Current Affairs 10th May

‘COVID waves inevitable without proper protocol’ #GS3 #SnT

Recurring waves of coronavirus infections are inevitable if existing practices such as expanding India’s vaccination drive and following COVID protocol are not adhered to, say experts.

Earlier last week, Principal Scientific Advisor K. VijayRaghavan said, “A phase three is inevitable, given the higher levels of circulating virus.” “There is, however, no clear time-line on when this third phase will occur. We should be prepared for new waves and COVID appropriate behaviour and vaccine upgrades are the way forward.

On Friday, however, he qualified his statement saying that such a wave was not a foregone conclusion. “If we take strong measures, the third COVID wave may not happen in all the places or indeed anywhere,” Dr. Vijay Raghavan said.

After cases peaked and registered a steady decline since September and well into early March, life in India had gone back to normal with the inevitable crowds. While multiple serology surveys by the Indian Council of Medical Research (ICMR) had suggested that at most 21% of India had been exposed to the coronavirus, the subsequent decisions to have a staggered vaccine rollout that would cover only the most at-risk populations and to be entirely dependent on locally produced vaccines reflected the government’s calculation that a devastating second wave was unlikely.


Not counting healthcare workers, effectively 75% of the country continued to be vulnerable in January. Social distancing, infrequent mask use and vaccine hesitancy have all played a role. I wouldn’t hesitate to say that a third and fourth wave is inevitable if these conditions continue.”

Unlike in January and February when the limited vaccine rollout was yet to accelerate, there is currently a shortage in vaccine supply, with less than 2 million doses being administered a day, and supplies of both Covishield and Covaxin unlikely to significantly pick up before July.

Dr. Panda adds that vaccines ought to be preventive and be administered before infections ravage a community and not after.

“In future, we should consider a cut-off, say a 10% test positivity, and through a smart combination vaccinate people in districts with low infection spread as well as high spread. That is the essential lesson from our previous experience with HIV epidemic.” Test positivity refers to the number of samples that test positive for the coronavirus and a percentage above 15% indicates high prevalence of the infection in a community.

Policy response

The Lancet Commission Task Force, which has a range of public health and policy experts spanning the State universities and even those with the ICMR, has in two reports, in April and May, pointed out that there was no unique policy response to rein in the pandemic.

The group presented a “checklist” that highlights a range of actions needed for different places with varying disease burden.

These include “credible and regular projections” of the trajectory of the pandemic that would help policy makers to evaluate the relative success of different approaches, putting in place a system to share anonymised microdata with a larger pool of researchers to understand more nuanced trends of hospitalizations, disease severity, long COVID-19 characteristics.

This would help to better prepare the health system and the administration with the consequences of the surge and, ramping up genome sequencing to 5% of all tests on a monthly basis and ensure that the data on variants of concern (VoCs) from genomic surveillance was shared across to the districts.

Gautam Menon, modeller and Professor, Ashoka University said he believed a “third wave” was not inevitable.

“Hopefully, the powerful lessons of what is happening now will not be forgotten in a hurry. Social factors, more than even the biology of the virus, govern how epidemics proceed. Provided we can reconfigure our lives so that physical distancing, mask wearing, working from home where possible, reducing crowding in public places and paying careful attention to ventilation becomes a part of our daily life, we can be spared another wave.

To do this until a substantial proportion of our population can be vaccinated, that is what should be our priority. In the long run, dominant strains of the coronavirus would tend to be more transmissible and less virulent but when that would happen couldn’t be calculated at present.

Shahid Jameel, virologist and advisor to the Indian Scientists SARS-COV2 Genome Consortium, however, said waves would keep happening until actions were taken. “We know some variants are more transmissible. We should be testing the India variants against vaccines, in labs and in real world settings.

China Red Cross sends oxygen concentrators, ventilators #GS2 #IR #GS3 #SnT

A first batch of oxygen concentrators and ventilators donated by the Red Cross Society of China arrived on Sunday on a cargo flight from China.

The consignment marks among the biggest donations of medical supplies so far from China, from where India has been purchasing a huge amount of supplies, including oxygen concentrators.

“The first batch of 100 oxygen concentrators, 40 ventilators and other anti-epidemic supplies donated by the Red Cross Society of China (RCSC) arrived in India today by Chinese cargo flight from Chengdu, China.

“[The] RCSC also decided to provide $1 million in cash assistance to the Indian Red Cross Society through International Federation of Red Cross and Red Crescent Societies to help India fight against COVID19.

India has said it is open to receiving assistance from civil society organisations and private companies in China, some of which is being sent to the Indian Red Cross Society. China’s government has also offered official assistance, conveyed on April 30 in a letter from President Xi Jinping to Prime Minister Narendra Modi and in a phone call between the two Foreign Ministers on the same day.

Much of the critical imports of medical supplies have been coming in from China with a surge in orders from Indian companies. Since April, orders for at least 40,000 oxygen concentrators have been placed by Indian companies, of which 21,000 have so far been delivered, along with more than 5,000 ventilators, 21 million face masks and 3,800 tons of medicines, according to official Chinese customs figures.

‘FCRA amendments crippling our work’ #GS2 #IR

The amendments to the Foreign Contribution Regulation Act (FCRA) enacted last year that among others made it compulsory for NGOs to open a bank account in Delhi has crippled the work of many organisations who are unable to receive foreign funds.

Registered NGOs can receive foreign contribution for five purposes — social, educational, religious, economic and cultural. An FCRA registration is mandatory for NGOs to receive foreign funds. There are 22,591 FCRA registered NGOs.

An NGO has now moved the Delhi High Court seeking exemption from the Union Home Ministry’s March 31 deadline to open an FCRA account with the SBI branch at Parliament Street here.

The petitioner argued that it applied to open the account before the March 31 deadline but the administrative delays on the part of the bank and the Ministry severely restricted its activities including providing COVID-19 relief and paying of urgent salaries of staff and also affected its charitable and educational activities.

The court in a hearing on May 7 issued notice to the Ministry. Abishek Jebaraj, the NGO’s lawyer, said there were many NGOs who were affected by this order and the new regulations were hampering charitable work during the pandemic.

“There is also severe inconvenience involved in submitting copies of all the necessary papers and personal documents, such as Aadhaar card copies and the KYCs of trustees and other members of the NGO. The trustees and members live in different parts of the country, and getting documents together poses immense challenges due to COVID-19 restriction.

The NGOs continue to face problems even as the National Disaster Management Authority (NDMA) on May 6 wrote to all States to involve NGOs, faith-based organisations, religious and social trusts at local level to handle the “unprecedented COVID-19 crisis”.

The NDMA held a virtual meeting with 1,000 NGOs on May 5. NDMA member secretary Sanjeeva Kumar said in a letter to States that an NGO coordination centre shall should be set up at the local level and office and other logistics be provided by the State. The letter said the NGOs could offer their services in containment zones and other areas where curfew is imposed and special passes could be given to them.

Green panel allows Great Nicobar plan to advance #GS3 #Environment

The Environment Appraisal Committee (EAC) – Infrastructure I of the Ministry of Environment, Forest and Climate Change (MoEFCC) has flagged serious concerns about NITI Aayog’s ambitious project for Great Nicobar Island (‘NITI Aayog vision for Great Nicobar ignores tribal, ecological concerns’, The Hindu , March 21, 2021).

The committee has, however, removed the first hurdle faced by the project. It has “recommended” it “for grant of terms of reference (TOR)” for Environmental Impact Assessment (EIA) studies, which in the first instance will include baseline studies over three months.

Documents uploaded recently on the MoEFCC’s Parivesh portal show that the 15-member committee headed by marine biologist and former director, Bombay Natural History Society (BNHS), Deepak Apte, made the decision following two meetings held on March 17 and 18 and April 5 and 6.

The EAC was responding to the 126 page ‘pre-feasibility’ report, ‘Holistic Development of Great Nicobar Island at Andaman and Nicobar Islands’, prepared for the NITI Aayog by the Gurugram-based consulting agency Aecom India Private Limited.

The proposal includes an international container transhipment terminal, a greenfield international airport, a power plant and a township complex spread over 166 sq. km. (mainly pristine coastal systems and tropical forests), and is estimated to cost Rs. 75,000 crore.

Concerns on site

The committee’s concerns were both procedural and substantive. A discussion on the proposal in the March meeting was deferred because of delayed and incomplete submission of documents. The missing information included the minutes of the meeting note, details of the township to be developed over 149 sq. km., a note on seismic and tsunami hazards, freshwater requirement details (6.5 lakh people are envisaged to finally inhabit the island when the present population is only 8,500; the current total population of the entire island chain is less than 4.5 lakh), and details of the impact on the Giant Leatherback turtle.

The committee also noted that there were no details of the trees to be felled — a number that could run into millions since 130 sq. km. of the project area has some of the finest tropical forests in India. A point-wise response to concerns was submitted by the project proponent, the Andaman and Nicobar Island Integrated Development Corporation (ANIIDCO), on April 5, the very day the committee convened for its next meeting. Yet, the proposal was taken up for consideration and even recommended for grant of ToR to go ahead.

This, despite the fact that the committee raised a number of additional issues, including about Galathea Bay, the site of the port and the centrepiece of the NITI Aayog proposal. Galathea Bay is an iconic nesting site in India of the enigmatic Giant Leatherback, the world’s largest marine turtle — borne out by surveys done over three decades by the island’s Forest Department and research agencies like the Andaman and Nicobar Environment Team, Dakshin Foundation and the Indian Institute of Science (IISc) (‘Leatherback nesting sites could be overrun by Andamans projects’, The Hindu , February 15, 2021).

The committee noted that the site selection for the port had been done mainly on technical and financial criteria, ignoring the environmental aspects. It has now asked for “an independent study/ evaluation for the suitability of the proposed port site with specific focus on Leatherback Turtle, Nicobar Magapod (sic) and Dugong”.

Action points

This, in fact, is only one of over a 100 specific points of action listed out by the committee. They include, among others, the need for an independent assessment of terrestrial and marine biodiversity, a study on the impact of dredging, reclamation and port operations, including oil spills (to be carried out by nationally recognised institutions such as the Wildlife Institute of India, IISc or the Salim Ali Centre for Ornithology and Natural History), the need for studies of alternative sites for the port with a focus on environmental and ecological impact, especially on turtles, analysis of risk-handling capabilities, a seismic and tsunami hazard map, a disaster management plan, details of labour, labour camps and their requirements, an assessment of the cumulative impact, and a hydro-geological study to assess impact on round and surface water regimes.

Corporate policy

The committee has also asked for details of the corporate environment policy of the implementing agency — whether the company has an environment policy, a prescribed standard operating procedure to deal with environmental and forest violations, and a compliance management system.

ANIIDCO, the Port Blair project proponent, is a government undertaking involved in activities such as tourism, trading (iron and steel, milk, petroleum products, and liquor) and infrastructure development for tourism and fisheries. Its annual turnover for 2018-19 was Rs. 379 crore, and handling a mega infrastructure project estimated to cost Rs. 75,000 crore appears way beyond its capacity.

AECOM’s pre-feasibility report has proposed 2022-23 for the commencement of work on the site. “How is that possible,” asks an island expert, requesting anonymity.

Ecological surveys in the last few years have reported a number of new species, many restricted to just the Galathea region. These include the critically endangered Nicobar shrew, the Great Nicobar crake, the Nicobar frog, the Nicobar cat snake, a new skink (Lipinia sp), a new lizard (Dibamus sp,) and a snake of the Lycodon sp that is yet to be described.

China rocket debris falls in Indian Ocean near Maldives #GS2 #IR #GS3 #SnT

Debris from the last stage of China’s Long March rocket that had last month carried a key component of its under-construction space station fell into the waters of the Indian Ocean west of the Maldives.

The re-entry of the rocket, described by astrophysicists as the fourth-largest uncontrolled reentry in history, had evoked concerns in recent days about possible damage should it have fallen on land, and had been criticised by the National Aeronautics and Space Administration (NASA) in the U.S. for “failing to meet responsible standards”. China had rejected those concerns, saying most of the debris had been burned during reentry and that a fall into international waters was most likely.

The China Manned Space Agency (CSMA) said on Sunday “the vast majority of the device burned up during the reentry, and the rest of the debris fell into a sea area with the centre at 2.65 degrees north latitude and 72.47 degrees east longitude,” placing it west of the Maldives in the Indian Ocean. The Maldives National Defence Force said on Sunday its Coastguard Squadron “is active after receiving reports of rocket debris fallen in Maldivian waters”.

NASA Administrator Bill Nelson in a statement called on “spacefaring nations” to “minimise the risks to people and property on Earth of re-entries of space objects and maximise transparency regarding those operations.” “It is clear that China is failing to meet responsible standards regarding their space debris,” he said.

Chinese experts rejected the criticism over the uncontrolled entry, saying authorities had been tracking the course, although they did not have any control over where the debris would fall.

‘Double standards’

“It only refers to the loss of propulsion, but in no way means that China has lost track of its flying trajectory and real-time location,” Song Zhongping, an aerospace commentator and former instructor at a PLA Rocket Force affiliated university, told the Global Times , saying that debris from the U.S. SpaceX Falcon 9 rocket that fell on a farm in Washington State did not attract similar criticism and showed Western “double standards”.

Jonathan McDowell, an astrophysicist at the Harvard-Smithsonian Center for Astrophysics, said the uncontrolled reentry of the Chinese rocket was “the equal fourth-biggest” among uncontrolled reentries, on a par with the first Long March rocket that last year fell in the Ivory Coast where there were reports of debris damaging homes in villages. “

An ocean reentry was always statistically the most likely. “It appears China won its gamble (unless we get news of debris in the Maldives). But it was still reckless.”

The Long March-5B Y2 rocket was carrying the Tianhe, or Heavenly Harmony, module, which is the first of three key components for the construction of China’s space station, which will be completed by the end of next year.

Tianhe will act “the management and control hub of the space station” which is called Tiangong, or Heavenly Palace, Chinese authorities said after the April 29 launch of the rocket from the Wenchang Spacecraft Launch Site on the island province of Hainan.

The space station, which will be only the second after the International Space Station (ISS), has been designed with a lifespan of 10 years but could last 15 years, or until 2037. The life of the ISS, experts say, could be extended until 2030, by when one of its members, Russia, has said it would launch its own space station.

‘Black fungus’ in Covid patients #GS3 #SnT

A rare but serious fungal infection, known as mucormycosis and colloquially as “black fungus”, is being detected relatively frequently among Covid-19 patients in some states. The disease often manifests in the skin and also affects the lungs and the brain. With a number of mucormycosis cases detected in Delhi, Maharashtra and Gujarat, experts in the national Covid-19 task force on Sunday issued an evidence-based advisory on the disease.

What is the disease?

Although rare, it is a serious infection. It is caused by a group of moulds known as mucormycetes present naturally in the environment. It mainly affects people who are on medication for health problems that reduces their ability to fight environmental pathogens, say experts from the Covid-19 task force task force.

Sinuses or lungs of such individuals get affected after they inhale fungal spores from the air. Doctors in some states have noted a rise in cases of mucormycosis among people hospitalized or recovering from Covid 19, with some requiring urgent surgery. Usually, mucormycetes does not pose a major threat to those with a healthy immune system.

What happens when one contracts it?

Warning signs include pain and redness around the eyes or nose, with fever, headache, coughing, shortness of breath, bloody vomits, and altered mental status. According to the advisory, infection with mucormycetes should be suspected when there is:

* Sinusitis — nasal blockade or congestion, nasal discharge (blackish/bloody);
* Local pain on the cheek bone, one-sided facial pain, numbness or swelling;
* Blackish discoloration over bridge of nose/palate;
* Loosening of teeth, jaw involvement;
* Blurred or double vision with pain;
* Thrombosis, necrosis, skin lesion;
* Chest pain, pleural effusion, worsening of respiratory symptoms.

Experts advise that one should not count all cases of blocked nose as cases of bacterial sinusitis, particularly in the context of immunosuppression and/or Covid-19 patients on immunomodulators. Do not hesitate to seek aggressive investigations for detecting fungal infection, they advise.

What’s the treatment?

While it is treated with antifungals, mucormycosis may eventually require surgery. Doctors have said that it is of utmost importance to control diabetes, reduce steroid use, and discontinue immunomodulating drugs. To maintain adequate systemic hydration, the treatment includes infusion of normal saline (IV) before infusion of amphotericin B and antifungal therapy, for at least 4-6 weeks.

Experts in the task force have stressed the need to control hyperglycemia , and monitor blood glucose level after discharge following Covid-19 treatment, and also in diabetics. One should use steroids judiciously — correct timing, correct dose and duration are important.

Management of Covid patients with mucormycosis is a team effort involving microbiologists, internal medicine specialists, intensivist neurologist, ENT specialists, ophthalmologists, dentists, surgeons (maxillofacial/plastic) and others.

What kind of surgery is required?

Mucormycosis can lead to loss of the upper jaw and sometimes even the eye. “Patients would need to come to terms with loss of function due to a missing jaw — difficulty with chewing, swallowing, facial aesthetics and loss of self-esteem, doctors say. Be it the eye or upper jaw, these can be replaced with appropriate artificial substitutes or prostheses.

While prosthetic replacement of the missing facial structures can commence once the patient stabilises after surgery, doctors it is important to reassure him about the availability of such interventions instead of leaving him to panic with the sudden unforeseen loss, augmenting a post-Covid stress disorder which is already a reality.

“Prosthetic reconstruction can be effected after surgery, but interim solutions should be planned even before surgery of the jaws for better long-term outcomes. Prosthetic reconstruction can ensure that the cure is not more dreadful than the disease itself,” he said

How can one prevent it?

One should remember that it is a rare disease. However, some groups of people are more vulnerable than others. What predisposes patients is uncontrolled diabetes mellitus, immunosuppression by steroids, prolonged ICU stay, and comorbidities — post transplant/malignancy, voriconazole therapy.

Experts advise that you use masks if you are visiting dusty construction sites. Wear shoes, long trousers, long-sleeved shirts and gloves while handling soil (gardening), moss or manure. Maintain personal hygiene including a thorough scrub bath.

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