COVID-19 Disease Status in India: Need for Integrative Approach to Combat

Opinion

In India, as of 8th August, 2020, the total number of people affected with Corona Covid-19 disease caused by the infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exceeded 2.02 million; the figure would place India at the 3rd position worldwide among some 72 countries affected by the pandemic so far, only next to Brazil having 2.89 million active cases and USA with 4.78 million active cases standing at the top of the table (WHO Coronavirus Disease (COVID-19) Dashboard, Data last updated: 2020/8/7, 4:16pm CEST, available at: https://covid19.who.int/table) . In terms of mortality, India now stands at 5th position already losing some 42 thousand people to Covid 19. The fatal cases in the US are now at a staggering high- over 158 thousand-despite having an advanced healthcare system put in place in this country. In another advanced country UK, the total number of deaths caused due to Covid 19 disease is 46 thousand while the death toll in two other third world countries, is higher, about 98 thousand in Brazil and nearly 50 thousand in Mexico. Therefore, the Cornona virus is not sparing any nation and causing a tremendous impact on both advanced and developing countries alike. This is primarily because of the failure to formulate and develop an effective vaccine so far or for unavailability of any other conventional medicine that can prevent the virus from attacking human being, or specific drug that can combat and cure the disease after one gets an infection. Another cause of concern is the fact that there is a steady rise in the number of attack on a daily basis, the curve being on the ascending scale, now indicating over 62 thousand fresh infections per day in India., though the propagation of Covid 19 in India is still considered in the sphere of cluster transmission (WHO Coronavirus Disease (COVID-19) Dashboard, Data last updated:  2020/8/7, 4:16pm CEST, available at: https://covid19.who.int/table).

In a densely populated country like India having a total Opinion

population of over 1.34 billion people [1], it is high time to put a stop on the increasing trend of fresh attack by taking into consideration new strategies and implementing it effectively, otherwise if community transmission starts, there will be a devastating outcome killing millions of people in India soon as a result of infection of this deadly virus, capable of producing newer strains rapidly through mutations. The general trend of infection and mortality shows that the kids are relatively less vulnerable, but people in the age group of 18 to 60 years are a little more vulnerable, while the older population, aged over 60 years are the most vulnerable, particularly those with some other co-morbidities like diabetes, heart ailment, lung ailment or other ailments resulting in reduced immunity level [2].

Ever since the first record of Corona infection on the 30th January in Kerala state, the infection spread initially at a lower rate, but then spread quite rapidly in the other states too. One of the major factors that helped the virus most to spread was non-imposition of restriction on international travel of air travellers from countries already infected with Corona virus and leniency shown on their proper virus tests on arrival and allowing unrestricted movement in this country without implementing the quarantine or self isolation rule for a specified period; this could have been one major step to restrict virus dissipation at the initial level as the virus had by then been known to transmit from human to human. So social distancing and maintenance of personal hygiene and frequent sanitization should have been strictly imposed during the initial days as done by some other countries where the virus could not spread much and was soon successfully eliminated. Further, declaration of complete lock down was imposed for one day only on 22nd March, 2020 and then finally for a longer period till 17th May, 2020 from the 25th March, but with only a hasty and improper pre-planning. By then, the situation escalated considerably owing to certain other factors, including movement of migrant labourers and laxity in maintenance of social distancing and lock down rules by a section of people that helped the infection to spread further. Then the unlock down phases were also not quite well planned. In this scenario, when the number of active Covid patients has crossed 2 million, let us take stock of the number of dedicated Covid hospitals available in India and the total number of beds available therein. As of 17th May, 2020, according to union health minister, Government of India, there are 916 dedicated COVID hospitals in India with 1,80,473 beds, of which 1,61,169 were isolation beds and the remaining 19,304 were ICU beds (available at: https://www. huffingtonpost.in/entry/india-covid-19-cases-hospital- beds-icu-ventilators_in_5ec375adc5b6e607c1990187). In the meanwhile, provision for some additional beds and dedicated centres for covid treatment have been made available, where an approximate number of 48200 ventillators are available for treatment of serious patients needing ventilation. Though the overall recovery rate of Covid patients is estimated at or near 68%, the capacity of rendering conventional treatment at dedicated hospitals will dwindle fast with the rise of more active cases at the present rate, which has already compelled some states to advise less serious patients to stay back at home and not to move to hospitals unless expressly called for. With the rise of Covid cases in many states, other serious patients like those suffering from cancer, or maternity patients needing hospital care or those kidney patients needing dialysis are also facing difficulties, because of lack of facilities offered to them at these Covid hospitals, for fear of contamination and spread of the virus to such patients receiving these therapies, compounding the problems of these patients as well.

If a state-wise distribution of occurrence of Covid 19 disease is considered in India till 8th August, 2020, there appears to be a few states which are more vulnerable compared to others (data available at: https://www.mygov. in/covid-19). As for example, in the state of Maharastra, among some 4.9 lakh confirmed cases, some 1.46 lakh are active cases and more than 17 thousand people succummbed to the disease so far in this state alone. The states of Andhra Pradesh (active cases 84.6 thousand), Karnataka (active cases 77.7 thousand), Tamil Nadu (active cases 52.8 thousand) and Uttar Pradesh (active cases 44.6) are some other states still showing increasing numbers of active cases everyday. On the other hand, though Delhi is now showing an apparent decline in fresh active cases, the number of deaths occurring due to Covid 19 already crossed 4 thousand in this state. Initially, relatively low number of tests might be attributed for the low number of cases reported in different states. But at present the total number of tests has considerably gone up, being around six lakhs per day, and that may contribute to the finding of much higher number of active cases in India now. In view of the total population data, however, still higher number of tests is required and more facilities are being currently developed in this direction. With more number of daily tests, Corona infection in West Bengal as well as in some other states is also increasing alarmingly and the number of casualties is catching up fast with the abovementioned vulnerable states.

It has already been mentioned that scientists around the world are trying seriously to develop an effective and safe vaccine to prevent the virus from attacking human. But because of the fact that the virus has already produced many strains (more than twenty already) through mutations in different countries and also because of some inherent problems of developing a foolproof, safe and effective anti- viral vaccine through extensive trials, it is quite uncertain when such a vaccine will be available in the market after getting the statutory approval of regulatory bodies [3]. So far conventional allopathic treatment is given only on symptomatic basis in India and patients who opt for or seek additional support from traditional systems of medicine like ayurvedic, homeopathic, yoga, siddha or unani, are occasionally allowed to get such treatment by the AYUSH ministry, Government of India. But still there is much scope for improvement and execution of an integrative approach which seems to be the need of the hour.

It is high time that in accordance with the Advisory of AYUSH ministry, unaffected people are aggressively encouraged to take preventive AYUSH-recommended medicines (for more details, read at: https://pib.gov.in/ PressReleasePage.aspx?PRID=1600895), particularly, the homeopathic drug, Arsenicum Album 30, once daily in the morning for three consecutive days and also to repeat this course after 20-30 days, depending on the type of zone (red, yellow or green) they belong to. If some of these subjects develop some initial symptoms of Covid, they should be treated with homeopathy by quaified homeopathic doctors at clinics or homeopathic college hospitals. Patients responding well to homeopathic treatment and those not showing any alarming sign of deterioration, need not go to conventional Covid hospitals unless they expressly need ICU or ventillation facilities. This will reduce considerable pressure on hospital beds, doctors, nurses and health staff in hospitals. Further, as death rates in most sofisticated hospitals in the USA and other advanced countries like UK, France, Italy and Spain, giving the best possible conventional treatments also failed to stop the death rates and over one and a half lakhs of patients already died in hospitals of the US alone, there is no guarantee that giving alloathic treatment would be better to save lives than that given by homeopathic treatment. Further, homeopathic medicines by qualified doctors should also be given to those patients who may opt for additional supportive treatment, in all Covid dedicated hospitals, along with giving allopathic or conventional modern medicines to them, because in the absence of any specific anti-viral drug or any other specific drug for netralizing the virus so far, Covid patients are merely treated for palliation of their symptoms, like fever, cough, lung congestion etc. by the conventional doctors, and giving critical care through oxygen supplementation or ventillation when needed. For such critical patients, additional administration of the right homeopathic drug as a supportive medicine can relieve/save the patient of their acute sufferings and impending death. Prior permission/consent of the patients can be obtained at the time of hospitalization if he/she intended to opt for the homeopathic treatment in case it is adjudged necessary by the doctor, depending on the critical health status, in an effort to save life of the patient. The potentized homeopathic drugs are safe to administer because of their ultra-high dilution and clinical effect in ultra low doses, and they are known to have anti-viral effects, but no or negligible side effects [4, 5, 6]; it is high time that this system of medicine be allowed to be administered to willing patients to save their lives.