Reopening after lock down — Making the situation worse??

Freedom

The people all over the world want same thing. Reopening .They are tired of the forced confinement. This type of situation has never ever happened or even no one would have ever imagined. We are all used to the freedom. I saw in news channel, people in some part of US out on the streets with the slogan “we want freedom”. Well, everyone wants it, as Gandhiji said years ago “Freedom is our birthright”. it is also true. People are now extremely tired of confinement. They are all hoping against hope that by reopening, the situation will progress towards normal though deep inside their mind they have their doubts. It is like ostrich. If it buries its head under sand and hopes for the storm to pass because it can’t see it, it is not going to happen. The big question is, are we there yet?

Covid 19 Cases

It does not look so. We also hear a lot about economy and slowing of it and need to boost it. That thinking is right but is it possible? I don’t think so. There are so many problems larger than life. The pandemic is not slowing down. All over the world, may be except china, cases are either steady or still increasing. Their lives are in danger. The figures that we see are sham. We should not get mislead by them. These figures are because of lock down, containment, absent travel (except the worrying scenario of daily wagers and laborers walking long distances and now government transporting stranded people in country or from other countries. No business is open. All markets are closed. So the figures may give a false sense of improvement. The minute the lock down is lifted, there may be spurt of cases, even may be exponential in countries like India. How is it even possible to think that social distancing will be maintained once the reopening occurs? Not in any shop, market place, public places, offices, or institutions. It seems like an impossible task. Even if we hope and pray, the situation is not going to be normal for a long time to come.

Treatment

We are not anywhere near a definitive treatment for the corona virus. All different medicines starting from Chloroquine, Hydroxychloroquine, Ramdesivir(which has some effect on the recovery days of the corona infection shown in studies) Lopinavir+ Retonavir combination, Oseltamavir, Feviperavir, Interferons, Tocilizumab, Heparin and other anticoagulants, Desferoxamine, Pentoxyfilline, TPA(used for ischemic stroke),steroids like MPS and so on. The fact that so many medicines with different mechanism of action have been tried or are being tried, that itself shows that we are nowhere near a curative treatment unless a miracle happens. The finding of new antiviral drug effective against corona is not a logical option in present circumstances though many companies are doing significant research to find many new molecules which are already in various stages of development and which may have effect on corona virus. To find a new compound may take years of research and we don’t have that time.

Vaccine

The vaccines are in various stages of developments. From candidate vaccines to RNA vaccine, we do hear about lot many trials in various stages of development. If any of them successfully completes phase 3 human trials that would be the day to celebrate but no researcher is sure about the time duration of the probable vaccine. There are also theories that what if it is never developed? It is a possibility. The vaccines for diseases like HIV, Ebola, Malaria, Hepatitis C etc are still not available. We hope it does not become the same with corona. Lot of research is going on by many companies and laboratories and we may surely hope for the result.

New Syndrome in children

Another worrying fact is the development of a n entirely new syndrome due to corona in children, called Multisystem inflammatory syndrome in children (MSIS). It is post corona syndrome due to immune response of the patient and already seen in around 150 children in US and UK. Experts say that each of the epicenters will see clusters of these cases emerging roughly four to six weeks later. Fortunately most children recover with blood thinners and immune modulators but awareness of this syndrome is less and treatment may be difficult in developing countries.

Seasonal Effect

The monsoon is approaching and then the winter. The viral transmission may occur more. There may be second wave that the researchers are talking about though we in India are not out of the first wave and so is the situation in many parts of world, be it US or Europe, cases are occurring .In some countries like Russia or Brazil or Mexico it is even worse.

Wait and watch

In nutshell, we all want the normalcy but there is a big difference between wanting and happening. We have no option but to wait out and hope for the effective vaccine and continue the holy trinity (as called by some professionals in western countries), mask, social distancing and hand washing. All of us have to remember these things for a long time and one mistake can cause so much trouble which is really not worth taking.

Dr Asha Shah

Professor of Medicine, GCS Medical college, Ahmadabad ,India

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Dr. Asha Shah

Dr. Asha Shah

Professor of Medicine GCS, Ex-HOD Medicine BJMC, Ahmedabad, Gujarat, India