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Fighting......,Living........, Surviving with Coronavirus (severe acute respiratory syndrome-coronavirus-2)!

Department of Anaesthesiology and Intensive Care, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India
Corresponding author: Mridul Madhav Panditrao, Department of Anaesthesiology and Intensive Care, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India. drmmprao1@gmail.com
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This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
How to cite this article: Panditrao MM. Fighting..., Living..., Surviving with coronavirus (severe acute respiratory syndrome-coronavirus-2)! Adesh Univ J Med Sci Res 2020;2(1):1-4.

ORIGIN

At the dawn of year AD 2020, if anyone had predicted, how the entire world system was going to turn head over heels and go topsy-turvy, no one in their right minds would have taken them seriously! The life, globally, was going on at its hectic speed. Unfinished projects, unfulfilled dreams, unattained targets, planned as well as unplanned “power meetings,” take-overs, ups and downs of markets, buyouts/sellouts, mega shows, parties, social (and not so social) gatherings…. so on and so forth, were happening relentlessly all over the world. The “merry-go round” of the modern life was moving on and on. The human race was engrossed completely in its own, petty desires, commitments and aspirations and was running amok without a second thought of any untoward happening.

Then, on the horizons of collective consciousness, from some, up till now, little known and hardly ever heard of place called “Wuhan” in some province called “Hubei” of People’s Republic of China (PRC) vague reports of “some unusual happenings,” started trickling in…nothing official, but on our bombastic television channels and popular social media platforms. They were not only unusual, but rather disturbing. They included videos and photographs of, “sudden collapse,” literally, instantaneous falling down of standing individuals, unconscious/immobile human figures scattered over the roadside, brutal and systematic “lock downs/confinement” of local residents, barricading their doors/areas, barbaric manhandling/grabbing and swishing away in parked official vehicles of motorists after, thermal screening or mere suspicion and went viral. Alas, the world in general, was going about its business not so much concerned (because it was happening in some remote corner/place called “Wuhan, China” and not in my backyard, alley, or precinct), blissfully ignorant about the grave consequences of these happenings. Eventually, the World Health Organization (WHO) came out with its own proclamation.[1] Some “alarm bells” started ringing, but in general, the most of the Western world was, not much concerned about this so called “local Chinese problem”. This lackadaisical attitude further fueled, the globetrotting (air travel) of humans from one corner of the globe to another, unabatedly. In fact, according to an anecdotal report (on WhatsApp university), before the ban of flights out of China, there was a massive egress of multiples of tourists/air-travelers on multiples of flights originating from multiples of cities in China to multiples of cities in multiples of countries in Americas, Europe, and Asia, such as the USA, Brazil, France, the United Kingdom, Spain, Italy, Iran, Malaysia?? (Which became epicenters of corona, later on). Whether this is a fact or not, but the WHO, declared the corona outbreak as a Pandemic on March 11, 2020, almost 2 months after the first case outside China from Thailand had been declared (January 13, 2020).[1]

On January 12, 2020, China publicly had shared the genetic sequence of 2019-nCoV, as it was provisionally named and later on referred to as severe acute respiratory syndrome- coronavirus-2 (SARS-CoV-2). It became abundantly clear, this is a “novel” virus from, the ubiquitous corona family.[1] Why novel, because, this is the 1st time it has been transmitted to human beings, but it does not seem to be spreading by human to human contact. The original version was that this “mutated/novel” virus has “jumped” from the animal species such as bats or pangolins to humans, because of peculiar eating habits of Chinese people. The explanation was given that origin of this virus is from “Wuhan Meat market,” where live as well culled animals are sold. Then, there was a flurry of viral videos from this market, with graphic and gory details. By this time, the “conspiracy theories” of how, this was not a natural, but a manmade virus started making rounds.

In India: At that time, the situation was emergent. China, no longer being on the list of “favored nations” and timely ban on the travel, the free inflow of travelers from China to India was restricted. Logically, the mass exposure as happened in Europe and Americas, including Latin America, was curtailed. However, borders being porous for the indirect spread (from China to some intermediate South or Southeast Asian countries), it did happen. As a result, the southern state of Kerala was first to report the first cases of corona. By this time, in the Western world, Europe and in Middle East, the terror of corona reigned unchallenged.

IMPACT OF CORONA PANDEMIC!

In the history of humankind, events of this mega proportions have had major and massive consequences/effects. However, it would not be an exaggeration, to affirm that “Pandemic of COVID-19 (novel coronavirus disease-2019)” has been unique/novel as the name of the virus and so also its impact has been and going to be. No such event in the history of humankind has had, such a huge, widespread and irrevocable impact. The world as we knew and would have expected to remain, has undergone, a complete and near-total metamorphosis.

The consequences can be categorized as follows:

  1. Social

  2. Economical

  3. Medical/health related

  4. Political.

Social

Gregariousness of the humankind has been the main reason for man becoming the “master of the world.” The basic instinct of living in groups of related as well as unrelated members with social intimacy at various levels of their existence and forming large communities/societies are the soul reasons of survival and continued evolution and progression of Homo sapiens sapiens.

However, SARS-CoV-2 has attacked and completely overpowered this trait of humans for its own persistent and dominant survival. As a result, all those values such as physical, emotional and societal intimacies have become a taboo. All humans are concerned with “social distancing,” staying home and making sure of minimal physical contact, directly or indirectly. Gone are the mega events, such as large and lavish marriage celebrations, parties, other public events, rallies and such activities, where the presence of a large number of humans was a norm and necessity. At present, the mere presence of another human being in your vicinity is considered as unwanted, unwelcome and alarming. This has led to loneliness, isolation and depression.

The most significantly affected is the “Teaching/Learning” modality or academics!

For centuries/generations classroom, T/L was the most widely accepted model. The pupil/student was expected to go through the morning ablutions, groom, attire themselves in a presentable manner and reach the place of learning. Same would be anticipated of the teacher/trainer. Such teachers/trainers would do their job at a prescribed place, in a prescribed fashion and pupils assimilated this imparted knowledge, skill and knowhow in a prescribed manner. This was the “routine.” COVID-19 has completely changed this pattern. The whole system suddenly became redundant, obsolete, and superfluous, to be replaced by “Online” training with a whole new gamut of technicalities and brouhaha. “Zoom” “Go to webinar,” “Google Meeting,” and such have become the most commonly used words. A whole new market has opened up and is flourishing, based up on the technology.

The promoters of this modality do not get tired of harping on its efficacy, extolling its benefits, but overlooking the loss of comradery, interactivity and same gregariousness that was the essence of life in all the educational institutions, be it higher, middle or lower level. The total lack of that inclination of the students to reach the venue in a “tiptop” manner is a major loss. While learning “online,” the student is completely disinterested in their appearance, remaining in the most unkempt, uncivil appearances. If that was not enough, the actual, physical presence of the student after “logging in,” their intellectual involvement and the net understanding of the content delivered are very seriously questionable aspects. There is a major flaw/uncertainty regarding, one of the most essential aspects of the T/L, namely, the assessment/ examination process. How, when, where, what and why are the major, “sword of Damocles” hanging over the heads of the academicians/educators and the regulatory bodies.[2] The conduct of so-called “online” examinations is financially taxing, fraught with their own inadequacies, can lead to legalities and would require a major realignment in the infrastructural and attitudinal requirements.

Economical

The most worrisome and scary aspect of the COVID-19 is going to be the far-reaching and down-spiraling effect on the economy. The major “lock downs”/containments, demarcation of various zones (red/orange/green), break up of almost all commercial/revenue generating activities and their consequences such as loss of livelihood of majority of the humans, increased need and expenditure on the things, previously unheard of or unnecessary, such as masks, sanitizers and “personal protection equipment” (PPEs), have brought on major economic downtrends. The threat of recession and financial depression is looming over the entire world, including India, except PRC. Only time will tell us how fairly or badly the world shall fare, in these testing times.

Medical/health related

A pandemic is bound to affect the health of the populace adversely. So as would be expected, all the indices of health have gone haywire. Globally, millions of persons have been victims of SARS-CoV-2 from the point of view of morbidity as well as mortality. India is no exception. On daily basis, the “Corona graphs,” “corona meter” is rising at a horrendous speed and persistence. In fact, in daily conversation, discussion about these issues has become the new norm. Since opening up of “Lockdowns,” all over the world and especially in India, the extent of the problem is growing at an alarming rate. Silver lining being, especially, in India, the rate of persons recovering from the disease is also increasing.

However, one has to take in to consideration, the other side of the situation or facts: There, have been, are and will be spread of multiples of pathogens, infecting agents, such as viruses, bacteria and parasites in the whole world throughout the existence of humanity. The classical example that can be quoted is “Ten (10) Biblical plagues,” which were brought, by the “Lord God” of Jews, upon Egyptians for persecuting and terrorizing the Jews.[3] There will be similar episodes happening. So what is unique or novel about this: There are multiples of factors.

  1. Uniqueness of the SARS-CoV-2: “Whether natural transfer from the species, namely; bats/pangolins to man” or “manmade” (as the “sensationalist” claims made by world leaders, politicians, scientists, media persons… so on and so forth)?. This virus has come into existence in the humans for the 1st time so we are devoid of any immunity or protective mechanisms against this. Also as happened in case of human immunodeficiency virus (HIV) or hepatitis B or C (HBsAg or HCV), this virus, is here to stay

  2. Heightened awareness: As a result of hype in the social media/mass hysteria, hue and cry, the common man has become aware about it and as people, especially, in developed countries, voluntarily and publically are tracking the virus, there is more stress on self/home quarantine, social distancing and other measures

  3. Increased screening, testing, detection and diagnosis: Never in any such epidemics/pandemics so much and widespread stress was being laid down on these efforts on such a large scale

  4. Treatment: Since the outbreak of SARS-CoV-2, use of therapeutic measures has been a major challenge. The sheer number of protocols for the treatment has been so varied and so confusing that, there have been multiples of revisions of these. In the absence of certain specific treatment modalities, everyone has become an expert of some sort and put forward their own guidelines. In the center of the controversies are “regular” and “not so regular” therapeutic agents. Forerunner in this race was hydroxychloroquine (HCQ). Till date, there have been so many controversies (WHO included, not to forget Lancet), that at one point in time, HCQ was considered as the “miracle” drug and “panacea” for COVID-19 (the USA had specially requested India to export the tons of the same), now has become contraindicated, but still being prescribed to and being consumed by many. There were many other contenders, which came and went away, such as ivermectin, chloroquine, and remdesivir, to mention a few. Remdesivir still holds promise, especially, as it received an emergency use authorization from the Food and Drug Administration in the U.S. on May 1, 2020, based on preliminary results from two clinical trials. Only last week, out of blue, our “good old” dexamethasone, all of a sudden, became the talk of the town. On June 20, 2020, a pharmaceutical giant, Glenmark Pharma, has been granted approval by the Drug Controller General of India to market a new drug called Flavipiravir (Tab. Fabi-flu, 200 mg.). So may be a new chapter is being written in this challenging battle[4]

  5. Prevention/prophylaxis: Since the outbreak of corona pandemic, almost all the major countries/pharma companies have been in a breakneck race to procure a vaccine. There are players such as Moderna, Oxford University, Pfizer, Glaxo SmithKline, Astra Zeneca, and Johnson and Johnson and many such are trying their best to come with a vaccine which will grant a long-term prophylaxis.

Political

Last but not the least, there has been another very explosive, controversial and counterproductive impact of corona pandemic. Politically speaking, taking into consideration, the two world wars and some minor wars (like gulf war), the world powers, bigger as well as smaller ones, were never so dramatically and categorically polarized, as is happening during corona onslaught. Clearly, the world seems to be getting divided in to two camps, on one side of the arena is China and its subjugated, indebted cronies and on the other side, the rest of the world, openly/directly or indirectly. So much of the undercurrents, even open anger, frustration and outpouring have happened and have been going on against China. It is debatable, whether, the virus was man-made inside a laboratory as a weapon of mass destruction or not, the fact remains, it originated in Wuhan, Hubei, China and has spread like a wild fire all over the globe and whether intentionally or unintentionally, has acted like a weapon of mass human destruction with millions of people getting affected and dying. For the countries, which have been very seriously affected, these facts have become very difficult to ignore, digest and accept. Adding fuel to the already burning fire is the belligerent and indifferent approach of China and ambiguous and uncertain policies of the WHO.

In our motherland, any and every politician worth his/her salt is using this challenge as an opportunity to pull down, his/her opponents, while trying to sharpen his/her image at any cost. Unabashedly, all the political parties are playing the game of musical chair to garner public sentiment in their favor, to the best of their abilities. Effectively, the common Indian is not only being adversely affected by the present pandemic but also falling prey to mechanizations of various political gimmicks. Classical example being, mass exodus of “migrant labor/ workers,” when actually, that should have been the last thing to have happened foreseeing the grave consequences of such a move. The threat of looming recession and economic woes is going to take its toll on the populace. All of these are going to increase the challenges of health-related issues, in coming days.

FUTURE???

There is a big question mark on when and how will this end and what is going to happen in future, recent as well as long term?

Considering the present circumstances, it appears, to be a bleak picture. Assuming that, some or the other therapeutic agent/s and some prophylactic vaccine/s shall be appearing on the horizon, in near or distant future, natural individual, and herd immunity shall develop, SARS-CoV-2 is here to stay with us for more than a foreseeable future. It is not going away so fast and so easily. One has to learn to not only fight/ live with it but to make more than ordinary efforts to survive with it.

CONCLUSION

In conclusion, human race has been challenged by many such events in past. It is the “never say die” human spirit in the end that has ensured human survival, in the face of challenges and adversities. In this COVID-19 pandemic adversity also --

We shall prevail!!

Prof. Mridul M. Panditrao

Editor In Chief

References

  1. Information about Time Line of Covid -19. Available from: https://www.who.int/news-room/detail/27-04-2020-who-timeline---covid-19 [Last accessed on 2020 Jun 21]
  2. About the Legendary Sword of Damocles. Available from: https://www.en.wikipedia.org/wiki/Damocles [Last accessed on 2020 Jun 21]
  3. Information about the 10 plagues inflicted by God on Egypt, as Written in Book of Exodus in Old Testament of Bible. Available from: https://www.chabad.org/holidays/passover/pesach_cdo/aid/1653/jewish/The-Ten-Plagues.htm [Last accessed on 2020 Jun 21]
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