Treating COVID-19 may lead to increased antibiotic resistance, UK study finds

Patients hospitalised due to the novel coronavirus infection are being given a combination of

medications to prevent possible secondary bacterial infections

The use of antibiotics in people with COVID-19 could lead to raised levels of the drugs within

rivers or coastal waters which may in turn result in an increase in antimicrobial resistance,

according to a UK study.

Patients hospitalised due to the novel coronavirus infection are being given a combination of

medications to prevent possible secondary bacterial infections, noted the researchers at the

University of Plymouth in the UK.

The study, published in the Journal of Antimicrobial Chemotherapy, suggests their increased

use during the pandemic could be placing an additional burden on waste water treatment works.

Scientists noted that this could lead to raised levels of antibiotics within rivers or coastal waters

which may in turn result in an increase in antimicrobial resistance (AMR), where bacteria

become resistant to the action of antibiotics.

This would be particularly acute in receiving waters from waste water treatment works serving

large hospitals, or emergency hospitals, where there is a concentration of COVID-19 patients,

they said.

The findings are based on reports that up to 95 per cent of COVID-19 inpatients are being

prescribed antibiotics as part of their treatment, and concerns that such a large-scale drug

administration could have wider environmental implications, according to the researchers.

"COVID-19 has had an impact on almost every aspect of our lives. But this study shows its

legacy could be felt long after the current pandemic has been brought under control,” said Sean

Comber, Professor of Environmental Chemistry in Plymouth.

"From our previous research, we know that significant quantities of commonly prescribed

drugs do pass through treatment works and into our water courses.

"By developing a greater understanding of their effects, we can potentially inform future

decisions on prescribing during pandemics, but also on the location of emergency hospitals and

wider drug and waste management," said Comber.

The COVID-19 guidance issued by the National Institute for Health and Care Excellence

(NICE) suggests patients with COVID-19 should be treated with doxycycline and either

amoxicillin or a combination of other medications if a bacterial infection is suspected, but to

withhold or stop antibiotics if a bacterial infection is unlikely, the researchers said.

"Common with other hospitalised patients in the UK, and other countries, the majority of our

patients with COVID symptoms were prescribed antibiotics because it is very difficult to know

whether a patient presenting with symptoms of COVID has an overlying bacterial infection or

not," Neil Powell, Consultant Pharmacist at the Royal Cornwall Hospital said.

"We did a lot of work to try and identify those patients who were unlikely to have a bacterial

infection complicating their viral COVID infections in an attempt to reduce the amount of

antibiotic exposure to our patients and consequently the environment," said Powell.

This research combined patient numbers for UK emergency hospitals set up temporarily around

the country with waste water treatment work capacity and available river water dilution serving

the emergency hospital and associated town.

https://www.tribuneindia.com/news/health/treating-covid-19-may-lead-to-increasedantibiotic-

resistance-uk-study-finds-131228

Covid-19: What you need to know today

India has seen 70,182new cases of Covid-19 on average every day in the week ended Monday.

That works out to 5.3 cases per 100,000 people (assuming India’s population at 1.3 billion).

One way of looking at the Covid-19 challenge is to target reducing the number of new cases to

less than one per 100,000. This isn’t a number picked without basis – it is the trend seen in

countries thatmanaged to crush the virus, if only temporarily. That’s a huge challenge for India.

India’s Covid-19 numbers could well see an increase in the coming weeks – as testing increases

(although states are blindly using rapid antigen tests without understanding when they should

be used – a theme discussed several times in this column), and as the virus moves into rural

India. Indeed, the pandemic’s progress in India has been outward – from the metros to the other

cities and towns; and from urban districts to rural ones (see front page).

India and the US are similar in terms of their approach to the pandemic – they opened up when

cases were still rising (unlike Europe, where countries opened up only after the number of new

cases started declining). Sure, the US saw a dip and then a long plateau between mid-April and

mid-June, but cases rose rapidly after that. They rose till late July, when they started falling

again. Interestingly, the seven-day average of daily cases in the US is well off its peak seen in

late July, but still higher than the peak seen in early April. In contrast, India’s seven-day

average has never dipped – the trajectory of the coronavirus disease, in terms of number of

cases, has been one steady upward curve as the infection spread across the second-most

populous country in the world.

In the week ended Monday, India added 463,999cases, according to the HT dashboard. This is

26%of the 1.75 million new cases recorded around the world in the same period (the second

number is from the New York Times database). This statistic is worrying, although India’s case

fatality rate of 1.85% is among the lowest in the world, and of the 3.16 million cases recorded

till Monday night, 76% had recovered. The disease is yet to peak in India but doctors have

clearly become better at saving lives.

There has been some debate about a possible second lockdown in the US. There hasn’t been

much talk of one in India. Through August, even some of the states that insisted on partial

lockdowns (on certain days) have eased up. This is understandable – the lockdown has wreaked

havoc on livelihoods and the economy. Once it became clear that the virus wasn’t going away

anytime soon, and that a vaccine wouldn’t be available till early 2021, the focus moved to

living and working with the virus.

The buzz in Delhi is that the next set of so-called unlock guidelines issued by the home ministry

could reflect that. HT reported on Tuesday that Delhi Metro could soon begin operations. This

is a good move, provided the safety protocols that have been put down on paper are faithfully

implemented. That could be problematic, though. Many Indians have shown poor discipline

when it comes to wearing masks or practising social distancing. Police departments around the

country do not seem keen to enforce the home ministry’s guidelines on masks (there is very

poor monitoring in markets and parks, especially). Many people who wear masks, wear them

improperly. And experience around the world has shown that crowds, especially in enclosed

places, are a magnet for the virus. Talk of restarting the DelhiMetro also comes at a time when

the number of cases in Delhi is beginning to inch up again (although it is still 60-70% off its

peaks) – all the more reason why safety and social distancing protocols will need to be strictly

followed, and monitored.

There is no point in pretending things have returned to normal – because they haven’t.

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

Coronavirus | Norms for post-COVID treatment soon

Reports of re-infection not cause for worry, says ICMR

“A technical body of experts is gathering data to develop a guideline for addressing post-

COVID complications,” Union Health Secretary Rajesh Bhushan said on Tuesday.

Speaking at a press conference, the official said while the Ministry is not tracking the number

of post-COVID syndrome cases in India, it was following reports of re-infection confirmed in

Hong Kong earlier this week.

“We have read with interest the reports of re-infection in Hong Kong, but we would like to

state that re-infection depends on a number of factors including immune status of the person,

whether the virus has mutated etc. This is just one case as of now and normally it doesn’t

happen in viral diseases for example measles,” said Indian Council of Medical Research

(ICMR) director general Balram Bhargava, who also addressed the press.

“This is still a relatively new virus — only about 7-8 months old. We aren’t alarmed with the

development but are following it closely.We still are understating the time period of immunity

that the infection provides,”Dr Bhargava added.

Talks over vaccine

Speaking about the Sputnik-5 vaccine (COVID-19 vaccine developed in Russia) the Ministry

said India and Russia are in communication. “Some initial information has been shared and we

are awaiting details,” said Mr. Bhushan.

While ICMR chief said, “It’s the irresponsible section of the population who don’t adhere to

COVID-safety norms, who are driving-up the pandemic numbers in India”, the Health Ministry

said of the total number of active cases in India, only 2.7% patients are on oxygen support,

1.92% patients are in ICU and 0.29% patients are on ventilator support.

Rising recoveries

Stating that India has on Tuesday reported the highest recoveries in a single day Mr. Bhushan

said, “66,550 COVID-19 patients have recovered and been discharged in the last 24 hours.

With this the total number of recoveries has crossed 24 lakh (24,04,585). India's Recovery Rate

has reached 76% (75.92%). The number of recovered patients has outpaced the active cases

(7,04,348) by more than 17 lakh. The recovered patients are 3.41 times the active cases, as on

date. There has been more than 100% hike in the recoveries in the last 25 days.”

“The record high recoveries have ensured that the actual caseload of the country viz. the active

cases, has reduced and currently comprises only 22.24% of the total positive cases. The steadily

falling Case Fatality Rates stands at 1.84% today,” he added.

As of Tuesday, India has tested nearly 3.7 crore samples, the ICMR said.

“The cumulative testing as on date has reached 3,68,27,520.With 9,25,383 tests conducted in

the last 24 hours, the Tests Per Million have seen a sharp rise to 26,685. Starting from a single

lab at Pune, India’s testing lab network has seen a substantial widening with a total of 1,524

labs today with 986 labs in the government sector and 538 private labs,” said Dr. Bhargava.

https://www.thehindu.com/news/national/coronavirus-govt-to-develop-norms-to-treat-postcovid-

condition/article32439706.ece

How useful are saliva tests for Covid-19?

 

The Indian Express

What serosurvey results imply

 

The Indian Express

Australia to make vaccine free for all its citizens

The Indian Express

 

In heart cells, clues why Covid is severe in the elderly

The Indian Express

 

Covid-specific health cover in high demand as cases surge

https://epaper.tribuneindia.com/c/54349221

 

Oz enters deal with AstraZenec for vaccine

 

https://epaper.tribuneindia.com/c/54359109

COVID-19: Herd immunity requires effective vaccine, says WHO

As a global population, we are nowhere close to the levels of immunity required to stop this

disease transmitting, says WHO's emergencies chief Dr Michael Ryan

COVID-19: Herd immunity requires effective vaccine, says WHO

The World Health Organization says the planet is nowhere near the amount of coronavirus

immunity needed to induce herd immunity, where enough of the population would have

antibodies to stop the spread.

Herd immunity is typically achieved with vaccination and most scientists estimate at least 70

per cent of the population must have antibodies to prevent an outbreak. But some experts have

suggested that even if half the population had immunity, there might be a protective effect.

WHO's emergencies chief Dr Michael Ryan largely dismissed that theory at a press briefing

on Tuesday, saying we should not live “in hope” of achieving herd immunity.

“As a global population, we are nowhere close to the levels of immunity required to stop this

disease transmitting,” he said. “This is not a solution and not a solution we should be looking

to.”

Most studies conducted to date have suggested only about 10 per cent to 20 per cent of people

have antibodies.

Dr Bruce Aylward, a senior adviser to WHO's director-general, added that any mass

immunisation campaign with a COVID-19 vaccine would aim to cover far more than 50 per

cent of the world's population.

“We don't want to be wrong,” he said. “You want to plan to get high coverage and not get lulled

into a dangerously seductive suggestion that (the herd immunity threshold) could be low.”

https://www.tribuneindia.com/news/health/covid-19-herd-immunity-requires-effectivevaccine-

says-who-127927

UK rates of depression double among adults during lockdown

UK rates of depression double among adults during lockdown

Rates of depression appear to have almost doubled in Britain since the country was put into

lockdown in late March as a result of the coronavirus pandemic, according to the country’s

official statistics agency.

The Office for National Statistics said in a special study released on Tuesday that 19.2% of

adults were likely to be experiencing symptoms of depression in June, three months into the

lockdown of large chunks of society and the economy.

That proportion is up from 9.7% recorded between July 2019 and March.

The statistics agency, which assessed the same 3,527 of adults before and during the pandemic,

said feelings of stress or anxiety were the most common way adults were experiencing some

form of depression, with around 85% of those reporting symptoms.

“Revisiting this same group of adults before and during the pandemic provides a unique insight

into how their symptoms of depression have changed over time,” said statistician Tim Vizard.

During the height of the lockdown, which was imposed on March 23 and has only been eased

over the past couple of months, people were isolated from friends and family, and often alone

— an isolation backdrop that has the potential to cause mental harm.

In addition, people have clearly fretted about contracting and then spreading the coronavirus

in a country that now has Europe’s highest COVID-related death toll with more than 40,000

victims.

Many people have also been worried about their jobs and future financial well-being as the

economy nose-dived in the face of the restrictions on everyday life.

Though all age brackets reported higher levels of depression, the study found that younger

adults between 16 and 39 years of age were proportionately more likely to do so, with nearly a

third reporting symptoms of depression — a generational contrast to the coronavirus’ impact

on physical health.

Simon Wessely, a professor of psychiatry at King’s College London, voiced worries that this

occurred even before the recession really bites “when we can expect things to get even worse”.

Though the economy has contracted by a fifth during the pandemic, the government has

managed to contain the number of people becoming unemployed by a special salary support

program that has been used by over a million firms to retain more than 9 million workers, who

may otherwise have been fired.

With the Job Retention Scheme due to end in October, there are worries that many of those

jobs will be lost. In addition, there are many younger people joining the labour market at a

particularly inopportune time.

Vizard said younger adults, women or disabled people were the “most likely” to experience

some form of depression during the pandemic, along with those who were not able to afford a

one-off but necessary purchase worth at least 850 pounds (USD 1,100).

According to the study, one in eight adults, or 12.9%, developed moderate to severe depressive

symptoms during the pandemic, while a further 6.2% of the population continued to experience

this level of depressive symptoms from before. It also found that around 3.5% of sufferers saw

an improvement during the pandemic.

Charley Baker, associate professor of mental health at the University of Nottingham, said the

study’s findings were “unsurprising” and that those highlighted as struggling the most are those

already deemed to be more vulnerable to symptoms such as anxiety.

“Perhaps we—all of us—need to reach in to proactively support people, rather than expecting

people to reach out when this may be even more challenging than when in non-COVID times,”

she said.

https://www.tribuneindia.com/news/health/uk-rates-of-depression-double-among-adultsduring-

lockdown-127963

COVID-19 pandemic causes mental health crisis in Americas, says WHO official

Attention must be paid to rising domestic violence, say experts

COVID-19 pandemic causes mental health crisis in Americas, says WHO official

For representation only. File photo

The COVID-19 pandemic is causing a mental health crisis in the Americas due to heightened

stress and use of drugs and alcohol during six months of lockdowns and stay-at-home measures,

the World Health Organization’s regional director said on Tuesday.

The pandemic also has brought a related problem in a surge in domestic violence against

women, Carissa Etienne said in a virtual briefing from the Pan American Health Organization

in Washington.

“The COVID-19 pandemic has caused a mental health crisis in our region at a scale we’ve

never seen before,” she said. “It is urgent that mental health support is considered a critical

component of the pandemic response.”

Etienne called on governments to expand mental health services and prioritize mental health

as part of their response to the pandemic.

Many people are stressed by fear of developing the severe illness caused by the novel

coronavirus, while doctors, nurses and health workers are working longer hours than ever

before and risking their lives in hospitals, she said.

Attention must be paid to rising domestic violence, Etienne said.

“Ongoing stay-at-home measures, coupled with the social and economic impacts of this virus,

are increasing the risks of domestic violence---home is not a safe space for many,” she said.

Helpline calls have risen in Argentina, Colombia and Mexico, but the real extent of domestic

violence during the COVID-19 pandemic is likely under-estimated, as survivors are stuck at

home and outreach services are interrupted, Etienne said.

“With reduced contact to friends and family or barriers in access to services and shelters, we

are leaving survivors with nowhere to go,” she warned.

Coronavirus cases in the Americas have reached almost 11.5 million and more than 400,000

people have died as a result of the pandemic, the WHO regional director said.

The region continues to carry the highest burden of the disease, with 64 per cent of officially

reported global deaths despite having 13 per cent of the world’s population. The biggest drivers

of the case counts are the United States and Brazil, she said.

But there are increasing cases in the Caribbean, and new infections are rising in Peru, the

Dominican Republic, Jamaica, the Bahamas and Trinidad and Tobago.

https://www.tribuneindia.com/news/health/covid-19-pandemic-causes-mental-health-crisisin-

americas-says-who-official-127964

India has largest number of kids with Thalassemia Major’

10,000-15,000 children having this blood disorder born every year in the country, says health

India has the largest number of children with Thalassemia Major who need regular blood

transfusion and 10,000-15,000 children having the blood disorder are born every year in the

country, Union Health Minister Harsh Vardhan said on Tuesday.

Lauding the work of the Indian Red Cross Society at the inauguration of a Thalassemia

Screening and Counselling Centre at its National Headquarters Blood Bank here, the minister

said such initiatives “will enable us in educating the common people on prevention of this

disease”.

He said there are around 270 million Thalassemia patients in the world.

“India has the largest number of children with Thalassemia Major in the world, about 1 to 1.5

lakh, and about 10,000-15,000 children having Thalassemia Major are born every year.

“The only cure available for such children is bone marrow transplantation (BMT). However,

BMT is difficult and not affordable by the parents of all these children. Therefore, the mainstay

of treatment is repeated blood transfusions, followed by regular iron chelation therapy to

remove the excessive iron overload, consequent to the multiple blood transfusions,” he was

quoted as saying in a statement.

Vardhan said this new initiative of IRCS will provide a golden opportunity to administer

adequate therapy to those affected enabling them lead a better life and preventing the birth of

children affected with hemoglobinopathies, through carrier screening, genetic counselling and

prenatal diagnosis.

“This programme will aid in prevention of birth of children affected with hemoglobinopathies,

through well-planned screening programmes, information dissemination and awareness

generation activities and help avert the imminent threat of this genetic disorder turning into a

major health problem.

“With these progressive initiatives, we shall soon be able to achieve the New India being

envisioned by the prime minister by 2022,” he said.

Haemoglobinopathies such as Thalassemia and sickle cell disease are inherited disorders of red

blood cells and are preventable. These illnesses are chronic, life impairing and in some cases,

life threatening and impose a heavy emotional and financial burden on families.

In India, Thalassemia Major and the severe form of Thalassemia Intermedia (TI) constitute the

major burden of disease. Both are commonly managed by regular lifelong blood transfusions

and regular iron chelation, the statement said.

These Thalassemia syndromes are caused by inheritance of abnormal (beta) Thalassemia genes

from both parents or abnormal beta-Thalassemia gene from one parent and abnormal variant

haemoglobin gene (HbE, HbD) from the other parent, it said.

https://www.tribuneindia.com/news/health/india-has-largest-number-of-kids-withthalassemia-

major-127968

Scientists invent low-cost emergency ventilator

Using standard parts that cost less than USD 400, scientists have developed an emergency

ventilator which could be an affordable option when more sophisticated technology is not

available, or in short supply, an invention that may help save the lives of those suffering from

COVID-19.

While in the simplest ventilators, doctors squeeze a self-inflating bag by hand to pump air into

the lungs, and high-end automated versions use complex electronics to control multiple

parameters, the current innovation, described in a yet-to-be peer-reviewed study in medRxiv,

is a cost-effective device with a mechanism that automatically squeezes the self-inflating bag.

"We wanted to build the simplest device that could be effective. Our acute shortage ventilator

is exactly that, and we now want to get it into use as quickly as possible,” said Martin

Breidenbach, a co-author of the study from Stanford University in the US.

The researchers, including those from Stanford University in the US, said ventilators are

lifesavers for those who can't breathe sufficiently on their own -- a common problem for those

severely affected by COVID-19.

They explained that the device compresses oxygen-rich air and pushes it through tubes into a

patient's lungs, expanding them, and helping take up oxygen, following which the lungs

contract on their own, pushing the air back out.

The current innovation, according to the scientists, is based on a simple model, with the

addition of a mechanism that automatically squeezes the self-inflating bag.

They said the system also incorporates modern, inexpensive electronic pressure sensors and

microcomputers with sophisticated software that precisely controls the squeeze.

According to the study, the microcomputers also drive a small control panel, and operators can

control the system with that or with a laptop computer.

While several groups across the world have developed low-cost emergency ventilators in recent

months, the scientists believe their current invention stands out as a fancier version of the

simplest ventilator design.

They said they could build the ventilator at a cost less than USD 400 per unit, compared to

USD 20,000 or more for a professional-grade system with field support.

"These qualities should make the ventilator particularly helpful for mid- and low-income

countries, where medical resources are scarce," said study co-author Michael Bressack from

Stanford University.

While the team or the university does not produce or distribute the ventilator, the researchers

said they are offering the technology at no cost to others who want to build the ventilator and

deploy it after having obtained regulatory approvals.

https://www.tribuneindia.com/news/health/scientists-invent-low-cost-emergency-ventilator-

127019

USFDA clears simple saliva test for faster detection of COVID-19

'New saliva test would increase efficiency and avoid shortage of crucial test components like

reagents'

USFDA clears simple saliva test for faster detection of COVID-19

The US health watchdog has authorised the emergency use of new and expensive saliva-based

laboratory diagnostic test for COVID-19

The US health watchdog has authorised the emergency use of new and expensive saliva-based

laboratory diagnostic test for COVID-19 that could be a game-changer in the diagnosis of the

infection as it will enable rapid testing amongst more people easily.

Stephen Hahn, the Food and Drugs Administration Commissioner, said the new saliva test

would increase efficiency and avoid shortage of crucial test components like reagents.

“Providing this type of flexibility for processing saliva samples to test for COVID-19 infection

is groundbreaking in terms of efficiency and avoiding shortages of crucial test components like

reagents,” he said in a statement.

The agency has previously authorised four other tests that use saliva for sampling, but these

yielded varying results. Authorisation of the new test occurs amid ongoing disarray over

COVID-19 testing.

The US has been plagued by an inconsistent strategy for detecting the virus, thanks in part to

persistent shortages and the use of a variety of different tests that have sometimes yielded

unreliable results.

The new method called SalivaDirect is being further validated as a test for asymptomatic

individuals through a programme that tests players and staff from the National Basketball

Association (NBA).

SalivaDirect is simpler, less expensive and less invasive than the traditional method for such

testing known as nasopharyngeal (NP) swabbing.

Results so far have found that SalivaDirect is highly sensitive and yields similar outcomes as

NP swabbing.

With the FDA's emergency use authorisation, the testing method is immediately available to

other diagnostic laboratories that want to start using the new test, which can be scaled up

quickly for use across the nation and, perhaps, beyond—in the coming weeks, researchers said.

A key component of SalivaDirect, the researchers note, is that the method has been validated

with reagents and instruments from multiple vendors.

This flexibility enables continued testing if some vendors encounter supply chain issues as

experienced early in the pandemic.

“This is a huge step forward to make testing more accessible,” said Chantal Vogels, a Yale

postdoctoral fellow, who led the laboratory development and validation along with Doug

Brackney, an adjunct assistant clinical professor.

“This started off as an idea in our lab soon after we found saliva to be a promising sample type

of the detection of SARS-CoV-2, and now it has the potential to be used on a large scale to

help protect public health. We are delighted to make this contribution to the fight against

coronavirus,” he said.

Development of SalivaDirect as a means of rapidly expanding SARS-CoV-2 testing was

spearheaded this spring by Nathan Grubaugh and Anne Wyllie, assistant professor and

associate research scientist, respectively, at Yale School of Public Health.

After finding saliva to be a promising sample type for SARS-CoV-2 detection, they wanted to

improve the method further.

“With saliva being quick and easy to collect, we realised it could be a game-changer in COVID-

19 diagnostics,” said Wyllie.

With testing urgently needed, the Yale team was determined to decrease both testing times and

costs, to make testing widely accessible.

“Wide-spread testing is critical for our control efforts. We simplified the test so that it only

costs a couple of dollars for reagents and we expect that labs will only charge about USD 10

per sample. If cheap alternatives like SalivaDirect can be implemented across the country, we

may finally get a handle on this pandemic, even before a vaccine,” said Grubaugh.

Grubaugh and Wyllie said that they are not seeking to commercialise the method rather want

the simplified testing method to help those most in need.

Testing for SARS-CoV-2 has been a major stumbling block in the fight against the pandemic,

with long delays and shortages of testing.

Some experts have said that up to 4 million tests are needed per day and SalivaDirect provides

one pathway toward that goal, the researchers said.

“Using SalivaDirect, our lab can double our testing capacity,” said Professor Chen Liu, chair

of Yale Pathology, who oversaw the clinical validation of the study.

https://www.tribuneindia.com/news/health/usfda-clears-simple-saliva-test-for-fasterdetection-

of-covid-19-127018

Digital health IDs for all citizens by 2022

 

https://epaper.tribuneindia.com/c/54284178

Study reveals why Covid-19 virus impacts patients differently

Researchers at McMaster University and the University of Waterloo are searching how the

SARS-CoV-2 virus infects lungs

Study reveals why Covid-19 virus impacts patients differently

Researchers says differential response to the same virus suggests that each individual patient,

with their unique characteristics, heavily influences Covid-19 disease severity.

Previously scientists had determined that entry of SARS-CoV-2 into cells occurs through a

receptor on the cell surface, known as ACE2 but a new study has found that the ACE2 receptor

is at very low levels in human lung tissue.

Researchers at McMaster University (MU) and the University of Waterloo in Canada are

searching for how the SARS-CoV-2 virus infects the lungs - and they're challenging what has

become an accepted truth about the virus.

"Our finding is somewhat controversial, as it suggests that there must be other ways, other

receptors for the virus, that regulate its infection of the lungs," said study researcher Jeremy

Hirota from MU.

"We were surprised that the fundamental characterisation of the candidate receptors in human

lung tissue had not yet been done in a systematic waywith modern technologies," Hirota added.

"Finding such low levels of ACE2 in lung tissue has important implications for how we think

about this virus. ACE2 is not the full story and may be more relevant in other tissues such as

the vascular system," said study researcher Andrew Doxey from Waterloo.

To explore alternate additional infection pathways and different patient responses to infection,

the team is using nasal swabs that were collected for clinical diagnoses of Covid-19, the study,

published in the European Respiratory Journal, reported.

These samples offer the opportunity to determine which genes are expressed by patients' cells

and associate this information with the development of the patients' disease.

The ongoing study will better identify and treat patients who are at risk of developing serious

complications and provide predictive capacity for hospitals.

According to the researchers, It is clear that some individuals respond better than others to the

same SARS-CoV-2 virus.

"The differential response to the same virus suggests that each individual patient, with their

unique characteristics, heavily influences Covid-19 disease severity," said Hirota.

"We think it is the lung immune system that differs between Covid-19 patients, and by

understanding which patients' lung immune systems are helpful and which are harmful, we

may be able to help physicians proactively manage the most at risk-patients," he noted. IANS

https://www.tribuneindia.com/news/health/study-reveals-why-covid-19-virus-impactspatients-

differently-125972

TB vaccination linked with significantly improved COVID-19 outcomes: Study

There was no effect among older adults who had received the BCG vaccine

TB vaccination linked with significantly improved COVID-19 outcomes: Study

A tuberculosis vaccine administered during the past 15 years is associated with significantly

improved COVID-19 outcomes, especially in young adults, according to a new study.

The researchers from Ben-Gurion University of the Negev (BGU) and The Hebrew University

of Jerusalem, analysed the correlation between the Bacille Calmette-Guerin (BCG) vaccine for

tuberculosis and COVID-19 outcomes.

The study, published in the journal Vaccines, found that BCG regimes are associated with

better COVID-19 outcomes, both in reducing infection rates and death rates per million,

especially for people aged 24 or younger who had received the vaccination in the last 15 years.

There was no effect among older adults who had received the BCG vaccine, the researchers

said.

Many countries have stopped inoculating their entire population, but some still use BCG

widely, they said.

"Our findings suggest exploring BCG vaccine protocols in the context of the current pandemic

could be worthwhile," said Nadav Rappoport from BGU.

"A growing number of clinical trials for testing the efficacy of BCG vaccination have been

initiated,” Rappoport said.

The researchers analysed data from 55 countries with populations of more than three million

people, which comprise some 63 per cent of the world's population.

As the pandemic reached different countries at different dates, they aligned countries by the

first date at which the country reached a death rate of 0.5 deaths per million or higher.

The researchers controlled for 23 variables including demographic, economic, pandemicrestriction-

related, and country health-based.

BCG vaccine administration was shown to be constantly associated with COVID-19 outcomes

across the 55 countries, they said.

To ascertain whether other vaccines also influenced COVID-19 outcomes, the team conducted

the same analysis for the measles and rubella vaccines and found that those did not have a

significant association with COVID-19 outcomes.

Other epidemiological studies have shown the effect of the BCG vaccine beyond tuberculosis,

but scientists do not yet know why the vaccine has such an effect.

https://www.tribuneindia.com/news/health/tb-vaccination-linked-with-significantlyimproved-

covid-19-outcomes-study-126010

Put all adults in organ donor registry: Varun Gandhi to move Bill

Rate of deceased organ donation in India is one of the lowest in the world

Pilibhit MP Varun Gandhi on Thursday said he would soon introduce a private members’ Bill

in the Lok Sabha proposing the inclusion of all adults in the national organ donors’ registry.

“I will be introducing a private member’s Bill that proposes to put all adult citizens in a national

organ donation register, which anyone can voluntarily opt out of. This will ensure a reduction

in the number of deaths due to non-availability of organs,” said Gandhi on the occasion of the

National Organ Donors Day.

India’s rate of deceased organ donation remains among the lowest in the world less than 1 per

million.

In Spain and Croatia, the corresponding rates are 46.9 and 38.6 per million, respectively.

Despite the easing of national organ donation laws and policy push by the government, the gap

between annual demand of organs for transplant and their availability in India remains huge.

Health Ministry data show that annually the following number of persons need organ and tissue

transplant—kidneys (2.5 lakh), liver (80,000), heart (50,000), cornea (one lakh). Actual

number of organ transplants done every year is acutely low—kidneys (160), liver (33), heart

(45) and cornea (2,188).

Medical experts have repeatedly said they can save several road accident victims if the country

reaches satisfactory levels of organ donations.

As per latest data India saw 4.61 lakh road accidents in a year involving 1.49 lakh deaths.

Doctors say there are two kinds of organ donations.

One is deceased organ donation. The other is living donor organ donation.

Living donor has to be a person above 18 years and it means any person above 18 years can

pledge to donate one kidney (the other is capable of maintaining body functions); a portion of

pancreas (half the pancreas are enough to sustain required functions) and a part of the liver

(segments of liver will regenerate after some time in both the donor and the recipient) in their

lifetime.

People can pledge organs online through the National Organ and Tissue Transplant

Organisation (NOTTO) website www.notto.gov.in

https://www.tribuneindia.com/news/health/put-all-adults-in-organ-donor-registry-varungandhi-

to-move-bill-126041

Serum Institute of India to price Covid-19 vaccine at USD 3 per dose

SII to produce 100 mn doses of Covishield for India and other low- and middle-income nations

Serum Institute of India to price Covid-19 vaccine at USD 3 per dose

Photo for representational purpose only.

World’s leading vaccine maker Serum Institute of India on Friday said it would produce up to

100 million Covid-19 vaccine doses for India and low- and middle-income countries as early

as 2021.

The institute in a statement said it would price each dose of the vaccine for USD 3 which

roughly translates into Indian Rupees 225.

SII issued the statement after entering into what it called a new landmark collaboration between

the SII, GAVI (Global Alliance for Vaccines) and Bill and Melinda Gates Foundation.

SII to get $150 mn from Gates Foundation

Under the arrangement the Bill andMelinda Gates Goundation via its strategic investment fund

will provide at-risk funding of USD 150 million to GAVI which will be used to support the SII

to manufacture the potential vaccine candidates.

“Vaccines will be priced at maximum USD 3 per dose and made available to the 92 countries

included in GAVI’s COVAX Advance Market Commitment,” Adar Poonawala-led SII said in

a statement.

Pune based Serum Institute has partnered with Oxford University and British Swedish Pharma

firm Astra Zeneca to mass produce the frontrunner COVID 19 vaccine Covishield which has

entered phase 3 clinical trials in some countries after showing safety and immune response in

phase 1 and 2 studies in the UK.

Indian Drug controller has also permitted SII to undertake phase 2 and 3 human trials on

Covishield in India.

https://www.tribuneindia.com/news/health/serum-institute-of-india-to-price-covid-19-

vaccine-at-usd-3-per-dose-123458

Covid-19: Scientists develop low-cost method to test mask effectiveness

Covid-19: Scientists develop low-cost method to test mask effectiveness against viral droplets

Using widely available tools, scientists have developed a simple method to visualise how

effectively different types of masks prevent the spread of droplets that could contain novel

coronavirus particles, an advance which could aid small scale mask producers to optimise

designs, and help community outreach organisations demonstrate proper mask fitting

procedures.

The technique, described in the journal Science Advances, is still in the early stages, and has

so far only been tested in a small group of people, the scientists said.

According to the researchers from Duke University in the US, the preliminary, proof-ofprinciple

findings suggest that professional-grade N95 masks, surgical or polypropylene

masks, and handmade cotton masks may all block much of the droplet-spray produced when

wearers speak.

However, they said bandanas and neck fleeces likely provide little protection, as the scientists

observed that more droplets are expelled through these materials.

They said this is likely because the materials break up larger droplets as they pass through the

material.

In the study, the scientists evaluated the effectiveness of 14 different types of masks and other

frequently substituted face coverings, using a simple approach in which either onemale speaker

or, in some cases, four speakers wore each mask while standing in a dark enclosure.

The speaker then uttered the phrase “stay healthy, people” five times in the direction of a laser

beam, which scattered light from the droplets released during speech, the study noted.

A cell phone camera recorded the droplets and a simple computer algorithm counted them, the

scientists added.

The setup, intentionally designed to be simple and inexpensive, can be replicated by nonexperts,

according to the researchers.

They said the hardware it requires, including laser equipment, is commonly available and can

be purchased for less than USD 200.

While the researchers acknowledge the need for further testing, they suggested based on the

findings that N95 masks without valves blocked droplet spread best, and surgical or

polypropylene masks and handmade cotton face coverings were also effective.

But the early findings suggested that bandanas and neck fleeces do not provide protection.

“Our work was a demonstration of a simple measurement method, not a systematic mask

study,” noted Martin Fischer, the study’s corresponding author.

“More work is required to investigate variations inmasks, speakers, and how people wear them.

We also want to extend our method to other droplet-generating actions, like coughing and

sneezing. Further, we want to explore effects of incorrect placement and moisture saturation,”

Fischer said.

https://www.tribuneindia.com/news/health/covid-19-scientists-develop-low-cost-method-totest-

mask-effectiveness-against-viral-droplets-124234

Covid-19: What you need to know today

India crossed two million coronavirus disease (Covid-19) cases on Thursday, exactly three

weeks after it crossed a million cases on July 16 (according to the HT dashboard, it ended the

day with 1,004,652 cases). The number of active cases on July 16 (again, according to the HT

dashboard) was 343,298.

India ended Thursday with 2,022,730 cases. The number of active cases was 605,300. This

means that in 21 days, the country has seen 1,018,078 new infections, and the number of active

cases has increased by 262,002.

India had recorded 25,594 deaths by the time it crossed a million cases; by Thursday, that

number increased to 41,633, an additional 16,039 deaths in 21 days.

No country is currently adding as many cases as India. And, at the two million mark (crossed

only by the US and the Brazil before this), India’s growth rate in terms of cases is the highest

(see page 4). Indeed, according to five-day averages tabulated by the Johns Hopkins University,

the US’s five-day average (as on August 5) is down, as is Brazil’s. In the top five countries by

number of cases, only India and Colombia have five-day averages that are moving up. To be

sure, the absolute numbers are still higher for the US (seven-day average of 56,966 according

to the New York Times database), when compared to India (54,392) -- but only just. Brazil’s

is 43,830. India’s number is set to increase even more in coming days as the virus spreads

across the hinterland and the peninsula.

One reason for this is higher testing – India had tested 10,539 people per million of its

population on July 16, when it crossed a million cases; on August 5, poised at 1.96 million, it

had tested 16,617 people per million (testing data comes with a lag). That is just around 1.66%

of the population. The US has tested 18.8% of its population and Brazil 6.3%, according to

data from worldometers.info. Russia has tested 20%, South Africa 5%, and the UK 25%.

Among countries with a significant number of cases, only Mexico (0.8%) has tested less of its

population than India. Even Iran has tested 3%.

India needs to do more – for a start, target to test 5% of its population. This isn’t the first time

I’m pushing for more tests – this column was the first to call for a million tests a day in India

– and every time, I receive the same feedback from apologists for the government: India’s

population is far too high; or India’s GDP is far too low. The truth is, in absolute terms, India

ranks behind China, the US, and Russia, in terms of number of tests conducted.

To reach the 5% mark, India has to test roughly 32 million more people – preferably using the

Reverse Transcription Polymerase Chain Reaction, or RT-PCR test, which is the best way to

diagnose current infections. The rapid antigen test has become popular with many state

governments because it can offer tests within the hour -- as opposed to the RT-PCR tests whose

results reach the subject only in 24 to 48 hours -- but it is not very accurate when it comes to

identifying true negatives (some people shown to be negative for the virus in the test are

actually infected), and should be used only in certain circumstances and places – in a

containment zone, for instance; or in airports (where passengers can be tested before a flight).

That may seem like an impossible target (it also needs to be completed soon, perhaps 32 days,

sticking to this writer’s recommendation on the number of daily tests), but India conducts many

large-scale exercises that other countries would consider impossible – for instance, a universal

vaccine programme that covers almost 25 million children across the country; and elections.

Last year, 611 million people voted in the general elections in seven phases. In 2017, about 86

million people voted in the Uttar Pradesh state elections, again, across seven phases.

At the one million mark, I wrote a column on what India needs to do (called “A Million and a

Manifesto”). That still holds, but at the two million mark, the only thing the central and state

governments need to think about is testing.

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

Coronavirus may not infect taste buds directly : Study

The Indian Express

 

Serum Institute gets licence for Novavax vaccine in India

The Indian Express

 

Broad measures needed to check spread of TB in India, say researchers

Broad measures are needed to prevent the spread of tuberculosis, or TB, in India, as the country

accounts for 27 per cent of all global cases of the disease, say researchers.

Recently, the World Health Organization (WHO) changed its guidance for preventive

treatment in countries with a high TB prevalence, recommending proactive drug therapy for all

members of households exposed to TB by someone in the home with the pulmonary form of

the disease.

This is a departure from the current national guidelines in India that only require preventive

TB therapy for children under age six and people living with the human immunodeficiency

virus (HIV).

However, the new WHO recommendations for broader preventive measures is conditional and

not based on strong evidence, so health officials in countries such as India wanted more proof

that a switch in policy was warranted.

The research team that conducted the study, published in the journal PLOS One, in India was

directed by Amita Gupta from the Johns Hopkins University School of Medicine.

For their study, the researchers in India enrolled 1,051 adults in the cities of Pune and Chennai

who had been exposed to someone in their household with pulmonary TB.

The 997 participants who completed the study were screened for both TB infection (presence

of the bacteria) and TB disease using clinical, microbiologic and radiologic methods at

enrollment, at some time between four and six months, and at 12 and 24 months.

“We found that 707 of the 997 participants, or 71 per cent, tested positive for TB infection at

the start, and 20, or 2%, subsequently developed the disease during the 24-month follow-up

period,” said researcher Mandar Paradkar from BJ Government Medical College (BJGMC) in

Pune.

“Based on these numbers, we estimate that that 12 people per 1,000 per year will get TB disease

through household contact,” Paradkar added.

This is a large enough rate to support the new WHO guidelines for stopping the spread of the

bacteria, calling for all residents in households with TB present to receive therapy without

needing to first be tested for infection.

The research team that the development of TB disease through household exposure was not

associated with smoking, alcohol consumption, diabetes mellitus or when TB infection was

detected during the study period.

To increase the effectiveness of TB prevention on a large scale, the new WHO

recommendations provide options for shorter-duration treatments in addition to the previous

course of the antibiotic isoniazid daily for six months, the authors said.

The alternatives include a one-month daily regimen of another antibiotic, rifapentine, plus

isoniazid; three months weekly rifapentine plus isoniazid; three months daily rifampicin plus

isoniazid; or four months of daily rifampicin alone, they added.

https://www.tribuneindia.com/news/health/broad-measures-needed-to-check-spread-of-tb-inindia-

say-researchers-122899

Glenmark announces 400 mg 'FabiFlu' for Covid-19 treatment

Glenmark Pharmaceuticals, a research-led global pharmaceutical company, on Thursday

announced that it is set to introduce a 400 mg version of oral antiviral - FabiFlu -- for the

treatment of mild to moderate Covid-19 in India.

It was the first Indian company to commercially launch an antiviral drug - Favipiravir with

brand name FabiFlu - for the treatment Covid-19 patients. The company received marketing

and manufacturing approval from the Drug Controller General of India and launched the

product in the Indian market on June 20.

According to the company, the higher strength will improve patient compliance and

experience, by effectively reducing the number of tablets that patients require per day.

Earlier, the 200 mg dosage of FabiFlu required patients to take 18 tablets on Day 1, followed

by 8 tablets each day thereafter for a maximum of 14 days.

A higher pill burden has been associated with lower adherence to therapy, the latter affecting

viral suppression and overall treatment outcomes. Reducing the pill burden has also been a

demand from doctors and patients to enable adherence, the company said.

"With the new 400 mg version, patients will now have a more relaxed dosage regimen, with 9

tablets required on Day 1, and thereafter 2 tablets twice a day from Day 2 till end of the course,"

Glenmark Pharmaceuticals added.

Explaining the significance of this development, Monika Tandon, Vice President and Head,

Clinical Development of Glenmark Pharmaceuticals Limited said, "The 200 mg dosage of

FabiFlu was developed in line with global formulations of the drug Favipiravir, which had

similar strength. The 400 mg version is a result of Glenmark's own R&D efforts to improve

treatment experience for patients in India." She added, "Being the first company to launch

Favipiravir in India, we continue to innovate and seek new treatment options for Covid-19

patients. Introducing this higher strength of FabiFlu is in line with these efforts to ensure a

smoother experience for patients, by reducing their daily pill burden." Glenmark has also

commenced a Post Marketing Surveillance (PMS) study on FabiFlu to closely monitor the

efficacy and safety of the drug in a large pool of patients prescribed with the oral antiviral

Favipiravir, as part of an open label, multicentre, single arm study.

It is also conducting another Phase III clinical trial to evaluate the efficacy of two antiviral

drugs Favipiravir and Umifenovir as a combination therapy in moderate hospitalized adult

Covid-19 patients in India.

The combination study which is called the FAITH trial is looking to enrol 158 hospitalized

patients of moderate Covid-19 in India. Early treatment with combination therapy will be

evaluated for safety and efficacy as it is emerging as an effective approach in shortening

duration of virus shedding, facilitating early clinical cure and discharge of patients.

https://www.tribuneindia.com/news/health/glenmark-announces-400-mg-fabiflu-for-covid-

19-treatment-123336

Safety of Low-calorie Sweeteners used in Sugar Free confirmed by Regulatory Authorities worldwide

When used in place of sugar, low calorie sweeteners like Sugar Free can help reduce the net

calorie intake and assist in weight management.

Opting for Sugar Free will truly free you from health conditions that risk one’s well being

Sugar-free lifestyle has become a popular trend for those looking to lead healthy lives. And

with people becoming more calorie-conscious and transitioning to a sugar-free lifestyle,

‘Sugar Free’ and other low-calorie sweeteners have made their way into the diets of the

health-conscious people. By providing the taste of sweetness with minimal calories, low

calories sweeteners like Sugar Free have helped countless people achieve their health and

fitness goals. While the calorie-cutting benefits and growing demand for low-calorie

sweeteners have made them popular, they have also remained controversial in mainstream

media over the years of their existence. This is because of the many myths related to their

alleged side-effects on human health. Though wide-spread, these myths remain just that —

myths. There’s no conclusive evidence to establish that aspartame and sucralose, the key

ingredients used in Sugar Free, cause any health problems.

Approved by United States Food and Drug Administration (USFDA)

Aspartame is one of the most exhaustively studied substances in the human food supply, with

more than 100 studies supporting its safety.2 FDA scientists have reviewed scientific data

regarding the safety of aspartame in food and concluded that it is safe for the general

population under certain conditions. {USFDA} [G H] All approved low or no-calorie

sweeteners have undergone thorough risk assessments by food safety authorities globally

before being approved for use inf the market. Sucralose has been extensively studied and

more than 110 safety studies were reviewed by FDA in approving the use of sucralose as a

general purpose sweetener for food .{USFDA} [A]. This shows that products like Sugar Free

do not have any side-effects*.

Determined Safe by European Food Safety Authority (EFSA) & World Health Organization

(WHO)

Recent studies and extensive research in Europe and the United States have confirmed the

safety of the sweeteners used in Sugar Free. Aspartame and its breakdown products are safe

for human consumption at current levels of exposure, EFSA concludes in its first full risk

assessment of this sweetener. To carry out its risk assessment, EFSA has undertaken a

rigorous review of all available scientific research on aspartame and its breakdown products,

including both animal and human studies.8 {EFSA} [A] Studies reviewed in the risk

assessment include the 112 original documents on aspartame that were submitted to support

the request for authorization of aspartame in the early 1980s. {EFSA} [B] Based on

recommendations from the European Commission’s Scientific Committee on Food, and a

joint FAO/WHO expert committee on food additives4, it has been concluded that aspartame

is safe for human intake.

Thus even reputed world health bodies have concluded that there are no side-effects of the

low calorie sweeteners.

Low-calorie sweeteners — Role in weight-control

Low-calorie sweeteners are a palatable way to lower the calorie intake and may aid weight

loss7 . Replacing sugar with these sweeteners is a great way of reducing the diet’s energy

while preserving the palatability of foods and beverages. When they’re used in place of sugar,

they can help reduce the net energy (calorie) intake and assist in weight management. Also,

unlike sugar, they don’t raise the blood sugar level. 5, 6

Reducing the sugar burden — Sugar Free is your “Guilt-free” sweetener

Regular tea drinkers need to ditch sugar in favor of Sugar Free. Adding Sugar Free to your

diet allows you to satisfy your cravings for tea without the guilt. Also, you need less of it to

provide the same amount of sweetness.

For weight watchers and diabetics, it’s important to remember that there is no “magic bullet”

solution that can make them achieve their health goals. But smart use of low-calorie

sweeteners, along with healthy lifestyle practices can certainly help them reach their weightloss

goals. All in all, low-calorie sweeteners should be consumed in moderation for best

outcomes, and users should not worry about their ill-effects as they have been thoroughly

investigated for safety.

https://indianexpress.com/article/lifestyle/sponsored-lifestyle/safety-of-low-caloriesweeteners-

used-in-sugar-free-confirmed-by-regulatory-authorities-worldwide-6533099/

Germany, world’s one-time pharmacy now has a globalization headache

Once known as the pharmacy to the world, Germany now has its work cut out to supply

enough medicines to its own citizens.

Europe remains a manufacturing hub for more lucrative prescription medicines, and the most

obvious answer might be to build more factories there.

Once known as the pharmacy to the world, Germany now has its work cut out to supply

enough medicines to its own citizens.

The globalization-driven shift in drug making from Europe’s biggest economy to cheaper

locations wasn’t too much of an issue until the coronavirus crisis, when India imposed export

curbs on products including paracetamol. That over-the-counter painkiller was first clinically

used in Germany, which dominated the industry before World War I.

India’s move jolted officials in Berlin and Brussels awake to the risk of pharmaceutical

shortages. Their challenge, now being prioritized by Germany in its current presidency of the

European Union, is how to ensure a supply of so-called generics — cheap drugs from

painkillers to antibiotics whose patents have expired — when few companies in the region

make them anymore.

“We have delivery problems in Germany and in Europe generally — and they’re getting

worse,” said Mathias Arnold, vice president of the country’s ABDA organization of

pharmacists, who runs a pharmacy in Halle, in eastern Germany. While India’s ban was in

force only a few weeks, “what would we have done if it had lasted for half a year? We’d have

had a really serious problem.”

The generics business is one of extreme price pressures: In Europe’s state health-care

systems, an antibiotic pill can retail for less than a piece of chewing gum. The majority of

active ingredients are therefore produced in cheaper locations such as India and China,

including the Hubei province where the Covid-19 virus originated.

Made in Austria

A factory in the small Austrian town of Kundl showcases the problem. Owner Sandoz, a unit

of Swiss pharmaceutical giant Novartis AG, says it’s the last remaining manufacturer in the

western world to house all production steps of the life-saving antibiotic penicillin, from the

synthesis of active ingredients to finished pills, under one roof.

Germany’s health minister, Jens Spahn, wants to lessen the reliance on Asian production that

leaves the region’s supply at the mercy of foreign governments, and is using the country’s

rotating presidency of the EU to pursue that.

“It’s not about ending globalization completely, nor is it about having everything in Europe,

but identifying certain products that we want to have manufactured in Europe,” he told EU

lawmakers on July 6. “And talking about how we can make this happen.”

Europe remains a manufacturing hub for more lucrative prescription medicines, and the most

obvious answer might be to build more factories there.

Higher Costs

But unless prices for generics increase significantly, that wouldn’t be economically viable.

Morris Hosseini, senior partner at the consultancy Roland Berger, calculates a drugmaker

would need to charge 46 euro cents ($0.54) per dose of antibiotics to start production in

Germany. Current prices are between 6 and 16 euro cents.

Recognizing the problem, Austria’s government struck a deal with Novartis to invest 150

million euros in the Kundl facility to ensure it can produce enough penicillin for the EU.

“It’s important that Austria and Europe aren’t too dependent on other countries,” Austrian

Economy Minister Margarete Schramboeck said at a press conference on July 27.

An EU-level push on the matter may yield little more, however, since leaders on July 21

downsized a planned health program whose goals include shortening drug-supply lines. The

“EU4Health” initiative, now totaling 1.7 billion euros, is less than a fifth of the size initially

proposed, threatening to undermine a new pharmaceutical strategy for the region.

“I am of course disappointed that the agreement reached by EU government leaders

significantly reduced the proposed budget,” European Health Commissioner Stella

Kyriakides said. Still, “while many of the foreseen actions will have to be scaled back, it is

also important to keep in perspective” that the 1.7-billion-euro planned health spending is still

larger than previous budgets.

Ensuring Stockpiles

Another option for the EU might be seek to fund innovation into processes that could make

cheaper local production more feasible.

Rather than rebuilding production capacity, it’d be cheaper and easier to strengthen Europe’s

supply by penalizing companies that run out of products — an approach that some countries

have taken successfully, according Martin Loesch, a senior partner specializing at the

consultancy McKinsey & Company.

“That’s something you could do for all European markets,” he said. “That could be a very

simple method to stimulate better availability of generics.”

The Sandoz executive in charge of strategy believes that supply resilience could be a better

option than turning back the clock on production. He advocates establishing two sources for

crucial components as well as maintaining sufficient stockpiles to bridge bottlenecks.

“You cannot just have your cake and eat it,” Christian Pawlu, head of strategy at Sandoz,

said. “If we think over a few years we can turn back the wheel and bring back manufacturing

to Europe and North America — I think this isn’t ultimately desirable.”

https://indianexpress.com/article/coronavirus/germany-worlds-one-time-pharmacy-now-hasa-

globalization-headache-6538335/