Discussion on Covid 19

As planned discussion on Covid 19 took place on March 31^st, 2020 at 6:00 pm via video conferencing. Main pannel  was joined by Dr. Rajat (Medical Microbiologist, Dehradun), Prof. Sudha (Biotechnology JIIT), Jaydeep, Ankit, Pankaj, and Mrigank. Dr. Vijay Gujjar from AIIMS, Dr. Bittu (Ashoka University), Dr. Avani and Atul could could not join due to different reasons. Certain points were framed to be focussed in discussion like:

i. whether this virus lab produced or a natural virus.
ii. Its mode of spread
iii. its immunity and possibility of developing it naturally
iv. vaccine
v. symptoms and treatment
vi. diagnostic tools
vii. is it thermostable, up to what temperate, will it be killed in summer?
viii. The role of governments and their responses
ix. Situation in India, and world. Do we expect an explosion?

x. Different narratives and pseudo science around this.

The discussion lasted for more than two hours. A brief extract is as follows.

i. whether this virus lab produced or a natural virus

Prof. Sudha made a detailed presentation on the issue summarised below:

Basing largely on reputed Science Journal report ( Andersen et al. Nature Medicine, 17 March 2020 ) she said that the recent social and electronic media are filled with speculation that Covid-19 is an engineered bioterrorism weapon.

We would like to present a scientific report from Nature Medicine that strongly indicates that its more likely a natural evolution of coronavisus.

Covid-19 is a SARS coronavirus (SARS-CoV-2) that causes severe disease in humans in addition to SARS-CoV and MERS-CoV while other coronavirus like HKU1, NL63, OC43 and 229E also infect humans but with mild symptoms. Comparative analysis of genomes of coronaviruses, shows maximum resemblance (96% identical) to that of bat SARS-CoV. However, RBD the region responsible for binding with human receptor (ACE2) contains five different amino acids out of the reported six crucial amino acids. These RBD mutations results in stronger binding of COVID-19 with human receptor as compared to other coronaviruses. This immediately raises doubts that someone might have mutated these amino acids to achieve stronger binding, however as per computational analysis the binding energies are poorer with these mutations. Instead, computational analysis predicted few other mutations that might lead to optimum binding. In addition to this, all six mutations present in RBD domain of COVID 19 are present in Pangolin coronavirus that has lesser genomic sequence similarity than bat coronavirus. In other words, based on computational predictions the COVID-19 mutations could not have been engineered. Infact, it is suggestive of natural selection process with coinfection of bat and pangolin coronavirus.

Secondly, Covid -19 sequence also contains insertion of furin cleavage site that is not present in any of these beta coronaviruses. This suggests that probably it is the result of evolutionary process. Similar furin cleavage site insertion was observed in evolutionary progression of influenza virus. This is possible only when there is transfer from human-to-human for quite sometime before insertion of these cleavage sites. Since the first report of coronavirus came in November 2019, hence insertion event is less likely. Although, few of the reports show coronavirus infection in china in early 2019, but its not sure whether it was from COVID19(SARS CoV-2) or other SARS-CoV. To establish this one needs to screen blood samples of other patients with similar symptoms reported during early 2019.

Alternatively, let us evaluate the possibility of leakage of coronavirus from Laboratory as was observed in case of SARS-CoV, i.e., during laboratory studies it leaked into the environment. There is a possibility of mutations in RBD domain during cell culture. But there were no reports of cell culture studies on some progenitor of SARS-CoV-2. Hence it is more probable that a natural recombination or mutation event through Pangolin coronavirus. In addition to this, the presence of furin cleavage sites and especially the O-linked glycans that is immune response associated feature is not possible through cell culture system.

All the above facts strongly suggest COVID-19 a result of natural process rather than any bioterrorism or engineered product. Though it cannot be proved or disproved with surety as that would require many more studies.

It was supported by Dr. Rajat as he also said that SARS-CoV-2 and the resulting CoVID-19 seems to be a consequence of natural spill over from animal reservoir into humans, due to extensive close interactions with wild-life in China, especially for eating purpose.

It was discussed and generally agreed upon that it was not a laboratory generated virus.

ii. Its mode of spread, its immunity and possibility of developing it naturally, vaccine symptoms and treatment diagnostic tools

Diagnosis of COVID-19: The predominant symptoms of Covid-19 are sore throat, dry cough and high grade fever with or without rhinitis, especially in suspects with a travel history or with a history of close contact with laboratory confirmed cases. Till date, the real-time PCR based tests are the only methods to detect SARS-CoV-2. ICMR is working with a team of experts on serological test. As of now, till date there are no validated serological tests that can “diagnose” CoVID-19. So rapid test should not be used or promoted.

CoVID-19 is not an air-borne disease in community. So strict compliance to hand hygiene practices (washing hands with soap and water, with a contact time of soap for a minimum of 20 seconds, consistently shall be a good thing to keep the virus away. Washing the hands after coming in contact with high touch areas such as door knobs, cell phones etc. shall be practised. At no point of time the contaminated hands shall come in contact with eyes, mouth and nose.

vii. is it thermostable, up to what temperate, will it be killed in summer?

It is very difficult to ascertain this as its a new virus. There are no concrete studies. One paper cited that it gets killed at temperature above 25 C. But obviously wrong as human body temperature is 37 C, anther paper suggested it can survive up to 70 C. But the point is its spread. On what medium and surface will it withstand temperature is yet to be seen. No conclusions can be drawn as of now.

viii. The role of governments and their responses

All agreed and suggested in different ways that the response and role of the government was far from adequate. First they kept sleeping early this year. Even WHO responded late, but when it did GOI took no heed. They should have cheeked the incoming flights, diverted international flights to less used airports, screened the passengers appropriate steps could have been taken. As this is not a virus originally found in India, the outbreak could have been avoided. In February we were told that Health Minister is taking close watch and no need to worry. Early March to PM reiterated that India is out of danger. They were busy in MP government toppling etc. They kept on exporting masks and ventilators till mid March without any foresight or worry for the country.

When it did it was not adequate. Modi was busy in event making only. Lock-down was done without any planning. It has put millions of poor people into great misery. The relief announced was very very small and inadequate. While US decided to spend 10% of GDP India decided only 1% for it. Many other countries are spending more than that. And if we compare to size of GDP and population, we will see horrifying figures. In any case, magnanimous amount is only about Rs. 1200/- per person in India.

While a nation wide drama was called for on 22^nd of March, 5 pm for thanks giving do medical , sanitation staff etc., no concrete messures were taken to help them. We see healthcare staff working without PPEs and reports of doctors getting infected started tricking in. Many of those who must have clapped or banged the plates etc. And are landlrds ahve asked their tenants medical staff to vacate. So much for (pseudo)thanks giving. Someone aptly remarked that it became clear at 5 pm on March 22nt as to why India was ruled by Britons for about 200 years. Response of Delhi government was also far from adequate. It has left a majority of people out of its net of relief.

Pankaj substantiated it with some data of UP.

Other all over the world have been poor in response. US kept on denying it till it really became a threat. US companies initially saw it an opportunity to reap profit. Even later there was a lobbying that as younger people are more resistant, they should be allowed to work.

The example of China was discussed where quarantine was done with door step delivery of all essential commodity and medical care (for all ailments). That is how they could control it.

Various other aspects were discussed.

ix. Situation in India, and world. Do we expect an explosion?

The explosion is possible but probably can be avoided. As of now figures are deceptive as not enough testing is done in India. We may expect a higher number in a week as incubation time for most of the suspected to be infected will be over by then. If it reaches below (socio economically lower strata) explosion is not unexpected. All is only speculation.

x. Different narratives and pseudo science around this.

A narrative that china has designed a biological weapon. Some videos that a chines women is spitting and spreading the virus were made viral. It was shown that these videos are fake as shown by fact checking sites. As discussed in first part, this is unlikely. In any case if it was so, it is a very poor bio bomb, with low rate of mortality.

All the pseudo science that is propagated like “cow therapy”, “bell Therapy” poojas and rituals are obviously not right. But it is coming from those in power and misguiding people from real science is very dangerous for society.