Dr Shikha Sharma
The coronavirus outbreak was first identified in China in December 2019. According to the worldometer site approximately 52.08 lakhs of coronavirus cases have been identified so far andcurrently between 80,000 to 1 lakhs cases are increasing per day. Coronavirus has caused approx. 3.34 lakhs deaths across the world. USA, Russia, Brazil, Spain, UK, Italy, France, Germany, Turkey, Iran, India and Peru are the top 11 countries where coronavirus cases are more than 1 lakhs. Most of the countries have implemented lockdown to stop the spread of virus which has also increased the social-economic pressure. However lockdown has resulted in the decrease in the number of cases in many countries but this has also led to the increase in the unemployment rate, depression, fear and anxiety among the people. Moreover there is no guarantee that after uplifting lockdown a second wave of coronavirus will not arise sooner or later. Indeed with strict lockdown measure the cases have reduced but it has not come down to zero in any country due to the higher transmission rate of coronavirus. The current scenerio demands the development of drugs, vaccine, and stem cell therapy at faster pace for the prevention and treatment of coronavirus. Vaccination is the most effective way for the prevention of infectious diseases. In the past vaccination has eradicated the small pox and greatly restricted the various diseases such as polio, measles, diptheria, rubella, haemophilus influenza and tetnus. To stop coronavirus transmission, vaccine development is in progress and are at different stages of clinical trial. According to the world health organization there are 9-10 top vaccine candidate for COVID-19 infection. Top contenders for coronavirus vaccines are Moderna Therapeutics, USA; University of Oxford, UK collaborated with Astrazenca and Serum Institute of Pune, India ; Novavax Inc, USA; INOVIO pharmaceuticals, USA; Pfizer, USA in collaboration with BNTECH, Germany; Sanofi France, Johnson & Johnson, USA; CanSino Biologics Inc, China; Sinovac Biotech, China, British American Tobacco, UK. If Vaccine trials become successful then most of the companies are expecting to produce millions of doses in 2020 and billion in 2021.
Long Journey of polio Virus
The worst epidemic of the first half of 20th century was Polio. In USA every summer used to begin with the fear of the arrival of invisible enemy “Polio virus”. At that time there was no cure for the virus which led to the closing of movie theatres and swimming pool for the next four decade. Fear used to imbibe inside the parents for sending their children’s to playground and birthday parties. Similar to current coronavirus infection, in 1916 during polio outbreak in US, children who were suspected of infections were taken from the homes, away from their families and isolated in sanitariums. Polio cases peaked in USA in 1952 with 57,879 cases and 3145 deaths. Those who were lucky enough to survives this deadly infectious disease ended up with some form of paralysis. It caused approximately 15000 cases of paralysis per year until the vaccine arrived. In 1955 vaccination of poliomyelitis was developed by scientist Jonas Salk and his team in USA. Between 1955 and 1962 400 million doses of polio vaccine was distributed which led to the drop in polio cases by 90%. Another polio vaccine came into commercial use was developed by Albert Sabin. Polio got eliminated from the developed countries between 1960s and 1970s. However till 1980s the disease was still prevalent in 125 countries with estimated 3.5 lakhs paralytic cases per year. In 1988 Global polio eradication initiative was started to stop the virus spread with global vaccination campaign. India was also the part of this campaigning which led to the decrease in the cases from 2 lakhs to few thousands. Initially the process to eradicate polio virus was slow in India until 1994 when Delhi government conducted mass immunization campaign and targeted 1 million children upto 3 years of age. In 1995 after getting success in Delhi, India launched nationwide polio campaigning targeting children upto 5 years of age. Polio virus first strain got eradicated in 1999 while second polio virus strain reappeared in 2009 in UP and Bihar and eradicated by 2011.According to the world health organization the number of polio cases have come down to 99.99% with 175 cases reported in 2019. While as of 2020, polio virus is only prevalent in two countries Pakistan and Afghanistan.Count the number of years the world has dealt with poliovirus to prevent its spread.
Polio and Coronavirus: Does history repeat itself? Lesson to learn from past endemic how we will combat Coronavirus pandemic?
Polio and coronavirus are highly infectious diseases, spread by direct contact from person to person, Polio affects the children less than 5 years of age while coronavirus doesn’t distinguish the age group whether its children, adult or aged person thus number of cases are more with COVID-19. Moreover polio was seasonal infectious disease while coronavirus doesn’t seem to be the same. How long it will take to eradicate coronavirus is the present question?Poliovirus vaccine is given mandatory to all the children below 5 years of age and it took 38 years to eradicate polio from India completely since it joined the global polio eradication initiative. How we will combat coronavirus infection spread? Once the coronavirus vaccine will arrive, do we need to give coronavirus vaccine to everyone?The current population of India is approx.1.38 billion second to China.Is it possible? If yes how long it will take? How many vaccine doses India will receive/ manufacture each month? Who should be given the first preference?Earlier USA President Donald Trump said in interview that older people and nursing homes will be given the first preference in their country. Do we also need to adopt a similar kind of strategy? Or it could be according to the infected area? During polio eradication campaigning, reluctances of many people in taking the vaccine was also the major issue? We need to be prepared to deal with such issues in advance. Let us compare the population statistics with other developed countries. The population of USA is aprox 33 crores almost 4-5 times less than India and most of the European countries population is less than 20 crores while most of them fall below 10 crores i.e5-10 times less than India. This indicates that requirement and delivery of vaccination would be far less for these countries as compared to India. USA is investing on top notch companies such as Astrazeneca, UK; Moderna Inc, USA; Sanofi, France and setting up deal for coronavirus vaccine to start its economy at faster pace.
Does this mean that developed countries will be able to again tackle the coronavirus outbreak at faster pace similar to polio crises once the vaccine will be out? These are the few questions we need to address and to prepare our strategies in advance to deal with coronavirus infection spread.However with COVID-19 infection herd immunity is also developing simultaneously so there could be a possibility that along with vaccination, herd immunity may also help to eradicate coronavirus at faster pace. Our government can also plan random sampling for testing COVID-19 antibodies in normal people to estimate probable herd immunity in particular region and among different age groups. This will also help to determine the spread of coronavirus if at all it has gone unnoticed.Learning from the previous epidemic/pandemic, our government should be ready with the Coronavirus eradication plan. At this stage we should not be dependent on one particular treatment but maybe ready with multiple therapies to combat coronavirus infection. Finally, we need to be 100% sure that vaccine is safe/effective before starting administering it to everyone.
(The author is PhD and Postdoc in stem Cells)
Dr Shikha Sharma