May 20, 2020
A small virus threatens our existence — we are defenceless and anxious. But we are also clever, and nature favours the cunning. Comforting speculations are afloat: summer will kill the virus. But experiments or the real world offer no solace. High temperatures did not reduce the survival of the virus in the lab or in Australia and Iran. Let us face it: the coronavirus is not going away. We have to learn to avoid it and escape from it through two exit doors: therapy and immunity.
The fastest therapy option would entail re-purposing an old drug with a favourable safety profile. Hydroxychloroquine, Azithromycin and many antiviral drugs could help, if their effectiveness is proven. Remdesivir, an antiviral drug, is leading the pack. The results are a few months away. Inventing a new drug involves sequential steps: conceptualisation, computer simulation, laboratory experiments, animal testing and human trials. Out of 3,000 drugs which may have action on SARS Cov2, approximately 300 are in trial. Such a drug, moving on a fast track, but without cutting corners, will still take 2-3 years. And that is being optimistic.
The second escape is by acquiring immunity. The fastest way is to harness immunity from the antibody-laden blood of a recovered patient. A portion of the blood – called plasma – infused into a patient, can help him within hours. Trials are on and if successful, could be available in months. This therapy could be initially reserved for the very sick and frontline workers, until infrastructure and plasma become commonly available. A vaccine has to follow the same steps in its development as a new drug. Close to 40 institutions in the world, including India, are developing vaccines and a few have already reached human trials. Assuming all goes well, it still will have to be manufactured in millions of doses. It will take upto 18 months before a common man gets vaccinated.
A not-so-nice way to get immunity is by getting sick and recovering. But this cannot be our public health policy. We don’t know the duration of immunity and its protective effect. Our knowledge is rudimentary: we have known this virus for four months and answers will come with experience. It is reasonable to assume that many of us will get infected without symptoms and acquire immunity. Epidemiologists believe that 60 percent of the population has to be immune through vaccination or sickness, before we can break the chain of transmission. This undesirable scenario is a few years away.
Which brings us back to the present. This sinister virus compels us to avoid it and forces health officials to contain it by testing, quarantine and mini lock downs. We have to suppress temptations to venture out and have to take precautions if we have to — stay two metres away from others, wear a mask, don’t touch unknown objects, wash hands frequently and don’t touch your face. We have learnt that the virus cannot get to you unless you get it. This will be our new normal for the next 6-18 months or until we have a drug or a vaccine.
At the other end, we may rediscover what we have known all along: Washing of hands reduces intestinal infections, wearing masks prevents influenza, staying indoors cleans up the environment, solitude enhances creativity, curtailing greed spares enough for others and a helping hand gives meaning to life. The corona virus invites us to measure our success by two different parameters — the time we spend with loved ones and the number of people we help. This virus is, but a rare opportunity for a reality check.