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Explained: Is Covid-19 now endemic in India?

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According to World Health Organization top scientist Dr Soumya Swaminathan, India appears to be entering a period of Covid-19 endemicity, with low-to-moderate SARS-CoV-2 transmission. Scientists predicted in a survey earlier this year that the virus will become endemic and continue to spread in areas of the global population.

What is endemicity?

Endemic refers to something always present, as opposed to something that has been eradicated, such as smallpox or rinderpest. If a virus or pathogen is present in an animal reservoir, such as bats, camels, or civet cats, it can re-transmit once the population’s protection to it has waned. 

Dr Muhammad Jameel: Because coronavirus illness is present in the animal reservoir, it will continue to circulate. This also means that it will cause disease in persons who have not been vaccinated or exposed to it. If enough persons are vaccinated or have been exposed to the virus, however, the virus will only cause symptomatic infection rather than sickness.

When is SARS-CoV-2 likely to become endemic?

According to Dr Muhammad Jameel, director of the World Health Organization’s Centre for Infectious Diseases in West Africa, there is no clear answer as to when the Ebola virus will become endemic. He believes that focusing on immunization and limiting transmission is critical. He says that it is impossible to anticipate when the virus will become endemic.

According to the Indian Council of Medical Research’s (ICMR) most recent serological survey, nearly two-thirds of the population has antibodies. This indicates that the vast majority of people will be shielded from symptomatic sickness later on, according to Dr Jameel; they may become infected, but they will be protected. He believes it is impossible to foresee whether or not the virus would mutate to the point where immunizations will fail.

How long can the antibodies be expected to last?

According to Professor Partha Majumder, National Science Chair, Government of India, “most people now have antibodies that likely lower the probability of infection and, even if infected, may not develop a serious disease.” We may already have gained herd immunity, which means that most of us have antibodies — either through illness or vaccination — and hence will not develop the severe disease if infected. “Based on its – Why Maruti Suzuki will hike prices for the third time this year rate of transmission and mutation, many of us believe that this coronavirus will never be eradicated and will become endemic — not just in India, but globally.” 

According to an Indian doctor, about 67% of Indians, including a high proportion of youngsters, have IgG antibodies to the common cold virus. Dr Amitav Banerjee stated, “There is a need for further serosurveys for IgG levels to be carried out.”

Can an additional vaccine dose help?

Vaccine effectiveness appears to be declining with time, although substantial protection is still expected, according to Professor Gautam Menon of Ashoka University’s Physics and Biology Department. Whether or not a booster dose of a vaccine is required is determined by how quickly the average person’s antibody level drops. Professor Majumder states, “There are vast variances in the trajectory of declining antibody levels among people.”

Should we worry about numbers rising again?

According to experts at the University of British Columbia in Canada, the risk of serious illness, hospitalization, or death from the Delta variety of norovirus is likely to diminish as more people are vaccinated against it. The concern is whether a new variety will emerge that is far more transmissible than Delta and capable of eluding an immune response triggered by past infection or immunization.

“We are quite unlikely to see case numbers close to the second wave,” Dr Menon said of the number of norovirus infections. He adds that a stable number of infections is more likely, with some places, particularly those with low previous seroprevalence and low vaccination rates, seeing increases.

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Gates Foundation boosts access to Covid-19 drug for lower-income countries

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The Bill and Melinda Gates Foundation pledged up to $120 million as part of its Covid-19 response effort to help lower-income countries gain access to the investigational antiviral medication Molnupiravir, which some say might be a gamechanger.

The Gates Foundation’s co-chair, Melinda Gates, said: “To put an end to the pandemic, we must ensure that everyone has access to life-saving health services, regardless of where they live on the planet. Low-income countries, on the other hand, have had to wait for everything from personal protective equipment to vaccinations. That’s not good enough.”  

Concerned about lower-income countries’ struggles to access Covid-19 vaccinations and the risk of being left behind once again when it comes to medicines, the Gates Foundation is urging other donors to commit money to hasten the implementation of Merck’s experimental drug Molnupiravir, if it is approved.  

Merck expects trial tablets fto reach low-income countries by early next year. Regulatory authorities such as the World Health Organization (WHO) and national governments are in charge of deciding whether or not to approve the drug for usage. The Gates organization said it aims to significantly reduce the time it takes for new drugs to arrive in low-income regions after they become available in wealthier markets. That gap can be at least 12 months, it said.

The organization has already granted money to assist generics firms in developing low-cost production procedures that lower raw material costs and boost product yields. Some wealthy and middle-income countries, such as Australia, Malaysia, Singapore, and Thailand, have either obtained or are in the process of obtaining the therapy.

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The right pricing will be crucial for the launch of Zydus Cadila’s vaccine.

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The destiny of Zydus Cadila’s Covid vaccine is in doubt, as the vaccine’s price appears to be delaying its introduction into the vaccination program. The business has received emergency use authorization from the FDA to inject its Covid vaccine, ZyCoV-D, to children aged 12 to 18.

Zydus Cadila, located in Ahmedabad, has imported the pharmaJet, a needle-free applicator for painless intradermal vaccine delivery. 

Each jet is responsible for delivering a specific amount of vaccination. 

As a result, a single dose is split into two shots, one for each arm. “It’s an expensive device and hence jacks up the overall price,” a government official said.

Around 20,000 dosages can be administered with the jet injector.

The government has been purchasing Covaxin at 225 per dosage and Covishield, another Covid vaccine developed in India, at 215 per dose.

The price of the Zydus Cadila vaccine, according to Health Secretary Rajesh Bhushan, will be significantly more than that of existing vaccines.

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The next wave of healthcare innovation

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Healthcare industry is currently one of the leaders in this race of startups. From Practo to Netmeds, India has seen companies go progress exponentially.  

Launched in March 2021, Know Your Prescription (KYP) is a patient-centric product that explains the prescription and addresses general, treatment-related queries in English, Hindi, Punjabi, Bengali, and Malayalam.   

 KYP assists in the understanding of medical prescriptions. All a patient has to do is visit the AI-enabled portal (QR code), which, after proper diligence, connects them to a WhatsApp number. They are paired with pharmacists or retired medical professionals in order to fully comprehend what their prescription entails. This reduces medication errors while also improving patient compliance and adherence.  

 The product is specially designed keeping the general population in mind, and the startup is eyeing a pan-India audience “with a major focus on Tier II and III cities”.

 The Delhi-based startup, with a team size of 12, has also signed a three-year contract with Centre for Sight, which is one of the largest chains in India with more than 47 centres.  

 It hopes to develop an app soon that will allow users to submit their questions, as well as onboard   qualified pharmacists and doctors to assist them.  

 As of now, KYP has over 5,000 unique paid clients. By Diwali, SiCureMi intends to implement a Rs 299   yearly membership scheme. Users will be able to upload prescriptions an unlimited number of   times as a result of this.

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