HEALTH

 

1. Don’t let the ‘social recession’ ruin your mental and physical health

 

What is social recession?

—It is a collapse in our social contacts, matching the economic recession that is looming beyond COVID-19.

—We thrive on our social engagements and are wired to stay connected; when these connections are threatened or unavailable, our nervous system goes haywire and many negative effects on the body follow.

—So much so that both loneliness (the feeling of being alone) and social isolation (physical state of being alone) can trigger a cascade of stress hormones that produce well-orchestrated physiological changes like increased heart rate, increased muscle tension and thickening of blood.

—Together, these physiological changes are called the fight-or-flight response, because it has evolved as a survival mechanism enabling us to cope with physical and psychological threats.

 

What are the health risks of social recession?

—The uncertainty, fear of infection and lack of social interactions all can be perceived by our brains as a threat and can inadvertently switch our bodies to fight-or-flight mode.

—A recent meta-analysis published in Neuroscience and Bio-behavioural Reviews revealed that people who are more socially isolated have higher levels of C-reactive protein (CRP) and fibrinogen (a soluble protein that helps blood to clot), both of which are associated with chronic inflammation and poor physical and mental health.

—Another often-cited study in Perspectives on Psychological Science indicated that lack of social connection and living alone could be detrimental to a person’s health, respectively increasing mortality risk by 29% and 32%.

— They also pointed out that social isolation could lead to several chronic conditions like hypertension, increased heart rate, increased levels of stress hormones and even accelerated ageing.

—Chronic loneliness can manifest at any age and in many forms, from a simple feeling of exhaustion and fogginess, to interrupted sleep patterns, decreased appetite, body ache and pains; to feelings of anxiousness.

 

How to cope with isolation?

—Begin by acknowledging that these are unprecedented times, unlike what we have seen before, hence, it is quite normal to feel anxious and lonely.

—Use this time to establish forgotten connections via technology and catch up with friends and family whom you may have been putting on the back burner because of your busy schedule.

—Most importantly, put the focus back on your self-care, eat well, exercise regularly, find ways to calm and focus yourself.

Reference: https://www.thehindu.com/news/cities/Delhi/dont-let-the-social-recession-ruin-your-mental-and-physical-health/article31319862.ece

 

2. Gehlot suggests ‘food for work’ plan

 

—Rajasthan Chief Minister Ashok Gimlet suggested during a videoconference of Chief Ministers with Prime Minister Narendra Modi that the Centre should launch a “food for work” programme, on the pattern of a similar initiative taken by the then Prime Minister Atal Bihari Vajpayee during the 2001-02 drought.

—Capt. Amarinder also asked the Centre to think of some innovative solutions for relief to daily wageworkers and industrial labour either through ESIC funds or under MGNREGA. 

What are ESIC funds?

— Employees' State Insurance (abbreviated as ESI) is a self-financing social security and health insurance scheme for Indian workers.

—The fund is managed by the Employees' State Insurance Corporation (ESIC) according to rules and regulations stipulated in the ESI Act 1948.

—ESIC is a Statutory Body and Administrative Ministry is Ministry of Labour and Employment, Government of India.

 

What is MNREGA?

— Mahatma Gandhi Employment Guarantee Act 2005 is an Indian labour law and social security measure that aims to guarantee the 'right to work'. This act was passed in September 2005.

—It aims to enhance livelihood security in rural areas by providing at least 100 days of wage employment in a financial year to every household, whose adult members volunteer to do unskilled manual work.

 

Reference: https://www.thehindu.com/news/cities/kolkata/gehlot-suggests-food-for-work-plan/article31319884.ece

 

3. ‘8.2 lakh cases if there was no lockdown’: GoI

 

—Health Ministry said that had a lockdown not been imposed, the country would have been staring at least 8, 00,000 cases by April 15.

—The Indian Council of Medical Research (ICMR) — the technical arm of the Ministry that is overseeing testing and epidemiology — was not involved in preparing this estimate.

—Determining the rate of spread of infectious disease is different from extrapolating a given number of cases at an initial point and assuming a particular rate of growth and plugging it into an exponential mathematical equation.

 

from extrapolating a given number of cases at an initial point and assuming a particular rate of growth and plugging it into an exponential mathematical equation.

—However, a study in February, which was publicised on March 23, remains the only actual modelling study involving ICMR epidemiologists and international experts in the field. That study did not estimate numbers but based on the state of affairs in February — recommended that India should have focussed on finding transmission in the community and quarantining instead of “border control” because of the large uncertainty in detecting asymptomatic travellers harbouring the infection and becoming spreaders.

—Another ICMR study published this week found that 40% of those with severe respiratory illnesses sampled and detected with COVID-19 could not have their contact history established.

 

Reference: https://www.thehindu.com/news/national/coronavirus-without-lockdown-india-would-have-seen-over-8-lakh-cases-by-april-15-says-health-ministry/article31319364.ece

 

4. Coronavirus | Indian labourers in GCC countries are in dire need of help, say experts

 

—Most Indian migrants in the GCC countries are at the bottom of the pyramid in their host countries. Infected in large numbers and with limited access to healthcare, that humanitarian crisis is developing.

 

How are Indian migrants in GCC countries coping with the pandemic?

—Nurses, small businesspersons, labourers have been infected in significant numbers and there is no care for them.

—In Kuwait, Indian localities such as Jleeb Al Shuwaikh and Mahboula have been quarantined; currently 530 of its 993 confirmed cases are Indians.

—These low and semi-skilled labourers have multiple ailments like diabetes, blood pressure, cholesterol and even kidney, liver problems and cancer.

—Since medicines are very expensive in Gulf countries, migrants often procure their medication from India and stockpile for three to four months. Worryingly, there are reports these stocks have been used up and there is now an acute shortage.

— Indian associations have appealed to the Indian missions, particularly in Dubai, to hire and convert Indian schools into isolation wards.

 

Do their living conditions allow social distancing?

—Most of them are single men living in congested labour camps — using common toilets, rooms etc. One flat houses nearly 8 to 10 people using bunk beds, in what is commonly known as a “bed space”. Therefore, if anyone is infected, it will spread fast.

—At present, there are nearly 8 million Indian immigrants in GCC, of which nearly 2.1 million are from Kerala itself.

—The immediate task is to chart out a strategy that will, initially envisage a safe evacuation of emigrants back to India and their rehabilitation back in the home society.

 

Will the current pandemic change Kerala’s approach to receiving labour from outside the State?

—Some estimates put inter-State migrants in Kerala at about 30 lakhs, while 21 lakh Malayalis work outside. However, we call them replacement migrants — Keralite plumbers in Dubai being replaced by plumbers from Odisha, for instance.

—The mass exodus of Keralites over the years has led to a situation where Kerala needs migrants from other parts of the country.

—While the Kerala migrants are struggling for their safety and survival in Gulf, in sharp contrast, in Kerala, the internal migrants have been protected and guarded in the most respectful manner — how wills this play out into the future is now unpredictable.

 

What is GCC?

— The Cooperation Council for the Arab States of the Gulf originally (and still colloquially) known as the Gulf Cooperation Council is a regional intergovernmental political and economic union consisting of all Arab states of the Persian Gulf except Iraq, namely: Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates.

— The Charter of the GCC was signed on 25 May 1981, formally establishing the institution.

— All current member states are monarchies, including three constitutional monarchies (Qatar, Kuwait, and Bahrain), two absolute monarchies (Saudi Arabia and Oman), and one federal monarchy (the United Arab Emirates, which is composed of seven member states, each of which is an absolute monarchy with its own emir).

 

Reference: https://www.thehindu.com/news/national/coronavirus-indian-labourers-in-gcc-countries-are-in-dire-need-of-help-say-migration-experts-irudaya-rajan-and-ginu-zacharaia-oommen/article31318501.ece

 

 

5. Coronavirus | Drug candidate remdesivir, on trial now, holds promise

 

—A recent article published in the journal Science has shown that the already-promising drug candidate remdesivir, on trial now, exhibits promising activity against the COVID-19 causing virus and might work well in retarding virus replication.

—The SARS-CoV-2 virus exists as a mere strand of RNA and it requires a host to replicate.

— Scientists have discovered that the active site of RDRp shows striking similarities with the Polio Virus and the Hepatitis C virus, and using that knowledge, they have tried to use known drug candidates that work in that RDRp environment and work back to see if they are effective with the novel corona virus.

—They also showed exactly where on the RNA dependent RNA polymerase — the main machinery to form strands of RNA — that this drug will bind with.

—Remdesivir, a nucleotide analogue, then acts as part of the growing RNA chain, fooling the virus into believing it is replicating, and thereby stops true replication.

 

Reference: https://www.thehindu.com/sci-tech/health/coronavirus-drug-candidate-remdesivir-on-trial-now-holds-promise/article31319699.ece

 

5. Coronavirus | Contributions to CM fund will not qualify as CSR expenditure

 

—The Ministry of Commerce has clarified that the contributions to the Chief Minister’s Relief Fund or the State relief fund will not qualify as Corporate Social Responsibility expenditure, while any donation to the PM CARES Fund will.

 

Why CM fund will not qualify for CSR?

—“The Chief Minister’s Relief Fund’ or ‘State Relief Fund for COVID-19’ is not included in Schedule VII of the Companies Act, 2013, and therefore any contribution to such funds shall not qualify as admissible CSR expenditure,”

—The circular has said donations to the State Disaster Management Authority to combat COVID-19 can be counted as admissible CSR expenditure.

 

What is CM fund?

— Chief Ministers relief fund aims at providing immediate relief to the people in distress in the State as well as in the country. The Chief Minister Relief fund provides financial assistance to the people affected by the major natural calamities like flood, drought, fire accident etc.

 

What is PM CARES?

—Keeping in mind the need for having a dedicated national fund with the primary objective of dealing with any kind of emergency or distress situation, like posed by the COVID-19 pandemic, and to provide relief to the affected, a public charitable trust under the name of ‘Prime Minister’s Citizen Assistance and Relief in Emergency Situations Fund’ (PM CARES Fund)’ has been set up.

 

Objectives:

-To undertake and support relief or assistance of any kind relating to a public health emergency or any other kind of emergency, calamity or distress, either man-made or natural, including the creation or up gradation of healthcare or pharmaceutical facilities, other necessary infrastructure, funding relevant research or any other type of support.

-To render financial assistance, provide grants of payments of money or take such other steps as may be deemed necessary by the Board of Trustees to the affected population.

-To undertake any other activity, which is not inconsistent with the above objectives.

 

Constitution of the Trust:

-Prime Minister is the ex-officio Chairman of the PM CARES Fund and Minister of Defence, Minister of Home Affairs and Minister of Finance, Government of India is ex-officio Trustees of the Fund.

-The Chairperson of the Board of Trustees (Prime Minister) shall have the power to nominate three trustees to the Board of Trustees who shall be eminent persons in the field of research, health, science, social work, law, public administration and philanthropy.

-Any person appointed a Trustee shall act in a pro bono capacity.

-The fund consists entirely of voluntary contributions from individuals/organizations and does not get any budgetary support. The fund will be utilised in meeting the objectives as stated above.

-Donations to PM CARES Fund would qualify for 80G benefits for 100% exemption under the Income Tax Act, 1961. Donations to PM CARES Fund will also qualify to be counted as Corporate Social Responsibility (CSR) expenditure under the Companies Act, 2013

-PM CARES Fund has also got exemption under the FCRA and a separate account for receiving foreign donations has been opened.

 

About Corporate Social Responsibility

—Enactment of Companies Act, 2013 by the Ministry of Corporate Affairs, Government of India was one of the world's largest experiments of introducing the CSR as a mandatory provision by imposing statutory obligation on Companies to take up CSR projects towards social welfare activities.

—This has made India the only country, which has regulated and mandated CSR for some select categories of companies registered under the Act.

—This CSR Initiative will push the nation towards achievement of sustainable development goals and public-private partnership in transforming India.

Reference: https://www.thehindu.com/news/national/contributions-to-cm-fund-will-not-qualify-as-csr-expenditure/article31317943.ece         

 

6. COVID-19 | Taiwan, WHO clash over ‘early warning’ claim

 

—Taiwan released the text of its December 31 communication with the World Health Organization (WHO) that has been at the centre of a controversy about the first warnings of the COVID-19 outbreak.

—Beyond the early warning controversy, the WHO has faced broader criticism for some of its early actions as the outbreak was spreading. On January 14, the WHO repeated that investigations had found no evidence of human-to-human transmissions based on information provided to them by China.

—It would later, however, emerge that Wuhan authorities had not disclosed to the WHO that medical workers had, by late December, been reported as being infected in some Wuhan hospitals.

—Taiwan is not a member of the WHO as China has opposed its entry into international bodies.

 

About WHO

— The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. It is part of the U.N. Sustainable Development Group.

—The WHO Constitution, which establishes the agency's governing structure and principles, states its main objective as ensuring "the attainment by all peoples of the highest possible level of health."

—It is headquartered in Geneva, Switzerland, with six semi-autonomous regional offices and 150 field offices worldwide.

 

Reference:https://www.thehindu.com/news/international/covid-19-taiwan-who-clash-over-early-warning-claim/article31319270.ece

 

 

S&T

1. TRAI wants set top boxes to be made interoperable

 

—The Telecom Regulatory Authority of India has recommended that all set top boxes (STBs) in the country must be interoperable, meaning that consumers should be able to use the same STB across different DTH or cable TV providers.

—The regulator also suggested that the Ministry of Information and Broadcasting make the required amendments in licensing and registration conditions to make interoperability mandatory.

 

Impact of lack of interoperability

—It deprives the customer of the freedom to change her/his service provider, but also creates a hindrance to technological innovation, improvement in service quality, and the overall sector growth.

—It noted that while the STBs deployed in the cable TV networks are non-interoperable, those by direct-to-home (DTH) players complied with licence conditions to support common interface module based interoperability. However, in practice, even in the DTH segment the STBs are not readily interoperable.

—Noting that there are technical and commercial constraints to the universal STB, it added that the interoperability should be platform-specific, i.e., STBs are interoperable within the cable TV segment and similarly within the DTH segment.

—TRAI also recommended that a coordination committee be set up by the I&B Ministry to steer implementation of revised STB standards for both the DTH and the cable TV segments.

 

About TRAI

— The Telecom Regulatory Authority of India (TRAI) is a statutory body set up by the Government of India under section 3 of the Telecom Regulatory Authority of India Act, 1997.

—It is the regulator of the telecommunications sector in India.

—It consists of a Chairperson and not more than two full-time members and not more than two part-time members.

—The TRAI Act was amended by an ordinance, effective from 24 January 2000, establishing a Telecom Disputes Settlement and Appellate Tribunal (TDSAT) to take over the adjudicatory and disputes functions from TRAI.

 

Reference: https://www.thehindu.com/business/trai-wants-set-top-boxes-to-be-made-interoperable/article31319372.ece

 

2. Coronavirus | How does the immune system respond to a corona virus attack?

 

How does the immune system respond to a corona virus attack?

—A cascade of viral particles enters the body through the nose, eyes or mouth. Breathing carries some of these particles to the lower respiratory tract where the spike proteins of the corona virus, acting like a key, lock into epithelial cells that line the respiratory tract as well as those in the air sacs in the lungs.

—SARS-CoV-2 is able to stay undetected longer than many flu or corona viruses and its spike proteins are able to gain entry by unlocking the ACE2 protein on the lung cells.

—Once in, they hijack the cell’s machinery, replicate and multiply and infect adjoining cells.

— Like the defining ACE2 proteins on the epithelial cells, viruses too have a tell-tale signature on their surface called antigens and spotting these is what kicks the immune system into action by producing antibodies.

—The signals they generate trigger another class of chemicals — cytokines and chemokines — and they alert the immune system to send an array of different kinds of cells that specialise in destroying viral particles.

—However, these cytokines and chemokines trigger inflammation in the cells. In the nose and upper regions of the respiratory system, this inflammation produces mucus and a runny nose to trap viral particles and prevent their ingress. This also triggers sneezes to expel them.

—When the sinuses are inflammed, we get a headache and the general stuffiness that we associate with a cold. When a gland called the hypothalamus is inflamed, it results in a fever.

—However, in the case of SARS-CoV-2, the virus seems better at penetrating deeper. The inflammation triggers a fluid build-up in the lungs. The fluids also contain the residue of a host of specialised cells — including T cells — that carpet bomb and damage many of the body’s own cells as well as the viral particles. It is in expelling this fluid that a dry cough, characteristic of the corona virus infection, begins.

—As more air sacs are infected, the lungs find it harder to perform their core job of extracting oxygen from the air, and eventually, this aggravates breathlessness.

 

Why are some infections mild and others life-threatening?

—Depending on the degree of infection in the lungs, the inflammation and the fluid build-up can lead to pneumonia. A patient will require hospitalisation to treat the breathlessness and ventilator support to artificially provide oxygen if the condition worsens.

—However, massive levels of cytokines can cause extensive lung damage and a condition called Acute Respiratory Distress Syndrome.

—The unsustainable cytokine storm can cause organ damage far beyond the lungs and spread to the kidneys as well as the heart.

—If the infection is acute, it can also lead to a depletion of the frontline white blood corpuscles tasked with fighting the infection and making the body vulnerable to other secondary infections, which may lead to death.

 

How have the elderly reacted to the virus?

—The elderly, especially those with existing conditions such as diabetes and cardiovascular disease, already have an inherent malfunctioning in the immune system.

—In many ways, it is the reaction of the body in trying to combat the virus that ends up being suicidal.

—The different kinds of drugs, whether it is hydroxycholoroquine or anti-HIV drugs, deployed to treat serious COVID-19 infection, also work in some way to moderate the immune-system’s aggressive defence.

—Mortality statistics globally suggest that men are twice more likely than women to succumb to a COVID-19 infection. This follows from studies that show women, on average, have a better-regulated immune response than men in pathogenic infections.

— Estrogen is said to be an immune-system modulator and the ability to deal with a pregnancy, which also begins as a foreign body growing within prime’s women to better deal with infections.

 

Will a vaccine help?

—There are several vaccine candidates but it will be months before we know if any of them will be viable.

—The bulk are aimed at developing a molecular construct, in some cases a weakened version of the corona virus, that mimics the antigens of the virus and triggers an appropriate antibody response.

—There are complications — such as an antibody-dependent enhancement — in which insufficient levels of antibodies can actually end up aggravating an infection as in the case of dengue. However, in the case of COVID-19, that is a problem for another day.

 

Reference: https://www.thehindu.com/sci-tech/health/coronavirus-how-does-the-immune-system-respond-to-a-coronavirus-attack/article31319716.ece

 

3. Coronavirus | what are the options to ease the lockdown?

 

What are the health measures that must be in place before lifting the shutdown across States?

—The story so far: From March 24, the country went into a 21-day lockdown period as an emergency measure to combat the COVID-19 pandemic. With the available evidence, it was believed that physical distancing was the best weapon to combat this little-known virus, transmitted through respiratory droplets.

 

What is the logic behind the extension of the lockdown?

—America’s face of epidemic-control, Anthony S. Fauci, who heads the National Institute of Allergy and Infectious Diseases, said in a podcast with The Wall Street Journal: “It’s not a light switch, on and off. It’s going to be gradual, not all or none.”

—He went on to say that getting back to normal must be preceded by a “really clear indication that those areas with big outbreaks, with peaks, have not only stabilised and are starting to turn the corner, and the number of cases are coming down. I don’t think you need to get down to zero, though before you contemplate pulling back”.

—Consider Wuhan, which just reopened its borders after a long 76-day shut down: Reports from the Chinese city indicate that local health authorities remain vigilant to prevent fresh imports and resurgence of local transmission. Healthy residents and visitors are allowed to move out, but eternal vigil is clearly the price a connected world, where epidemics loom large, has to pay.

—Not surprisingly, the hints from what happened over a 100 years ago are strikingly similar. The Spanish flu of 1918 spread across the globe causing similar havoc, though the world was a vastly different place then.

 

What are the phases to follow?

—While recording slowing the spread of the epidemic is taken as phase 1, state-by-state (America) reopening is outlined as phase 2.

—Individual states can move to phase 2 when they are able to safely diagnose, treat, and isolate COVID-19 cases and their contacts.

—Progress towards phase 2 should be capability based, rather than time line based. Schools and businesses can reopen, and much of normal life can begin to resume in a phased approach.

—However, some physical distancing measures and limitations on gatherings will still need to be in place.

—For vulnerable populations, continuing to limit time in the community will be important.

—Public hygiene has to be improved, and deep cleaning of shared spaces should become more routine.

—People may initially be asked to wear face masks while in the community to reduce their risk of asymptomatic spread.

—Those who are sick will be asked to stay home and seek testing for COVID-19.

—Testing should become more widespread and routine, the report suggests.

—As per the AEI report during phase 3, physical distancing restrictions may be lifted, after establishing immune protection.

—This, along with sufficient data, improvement in health-care system capabilities (both in the private and public sectors), will help ensure that reliance by nations on physical distance as a primary tool to control the epidemic is reduced.

—Phase 4 — rebuild readiness for the next pandemic — might seem too far in the future. Nations will need to be prepared to face any new infectious diseases threat, and governments will have to invest in research and development, expansion of public and private health-care infrastructure and workforce.

 

What is the future?

—The world post-COVID-19 might well turn out to be a vastly different place to what it was before the SARS-CoV-2 virus swept across the globe, leaving mass casualties in its path.

—But the lessons from this epidemic — hand and surface hygiene, physical distancing — must never be forgotten. They are valuable in ensuring that if the next virulent pathogen were to strike, the world would be able to tackle it head on.

 

Reference: https://www.thehindu.com/news/national/coronavirus-what-are-the-options-to-ease-the-lockdown/article31319718.ece