Sunday, April 5, 2020

Ivermectin | CoroFlu | Social distancing | Nasal vaccine | COVID-19


CoroFlu is  COVID-19 nasal vaccine that has been shown safe and efficacy data in humans, during phase 1 and phase2 and clinical trials. Bharat biotech is involved in the development and testing of this vaccine. This is an international collaboration project between the University of Wisconsin-Madison along with Flugen and  Bharat Biotech. Coroflu will be built on the backbone of FluGen’s vaccine candidate known as M2SR. Based on an invention by UW-Madison virologists and FluGen Co-founders(Yoshihiro and Gabriele). This is a self-limiting version of the influenza virus that induces an immune response against the flu.


Is Social distancing is followed only in humans or other species too?

Yes, Animals to have their own strategies of social distancing, for example, infected ants spend most of the time outside their nest, in order to avoid infection to other ants.  

In honey bee hives, infected larvae emit certain chemicals called bee-pheromones. Older bees have the capability to smell these pheromones. So, the older bees will separate the diseased bees from the hives.
The infected bees will take up honey as self antibiotics, if this doesn’t work they self isolate from the group of bees. 

In 1966, a chimpanzee named McGregor had contracted polio. Other members of the group removed from their crew. Once they get cured, they will be welcomed back.

During an infection, sick mice remove themselves from the group. Female mice can smell parasitic infection in the male’s urine.

In aquatic species such as Caribbean spiny lobsters emit certain chemical signals, which can be smelled by fellow lobsters at an early stage of infection. When a virus infects lobsters it takes up o 8 weeks to get infected. Their fellow lobsters avoid them during the first 4 weeks of infection.

In the case of the cow, they self isolate themselves before giving birth to a calf in order to prevent the disease from their calf. Female fish generally prefer parasite-free partners. In this case, they use visual clues and chemical signals to identify infected individuals. This has been observed in Trinidad guppies.



Possible drug identified  by Australian scientists for coronavirus

Ivermectin, An FDA the approved antiparasitic drug has shown good results in vitro against broad range diseases such as Dengue, influenza and Zika virus. Based on the study, available antiparasitic drugs can kill the virus within 48 hours. Now, the next step is to determine the dosage calculation for preclinical and clinical testings. The above study was conducted between Monash University and Doherty institute of infection and immunity.

Friday, April 3, 2020

Ventilators | 3D-printers | FDA | Medical Research | Researchers | COVID-19


Engineers have developed a low cost fully functional ventilators. What is the advantage of this one? This one has adapters that allow 4 to 9 patients to benefit from a single ventilator. This can overcome the shortage of ventilators due to the COVID-19 pandemic. The cost of one ventilator could be less than $300, compared to big ventilators that cost much as $30,000.

When lungs of COVID-19 patients are damaged by a virus, they experience shortness of breath and require ventilators to continue breathing. Researchers from MIT developed an emergency ventilator called E-Vent. The design is an upgraded version of the bag-valve resuscitator. These are operated by hand to help patients with breathing difficulties during emergencies. Until an intervention such as a ventilator becomes available. The researchers devised a mechanical system to squeeze and release the Ambu bag.


A similar system was developed by researchers at Rice University and Metric Technologies. Their prototype was built primarily of 3D-printed and laser-cut parts. Their prototype allows adjusting the rate of air delivery to the lungs of COVID-19 patients.

Another low-cost version called VentilatorPAL was developed by a Dutch company. It comes with a mobile app that allows adjusting air pressure and airflow to the lungs.

Another low-cost open-source ventilator called VentilAid. Most parts can be made anywhere locally with the help of a 3D printer.

Engineers have also developed simple tools to save multiple lives using a single ventilator. Each ventilator is originally designed to be used by one patient at a time. But the new adapters adjust the ventilators to be used by 4-9 patients simultaneously. These adapters can be built using 3D printers.
One of them called VESper has already been approved by FDA for emergencies, These innovative things can save their lives.

The COVID-19 pandemic has led to worldwide shortages of Personal Protective Equipment (PPE), surgical masks, gloves, diagnostics kits, artificial respiratory apparatus like Ventilators, oxygen cylinders, and other appliances. India needs around 38 million masks and 6.2 million pieces of PPE, according to media reports.

This situation has led certain automobile manufacturers such as Tata Motors, Mahindra& Mahindra, Hyundai motor, Honda cars, and Maruti Suzuki to collaborate with the existing ventilators makers.

Maruti is collaborating with AgVA healthcare to rapidly scale-up production of 10,000 ventilators per month. Similarly, Mysuru based medical equipment maker Skanray Technologies is partnering with Bharat Electronics Ltd.

We need to invest more in science and technology-based companies. The Pune based Mylab discovery is one such example to show the scientific talent in a shorter duration. Even though if we want world-class science, a researcher in biotechnology sector earns  almost 40% less on average than data analytics based on publicly available data.

The COVID-19  crisis should reprioritize of medical research in the west. India needs strong public health infrastructure not only to COVID-19 but such as preventing chronic illness, controlling infectious diseases and increasing the frontline healthcare workers and affordability of medicine.

Thursday, April 2, 2020

Recession | COVID-19 | Developing countries | Lung Disease | Atrial fibrillation | Diabetes | Asthma | BCG Vaccine


As per the UN trade report, the world economy will go into recession this year with a prediction of trillion dollars due to the Corona pandemic. Before that what is a recession, In terms of economics a recession is a business cycle contraction where there is a decline in economic activity. As a result of this, the consequences may be unemployment, social effects, and business failures. But the report expects the recession in developing countries like China and India will be less. The report does not give detailed information on how China and India will be expected from the economic crisis.

A health condition that may be a risk of death from the coronavirus.

According to the patient's report from Italy, 76.1% of patients had hypertension or blood pressure.
How this is related to COVID-19?
Researchers  assume  that people with heart issues may have weak immune system and this COVID-19 affects the lung that may indirectly affect the heart as well. This coronavirus could have a negative effect on those with a plaque in their arteries.

Diabetes was the second  most common condition, some viruses thrive on higher blood glucose levels and patients had a weak immune system too.

About one-quarter people had atrial Fibrillation. What is Atrial Fibrillation?, According to the American  Heart Association, it is defined as an irregular heartbeat that can lead to stroke, heart failure and blood clots.

Do Cancer patients do get affected?
Yes, About 20% of Italy patients had active cancer in the past five years are been infected with COVID-19. Cancer treatment can impair the respiratory system and reduces the immune levels.

Patients with Lung Diseases such as chronic emphysema and bronchitis are weaker. COVID-19 causes inflammation in the lungs lining and irritation in the nerve around them. It may also cause inflammation in the air sacs that can lead to pneumonia ( lungs filled with fluid). This pneumonia prevents the lungs from getting enough oxygen into the bloodstream.

What about Asthma patients?
People with moderate to severe conditions may have a high risk of getting sick. This COVID-19 affects the respiratory tract that causes an asthma attack and may lead to pneumonia and acute respiratory disease.

Is Cigarette smokers are more prone to  COVID-19 infection?
Yes, tobacco has a huge impact on respiratory health. It is also a factor of Chronic Obstructive Pulmonary Disease ( COPD). Smoking is considered to be a risk for any lower respiratory  tract infection.

Dementia, it doesn’t increase the risk of COVID-19, but the characteristics of the people are being changed. In this list of medical illnesses, chronic liver disease was the least common among the report. People with liver transplants will be undergoing immunosuppressing medications.


U.S  Scientists  expect that Bacillus Calmette – Guerin ( BCG) vaccine administered to millions of Indians children after birth to protect against tuberculosis. This has been found to be a game-changer against COVID-19. But it is too early to say anything, BCG vaccine is the live weakened form of Mycobacterium bovis(causative agent of TB) in cattle.  BCG vaccine has quite effective against SARS infection.


Wednesday, April 1, 2020

Ventilators | Vietnam | COVID-19 test | Polymerase Chain Reaction | Masks | Infectious Diseases


How do COVID-19 tests work?
There are two types of tests carried out. In the U.S, they use long Q-tip to swab the back of your throat. In developed countries such as china, an antibody test may be carried out from the blood sample. The throat swab is well suited for Polymerase Chain Reaction (PCR).

PCR test works by detecting specific genetic material within the virus. From the sample, nucleic acid will be extracted, which holds the viral genome. Amplification of certain regions of the genome will be done by a reverse transcription-polymerase chain reaction.  A large sample be obtained that is compared to SARS-Cov2. It has 30,000 nucleotides. PCR targets  approximately 100 nucleotides that are specific to SARS-Cov2. These 100 nucleotides include 2 genes in the SARS-Cov2 genome.


A sample is positive if it has both the genes, whereas if both the genes are absent, they are COVID-19 negative. In  Contrast, serological tests look for specific antibodies. If they detect particular antibodies, it is positive. This test has an advantage that it can detect antibodies even the patient gets recovered.

How Vietnam tackled COVID-19?

Vietnam is a densely populated neighbor country of China. It has a low budget for the treatment of coronavirus. In addition to that is has a weak health care system. But somehow they managed to keep the infection rate very low. Vietnam shares 897 miles border with china. But they had 207 cases since the break and no fatalities. During Tet new year, the Vietnam government declared war on the coronavirus. Vietnam does have the capability to fight the outbreak like south Korea.


Ho Chi Minh city’s hospitals have a total of 900 intensive care beds. Based on available resources, Vietnam applied strict quarantine policies. They also tracked different levels of contact with infected persons. These were implemented at an earlier stage. Since the beginning of February, Schools and Universities were closed. Around 3000 businesses have closed in the first two months of 2020.



Does masks really protect form COVID-19?
 Types of masks and respirators

Face mask ( Cloth or paper masks)

Surgical mask

N95 respirator

Purpose
Prevents  large particles expelled by the wearer from reaching the environment.
To be used as a physical barrier to protect from large droplets of blood or body fluids,
Reduces exposure to very small airborne particles or contaminants.
May not protect against sprays and direct liquid splashes.
To be used as a physical barrier from large droplets of blood or body fluids as well as small particles
Filtration efficiency
 Not applicable
Bacterial filtration efficiency above 95%
 Minimum  95% against  particulate aerosols
Minimum  95% against  particulate aerosols
Fluid resistance
 Absent
Yes
Not applicable
yes


Coronavirus: How do ventilators work?

Since COVID-19 mainly affects the lower respiratory tract. Then the illness quickly becomes critical, and the most severe cases must be immediately connected to a ventilator in the intensive care unit.

Artificial respiration can save lives because if breathing stops, the organs are no longer supplied with oxygen. At the same time, the carbon dioxide produced during breathing is no longer exhaled via the lungs. But there is a worldwide lack of equipment.


Tuesday, March 31, 2020

Social Distancing | Tan re Qing | Leronlimab | COVID-19


Mylab Discovery Solutions who are they? Everyone may know the COVID testing kit made in India. But there is an interesting story about this organization. We all may not know that, Yes it is a start-up  business firm founded in 2016 and based in Pune. They were the first company in India to make ID-NAT (Individual Donor –Nucleic acid testing ) screening kits for quantitative HIV, Hepatitis  B vaccine and Hepatitis  C vaccines. Their area of interests includes medical diagnostics, drug discovery, biomedical research and agricultural genomics.

At least 8 strains of the coronavirus are spreading across the globe. The outbreak is traceable and the virus is mutating on average 15 days. Based on this a universal vaccine could be developed by comparing their genome and protein sequences. Since these strains share a common evolution throughout history.



Leronlimab, A CCR5 antagonist, has been suggested for the treatment of critically ill COVID-19 patients. This drug is treated for HIV, metastases and other diseases.

China is promoting bear bile as a traditional treatment for coronavirus treatment. Chinese  National Health Commission has now recommended using Tan re Qing (Traditional Chinese  medicine formula). Bile is secreted by the liver and stored in the gall bladder. Bile contains high levels of ursodeoxycholic acid(ursodiol) that help to dissolve gall stones. This Ursodiol has been available as a synthetic drug across the globe. But Some medicines such as pain relievers and cough syrup can treat symptoms associated with the disease. Traditional Chinese medicine such  as Tan re Qing is used to treat bronchitis and upper respiratory infections.

The FDA  has approved a process that would be helpful to clean N95 protective masks and it can be reused. Columbus-Ohio based Battelle used a vapor phase hydrogen peroxide process to decontaminate the masks used by healthcare workers.


Social Distancing is a set of non-pharmaceutical interventions or measures are taken to prevent the spread of a contagious disease.
How this can help in preventing COVID-19?
They are more effective when the infectious disease spread via droplet, direct physical contact. There is also drawback such as stress, anxiety, depression depending upon the individuals.

Monday, March 30, 2020

MADE IN INDIA | TESTING KIT | DIAGNOSTIC LABS | COVID-19 | MIGRANT WORKER


Made in India, yes  India’s first testing kit for COVID-19. As some may know that India was criticized for a low number of screening patients. Previously  India depended on imported kits, for diagnosing the coronaviruses. We can proudly now say that we too have our own kit, yes Mylab discovery a Pune based firm got approval to make and sell the kits. There is quite an interesting story in this, Ms.Bhosale  the head of this team, designed this testing kit called Patho detect. This was done in 6 weeks of time (a record). And this scientist was undergoing her pregnancy time that added a big challenge to her. Last week she delivered a girl baby. She added a statement that their 10 member team worked very hard during an emergency crisis. Big applause to the team. Just before she was admitted in the hospital, she submitted the proposal to CDSCO ( central Drug Standard control organization) for approval. The cost of the kit is something around 1200 and the results could be obtained within 3hrs.  On the other side, a large group of migrant workers was moving towards their hometown.

Who are migrant workers?

They are the working people who migrate within a county, they do not have a permanent residence to stay. Now, These people are jobless and penniless by the lockdown. Certain measurements have been to help those people. Uttar Pradesh government has made arrangements for 1000 buses and some of the relief camps have been made in different states of India.

Coronavirus – how this infect humans?
Once the coronaviruses enter through eyes, nose, and mouth. It attaches to the healthy cells in the body. The spike proteins of coronaviruses attach to ACE2(Angiotensin converting enzyme) receptors in the lungs. Now the healthy cells are been killed. Now, these viruses attack the respiratory tract as this region has more ACE2 receptors. After this, our immune system provides a signal to the foreign particle. Those are called signs/symptoms. Many viral infections cause pneumonia at this condition airways will be filled with fluid that leads to ARDS( Acute Respiratory Distress Syndrome).

Does COVID-19 infects TB patients?- Maybe but having TB does not make you more likely to fall ill with COVID-19. But if the patient had pulmonary TB they are more vulnerable to COVID-19.

Facts provided by the CDC( Centers for Disease Control and Prevention)
  • COVID-19 can infect regardless of race and ethnicity.
  • Older people and people underlying medical conditions are higher risks for the disease.
  • Wash your hands often with soap and alcohol-based rub for 20 seconds.



Sunday, March 29, 2020

Robots | Public Health | Infectious Disease | COVID-19

Robots in  managing public health and infectious diseases

The outbreak of COVID-19 has been declared pandemic. Yes, Robots have the capability of delivering disinfections, medications, food and assisting border controls. The above mentioned are just a proof of concept but they have limited use in china. Some of them may know that coronaviruses spread via close contact respiratory droplet transfer, in this case, robot-controlled noncontact ultraviolet (UV) surface disinfection could be used for disease prevention. Mobile robots have been used for diagnosis and screening. These mobile robots could repeatedly monitor the temperature of patients in public areas, hospitals and so on. The biggest challenge in an outbreak is sample collection, it requires a trained  staff but automated/robot-assisted nasopharyngeal and oropharyngeal swabbing may speed up the process and may reduce the risk of infections. There are so many obstacles to be overcome in order to make it a successful one.


Is there any vaccine for COVID-19?

No, it is under the developmental stage. Before that, we will know what is a vaccine and its type. A vaccine is a biological preparation that provides acquired immunity to an infectious disease.  RNA vaccine is a novel type of vaccine composed of RNA packed within a vector(lipid nanoparticles). There are so many clinical trials that been going around the globe. We will be looking into some of them.


Oxford  University begins enrolling volunteers over 500 for a vaccine trial. This is a part of rapid vaccine response. These volunteers will receive nCOV-19 vaccine or control injection for comparison. This team had previously worked on the Ebola outbreak in Africa(2014). Several organizations are currently working on a vaccine against coronaviruses.


  •    Moderna -  This US biotech firm is best known for personalized vaccines. The company has a history of involvement in public health threats. (Zika outbreak-2015). This firm has produced an RNA based vaccine which codes for a stabilized form of SARS-COV-2 spike protein. Phase 1 clinical trial is yet to start.
  • Curevac- This German-based firm used mRNA to activate the production of coronavirus proteins by triggering immune cells to produce antibodies against it.

  •  INOVIO- This US biotech uses DNA instead of RNA to make medicines. A preclinical stage began in January. It has produced 3000 doses for trials to be conducted in China,  USA, and  South Korea.
  •  Zydus Cadila-  This Indian based Pharmaceutical  firm had initiated 2 approaches for developing the covid-19 vaccine. The first involves the ring of DNA designed to produce coronavirus protein once inside the human body. The latter involves genetically manipulating, an attenuated recombinant measles virus, So that it will induce antibodies against Covid-19.

Well, there are currently, 50 plus institutes are working on vaccine development for Covid-19. Don’t get panic, Stay safe and follow the instructions of Officials.

Saturday, March 28, 2020

COVID-19 | Vaccine | Viruses | short updates


Who is COVID-19?
Coronavirus disease (COVID-19) is an infectious disease caused by a new mutated version of coronavirus. Coronaviruses are a group of viruses that cause diseases in mammals and birds. In humans, coronaviruses cause respiratory tract infections that can be mild, such as some cases of the common cold such as SARS, MERS, and COVID-1.

Morphology
The diameter of the virus particles is around 120 nm. The viral envelope consists of a lipid bilayer where the membrane (M), envelope (E) and spike (S) structural proteins are anchored. A subset of coronaviruses called betacoronavirus subgroup also has a shorter spike-like surface protein called hemagglutinin esterase (HE). 

Mode of Transmission
Coronavirus disease spreads primarily through contact with an infected person when they cough or sneeze. It also spreads when a person touches a surface or object that has the virus on it then touches their eyes, nose, or mouth.


Covid-19 a scenario in India- Till 12pm on March 28,2020 the number of infected cases are 800 plus, so how we are going  to tackle this, kindly follow the instructions provided by CDC, WHO to save lives. The worldwide confirmed cases of COVID-19 as on 12pm, March 28 is 597,252.  It has been declared as pandemic a few days before but still, there are some groups of people who are not aware of it. Below are the statistics of COVID-19, in which the top infected countries have been mentioned.

Countries
Confirmed cases
USA
104,671
Italy
86,498
China
81,394
Spain
65,719
Germany
50,871

20 Indian institutes are working to find a vaccine for COVID-19. Some of them are ICMR, NIV, ITI Aayog and DRDO. IIT-Kanpur and IIT-Roorkee incubation centers are working on making portable ventilators.  India, with less than 1 lakh intensive care units and a bed ratio of 1:1,000, will be at risk if an outbreak reaches the third stage. The unique nature of the disease requires 3-4 week of recovery and 21-day ventilator support.

Prevention:

·       Wash your hands regularly for 20 seconds, with soap and water or alcohol-based hand rub.
·       Cover your nose and mouth with a disposable tissue or flexed elbow when you cough or sneeze.
·       Avoid close contact with people who are unwell.
·       Stay home and self-isolate from others.




Will herd immunity be effective against COVID-19 | 25th post - Antivirals | DESREM |Mylan | Vaccines | COVID-19 | US | Pfizer | Herd immunity | Remdesivir

Mylan received approval from DCGI for the generic version of Remdesivir , that can be used for treating COVID-19 patients in adults and c...