He was a bachelor, a lifelong vegetarian and a lover of 'Carnatic' music. He held bombs and missiles in one hand and 'Gita' and 'namaz' in the other, with no sense of incongruity, an embodiment of the eclecticism of India's heritage of diversity - a complete Indian and more than anything else a simple and true good human being. He said something like this: " A 'Muslim Kalam' lighted a 'Hindu Kuthuvizhakku' with a 'Christian candle' ! " His religious vision is so broad without boundaries that he quipped at a question about his religious attitude: “My name has 3 initials – APJ – A for Allah; P for Perumal; J for Jesus !
'Pay what you can' Clinic, Perundurai, Erode Dt., TN, India.
Former Medical Superintendent (Special), RTS & IRT Perundurai Medical College and Research Centre.
COVID uncertainties
T. Rama Prasad For the openpage of THE HINDU
Over the past three years, I had been wishing to write something uncontestable about COVID. The pendulum of data had been continuously swinging. I looked out for advice. My better half advised me: ‘Keep on collecting data on the Net until you have a boxful of them. Then stop viewing and start writing up’. ‘But what data should I collect ?’, I asked. ‘That’, she said cynically, ‘doesn’t much matter, because those data won’t be valid the next day’.
This true conversation illustrates the uncertainty and volatility about Covid data and literature. So, I went on collecting and writing, and my 25th article on Covid titled “Zero-COVID strategy” is published today on December 1, 2022 an excerpt from which is the following: “Zero-COVIDs / Lockdowns, if at all necessary, should be tailor-made for a specific zone, time and intensity, depending upon the epidemiological situation. Covid is such a disease that uncertainty prevails on many of its facets. This can be perceived in many of my cited articles which include 24 articles on COVID-related matters published in The Antiseptic in 26 months (a World Record in medical journalism – one subject; one author; one monthly medical journal; 24 articles in 26 months)” (The Antiseptic, December, 2022, Vol. 119, No. 12 www.theantiseptic.in ).
Queries forever
In the context of the ongoing fierce encounters between the people and the government in China, one patient asked today: “With the trend to relax the Chinese draconian Zero-Covid policy, would the 60% of the above-80 Chinese population which didn’t complete three doses of the Chinese vaccines escalate the admirably small figure of 5,000 ‘Covid deaths’ to a million soon ?” A series of queries followed , loaded with doubt, anger, sarcasm and pessimism, for which we don’t really have sound answers. Is ‘locking down’ a blunder ? Was our overreaction the cause for all the misery ? Did we needlessly provoke the passing-by snake to inject the venom of ‘variants’ ? Is the ‘Zero-Covid’ strategy a solution or the problem ? Why the American President Joe Biden, British Queen Elizabeth II, and the US Surgeon-General Dr. Vivek Murthy had ‘breakthrough’ Covid infections after being fully vaccinated ? Why Novak Djokovic preferred to forego French Open and Wimbledon titles rather than getting vaccinated ? Why did three Canadian doctors and our comedian actor Vivek die following Covid vaccination ? And many more.
Taste of science
Officially, there was no evidence to suggest a link between the deaths and the vaccines. We doctors are like the judges who are convinced of the criminality but can’t put it down in judgements owing to lack of sufficient evidence. In the same way, with the available rickety evidence, we legitimised nonsense as science to a great extent in the prevention and treatment of Covid. It's a see-saw like situation with evidence for and against with shifting advisories. It’s an amusing history of ‘forward-backward’ flip-flops. For instance, the AIIMS and the Health Ministry, on September 2, 2020, advised not to use favipiravir, pirfenidone, methylene blue, itolizumab, tocilizumab, etc. too enthusiastically as sufficient evidence is lacking to support their use. Examples of U-turns are aplenty. We have to still learn on the go ! ‘Modern medicine’ is getting a taste of its own medicine !
Patients question, with a wry smile hidden by their facemasks, about the humongous consumption, during the past three years, of various drugs which were later written off as of no proven value. Bemoaned, they wonder whether the hospital bills, each one running into some lakhs of rupees, could be written off. Would ‘facemasks, hand hygiene and distancing’ also meet the same fate one day ? Uncertain. Orchestrated by ‘big pharma’ and ‘small research’, unethical promotion of ‘experimental’ medicines, even in children, and vested interests in formulation of treatment protocols, and Covid-related fraudulent research and publication have become almost a commonplace in ‘Covid business’. The ‘so-called evidence-based’ bugle blown by rich countries has become the marching tune for the poorer countries. Fear among the public paved the way for profiteers. No other disease kicked up such a ‘scientific storm’ with a great interplay of data, science, politics, money, publicity and personalities.
Covid comedy
Remdesivir recorded a sale of Rs. 593 crore in seven months in India with a black-market price of Rs. 60,000 per dose during the ‘second wave’. Plasma therapy was another glorified treatment of no proven value sold at the rate of Rs. 60,000 per dose. Ivermectin flew off the shelves. Hydroxychloroquine was blatantly touted by the POTUS Donald Trump who thought loudly of injecting disinfectants to combat Covid ! In the absence of robust data, national leaders exhibited their whims and fancies. Brazilian president Jair Bolsonaro preached that Covid vaccines would convert humans into crocodiles and change their sex ! The ‘monarch’ of China Xi Jinping has a fetish about his pet ‘Zero-COVID’ policy which is now under severe scrutiny after being feted for nearly three years. The list is endless.
It took more than two years to realise that an indefinite blanket ban of all activities to prevent some deaths due to just one disease is an example of profound insanity. Yet, Chinese authorities doubled down on ‘Zero-Covid’ policy amid violent and unprecedented protests by the public against the brutal policy. ‘Lockdown’, a blunt instrument, had become the default strategy and an epidemiological fashion, based on mathematical models of a limited theoretical frame. Even as China cut its ‘reserve requirement ratio’ to release $70 billion in November 2022 to spur the economy, the nation, as of December 1, 2022, hit a record high of around 40,000 new cases, despite the world’s strictest implementation of a rigid ‘lockdown’ policy. Nonetheless, the debate on the policy doesn’t seem to be a distinctly polarised one.
The way forward
However, the WHO took a swipe at China’s ‘Zero-Covid’ policy stating that it is unsustainable, while Chinese authorities, caught in a ‘Zero-Covid’ trap, are concerned about the possibility of a devastating scenario of a tsunami of infections and deaths, if the umbrella of ‘Zero-Covid’ policy is folded. The recent surge of cases, while still under the steel blanket of the china’s policy, raises the possibility of a new variant. Would it spread to the rest of the world in a new ‘avatar’ and deprive us of the liturgical joy of saying ‘hallelujah’ ? We have to wait and watch the vicissitudes of nature. If bigger pandemics strike, in times to come, this Covid would look like a tiddler. In November 2022, the WHO held a meeting of 300 top scientists from across the world to discuss about 25 virus families and bacteria, as well as ‘Disease X’, which could potentially trigger another pandemic. If such a microbe emerges, the world would – Heaven forbid – be back to the drawing board. Déjà vu !
COVID uncertainties
T. Rama Prasad For the openpage of THE HINDU
Over the past three years, I had been wishing to write something uncontestable about COVID. The pendulum of data had been continuously swinging. I looked out for advice. My better half advised me: ‘Keep on collecting data on the Net until you have a boxful of them. Then stop viewing and start writing up’. ‘But what data should I collect ?’, I asked. ‘That’, she said cynically, ‘doesn’t much matter, because those data won’t be valid the next day’.
This true conversation illustrates the uncertainty and volatility about Covid data and literature. So, I went on collecting and writing, and my 25th article on Covid titled “Zero-COVID strategy” is published today on December 1, 2022 an excerpt from which is the following: “Zero-COVIDs / Lockdowns, if at all necessary, should be tailor-made for a specific zone, time and intensity, depending upon the epidemiological situation. Covid is such a disease that uncertainty prevails on many of its facets. This can be perceived in many of my cited articles which include 24 articles on COVID-related matters published in The Antiseptic in 26 months (a World Record in medical journalism – one subject; one author; one monthly medical journal; 24 articles in 26 months)” (The Antiseptic, December, 2022, Vol. 119, No. 12 www.theantiseptic.in ).
Queries forever
In the context of the ongoing fierce encounters between the people and the government in China, one patient asked today: “With the trend to relax the Chinese draconian Zero-Covid policy, would the 60% of the above-80 Chinese population which didn’t complete three doses of the Chinese vaccines escalate the admirably small figure of 5,000 ‘Covid deaths’ to a million soon ?” A series of queries followed , loaded with doubt, anger, sarcasm and pessimism, for which we don’t really have sound answers. Is ‘locking down’ a blunder ? Was our overreaction the cause for all the misery ? Did we needlessly provoke the passing-by snake to inject the venom of ‘variants’ ? Is the ‘Zero-Covid’ strategy a solution or the problem ? Why the American President Joe Biden, British Queen Elizabeth II, and the US Surgeon-General Dr. Vivek Murthy had ‘breakthrough’ Covid infections after being fully vaccinated ? Why Novak Djokovic preferred to forego French Open and Wimbledon titles rather than getting vaccinated ? Why did three Canadian doctors and our comedian actor Vivek die following Covid vaccination ? And many more.
Taste of science
Officially, there was no evidence to suggest a link between the deaths and the vaccines. We doctors are like the judges who are convinced of the criminality but can’t put it down in judgements owing to lack of sufficient evidence. In the same way, with the available rickety evidence, we legitimised nonsense as science to a great extent in the prevention and treatment of Covid. It's a see-saw like situation with evidence for and against with shifting advisories. It’s an amusing history of ‘forward-backward’ flip-flops. For instance, the AIIMS and the Health Ministry, on September 2, 2020, advised not to use favipiravir, pirfenidone, methylene blue, itolizumab, tocilizumab, etc. too enthusiastically as sufficient evidence is lacking to support their use. Examples of U-turns are aplenty. We have to still learn on the go ! ‘Modern medicine’ is getting a taste of its own medicine !
Patients question, with a wry smile hidden by their facemasks, about the humongous consumption, during the past three years, of various drugs which were later written off as of no proven value. Bemoaned, they wonder whether the hospital bills, each one running into some lakhs of rupees, could be written off. Would ‘facemasks, hand hygiene and distancing’ also meet the same fate one day ? Uncertain. Orchestrated by ‘big pharma’ and ‘small research’, unethical promotion of ‘experimental’ medicines, even in children, and vested interests in formulation of treatment protocols, and Covid-related fraudulent research and publication have become almost a commonplace in ‘Covid business’. The ‘so-called evidence-based’ bugle blown by rich countries has become the marching tune for the poorer countries. Fear among the public paved the way for profiteers. No other disease kicked up such a ‘scientific storm’ with a great interplay of data, science, politics, money, publicity and personalities.
Covid comedy
Remdesivir recorded a sale of Rs. 593 crore in seven months in India with a black-market price of Rs. 60,000 per dose during the ‘second wave’. Plasma therapy was another glorified treatment of no proven value sold at the rate of Rs. 60,000 per dose. Ivermectin flew off the shelves. Hydroxychloroquine was blatantly touted by the POTUS Donald Trump who thought loudly of injecting disinfectants to combat Covid ! In the absence of robust data, national leaders exhibited their whims and fancies. Brazilian president Jair Bolsonaro preached that Covid vaccines would convert humans into crocodiles and change their sex ! The ‘monarch’ of China Xi Jinping has a fetish about his pet ‘Zero-COVID’ policy which is now under severe scrutiny after being feted for nearly three years. The list is endless.
It took more than two years to realise that an indefinite blanket ban of all activities to prevent some deaths due to just one disease is an example of profound insanity. Yet, Chinese authorities doubled down on ‘Zero-Covid’ policy amid violent and unprecedented protests by the public against the brutal policy. ‘Lockdown’, a blunt instrument, had become the default strategy and an epidemiological fashion, based on mathematical models of a limited theoretical frame. Even as China cut its ‘reserve requirement ratio’ to release $70 billion in November 2022 to spur the economy, the nation, as of December 1, 2022, hit a record high of around 40,000 new cases, despite the world’s strictest implementation of a rigid ‘lockdown’ policy. Nonetheless, the debate on the policy doesn’t seem to be a distinctly polarised one.
The way forward
However, the WHO took a swipe at China’s ‘Zero-Covid’ policy stating that it is unsustainable, while Chinese authorities, caught in a ‘Zero-Covid’ trap, are concerned about the possibility of a devastating scenario of a tsunami of infections and deaths, if the umbrella of ‘Zero-Covid’ policy is folded. The recent surge of cases, while still under the steel blanket of the china’s policy, raises the possibility of a new variant. Would it spread to the rest of the world in a new ‘avatar’ and deprive us of the liturgical joy of saying ‘hallelujah’ ? We have to wait and watch the vicissitudes of nature. If bigger pandemics strike, in times to come, this Covid would look like a tiddler. In November 2022, the WHO held a meeting of 300 top scientists from across the world to discuss about 25 virus families and bacteria, as well as ‘Disease X’, which could potentially trigger another pandemic. If such a microbe emerges, the world would – Heaven forbid – be back to the drawing board. Déjà vu !
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