virus

WHO Recommendation on Influenza Vaccines Paves Way for Affordable Shots

WHO and influenza experts have agreed that the ‘B/Yamagata lineage virus’ may no longer be necessary to be included in the flu shot. This opens doors for the return of the trivalent influenza vaccine, which could be less expensive, and have more takers.

Those who are considering getting an influenza vaccine may now save on costs as the World Health Organization (WHO) and influenza experts have agreed that the ‘B/Yamagata lineage virus’ may no longer be necessary to be included in the flu shot.

This opens doors for the return of the trivalent influenza vaccine, which could be less expensive, and have more takers.

Why is the B/Yamagata lineage virus being excluded?

The vaccine is manufactured with a live virus, which is then inactivated or attenuated. However, the B/Yamagata lineage virus has not been seen for the past four years, according to experts.

“The virus is currently only found in the vaccine labs around globe, and any lapses in handling and containment, could bring it back into circulation,” Professor Parvaiz A. Koul, who is former director of Sher-e-Kashmir Institute of Medical Sciences, J&K, told The Wire.

An avid influenza researcher, Koul, further said, “It defies logic as to why you should vaccinate for an infection that has not been seen for the past four years.”

He strongly advocated for the reintroduction and re-adoption of trivalent flu shots.

Separately, the WHO, in a four-day consultative meeting on Composition of Influenza Virus Vaccines, on 23 February, decided to omit the B/Yamagata lineage virus from the vaccines.

In September, WHO had declared the need to exclude the B/Yamagata strain from the vaccine because it is no longer warranted. Its influenza vaccine composition advisory committee said, “[The] inclusion of a B/Yamagata lineage antigen in quadrivalent influenza vaccines is no longer warranted, and every effort should be made to exclude this component as soon as possible.”

Influenza vaccines are updated biannually so that they align with circulating strains to match evolving flu viruses. This process ensures effective protection from the virus.

The Yamagata lineage virus

Influenza B/Yamagata is one of the two main lineages of Influenza B viruses that commonly circulate and cause illness in humans, alongside Influenza B/Victoria. Influenza A and Influenza B are two types of viruses that cause the flu. Influenza A, in comparison to Influenza B, is usually responsible for more severe flu outbreaks due to its ability to undergo significant changes, called antigenic shift.

The fresh recommendations mandate the the egg-based flu vaccines must contain an A/Victoria/4897/2022 (H1N1)pdm09-like virus, an A/Thailand/8/2022 (H3N2)-like virus, and a B/Austria/1359417/2021 (B/Victoria lineage)-like virus. Similarly, the cell culture or recombinant-based flu vaccines may contain an A/Wisconsin/67/2022 (H1N1)pdm09-like virus, an A/Massachusetts/18/2022 (H3N2)-like virus, and a B/Austria/1359417/2021 (B/Victoria lineage)-like virus.

These names represent specific strains of flu viruses. The first part refers to the type of flu virus (either influenza A or B), followed by the location where the virus was isolated (such as Victoria, Thailand, or Austria), and then a number and year indicating when the virus was identified or isolated. The egg-based flu vaccines are manufactured by growing the vaccine inside chicken eggs, while cell-culture based ones are grown inside animal eggs.

Days before WHO’s consultative meetings, the Lung India, a peer-reviewed medical journal, published a paper titled ‘Influenza vaccination: A case for removal of B/Yamagata from the quadrivalent vaccine’. The paper was written by professor Parvaiz A. Koul. The article advocated for the B Yamagata virus to be dropped from the vaccines.

It read: “After the onset of the COVID-19 pandemic, there was a virtual elimination of the influenza circulation from the globe (Influenza virus detections reported to FluNet for all viruses), which, however, reappeared in 2021 (mid-year). However, the recent global influenza surveillance has been notable in the virtual absence of the circulation of B/Yamagata lineage.”

“Given the virtual absence of B/Yamagata from the global circulation, after the onset of the COVID-19 pandemic in 2020, it would be apt to drop B/Yamagata totally from the vaccine and recommend only the trivalent vaccine with B/Victoria lineage,” it added.

“The two Influenza A lineages are determined by WHO twice every year, based on circulating strains data,” Koul said.

Kim Sampson, executive director – Asia Pacific Alliance for the Control of Influenza (APACI), and advisor to the Australian Immunisation Coalition, while endorsing the case for exclusion of B/Yamagata, told The Wire that the case was ‘clear’. “Inclusion of a non-existent virus in a vaccine is unreasonable, to say the least,” he said.

He further said, “The Lung India recommendations are very succinct and put forward a case for the removal of B/Yamagata from the forthcoming vaccine composition. Soon after the Lung India article publication, the WHO reached the same conclusion,” he said.

Koul’s article in Lung India said, “This (exclusion of B Yamagata) would also prevent inadvertent reintroduction of the vaccine-contained B/Yamagata strain into the community circulation.”

“Last year, WHO and the UK’s Medicines and Healthcare products Regulatory Agency noted in a meeting in London that there was no global circulation of B/Yamagata viruses since 2020, except for those derived from live attenuated vaccines,” he said in his article.

On February 28, the New England Journal of Medicine (NEJM) published a paper titled ‘Ending B Yamagata Flu Transmission – Shifting from Quadrivalent Vaccines’. The paper suggested that discussions may lead to an immediate return to trivalent vaccine formulation, analysing advisory group recommendations, manufacturer practices, regulatory requirements, and virus circulation patterns.

Earlier last week, the US Food and Drug Administration (FDA) issued a statement that called for the revamping of influenza vaccines, and switching to trivalent ones.

“In the interest of public health, FDA strongly recommended to influenza vaccine manufacturers the removal of the B/Yamagata lineage virus from seasonal influenza vaccines in the US for the 2024-2025 influenza season. FDA and the manufacturers have been working together so that the move from quadrivalent to trivalent seasonal influenza vaccines occurs for the upcoming influenza season,” read the statement.

The seasonal flu is a bi-annual incidence in India. As per estimates, ‘between 2,91,000 and 6,46,000 people die each year from seasonal influenza-associated respiratory illnesses, of which 36% occur in low and middle income countries (LMICs) like India’.

According to the WHO, children aged between six months and five years, pregnant women, adults aged 65 years and above, people with chronic medical conditions and healthcare workers constitute the high risk group for influenza.

Despite this, the vaccination coverage in India is ‘poor’.

A 2022 study assessing the vaccination coverage in older adults in India found that a miniscule 0.6% had taken the flu shot. Among healthcare workers, a study found that over 71% had been vaccinated at least once. The wide disparity, Koul said, could be due to a variety of reasons. “Many hospitals have influenza vaccines at subsidised prices for healthcare workers; healthcare workers have a better education about influenza and vaccines; the threat perception is more,” he said.

The cost

In India, the annual influenza vaccine shot costs around Rs 1,500 to Rs 2,000. Many believe that the switch to trivalent would reduce the cost and increase the uptake, especially in countries like India where the vaccine is not covered under any support or insurance system.

Sampson said having a lower price will certainly make people consider an annual flu shot, especially those in the community that have been introduced to the significance of vaccination against influenza. He said that while there certainly was ‘a correlation between price and uptake, it is not the only factor to be considered when thinking about influenza vaccination at a global level’.

“Government funded programmes will have the most significant impact, but such programmes are limited to countries that can afford them,” he said.

Koul said influenza vaccines saved lives. “Influenza is a serious threat for many people and has been responsible for so many deaths. These deaths are preventable,” he said. “Switching to trivalent flu shots could help bring the costs down and probably help in making vaccines more affordable for people,” he said.

CSL Seqirus, one of the largest vaccine companies, has announced that the transition from quadrivalent to trivalent influenza vaccines for the US will take place in time for the 2024-25 season. “For other countries, we are continuing to consult on the most optimal timing,” the company said.

Monkeypox Outbreak ‘Not Normal’ but ‘Containable’ Says WHO as Govts Ready Vaccinations

Scientists do not expect the outbreak to evolve into a pandemic like COVID-19, given the virus does not spread as easily as SARS-COV-2.

Geneva: The outbreak of monkeypox cases outside of Africa can be contained, the World Health Organisation (WHO) said on Tuesday, May 24, as more governments said they would launch limited vaccinations to combat rising infections of the virus.

The moves came as authorities investigated 237 suspected and confirmed cases of the virus in 19 countries since early May.

That number is expected to increase, WHO officials have said, but most of the infections so far have not been severe.

Scientists do not expect the outbreak to evolve into a pandemic like COVID-19, given the virus does not spread as easily as SARS-COV-2.

Monkeypox is a usually mild viral infection that is endemic in parts of West and Central Africa.

It spreads chiefly through close contact and until the recent outbreak, was rarely seen in other parts of the world, which is why the recent emergence of cases has raised alarms. The majority have been reported in Europe.

On Tuesday, England reported 14 new cases, taking its total to 70 since May 7 and the United Arab Emirates and the Czech Republic registered their first infections.

“We encourage you all to increase the surveillance of monkeypox to see where transmission levels are and understand where it is going,” said Sylvie Briand, WHO director for Global Infectious Hazard Preparedness.

While she said the outbreak was “not normal”, she stressed that it was “containable.”

There are also vaccines and treatments available for monkeypox, she added, calling for appropriate containment measures, more research, and global collaboration.

“Let’s not make a mountain out of a molehill,” she said, speaking at the World Health Assembly in Geneva.

The WHO is working on new guidance for countries on vaccination strategies and is convening further meetings to support member states with more advice on how to tackle the situation.

Targeted vaccinations

Some countries are already taking precautionary measures to provide protection to people who might have been exposed to the virus.

On Tuesday, France’s health authority recommended that at-risk adults who have been in contact with a person with confirmed monkeypox and health staff exposed to an infected patient should be vaccinated.

Denmark acted similarly, providing vaccines to close contacts of those infected with the virus, the Danish Health Authority told public broadcaster DR. The country has registered two cases.

The vaccine being deployed is produced by Bavarian Nordic. It is branded Jynneos in the United States, where it is approved for use against smallpox and monkeypox. It is also approved for smallpox in Europe, where it is called Imvanex, but has been provided for off-label use in response to monkeypox cases.

Germany has ordered 40,000 doses to be ready to deploy on contacts of those infected if an outbreak in the country becomes more severe.

Also Read: Seven Countries in Europe and North America Report Monkeypox Cases

But for now, officials said they were banking on other precautionary measures.

Health Minister Karl Lauterbach said the outbreak could be contained with early intervention and did not signal the start of a new pandemic, and a senior WHO official gave similar guidance on Monday.

US health officials were on Monday preparing to releasing some Jynneos doses. British authorities were the first to take such action, offering vaccines to some healthcare workers and others who may have been exposed to monkeypox last week.

No mutation

The moves come as scientists seek to understand more about the means of transmission and who might be most at risk.

Briand reiterated the WHO‘s view that it was unlikely that the virus has mutated, but said transmission might be being driven by a change in human behaviour, particularly as people return to socialising as COVID-19 restrictions are lifted worldwide.

Health experts watch for concerning mutations that could make a virus more easily transmissible or severe.

Many, but not all, of the cases have been reported in men who have sex with men, and Briand said it was particularly important to try to prevent sexual transmission.

Symptoms include a fever and a distinctive bumpy rash. The West African strain of monkeypox, which is the one identified in the current outbreak, has a mortality rate of around 1%.

(Reuters)

Interview: ‘The World Should Have Acted During Past Monkeypox Outbreaks in Africa’

Virologist Boghuma Kabisen Titanji suggests that countries like India, which haven’t detected cases yet, should maintain a ‘high index of suspicion’.

New Delhi: As many as 108 monkeypox virus cases have been reported from 15 countries of Europe and North America as of the evening of May 22. The World Health Organisation (WHO) has issued two major statements in quick succession; this one on May 21 and this, on May 20, in which it warned more cases are to be expected as “surveillance expands”.

The genome sequencing results of some of the virus samples indicate that the virus has undergone 94 mutations. Some experts consider this a high number, especially since it is a DNA virus, which are usually considered to be stable. So, has a new variant of the virus appeared and could it be driving the rise in cases at a speed unheard of in its case?

The disease, before the 2022 outbreak, was already endemic (outbreaks were frequently happening) in West and Central African countries. But its outbreaks outside these regions used to be sporadic. So, what is driving the trajectory now, at this unprecedented speed, in other parts of the world? And what is the science behind this?

The Wire caught up, via email, with leading infectious diseases specialist and virologist at Emory University (Atlanta) Boghuma Kabisen Titanji on these and other issues related to monkeypox.

The interview is presented in full, with light edits for style and clarity. The questions are in bold and editor’s clarifications are enclosed in square brackets.

Though these are too early days to say, broadly speaking, what do you think might be responsible for the current uptick in monkeypox cases across so many countries?

I think, like with most outbreaks, this is a case of right timing and opportunity. We know that monkeypox has been circulating in West and Central Africa for a while now, with recent and ongoing outbreaks in Nigeria and the Democratic Republic of Congo (DRC). With the world beginning to reopen [after COVID-19 restrictions] and more people travelling and mixing, maybe [this] provided the right opportunity for the [monkeypox] virus to be introduced and to spread in non-endemic geographies [as well].

There is a view among a section of scientists that the mutations in the virus are responsible for the uptick since human-to-human transmission is not known to be this fast in this virus. Although genome sequencing results have indicated some mutations have taken place, they do not completely establish the case of a new variant. Do you think it is still a possibility?

I think this is unlikely. Viruses like opportunity and I think what we are seeing is a reflection of that. An introduction of monkeypox virus into susceptible populations with spread likely facilitated by optimal conditions that are just now being uncovered as outbreak investigation is ongoing.

We know some clusters have been linked to parties and shared public facilities (like saunas) in some European countries reporting cases. For a virus that spreads through close contact, these are all optimal settings for it to spread if introduced.

Boghuma Kabisen Titanji, infectious diseases specialist and virologist at Emory University. Photo: Twitter/@Boghuma

Some experts have also expressed apprehensions that there may be airborne transmission of the monkeypox virus and now the US-CDC also says it is ‘theoretically’ possible. What are your thoughts? If yes, how serious could this be?

A lot of things are theoretically possible but based on previous outbreaks of monkeypox reported in the literature, airborne transmission has not been extensively studied or described. The virus can spread by droplets. So airborne transmission cannot not be ruled out [either].

With that said, the current situation is still quite different from a respiratory virus like COVID. Firstly, we already have a vaccine [against monkeypox] that is effective and can be used to prevent infections. And also, [it can] prevent progression to disease when administered as post-exposure prophylaxis [after onset of symptoms].

[The vaccine at the moment is currently in very limited supply. Even the WHO’s May 21 statement stressed this point].

We know that contact tracing, case identification and isolating identified cases is an effective way of breaking transmission chains. We need to give the ongoing outbreak the seriousness it deserves but also proactively utilise the tools already available to us to prevent it from spreading.

The fact that the incubation period is comparatively long (6-13 days), do you think the virus was in community transmission from quite some time ago; and it is only recently that we got to know?

Also, are there chances of asymptomatic transmission? [Long incubation periods mean it would take a longer time to disease to manifest in someone after being infected with virus]

Absolutely. One of the challenges with infections which have a long incubation period is that secondary transmissions can occur before people become symptomatic, making it easier for these pathogens to spread with stealth.

I think the spread of monkeypox has been ongoing for a while and only being picked up recently. Now that everyone is on alert and looking for it, we are likely to see even more cases reported in coming days and weeks.

Do you think the current rise in cases is also a result of the fact that the scientific community outside Africa, as well as policymakers, neglected monkeypox after the eradication of smallpox? There is scientific literature available where researchers had warned of an upsurge, but did we ignore all of that?

Yes I do think so, and sadly, the same is true for many other infectious pathogens with outbreak potential.

The previous outbreaks [of monkeypox], which have mostly happened in Africa, largely went ignored by the news media and the scientific community. This, despite monkeypox outbreaks happening with increasing frequency in recent years. I think there were missed opportunities to take this threat seriously and to act pre-emptively.

Also read: Only Data Driven Insights Can Tackle India’s Health Inequalities

Vaccinations [against monkeypox] could have been restarted in communities with the highest risk of outbreaks from spill-over events [jump over of the virus from animals to humans]. Better surveillance could have been put in place. More investment could have been poured into developing new antivirals and stockpiling vaccines. There are a lot of things that could have been done to prepare for the eventuality of a larger outbreak involving multiple countries, like the one we are seeing now.

Finally, how do you think this outbreak might behave in weeks to come. Do you apprehend major outbreaks, not necessarily on the lines of Covid-19 though? And what is your advice to countries, especially like India, where no case has been detected yet?

I think we will see more cases being reported and the outbreak may extend to involve even more countries than we know currently. Viruses are always a few steps ahead in outbreaks and we need to bear this in mind and plan accordingly. I think it is important for the general public to be educated on what monkeypox is and how it spreads and to be encouraged to report if they notice any concerning symptoms.

Public health authorities, even in countries which have not yet reported cases, need to maintain a high index of suspicion, educate clinicians and communities to be on the lookout so any new cases and transmission chains can be identified.

‘Coronavirus a Living Organism, Has a Right to Live’: Former Uttarakhand CM Trivendra Rawat

Rawat was trolled on social media for his unusual observation on coronavirus as it went viral at a time when the entire country is battling a strong second wave of COVID-19.

Dehradun: Former Uttarakhand chief minister Trivendra Singh Rawat on Thursday said that coronavirus is a living organism which has a right to live.

“Seen from a philosophical angle, coronavirus is also a living organism. It has the right to live like the rest of us. But we (humans) think ourselves to be the most intelligent and are out to eliminate it. So it is constantly mutating itself,” he told a private news channel here.

However, he said man needs to outpace the virus to stay safe.

Also read: From the Kumbh to Ramzan, Contrasting Court Orders in COVID Times

Rawat was trolled on social media for his unusual observation on coronavirus as it went viral at a time when the entire country is battling a strong second wave of COVID-19.

One Twitter user sarcastically said, “This virus organism should be given shelter in the Central Vista.”

India reported 343,144 new coronavirus cases and 4,000 deaths in the past 24 hours, Union health ministry data showed on Friday.

(With inputs from PTI)

No Time for Conviviality: France Imposes Curfews to Rein in Coronavirus Surge

Macron announced the curfews, which will take effect from Saturday and run nightly from 9 pm to 6 am the following morning.

Paris: French President Emmanuel Macron ordered a third of France‘s population be put under nightly curfew on Wednesday to tackle a surging second wave of the coronavirus, saying now was not the time for conviviality.

The virus was spreading at parties and private gatherings, the president said, and action was needed now in Paris and eight other big French cities to slow the rate of infection or else hospitals risked being overwhelmed.

Macron said the curfews were to put a temporary halt to “the parties, the moments of conviviality where there are 50 or 60 people, festive evenings because, unfortunately, these are vectors for the acceleration of the disease.”

Macron announced the curfews, which will take effect from Saturday and run nightly from 9 pm to 6 am the following morning, hours after the government declared a new state of emergency.

The curfews will last an initial four weeks, but Macron said the government would seek a two-week extension from parliament, meaning the measures will be in place until December 1, 2020.

“It means that we won’t go to restaurants after 9 p.m., we won’t go round to a friend’s place, we won’t go out partying,” the president said in an interview on national television.

France, like other European countries, is grappling with how to slow the virus’ spread and ease pressure on a once-again strained healthcare system while keeping its 2.3 trillion euro ($2.71 trillion) economy open and protecting jobs.

On Wednesday it reported 22,591 new cases, the third time in six days the daily COVID-19 tally has gone beyond the 20,000 thresholds. The virus has killed more than 32,000 in France.

The curfew applies to the Paris region, Marseille, Toulouse, Grenoble, Montpellier, Rouen, Lyon, Saint-Etienne and Lille. The cities have a combined population of about 20 million people.

‘We’ll get through this’

Macron said France faced a worrying situation.

“We have to adopt stricter measures to completely restore control,” the president continued.

Essential trips during curfew would still be allowed, Macron said. There would be no restrictions on public transport, and people would still be able to travel between regions without restrictions.

Anyone violating the curfews will be fined 135 euros ($159).

Macron said the goal was to reduce the current rate of 20,000 new cases per day to around 3,000 and to sharply reduce the burden on intensive care units in hospitals.

Also read: India, France, Australia Hold First Trilateral Dialogue With Focus On Indo-Pacific

The French government previously declared a state of emergency in March, when hospitalisations caused by the pandemic were near their peak. That time, the authorities used their extra powers to put France under lockdown except for essential work, buying food or taking one hour of daily exercise.

Another national lockdown was not envisaged, said Macron.

“We’ll get through this if we stick together,” the president said.

But the move is likely to infuriate France‘s already-battered hospitality industry, reeling from the three-month spring confinement and a more recent government-ordered shutdown of bars in virus hotspots.

Brasserie manager Steve Dervechian said his turnover was down more than half over the summer and even more during the lockdown. Depriving him of a dinner crowd would be a disaster, he said hours before Macron spoke.

“A curfew will not stop the virus. People congregate in public transport, at work, in schools,” he said. It’s not in places like ours where people gather in big crowds.”

(Reuters)

The Virus of Our Discontents

The enemy is no longer just religious and ideological. The enemy is biological too.

I was stunned to read American President Donald Trump’s tweet on March 13, 2021, where he declared March 15 a national day of prayer:

“We are a Country that, throughout our history, has looked to God for protection and strength in times like these…”

Suddenly, it was time, and necessary, to trust in god. For other times, trust in military strength was enough.

When Trump decided to build a wall across the Mexican border to prevent refugees, when he declared war crimes against Iran, and when he boasted of the capability to erase Afghanistan from the map in ten days, what was he depending on? The sheer might of his country.

God was not necessary for these campaigns. At least, he wasn’t summoned to bless America wage or declare war. But there would have been no problem if Trump declared his ambitions by invoking god, because god wouldn’t have contradicted him. It is a historical belief that god sides with power.

God is on the side of the victor. He cannot be on the loser’s side. That is why Arjuna chose Krishna to be on his side during the Mahabharata.

But weak and defeated people also summon god, beg for protection, for mercy. Trump’s tweet is ironic because the most powerful man belonging to the most powerful country on earth is seeking god’s protection. No security can work against an invisible intruder, and enemy. The secret service is of no use. You can’t negotiate, or placate, or issue threats.

The invisible intruder has a mythical quality. It comes from nowhere and anywhere. The invisible intruder can take lives at will. It is stealthier than the stealth bombers in America’s defense arsenal. You realise your limitations: you can only battle what you see. You are powerless against invisibility. So you summon the invisible force of god against the invisible intruder. It is ridiculously logical and ironic.

Janata curfew in Vijayawada. Photo: PTI

In India, we are living in a time of an internal political war against people who are being described “anti-nationals”, or enemies of the nation. They include people belonging to the minority community, and political activists who disagree with the government. In other words, the enemy is either religious or ideological. Since 2016, a national hysteria has been generated against these “anti-nationals”, some named in television studios, others threatened and abused in the social media. Once the nature of an enemy is declared, everyone wants to contribute to the vigilante culture.

The latest, disquieting incident is the putting up of posters (with names, photographs and addresses) of anti-CAA activists on the walls of Lucknow. It is an old fascist method to whip up social consensus. The manufactured virus of discontent has spread way before a real virus arrived on the scene. The wonder drug against both discontents is not likely to appear soon.

A bizarre video surfaced of angry passengers whose passports were taken away as they waited to be tested for coronavirus at Terminal 3 of New Delhi’s Indira Gandhi International Airport. A man could be heard screaming at the airport authorities, “Shoot us. Please shoot us. Kill us”. The paranoia on both sides is palpable. Paranoia produces violence. It can even invite violence upon oneself.

The Italian philosopher, Giorgio Agamben responded to the coronavirus epidemic with an initial piece in an Italian journal in February, where he warned against governments declaring a state of exception and creating panic amongst people against a viral infection that is curable.

He showed concern about further governmental restrictions on freedom. This may remind us in India of the report in The Wire, where a protester in Shaheen Bagh, asked if they would vacate the site to help precautionary measures against the coronavirus, provocatively said, “We are afraid of detention camps, not coronavirus”.

She prefers to fight for a constitutional guarantee of her negative freedom (of being declared illegal, and detained in a camp), rather than succumb to fear. For her, detention is longer, and more painful, than death.

Janata curfew in Varanasi. Photo: PTI

In a rejoinder on March 17, Agamben made clarifications after responses to his earlier piece. “Fear is a poor advisor”, he writes. Agamben explains with aphoristic precision: “Bare life — and the danger of losing it — is not something that unites people, but blinds and separates them.”

The fear of saving and securitising the nation from imagined enemies, has now shifted (and extended) to the fear of saving and quarantining the nation from a different sort of enemy. The concern has passed from preserving the good life of the nation, to preserving its bare life. The enemy this time is invisible, but not imagined. It is real. And “not outside” as Agamben emphasises, but “within us”.

We are all susceptible to the enemy of a nation that is trying to save its life. For once, fear and the enemy of fear are both within. We no longer face the imaginary national enemy.

The enemy is no longer just religious and ideological. The enemy is biological too.

We are all potentially enemies. In an ironic twist of history, (the dangers of) the natural overtakes the political. It’s time to cure the collective symptom of enemy-making. Time to consider our most intimate reality: human life.

Manash Firaq Bhattacharjee is the author of Looking for the Nation: Towards Another Idea of India, published by Speaking Tiger Books (August 2018).

Indian Crew on Board the Diamond Princess Speaks out About Flawed Quarantine

A 31-year-old hailing from a small village in West Bengal provided early warning on a major COVID-19 outbreak.

It was a dramatic SOS from the Diamond Princess, the cruise ship quarantined in Yokohama Port after an outbreak of the 2019 novel coronavirus, dubbed COVID-19. “We are very scared. Please save us from this quagmire,” pleaded Binay Kumar Sarkar in a Facebook video posted on February 10. Along with him were fellow Indians wearing face masks.

Sarkar was the first crew member on the Diamond Princess to publicly draw attention to one of the major flaws in the ship’s quarantine process: passengers were isolated in their cabins but the crew was not. As cases ticked up, he grew concerned that the crew might be inadvertently contributing to the spread of the virus on the ship, which by then had the biggest cluster of COVID-19 cases outside China.

A native of Kanki in West Bengal, Sarkar prepares meals and washes dishes onboard the Diamond Princess. He first sounded the alarm on February 6. “We all eat together in the mess,” he said filming the video from his room. “If one man gets the virus, he takes the plate (to one of the passengers). … If that plate is not washed properly and I take the plate, the virus comes to me also.” Epidemiologists may not agree with the plate analogy but Sarkar’s broader point about person-to person transmission is valid.

Hlwww….. Frndzz…. My name is Binay Kumar Sarkar…. Aj mai Ek vdo bana raha hu Dimond princess cruise se… Mai apni savi members ki taraf se batana chahata hu kya.. hamara crush hai woo bohot Dangerous situation mai hai…. effected from corona virus…. 20 additional people have tested positive for Coronavirus…. So I kindly request Indian government to look for it and help us…… So i want to tell you that ke Yea virus spread honese pehele hum logomese jo effected nehi hai unevi kisi save zone mei le jane ka request karta hu…….. Plzzzz share this VIDEO……. So that my Vdo can reach to the Government…..

Posted by Binay Kumar Sarkar on Thursday, 6 February 2020

Watching ambulances take infected patients off the ship daily added to his sense of urgency: “I need to speak out because I don’t know if I will be alive tomorrow.” In another video, he begged for help in Bengali, saying, “Please isolate us.” The crew had not been tested for the virus, he said, adding that Japan should “get help” if they did not have the capacity to test everyone on board.

The crew’s predicament was highlighted by a reporter from the New York Times who interviewed Sarkar. The fact that the staff ate buffet-style meals and shared bathrooms while passengers were served croissants and smoked salmon in their private cabins underscored the inequities onboard the ship. Indeed, the plight of the ship’s 1,045 crew members became a trending story worldwide.

“We are trying to treat all the people equally,” said Japan’s vice-minister of health, Gaku Hashimoto, although he conceded that crew members did not have private rooms like the passengers and conditions on board the ship were “not all equal”. Eric Rubin, chair of immunology and infectious diseases at Harvard’s T.H Chan School of Public Health, told CNN, “A lot of thought went into what to do with the passengers” but the lack of a quarantine plan for the crew was putting the entire ship at risk.

Also read: Two More Indians Test Positive for Coronavirus on Cruise Ship off Japan

Once Sarkar came forward, other Indian crew members spoke out as well. Sonali Thakkar, a member of the security team, pointed out the potential for infection during mealtimes. “We all remove our masks and gloves when we are eating and we are all sitting in the same place,” she told CNN. Thakkar, who hails from Mumbai, was quarantined in her room after she came down with fever and chills but had not been tested for the virus. “We want to move to a safer environment,” she told NDTV. Anbazhagan, a crew member from Tamil Nadu, had made a similar request through a WhatsApp video. Some 13% of the ship’s crew are from India and thus far, six have tested positive for the virus.

Sarkar and Thakkar’s videos were broadcast by media outlets back home, and India’s foreign minister S. Jaishankar tweeted a message of support. However, Union health minister Harsh Vardhan seemed more realistic: “We are … in touch with Japan but we cannot force them to send our people from there,” he told Republic World. The crew of the Diamond Princess however continues to hope the Government of India will take concrete action before it is “too late”.

Meanwhile, passengers on board the ship have been expressing their gratitude to the staff. Clare Hedger put a note outside her door that read, “Thank you to all you AMAZING CREW!! WE are SO SO grateful.” Novelist Gay Courter told the New York Post, “the real hero for me on the ship is the pastry chef.”

Princess Cruises announced it would give the crew two months of paid leave after the quarantine. But since the crew had not been isolated, they would face a “more formal quarantine” after the passengers disembarked. “I know this is disappointing news,” said Jan Swartz, president of Princess Cruises. Swartz said the crew were not isolated initially because passengers were seen as higher risk due to their age and health. The rate of transmission among passengers was also higher.

The saga of the Diamond Princess is still playing out but one thing is clear: a 31-year-old hailing from a small village in West Bengal provided early warning on a major COVID-19 outbreak. By speaking out, he and fellow Indian crew members gave doctors, public health officials and epidemiologists a window into an unfolding global health crisis.

In his latest Facebook post, Sarkar says he is determined to stay cheerful in the face of adversity. To prove it, he bursts into a Hindi love song.

Sribala Subramanian writes on environment and health, and tweets at @bsubram. She was formerly with Time magazine.

Contain Coronavirus Outbreak Before ‘Spark Becomes a Bigger Fire’: WHO

“In recent days we have seen some concerning instances of onward transmission from people with no travel history to China,” the WHO said on Monday.

United Nations: Expressing concern over instances of coronavirus infection among people with no travel history to China, the head of the World Health Organisation has warned that the small number of cases could be the “spark that becomes a bigger fire”, urging the countries to use the “window of opportunity” to contain the novel virus that has killed over 1,000 people.

Tedros Adhanom Ghebreyesus said while the spread of the respiratory disease appeared to be slow, it could accelerate. His remarks have come a day after he warned the overseas coronavirus spread may be “tip of the iceberg”.

“In recent days we have seen some concerning instances of onward transmission from people with no travel history to China, like the cases reported in France yesterday and the UK today. The detection of this small number of cases could be the spark that becomes a bigger fire,” Ghebreyesus said in Geneva on Monday.

He said the detection of this small number of cases for now was only a spark and the objective for countries “remains containment”.

“We call on all countries to use the window of opportunity that we have to prevent a bigger fire,” he said.

The death toll in China’s novel coronavirus outbreak has gone up to 1,016 with 108 new fatalities reported mostly in the worst-affected Hubei province while the confirmed cases of infection have soared to 42,638, Chinese health officials said on Tuesday.

Outside China, there have been more than 350 infections reported in almost 30 places with two deaths, one in the Philippines and the other in Hong Kong.

Apart from Germany, Britain and Italy, other European nations with cases of the virus include France, Russia, Belgium, Sweden, Finland and Spain.

The overall pattern of infections has not changed, Ghebreyesus said, adding that 99% of the reported cases were in China, and most cases are mild.

Also read: China to Allow in US Health Experts as Coronavirus Shows No Sign of Slowing

WHO’s Director of Pandemic and Epidemic Diseases Sylvie Briand said that 80% of cases displayed mild symptoms, 15% were severe developing into pneumonia and 3-5% required intensive care.

“This is of course too many,” the WHO chief said of the fatalities, noting that many questions still needed answering, such as where the outbreak was growing and where it was getting better or worse.

As part of measures to coordinate an international response to the epidemic, on Sunday, Tedros confirmed that WHO had sent an advance team of international epidemiology experts to Beijing, to assist the authorities with the outbreak.

Leading them is Bruce Aylward, a WHO veteran outbreak expert, who recently coordinated the agency’s response to the Ebola epidemic in West Africa.

His job will be to “lay the groundwork” for a larger international team of experts which is expected to follow to China, Tedros said.

WHO’s other measures have included equipping laboratories in some 14 countries with kits to “fast diagnose” infections, including to Cote d’Ivoire, Kenya, Tunisia and Zambia. This was essential to being able to identify coronavirus infections which can resemble other respiratory bugs, the WHO chief said.

To date, WHO has identified 168 labs around as having the right technology to identify the coronavirus. On concerns that the incubation period for the coronavirus could easily be as long as 24 days, WHO’s Health Emergencies Programme chief Michael Ryan said that the agency was not considering changing the current 14-day quarantine requirement period.

The UN health agency also reported that all crew and passengers on board a cruise ship harboured in Yokohama, Japan, were being quarantined for a 14-day period on board. Their quarantine period will come to an end on February 19, but will be extended for any close contacts of newly confirmed cases, WHO said.

(PTI)

Coronavirus Death Toll in China Crosses 1,000; Over 42,500 Confirmed Cases

As many as 108 deaths were reported on Monday and 2,478 new cases of the lethal disease confirmed, the National Health Commission said in its daily report.

Beijing: The death toll in China’s novel coronavirus outbreak has gone up to 1,016 with 108 new fatalities reported mostly in the worst-affected Hubei province while the confirmed cases of infection have soared to 42,638, Chinese health officials said on Tuesday, as a team of international experts led by the World Health Organisation (WHO) arrived in Beijing to help contain the epidemic.

As many as 108 deaths were reported on Monday and 2,478 new cases of the lethal disease confirmed, the National Health Commission said in its daily report.

The death toll due to coronavirus rose to 1,016 and the confirmed cases have gone up to 42,638, according to the commission.

Among the deaths, 103 were in Hubei province, the epicentre of the outbreak, and one each in Beijing, Tianjin, Heilongjiang, Anhui and Henan, state-run Xinhua news agency quoted the commission as saying.

A total of 3,996 patients infected with the coronavirus have been discharged from hospital till Monday after recovery, it said.

On Monday, 3,536 new suspected cases were reported and 849 patients became seriously ill, while 716 people were discharged from hospital after recovery, the commission said.

As many as 7,333 patients remained in severe condition and 21,675 people are suspected of being infected with the virus. Over 4.28 lakh close contacts had been traced and more than 1.87 lakh others are still under medical observation, according to the commission.

By the end of Monday, 42 confirmed cases, including one death, have been reported in Hong Kong, 10 confirmed cases in Macao and 18 in Taiwan.

A team of international experts led by the WHO arrived in China on Monday night to assist the Chinese health officials in containing the coronavirus outbreak.

The team is led by Bruce Aylward, a veteran of past public health emergencies.

Composed of international experts in various fields, the expert group will work with their Chinese counterparts to increase understanding of the epidemic and guide global responses, state-run People’s Daily reported.

China and the WHO will form a joint expert team to conduct in-depth discussions on and evaluations of the novel coronavirus epidemic and the containment, a National Health Commission (NHC) spokesperson said.

They will provide suggestions on joint prevention and control of the coronavirus outbreak to China and other affected countries in the next step, Mi Feng, an official with the NHC, told a news conference in Beijing.

“We welcome international experts including those from the United States to take part in the joint expert team,” Mi said, adding that appropriate arrangements for the team would be made after thorough consultation and communication.

Chinese President Xi Jinping, wearing a mask, on Monday toured Beijing city and said China can score a full victory over the epidemic, even as the situation remained “very serious”.

Outside China, there have been more than 350 infections reported in almost 30 places with two deaths, one in the Philippines and the other in Hong Kong.

Several countries have banned arrivals from China while major airlines have suspended flights to the country.

China and countries around the world are scrambling to contain the spread of coronavirus which is wreaking havoc in China and abroad. Apart from Germany, Britain and Italy, other European nations with cases of the virus include France, Russia, Belgium, Sweden, Finland and Spain.

China to Send Charter Flights to Bring Back Residents of Virus-Hit Wuhan From Abroad

The death toll in China’s novel coronavirus outbreak on Friday climbed to 213 with the number of confirmed cases totalling to 9,692.

Beijing: China will send charter flights to bring home residents of coronavirus-hit Hubei province, especially capital Wuhan, from abroad, the foreign ministry announced on Friday.

Foreign Ministry spokeswoman Hua Chunying in a brief statement said citizens from Hubei province will be brought back in view of “practical difficulties” they were facing abroad.

The move followed Chinese officials’ announcement that about five million people from Hubei province and capital Wuhan, the epicentre of coronavirus, have travelled out of the region before the province was officially closed on January 23.

These people are reported to have travelled within China and abroad to avail the weeklong holidays of the Chinese New Year and the ongoing Spring Festival.

The new type of virus originated in Wuhan and has since spread to more than a dozen nations.

Also read: Why India Should Worry About the New Coronavirus

The Hubei province with about 50 million people has been isolated and all public transport has been stopped. The people there are not allowed to travel out.

Chinese officials believe that the best way to control the virus is to trace the people from the province as most of the casualties so far from China and abroad either hailed or travelled there.

The death toll in China’s novel coronavirus outbreak on Friday climbed to 213 with the number of confirmed cases totalling to 9,692.

Hubei province, the epicentre of the outbreak, reported 5,806 confirmed cases, including 204 deaths, official media reported.

Many countries, including India, have reported confirmed cases of the virus in travellers coming from China.

The World Health Organisation (WHO) has declared an international emergency over the deadly novel coronavirus from China, a rarely used designation that could lead to improved international co-ordination in tackling the disease.