell us that we need to try EEG on a wider range of patients, as well as other types of brain imaging, such as MRI or CT scans, that will give us a closer look at the frontal lobe," Haneef said. "A lot of people think they will get the illness, get well and everything will go back to normal, but these findings tell us that there might be long-term issues, which is something we have suspected and now we are finding more evidence to back that up," he added.


https://www.tribuneindia.com/news/health/scientists-find-brain-abnormalities-in-covid-19- patients-162346 

High intake of vitamins A, E and D linked to fewer respiratory issues

Nutrition has key role in cutting the risk of several infections High intake of vitamins A, E and D linked to fewer respiratory issues Photo for representational purpose only. one of Indian-origin, have found that high intake of vitamins A, E, and D may be linked to fewer respiratory complaints in adults. Nutrition has a key role in cutting the risk of several infections, although exactly how it boosts immunity is complex and not fully understood, the study, published in the journal the BMJ Nutrition, Prevention & Health, reported. "Micronutrient deficiencies are often overlooked as a key contributor to the burden of malnutrition and poor health, presenting an additional layer of challenge during the Covid-19 pandemic," said study author Sumantra Ray from Imperial College London in the UK. The researchers wanted to explore whether the intake of these vitamins from both diet and supplements might be linked to the prevalence of respiratory complaints in a nationally representative sample of UK adults. They drew on information provided by 6,115 adult participants in the 2008-2016 National Diet and Nutrition Survey Rolling Programme (NDNS RP) who had completed three or more days of diet diaries. Respiratory complaints were reported by the participants and had not been diagnosed by a clinician. They were broadly defined, and included both infectious and non-infectious conditions, such as colds, chronic obstructive pulmonary disease, and asthma. The researchers looked at dietary intake only and that from diet and supplements, accounting for potentially influential factors, such as age, sex, weight (BMI), smoking, household income and total energy intake. In all, there were 33 cases of respiratory complaints. These respondents were generally older and less likely to say they regularly took vitamins A, E, C or D supplements. There was no obvious association between BMI and vitamin intake, or between BMI and respiratory complaints. But vitamin A and E intake from both diet and supplements was associated with a lower prevalence of respiratory complaints in UK adults. And vitamin D intake from supplements, but not from diet, was associated with fewer respiratory complaints, prompting the researchers to suggest that the findings add to the current scientific debate on the value of vitamin D supplementation. "Our findings are consistent with the hypothesis that supplementation is critical to ensuring adequate vitamin D status is maintained and potentially indicate that intake of vitamin D from diet alone cannot help maintain adequate vitamin D status," the authors wrote.


https://www.tribuneindia.com/news/health/high-intake-of-vitamins-a-e-and-d-linked-tofewer-respiratory-issues-162347

Air droplets ineffective in virus spread: Study


https://epaper.tribuneindia.com/c/55996910

 

October 28, 2020

High-fat keto diets can prevent, reverse heart failure: Study

Heart problems? A special diet might help as researchers have found that the popular and

controversial ketogenic diet could completely prevent, or even reverse heart failure caused by

a metabolic process.

For the findings, published in the journal Nature Metabolism, the research team looked at a

metabolic process that seems to be turned down in failing human hearts.

"In an animal model, drastic heart failure in mice was bypassed by switching to high fat or

"ketogenic" diets, which could completely prevent, or even reverse the heart failure," said study

author Kyle S McCommis from the Saint Louis University in the US.

"Thus, these studies suggest that consumption of higher fat and lower carbohydrate diets may

be a nutritional therapeutic intervention to treat heart failure," McCommis added.

According to the researchers, the heart's myocardium requires vast amounts of chemical energy

stored in nutrients to fuel cardiac contraction.

To maintain this high metabolic capacity, the heart is flexible and can adapt to altered metabolic

fuel supplies during diverse developmental, nutritional, or physiologic conditions.

Impaired flexibility, however, is associated with cardiac dysfunction in conditions including

diabetes and heart failure.

The mitochondrial pyruvate carrier (MPC) complex, composed of MPC1 and MPC2, is

required for pyruvate import into the mitochondria.

This study demonstrated that MPC expression is decreased in failing human and mouse hearts,

and that genetic deletion of the MPC in mice leads to cardiac remodelling and dysfunction.

"Interestingly, this heart failure can be prevented or even reversed by providing a high-fat, low

carbohydrate ketogenic diet," McCommis said.

"A 24-hour fast in mice, which is also ketogenic also provided significant improvement in heart

remodelling," McCommis added.

The findings showed that diets with higher fat content, but enough carbohydrates to limit

ketosis also significantly improved heart failure in mice lacking cardiac MPC expression.

"Our study highlights the potential of dietary interventions to enhance cardiac fat metabolism

to prevent or reverse cardiac dysfunction and remodelling in the setting of MPC-deficiency,"

the authors wrote.


Source: https://www.tribuneindia.com/news/health/high-fat-keto-diets-can-prevent-reverse-heart-

failure-study-161837

Startup develops hand-held oral cancer screening tool

 Device to used for screening, detection and biopsy guidance of oral cancer

Startup develops hand-held oral cancer screening tool

OralScan, an indigenously developed hand-held imaging device for screening, detection and

biopsy guidance of oral cancer, has been developed by a startup here.

OralScan, an indigenously developed hand-held imaging device for screening, detection and

biopsy guidance of oral cancer, has been developed by a startup here.

The startup, M/s Sascan Meditech Pvt Ltd, which was incubated at TiMED, the Technology

Business Incubator of the city-based Sree Chitra Tirunal Institute for Medical Sciences &

Technology, is launching the device, a press release said.

Oral Scan, a Make-in-India initiative with seed funding from the National Initiative for

Developing and Harnessing Innovations (NIDHI) scheme of the Department of Science &

Technology (DST), Government of India, was designed and developed entirely in India and

supported by Biotechnology ignition grant of Biotechnology Industry Research Assistance

Council (BIRAC), INVENT (DST) and Kerala Startup Mission.

The company recently received investment from Unicorn India Ventures.

State Health Minister K K Shailaja, will launch OralScan at a function here on Wednesday.

An online event kickstarting the product sales and distribution network will also be held in the

presence of dignitaries, oncologists and channel partners identified across the country.

Dr Asha Kishore, Director, SCTIMST will perform the first sale to Ketan Parmar, Innovative

India, Surat.

According to Dr Subhash Narayanan, CEO of Sascan, oral cancer is a growing concern in India

with more than 80,000 fresh cases reported each year.

The disease has a high mortality rate due to the delay in detection.

Current practice relies on oral examinations using torchlight to detect early-stage cancers of

the oral cavity.

Various studies have demonstrated that this screening technique is not very reliable and often

oral potentially malignant lesions (OPMLs) go undetected in the early stages, the release said.

Even experienced clinicians find it difficult to locate the optimal site for a biopsy based on

conventional oral examination.

This leads to multiple biopsies, increased expenditure and false-negative reports which can

delay diagnosis and outcome.

Proprietary software in the device assists the surgeon in taking a biopsy from the most

appropriate site which is likely to confirm the diagnosis of malignancy.

This will avoid multiple biopsies and false-negative reports.

The device will be marketed for Rs 5.9 lakh.

This will be a one-time investment for hospitals and laboratories without any additional costs

of consumables.


Source: https://www.tribuneindia.com/news/health/startup-develops-hand-held-oral-cancer-screening-

tool-161831

Covid-19: What you need to know today

I wrote: “So, bored, tired, lonely perhaps, and physically, mentally,

and emotionally weary, we let things slip. And the virus wins.”

There’s a term for this, pandemic fatigue, and as the second wave roils Europe, and the third

the US, everyone is talking about it.

“Pandemic fatigue is real — and it’s spreading.” That’s in Tuesday’s Wall Street Journal. “Sick

of Covid-19? Here’s why you might have pandemic fatigue.” That’s in the conversation.com

from October 23. “As the Coronavirus surges, a new culprit emerges: Pandemic fatigue.”

That’s from October 17’s New York Times.

And on Monday, World Health Organization (WHO) director general Tedros Adhanom

Ghebreyesus spoke of pandemic fatigue. “Working from home, children being schooled

remotely, not being able to celebrate milestones with friends and family or not being there to

mourn loved ones — it’s tough and the fatigue is real,” he said.

The problem has become serious enough for WHO to, earlier in October, release a document

titled “Pandemic fatigue: Reinvigorating the public to prevent Covid-19”. In the document,

WHO actually defined pandemic fatigue.

“Pandemic fatigue is... demotivation to follow recommended protective behaviours, emerging

gradually over time and affected by a number of emotions, experiences and perceptions,” the

document said.

It “is expressed through an increasing number of people not sufficiently following

recommendations and restrictions, decreasing their effort to keep themselves informed about

the pandemic, and having lower risk perceptions related to Covid-19,” the document added.

It would be alright if Covid fatigue involved merely how people feel; unfortunately, this also

extends to how people behave, and it is behaviour that puts them and others at risk. Still worse,

because their behaviour is directly correlated with a rise in infections, governments may be

forced to react by imposing restrictions on movement and activities, even a partial lockdown

(most countries are very averse to going down the total or hard lockdown path again). And

when this happens, a population that is already in the grip of pandemic fatigue is unlikely to

listen. That’s happening in Europe and the US, and it is happening in India too.

So, what should governments and administrators do? As WHO’s DG put it on Monday: “We

cannot give up... Leaders must balance the disruption to lives and livelihoods with the need to

protect health workers and health systems as intensive care fills up.”

Enforcement may not work in all cases and may end up being counterproductive.

The problem will be familiar to behavioral economists, though. In 2012, Niranjan

Rajadhyaksha, then Mint’s executive editor, wrote an article titled “How behavioural science

can reduce deaths on railway tracks”.

In the article, Rajadhyaksha detailed how Final Mile Consulting, a firm headed by Biju

Dominic that used behavioural economics, cognitive neurology and anthropology to shape

people’s behaviour, did this in one part of Mumbai – “The Final Mile team hung around the

most lethal crossings for several weeks, melting into the crowd,” says Dominic, “like method

actors living the character.”

“They quickly noticed that the people crossing the tracks were overconfident, one of the biases

that behavioural scientists say are hard-wired into our brains, the same bias that ensures that

equity analysts overestimate corporate earnings or cigarette smokers refuse to believe they can

be struck down by cancer” Rajadhyaksha wrote.

It’s the same overconfidence that makes people believe that they are unlikely to contract Covid-

19, or assume that they are safe because most people who do get infected are either

asymptomatic or experience only mild symptoms.

I won’t tell you how Final Mile solved the rail crossing problem. You can read about it yourself

by scanning the QR code with this column.

The WHO document actually has some interesting pointers for administrators on how to “allow

people to live their lives, but reduce the risk” — for it is the disruption to their lives that is

perhaps the biggest contributor to pandemic fatigue. This involves: differentiating “between

lower-risk and higher-risk activities”; guidelines on carrying “on with life while reducing the

risk of transmission”; proactively planning for “end-of-the-year celebrations”; avoid cancelling

all cultural events and find “creative solutions” to host them; and “avoid judgment and blame.”

It’s always toughest to protect people from themselves.


Source: https://epaper.hindustantimes.com/Home/ArticleView

October 27, 2020

Study shows how exercise stalls cancer growth through immune system

A recent study suggested that people with cancer who exercise generally have a better

prognosis than inactive patients. Now, scientists explain 'Why?'

The study is published in the journal eLife.

Researchers at Karolinska Institutet in Sweden have found a likely explanation of why exercise

helps slow down cancer growth in mice. Physical activity changes the metabolism of the

immune system's cytotoxic T cells and thereby improves their ability to attack cancer cells.

"The biology behind the positive effects of exercise can provide new insights into how the body

maintains health as well as help us design and improve treatments against cancer," said Randall

Johnson, professor at the Department of Cell and Molecular Biology, Karolinska Institutet, and

the study's corresponding author.

Prior research has shown that physical activity can prevent the health condition as well as

improve the prognosis of several diseases including various forms of cancer. Exactly how

exercise exerts its protective effects against cancer is, however, still unknown, especially when

it comes to the biological mechanisms. One plausible explanation is that physical activity

activates the immune system and thereby bolsters the body's ability to prevent and inhibit

cancer growth.

In this study, researchers expanded on this hypothesis by examining how the immune system's

cytotoxic T cells, that is white blood cells specialized in killing cancer cells, respond to

exercise.

They divided mice with cancer into two groups and let one group exercise regularly in a

spinning wheel while the other remained inactive. The result showed that cancer growth slowed

and mortality decreased in the trained animals compared with the untrained.

Next, the researchers examined the importance of cytotoxic T cells by injecting antibodies that

remove these T cells in both trained and untrained mice. The antibodies knocked out the

positive effect of exercise on both cancer growth and survival, which according to the

researchers demonstrates the significance of these T cells for exercise-induced suppression of

cancer.

The researchers also transferred cytotoxic T cells from trained to untrained mice with tumours,

which improved their prospects compared with those who got cells from untrained animals.

To examine how exercise influenced cancer growth, the researchers isolated T cells, blood and

tissue samples after training sessions and measured levels of common metabolites that are

produced in muscle and excreted into plasma at high levels during exertion. Some of these

metabolites, such as lactate, altered the metabolism of the T cells and increased their activity.

The researchers also found that T cells isolated from an exercised animal showed an altered

metabolism compared to T cells from resting animals.

In addition, the researchers examined how these metabolites change in response to exercise in

humans. They took blood samples from eight healthy men after 30 minutes of intense cycling

and noticed that the same training-induced metabolites were released in humans.

"Our research shows that exercise affects the production of several molecules and metabolites

that activate cancer-fighting immune cells and thereby inhibit cancer growth," said Helene

Rundqvist, senior researcher at the Department of Laboratory Medicine at the Institutet, and

the study's first author. "We hope these results may contribute to a deeper understanding of

how our lifestyle impacts our immune system and inform the development of new

immunotherapies against cancer."


Source: https://www.newkerala.com/news/2020/188243.htm

Covid-19: What you need to know today

I skipped four instalments of this column because I decided to take a short break—part birding

trip, part R&R, but all safe, masked, and socially distanced. It involved driving through rural

and semi-urban Uttar Pradesh, where no one appears to be wearing masks (and there is no

social distancing), and Uttarakhand, where most people sport them, and there is some

adherence to social distancing norms.

That India’s largest state has managed to keep its Covid-19 numbers where they are (470,270

cases till the evening of October 25; 6,882 deaths; a mere 2,032 cases on October 25 itself; and

only 27,317 active cases) despite a dependence on rapid antigen tests (which are unreliable)

and lax enforcement of both mask discipline and social distancing is truly impressive — and

also surprising.

Uttarakhand, at least the part I went to, wasn’t crowded. The state insists that all inbound

tourists register themselves, and there was a check at the point of entry to ensure this. A test

isn’t required, although I did take a reverse transcription polymerase chain reaction (RT-PCR)

one a few days before I travelled (it was negative). According to the HT dashboard (which is

also the source of the Uttar Pradesh numbers), Uttarakhand saw 221 cases on October 25, has

seen 60,376 in all, and has had 993 deaths. That means it has fewer than 5,000 active cases.

To digress, it felt good to get out of Delhi after nearly eight months. I think, when this is all

over (which must be one of the most commonly used phrases these days), it will take me some

time to get used to not wearing masks; it felt strange to walk even on jungle trails without a

mask despite there being no one else around.

The sense of normalcy in both Uttar Pradesh and Uttarakhand isn’t surprising given their

current caseloads. India itself has just around 650,000 active cases at this point. And on Sunday,

India registered a mere 46,011 cases, half the number of cases it was registering per day in the

third week of September. The last time it registered such numbers was in late July. As Dispatch

176 on October 7 first pointed out, the first wave of the coronavirus disease in India is over. It

lasted roughly seven months.

There’s no telling how long the lull will last, and how low the daily case numbers could go.

Yet, based on what’s happening in Europe — Dispatch 155, on September 11, referred to the

emergence of the second wave in Europe that is now raging through that continent — and the

US (the same column mentioned the likelihood of a third wave in the US), the respite will

likely be temporary. And based on the trajectory of the second and third waves in the US and

the second in Europe, there is a high probability that the intensity of the second wave in India

will be stronger than the first. The second wave in Europe is following the same trend seen in

the second wave in the US: it is leading to fewer deaths, and it will be interesting to see if the

number of deaths in the ongoing third wave in the US is lower even than that seen in the second.

Still, lower deaths haven’t meant fewer hospitalisations. Hospitals in many European countries

have been overwhelmed by the sheer number of people needing treatment for Covid-19, and

the same thing is beginning to happen in several US states.

Part of the reason for the higher intensity of subsequent waves of the coronavirus disease is

obvious — they coincide with progressive easing of restrictions on movement and activities,

often encouraging people, usually the young, to indulge in irresponsible behaviour. In many

European countries, the median age of people infected in the second wave is lower than that in

the first.

The result isn’t just a spike in infection numbers but severe illnesses, and may be even deaths

in vulnerable populations. Research by Paraic Kenny of the Gundersen Medical Foundation,

Wisconsin, and others, published on pre-print server medRxiv and reported in Nature, shows a

strong correlation between the reopening of in-person education in colleges in one of the state’s

counties and an increase in coronavirus disease infections, with one of the strains (the

researchers carried out a genomic investigation) spreading to old-age homes where it infected

eight and killed two.



Source: https://epaper.hindustantimes.com/Home/ArticleView

Oxford COVID-19 vaccine trials produce robust immune response in elderly, reports Financial Times.

The findings echo data released in July which showed the vaccine generated ‘robust immune

responses’ in a group of healthy adults aged between 18 and 55

Oxford COVID-19 vaccine trials produce robust immune response in elderly, reports Financial

The COVID-19 vaccine being developed by the University of Oxford and AstraZeneca Plc

produces a robust immune response in elderly people, the group at highest risk, the Financial

Times has said on Monday, citing early results.

The vaccine triggers protective antibodies and T-cells in older age groups, the Financial Times

said, citing two people familiar with the finding, encouraging researchers as they seek evidence

that it will spare those in later life from serious illness or death from the virus.

Details of the finding are expected to be published shortly in a clinical journal, the Financial

Times said, without naming the publication.

The findings echo data released in July, which showed the vaccine generated “robust immune

responses” in a group of healthy adults aged between 18 and 55, the newspaper reported, citing

people aware of the results from so-called immunogenicity blood tests.

But the Financial Times cautioned that positive immunogenicity tests did not guarantee that

the vaccine would ultimately prove safe and effective in older people.

AstraZeneca, which is developing the vaccine with Oxford University researchers, is seen as a

frontrunner in the race to produce a vaccine to protect against COVID-19.

Oxford and AstraZeneca did not immediately respond to Reuters’ request for comments.

One of the world’s leading coronavirus vaccine candidates, called AZD1222 or ChAdOx1

nCoV-19, was developed by Oxford University scientists and licensed to AstraZeneca in April,

which took on the task of scaling trials and production.

AstraZeneca resumed the US trial of the experimental vaccine after approval by US regulators,

the company said on Friday.

It is a viral vector vaccine that uses a weakened version of a chimpanzee common cold virus

that encodes instructions for making proteins from the novel coronavirus to build immunity

against COVID-19.


Source: https://www.tribuneindia.com/news/health/oxford-covid-19-vaccine-trials-produce-robustimmune-response-in-elderly-reports-financial-times-161354

Indian, Pakistani women diagnosed with more aggressive breast cancer at younger age: Study

Indian, Pakistani women diagnosed with more aggressive breast cancer at younger age: Study

Research also has shown poor mammogram screening rates in Indian and Pakistani women

Indian and Pakistani women are diagnosed with breast cancer, including more aggressive

forms, at a younger age, according to a study that provides an insight into understanding the

risk factors influencing the disease.

The study, published in the International Journal of Cancer, examined the characteristics of

breast cancer among Indian and Pakistani-American and non-Hispanic white women in the US

using data from the National Cancer Institute's Surveillance, Epidemiology and End Results

Program.

Both, Indian and Pakistani women are diagnosed with more aggressive forms of the disease, at

a younger age, according to the researchers.

The researchers, who are part of the Rutgers School of Public Health and Rutgers Cancer

Institute of New Jersey, reviewed incidence data among Indian and Pakistani women between

1990 and 2014.

"Our results provide an insight into breast cancer in Indian and Pakistani women, suggesting

several hypotheses to guide future scientific studies to better understand the risk factors

influencing disease aetiology and prognosis," said Jaya M Satagopan, lead author and director

of the Center for South Asian Quantitative Health and Education at the Rutgers School of

Public Health.

South Asians are the fastest-growing major ethnic group in the United States with breast cancer

rates increasing within the population, but little is known about the disease in this socioculturally

unique population, according to the study.

The researchers also reviewed the disease characteristics, treatment and survival data between

2000 and 2016 for 4,900 Indian and Pakistani women and 482,250 non-Hispanic white women

with breast cancer.

They found that the occurrence of breast cancer in Indian and Pakistani women was lower than

in non-Hispanic white women, however, the number of Indian and Pakistani women diagnosed

with breast cancer increased over the years.

Indian and Pakistani women with breast cancer were more likely to be diagnosed at a younger

age and more advanced stages of the disease. Besides, they received more subcutaneous or

total mastectomies than non-Hispanic white women, it said.

While the researchers found that Indian and Pakistani women were less likely to die of breast

cancer than their non-Hispanic white counterparts, their health was tracked for a shorter time.

Prior cancer research has shown that fewer Indian and Pakistani women participate in scientific

studies and that several socio-cultural factors may delay their seeking health care.

Research also has shown poor mammogram screening rates in Indian and Pakistani women,

which is linked to a lack of family support, lack of transportation, modesty, fear, beliefs that

cancer is divine punishment for past deeds, having lived in the United States for less than 10

years, low English proficiency and a lack of faith in the health system.

"Our study indicated that there are important differences in this population that justify further

studies to better understand biological, sociocultural, and system-level factors such as

interactions with the health system, affecting breast cancer screening patterns, diagnosis, risk

and survival among South Asian women, given the paucity of literature on this topic,” said the

study's senior author Elisa V Bandera, co-leader of the Cancer Prevention and Control Research

Program at Rutgers Cancer Institute of New Jersey and professor at Rutgers Robert Wood

Johnson Medical School.

The study recommends identifying strategies to better engage Indian and Pakistani women in

breast cancer studies and to improve interactions between health care providers and Indian and

Pakistani women to identify socio-cultural factors associated with screening decisions and

health care use in this population.

"As the South Asian population in the United States—and especially in New Jersey—grows,

it is imperative that we work to promote health equity in cancer prevention, screening, early

diagnosis and treatment through community engagement and a team science approach," said

Anita Kinney, director of the Center for Cancer Health Equity at Rutgers School of Public

Health and Rutgers Cancer Institute of New Jersey and professor at the Rutgers School of

Public Health, who is also one of the study's authors.


Source: https://www.tribuneindia.com/news/health/indian-pakistani-women-diagnosed-with-moreaggressive-breast-cancer-at-younger-age-study-161390

Ban on public events can bring down COVID-19 transmission rate by 24 per cent: Lancet study

Pupils at Martin-Buber-Oberschule secondary school wear protective masks against the spread

of the coronavirus disease as school resumes following the autumn holidays in Berlin on

October 26, 2020. 

Ban on public events can bring down the COVID-19 reproduction number ‘R’ number—a key

measure of virus transmission—by 24 per cent in less than a month, according to a modelling

study published in The Lancet journal.

An R value above 1 indicates a growing outbreak, whereas an R value below 1 indicates a

shrinking outbreak.

The research using data from 131 countries suggests that individual measures, including

closure of schools and workplaces, ban on public events and gatherings of more than 10 people,

requirements to stay at home, and internal movement limits, are associated with a reduction in

transmission of SARS-CoV-2.

However, combined measures are more effective at reducing transmission, the researchers said.

“We found that combining different measures showed the greatest effect on reducing the

transmission of COVID-19. As we experience a resurgence of the virus, policymakers will

need to consider combinations of measures to reduce the R number,” said Professor Harish

Nair from the University of Edinburgh, UK.

“Our study can inform decisions on which measures to introduce or lift, and when to expect to

see their effects, but this will also depend on the local context—the R number at any given

time, the local healthcare capacity, and the social and economic impact of measures,” Nair said.

When looking at the measures individually, a ban on public events was associated with the

greatest reduction in R -- 24 per cent reduction after 28 days—which the researchers suggest

may be because they are likely to prevent super spreader events and it was often the first

measure to be introduced in countries.

The measures most strongly associated with an increase in R were lifting bans on gatherings

of more than ten people and re-opening of schools, according to the researchers.

Although reopening schools was associated with a 24 per cent increase in the R by day 28, the

researchers caution that they were unable to account for different precautions some countries

implemented for reopening schools, for example limiting class sizes, distancing measure,

routine deep cleaning, personal handwashing, face masks, and thermal temperature checks on

arrival.

They said these are essential for safer school reopening and should be taken into account when

interpreting this finding.

“We found an increase in R after reopening schools but is not clear whether the increase is

attributable to specific age groups, where there may be substantial differences in adherence to

social distancing measures within and outside classrooms,” Nair added.

“Furthermore, more data are needed to understand the specific role of schools in increased

SARS-CoV-2 transmission through robust contact tracing,” he said.

The study, however, does not account for other potentially influential factors that have an

impact on R—including, among other things, compliance with the interventions, changes in

population behaviour, sub-national differences in R, or the effects of contact tracing and

isolation – all of which vary by context.

Using the R number as a proxy for transmission also has limitations, as it is difficult to estimate

accurately, particularly when prevalence is low, the researchers said.

In this modelling study, data on daily country-level estimates of R were linked with data on

what measures those countries had in place from January 1, 2020 to July 20, 2020.

The timeline of each country was divided into individual phases when all measures remained

the same in that country.

The analysis included 790 phases from 131 countries and the authors used a model to measure

the association between which measures were in place and changes in the R.


Source: https://www.tribuneindia.com/news/health/ban-on-public-events-can-bring-down-covid-19-

transmission-rate-by-24-per-cent-lancet-study-161419

Air pollution may hinder India’s fight against COVID-19, say scientists

Increase in 1 microgram per cubic metre in PM 2.5 associated with an 8 pc rise in COVID-19

death rate: Study

Air pollution may hinder India’s fight against COVID-19, say scientists

A pollution and Covid mascot launched in New Delhi. Tribune photo: Mukesh Aggarwal

The causal link between air pollution and COVID-19 cases is yet to be established conclusively

but long-term exposure will certainly make people more vulnerable to lung infections, warn

scientists as the skies over large parts of north India, including Delhi, turn smoky and the air

quality deteriorates rapidly.

Their concerns come amid several global studies pointing to the possible connection between

higher air pollution levels and increased COVID-19 cases and deaths.

A study by researchers at Harvard University in the US in September showed that an increase

of only 1 microgram per cubic metre in PM 2.5 is associated with an 8 per cent increase in the

COVID-19 death rate.

“Given the current limited literature, the surge of PM2.5 level in Delhi may be associated with

increased COVID-19 cases... Although the literature is relatively sparse at this stage,” Xiao

Wu, corresponding author of the Harvard study, told PTI.

He said the relationship between long-term air pollution and COVID-19 has been documented

in many studies, which indicate that adverse health impacts of air pollution can make people

prone to the infection or exacerbate the severity of COVID-19 symptoms once infected.

This is interesting, especially considering COVID-19 causes viral pneumonia and acute

respiratory distress syndrome, and severe inflammation to the heart and circulatory system, the

scientist said.

Another study by the University of Cambridge in April found an association between living in

an area of England with high levels of air pollution and the severity of COVID-19, caused by

the SARS-CoV-2 virus.

“Based on our findings, I would expect to see an association between higher levels of air

pollution in India and COVID-19 in the winter, similar with what we found in England,” said

Marco Travaglio, corresponding author of the Cambridge study.

“If the levels of air pollution have been consistently above the legal limits for several months

or years before this coming winter, I would expect to see a relationship between those levels

and COVID-19 burden across different parts of India in November and thereafter,” Travaglio

told PTI.

He noted that a key component of PM2.5 toxicity is its composition which may vary

considerably between countries.

“Nonetheless, the WHO legal limits for PM2.5 are currently set at 10 μg/m³ (microgrammes

per cubic metre) annual mean. Levels beyond 500 μg/m³ are extremely high and may have

considerable impact on people’s health in relation to COVID-19 but also beyond it,” said

Travalgo.

The level of small particulate matter (PM2.5) levels in Delhi have averaged around 180-340

μg/m³ in the past few weeks while that of bigger pollution particles (PM10) has hovered

between 120 and 450 during the time.

Long-term exposure to chronically high PM2.5 levels weakens the ability of the lungs to fend

off infections, therefore making people more susceptible to COVID-19, the scientists said.

In addition, studies from Italy have shown that traces of SARS-CoV-2 RNA, the genetic

material of the virus, can be found on pollution particles, meaning that increased air pollution

may act as a vehicle to increase COVID-19 transmission in highly polluted places.

The air quality in north India is expected to deteriorate further from November to February due

to several factors such as stubble burning, festive fireworks and low wind speed conditions

which lead to an uptick in vehicular and industrial pollution being trapped in the lower

atmosphere.

“In view of this evidence, high levels of PM2.5 in Delhi may lead to a higher number of

COVID-19 cases,” Travalgo added.

Studies in humans have shown that toxic air particles can penetrate airways and cause

widespread infiltration of lung cells.

This chronic state of inflammation may induce or aggravate health conditions such as asthma,

chronic obstructive pulmonary disease, cardiovascular diseases and diabetes, experts said.

Because these conditions have been widely found to be associated with increased risk of

contracting COVID-19 or incurring into critical illness, it is likely that air pollution acts as a

risk factor to increase the susceptibility to COVID-19.

India has the world’s second-highest caseload of over 7.9 million and the third-highest death

toll with more than 115,000 from the novel coronavirus.

The National Centre for Disease Control (NCDC) has warned that Delhi is likely to report

around 15,000 COVID-19 cases daily in winter because of the prevalence of respiratory

illnesses during this season that worsen the symptoms of the disease. On Sunday, the national

capital recorded 4,136 fresh COVID-19 cases, the highest single-day spike in 38 days.

D J Christopher, head of pulmonary medicine at the Christian Medical College in Tamil Nadu,

noted that the increased severe form of COVID-19 among patients would lead to increased

ICU hospitalisations, thereby increasing the burden of the healthcare system.

“The lung is the gateway to the body and takes the first impact from inhaled pollutants. It causes

an inflammatory response which damages the lung and makes it more susceptible to

infections,” Christopher told PTI.

‘Let us hope the numbers are not so high. There is a chance of hospital beds getting filled and

shortage of ICU beds,” he added.

Prof Rajneesh Bhardwaj concurred, saying there is growing scientific evidence that airborne

respiratory droplets carrying the virus travel and contaminate the air after an infected person

coughs. He added that pollutionmay help this airborne droplet to remain suspended for a longer

time and may increase the spread of COVID-19.

“PM2.5 are finer particles which remain suspended in the air for a long time and hence droplet

or viral particles can cling on to these particles to increase the risk. They may increase the

number of cases as pollution increases especiallywith large PM2.5 levels,” Bhardwaj, associate

professor at the Indian Institute of Technology-Bombay, told PTI.

He said the government should make contingent plans to deal with an expected large number

of cases and warned that any healthcare system can be overwhelmed by a larger number of

cases.

According to pulmonologist Anurag Agarwal, however, the relation between air pollution and

COVID-19 cases is very complex. While in general high air pollution increases risk of

respiratory infections, it is difficult to say much more, he said.

“Studies finding more infections and deaths in areas with high pollution have tried to

statistically adjust for higher population density in polluted cities. Such adjusted correlations

are interesting but do not represent proof,” Agarwal, director of the CSIR Institute of Genomics

and Integrative Biology, told PTI.

“Nevertheless, it is clear that air pollution is bad for health and COVID-19 is more dangerous

in unhealthy people. So the message is clear - we must take steps to reduce air pollution for

many reasons,” he added.



Source : https://www.tribuneindia.com/news/health/air-pollution-may-hinder-indias-fight-againstcovid-

19-say-scientists-161422