UP DATED ARTICLE ON COVID 19 – A PANDEMIC CRISIS

UP DATED ARTICLE ON COVID 19 – A PANDEMIC CRISIS - CHALLENGES: LESSONS FOR FUTURE

-*Dr. S. Vijay Kumar

In the human history, nothing has killed more human beings than the viruses, bacteria and parasites that cause diseases. Not even, natural disasters like earthquakes, volcanoes or war. The recent “2019 novel corona virus” is a RNA Virus, announced as Covid 19 by WHO. Co stands for Corona; Vid stands for virus disease and 19 stands for 2019. It was first reported in Dec, 2019 from China's Wuhan city. The WHO declared the virus as a global pandemic on 11th March, 2020. The first infected humans by corona virus was in 2002 in China but, identified in 2003 with Severe Acute Respiratory Syndrome (SARS) epidemic. A second outbreak of severe illness began in 2012 in Saudi Arabia with the Middle East Respiratory Syndrome (MERS). On December 31st, 2019 Chinese authorities alerted the World Health Organization about the outbreak of Covid 19. On January 30th, 2020 WHO declared corona virus a global emergency. WHO says, Covid 19 is more than 10 times deadly than swine flu.

Origins of the Covid 19: According to the findings of Andersen and his collaborators published in the journal “Nature Medicine” concluded that the novel SARS-CoV-2 corona virus (Covid 19) is the product of natural evolution and not the product of genetic engineering. Most likely origins for this virus having one of two possible scenarios. In one scenario, the virus evolved to its current pathogenic state through natural selection in a non-human host and then jumped to humans. The researchers proposed bats as the most likely reservoir for SARS-CoV-2 as it is very similar to a bat coronavirus. The current epidemic would probably have emerged rapidly as soon as humans were infected, as the virus would have already evolved the features that make it pathogenic (viruses, bacteria, other germs that cause disease) and able to spread between people. In the other proposed scenario, a non-pathogenic version of the virus jumped from an animal host into humans and then evolved to its current pathogenic state within the human population. But, the chances are lower of a non-pathogenic coronavirus entering the human population and then evolving properties similar to SARS-CoV-2.

*Professor (Associate) & Head (Retd.), Department of Economics, KGC, (NAAC “A” Grade) Former Member of Board of Studies, Kakatiya University, Warangal., Telangana State.

Out Break of Covid 19: On January 30^th 2020, WHO declared corona virus a global emergency. By that time, India and the Philippines confirmed their first cases of the virus, with one infected patient in each country. The World Health Organization declared the virus as a global pandemic on 11/03/2020. This virus has spread to more than 240 countries around the world. COVID-19 symptoms are fever, tiredness, dry cough, aches, pains, nasal congestion, runny nose, sore throat or diarrhea and breathing difficulties. Recent new symptoms are loss of smell or taste, intense chills with shivering, pink eyes. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure, and death. The COVID-19 infection will spread from one person to others via droplets produced from the respiratory system of infected people, often during coughing or sneezing, touching any infected surface or cloth and then touching one’s mouth, nose or eyes can transmit the disease. Some people with the infection, but without any serious symptoms can also spread the disease. According to current data, time from exposure to onset of symptoms is usually between 1-14 days, with an average of 5-6 days. In some cases, it may be 24-27 days. 3-8 weeks for patients with severe or critical disease.

Table – 1: Covid 19: World & Top (More Cases) 4 Counties as on 08/05/2020

World & Countries	Total Infected	Total Recovered	Recovery Rate (%)	Total Deaths	Death Rate (%)	Active Cases (Total Cases – Total Deaths + Total Recovered)
World	39,46,118 +32,474	13,58,054	34.4	2,71,667 +1,241	6.8	23,16,397
USA	12,92,996 +373	2,17,251	16.8	76,948 +20	5.9	9,98,797
Spain	2,60,117 +3,262	1,68,408	64.7	26,299	10.1	65,410
Italy	2,15,858	96,276	44.6	29,958	13.8	89,624
UK	2,06,715	N/A	----------	30,615	14.8	1,75,756

Source: https://www.worldometers.info/coronavirus/?isci=010702

Table - 2 : Covid 19: India, Telangana, 3 States (More Cases), 5 States (Best Performed) & 5 States/UTs (Zero Cases) As on 08/05/2020

India, Telangana & Other States	Total Infected (Confirmed)	Total Recovered	Recovery Rate (%)	Total Deaths (Deceased)	Death Rate (%)	Active Cases
India	56,342 ↑ 3390	16,540 ↑ 1273	29.3	1,886 ↑ 103	3.3	37,916
Telangana	1,123 ↑ 16	650 ↑ 22	57.8	29	2.5	444
More Cases Maharashtra	17,974 ↑ 1216	3,301 ↑ 207	18.3	694 ↑ 43	3.8	13,979
Gujarat	7,012 ↑ 387	1,709 ↑ 209	24.3	425 ↑ 29	6.0	4,878
NCT of Delhi	5,980 ↑ 448	1,931 ↑ 389	32.2	66 ↑ 1	1.6	3,983
Best Performed Kerala	503	474 ↑ 5	94.2	4	0.79	25
Goa	7	7	100	0	0	0
Manipur	2	2	100	0	0	0
Arunachal Pradesh	1	1	100	0	0	0
Mizoram	1	1	100	0	0	0
Zero Cases Daman & Diu Sikkim Nagaland Dadra & Nagar Haveli Lakshadweep	0 0 1 0	0 0 1 0	------------	0 0 -------------- 0	0	0

Source: GOI, Aarogya Setu App.

https://telanganatoday.com/doubling-rate-of-covid-19-cases-at-11-days-centre

Reasons for Spread of Covid 19:

Negligence of China: China did not take immediate action and not alerted the WHO in time during COVID-19. This is confirmed by “Wuhan Diary” written by Wang Fang. In her online diary she mentioned "A doctor friend said to me: in fact, we doctors have all known for a while that there is a human-to-human transmission of the disease, we reported this to our superiors, but yet nobody warned people" she also wrote about shortage of masks. Today, because of China, Covid 19 has become Global Pandemic and whole world is suffering.

Indian Government’s Action: The WHO declared corona virus as a global emergency on 30^th January, 2020 and the first case of Covid 19 was also reported on the same day in India. But, the Government did not stop the travelers from abroad to India till 12/03/2020. Covid 19 imported to India through foreigners. Though, Government had initiated action, if it had acted much earlier as a preventive measure, the number of cases would have been much lesser than today.

US President Trump said Covid 19 - A Hoax: He has under estimated the impact of Covid 19 even after seeing several deaths in Italy and Spain and delayed the action. Hence, the number of cases are increasing in US very rapidly and huge number of people are infected and dying daily.

Stages of Covid 19: According to Indian Council of Medical Research (ICMR), there are four states of Covid 19 disease:

· Stage 1: Imported cases.

· Stage 2: Local transmission.

· Stage 3: Community transmission.

· Stage 4: Epidemic.

At present India is at 2nd Stage, experts say that as stern precautions were being taken, we do not go to 3rd Stage, which has happened in other countries like Italy, China, US and Europe. If entered the 3^rd Stage i.e. Community transmission takes place and becomes epidemic and spreads violently which causes thousands of deaths per day. According to ICMR, one covid-19 patient could potentially infect 406 people in 30 days, if he/she doesn’t practice social distancing.

1. Insufficient number of Hospitals, Doctors, Nurses and Paramedical Medical Staff: This is also one of the reasons for rapid increase of Covid 19 cases.

2. Poor Public Response: If public do not respond to the instructions of government, medical staff and police, number of Covid 19 cases will increase with in no time.

3. Poor Awareness in the Public: People not having sufficient information about the Covid 19 will increase the cases.

4. Poor Social Responsibility: This will augment and spread number of Covid 19 in the country.

5. Insufficient Virology Test Labs and Required Medical Equipment: This is also important factor which will increase Covid 19 cases.

6. Tablighi Jamaat meet turns Covid-19 Super Spreader: Due to Markaz International Religious Congregation 80% of the Covid 19 cases are confirmed from the Muslims who have attended Tablighi Jamaat Markaz.

7. Delay in Response: In Italy, Spain and in other countries delay in response has contributed to the spread of Covid 19.

8. Patients Misbehaving with Doctors: Some people and patients especially Muslims who attended Delhi Nizamuddin Markaz religious congregation are misbehaved with medical staff, which aggravated the situation. This is highly deplorable.

9. Doctors Complaints: In some States of India Doctors are complaining that they have not been provided with required safety equipment, staff, medicines and lifesaving ventilators. This may lead to the spread of Covid 19 cases.

10. Neglecting Preventive Measures: We all know that “Prevention is better than cure”: Neglecting preventive measures will spread Covid 19 cases at jet speed and will lead to several deaths.

11. Scarcity of Hospitals, Doctors, Medicines, Medical Equipment & PPEs.

Covid 19 – A Bio Warfare Virus?: Till date, there is no established proof that it has been created in a lab for bio warfare. In fact, the scientists concluded that it was the result of natural selection and not the product of genetic engineering. Recently, WHO also confirmed the same. Though, US President Trump called Covid 19 as “Chinees Virus”, no evidence shown. Moreover, within a short time he sought China’s help to combat Covid 19 collectively.

Democracy Vs Dictatorship: Amartya Sen has rightly pointed out that where democracy prevails, governments will take care of public welfare. In contrast to this, dictatorship governments will neglect public welfare. This is clearly evident from the recent outbreak of Covid 19 in China. Though, first case in China suffering from COVID-19 can be traced back to November 17, 2019 and Dr Li Wenliang, when he first wrote about the virus on social media on December 30, 2019, who later died of COVID-19, was warned by local police. Thus, because of negligence of China, Covid 19 has become a Global Pandemic.

Covid 19 - A Pandemic Crisis - Impact on World & India: IMF says this pandemic is much bigger than 2008 financial crisis. UN Conference on Trade and Development (UNCTD) estimates the economic impact at a minimum of $1 trillion in 2020. As China being a major manufacturing hub, the outbreak of Covid 19 has been seen to pose a major destabilizing threat to the global economy, concerns have shifted from supply-side manufacturing issues to decreased business in the services sector. There have been widespread reports of supply shortages of pharmaceuticals, masks with many areas seeing panic buying and consequent shortages of food and other essential grocery items. Some sellers are exploiting this situation and resorting to black marketing and selling the goods at exuberance prices. The technology industry, in particular, has been warning about delays to shipments of electronic goods. Dr. Panos Kouvelis, Director of "The Boeing Center" at Washington University in St. Louis, estimates a $300 + billion impact on world's supply chain that could last up to two years. The Organization of Petroleum Exporting Countries (OPEC) reportedly "scrambled" after a steep decline in oil prices due to lower demand. Due to a significant rise in the number of COVID-19 cases, by 28 February 2020, Stock Markets worldwide saw their largest single-week declines since the “2008 Financial Crisis”. As the pandemic spreads, global conferences and events across technology, fashion, and sports are being cancelled or postponed. While the monetary impact on the travel and trade industry is yet to be estimated, it is likely to be in billions and increasing. News reports indicating that the effect of Covid 19 on the US economy will be worse than expected. The pandemic has affected educational systems worldwide, leading to the widespread closures of schools and universities. According to data released by UNESCO on 25/03/2020 schools and universities closures due to COVID-19 were implemented nationwide in 165 countries. This affects over 1.5 billion students worldwide, accounting for 87% of enrolled learners. Shops and malls closed. In many of the world's major cities, planned travel went down by 80-90%. International Air Transport Association has predicted on 7/03/2020 that nearly 25 million jobs are at risk due to Covid 19 crisis. It is estimated that the impact of Covid 19 is more than the attacks on WTC (11/09/2001).

In India, the first case of Covid 19 was reported on 30/01/2020. The outbreak has been declared an epidemic in more than a dozen states and union territories, where provisions of the “Epidemic Disease Act 1897” have been invoked, educational institutions, many commercial establishments have been shut down and suspended all tourist visas, as a majority of the confirmed cases were linked to other countries. On 2/03/2020, the BSE SENSEX witnessed a flash crash. After WHO's declaration of the outbreak as a pandemic (11/03/2020), next day itself i.e. on 12/03/2020 Indian stock markets suffered their worst crash since June 2017. On 22/03/2020, India observed a 14-hour voluntary public curfew at the insistence of the Prime Minister Narendra Modi. Further, PM announced 21 days lock down from 25/03/2020 to 14/04/2020. Lockdown extended from 14/04/2020 to 3/05/2020. Lock down is further extended from 4/05/2020 to 17/05/2020. Some relaxations in orange and more relaxations in green zones are granted. But strict conditions in Red Zones/Hot Spots to contain Covid 19. To prepare themselves for likely emergencies, with the Covid-19, the public cash withdrawals from banks, hit a 16-month high, they withdrew ₹53,000 crore during the fortnight ended March 13, according to the data released by the RBI. A UN report estimated a trade impact of US$348 million on India due to the outbreak, making India one of the 15 worst affected economies across the world. Asian Development Bank has estimated that the outbreak could cause losses of up to US$29.9 billion to India's economy and GDP may fall up to 1% in the financial year 2020-21. It could lose an estimated three million tourists in the calendar year 2020 and foreign exchange of about $7 billion in related sectors. The WHO Executive Director Michel Ryan said that Covid 19 impact on India will be enormous. Economic devastation caused by the lockdown has huge effects on migrant labourers, informal workers, micro and small enterprises, farmers and the self-employed, who are left with no livelihood in the absence of transportation and access to markets. Due to lock down effect 90% of the trucks are off the road. According to ILO, 400 million Indian workers may sink into poverty. All these problems hitting the world of work from multiple directions, companies are finding it difficult to sustain in this environment. They are forced to take tough decisions such as cutting down the salaries, giving pink slips to employees and opting for other cost-cutting measures. Telangana and A.P States has resorted to cuts in the salaries of public representatives, government employees and pensioners. Central Government announced that DA and DR of employees and pensioners will be frozen from 1^st January, 2020 to January, 2021. While it makes all the sense in the world to stay at home and work, rather than be in a crowded office environment, it is affecting the non-IT companies, especially the small and medium enterprises (SMBs). The outbreak has presented new roadblocks for the Indian workforce and especially for the daily wage and contractual workers. It is reported in Poona that domestic violence increased during the lock down period.

Covid 19 – A Blessing in Disguise: It is a blessing in disguise for the planet as Climate Scientists forecast a drop in carbon emissions, Which improved the quality of air. The Indian sector has long been dependent on China to critical source imports. The good sign is now, a $163 billion Chemical industry struggles to reduce its dependency on Chinese imports. Including USA realized that dependence on China for its essential medicines is dangerous. The large scale lock downs across the globe has led to decrease in carbon emissions which will ultimately benefit the planet. Reduction in energy use and emissions mostly due to drop in electricity use, industrial production and transport benefitted the countries across the world. Analysis from Stanford University found the drop in nitrogen dioxide across the planet could save large number of lives. Environmentalists have calculated that the pollution reduction has saved several lives across the globe. Current Covid 19 pandemic threat has opened new ways like offering online classes on sustainability, life skills on communication, stress management, mental health, yoga etc. By taking advantage of this situation, we can ensure through E-learning that education does not come to a standstill and every child receives the education they rightly deserve. We can also make use of this situation to read a books, writing, listen to music, learn something new, talk to a loved one, relatives and friends, seek spiritual comfort.

Indian Traditions to combat Covid 19: As Covid 19 is spreading all over the world and creating havoc, “Indian Namasthe” is becoming popular across the globe to avoid physical contact. Ministry of AYUSH is advising to use traditional ancient medicines like Ayurveda, Yoga & Naturopathy, Unani, Siddha, Sowa Rigpa and Homoeopathy to contain Covid 19.

Myths Vs Facts of Covid 19:

MYTH 1: EATING GARLIC OR LEMON (AND OTHER FOODS COMMONLY USED AS HOME REMEDIES FOR FLU AND COMMON COLD) CAN HELP TO PREVENT INFECTION OF COVID 19. ThIS IS FALSE.

FACT: Garlic is a healthy food that may have some antimicrobial properties. Similarly, vitamin C is an essential nutrient that can support immune function. However, there is no evidence from the current outbreak that eating garlic or lemon (or other foods for that matter) has protected people from Covid 19.

MYTH 2: REGULARLY GARGLING WITH SALTWATER OR SALINE CAN HELP TO PREVENT INFECTION WITH THE COVID 19, AS WELL AS DRINKING WATER TO “FLUSH” THE VIRUS FROM MOUTH. This is false.

FACT: There is no evidence that regularly gargling has protected people from infection with Covid 19. While this may help soothe a sore throat, but this practice will not prevent the virus from entering the lungs—neither will drinking frequent sips of water.

MYTH 3: DRINKING WARM WATER AND GETTING ENOUGH SUNLIGHT ARE EFFECTIVE IN PREVENTING COVID-19. this is false.

FACT: Drinking warm water and getting enough sunlight may have health benefits. Sunlight is good to get Vitamin D, but too much exposure to sunlight may also lead to sunburn.

MYTH 4: TAKING A HOT BATH CAN PREVENT covid 19. this is false.

FACT. Taking hot bath will not prevent from catching COVID-19.

MYTH 5: HAND DRYERS ARE EFFECTIVE IN KILLING COVID 19. this is false.

FACT: Hand dryers are not effective in killing COVID-19.

MYTH 6: SPRAYING, drinking ALCOHOL OR CHLORINE ALL OVER THE BODY CAN KILL covid 19. this is false.

FACT: Spraying, drinking alcohol or chlorine all over the body will not kill the viruses.

MYTH 7: VACCINES AGAINST PNEUMONIA CAN PROTECT from covid 19. this is false.

FACT: No Vaccines against pneumonia, such as pneumococcal vaccine and Hemophilus influenza type B (Hib) vaccine, do not provide protection against the Covid 19. This virus is so new and different, it needs its own vaccine.

MYTH 8: THE NEW CORONA VIRUS CAN BE TRANSMITTED THROUGH MOSQUITO BITES. this is false.

FACT: Till date, there is no evidence that Covid 19 could be transmitted by mosquito bites.

MYTH 9: covid 19 AFFECTS ONLY OLDER PEOPLE. this is false.

FACT: People of ALL AGES can be infected by Covid 19. Ofcourse, old people and people with pre-existing medical conditions (such as asthma, diabetes, heart disease) are more vulnerable to Covid 19. WHO advises people of all ages to take appropriate steps to protect themselves from this virus.

HOW LONG CAN COVID 19 VIRUS LIVE ON SURFACES?: According to a recent study published in the New England Journal of Medicine, SARS-CoV-2, the virus that causes COVID-19, can live in the air and on surfaces between several hours and several days. The study found that the virus is viable for up to 72 hours on plastics, 48 hours on stainless steel, 24 hours on cardboard, and 4 hours on copper. It is also detectable in the air for three hours. But the important point one should know is that the virus that remains is less than 0.1% of the starting virus material.

IMPACT OF SUMMAR ON COVID 19: Recently, US Scientists observed that “Solar light appears to have on killing the virus, both surfaces and in the air, increasing the temperature and humidity or both is generally less favorable to the virus. Summer like conditions will create an environment (where) transmission can be decreased”. But the rate of infection is likely to increase in fall and winter.

COVID-19, airborne transmission may be possible? To date, there is no concrete evidence in this regard. But it is a droplet transmission.

Covid 19 virus's viability in exposure to heat or cold: There is no evidence, but an unpublished research predicts that temperate warm and cold climates are the most vulnerable and Tropical parts of the world are likely to be least affected.

State Role to Contain Covid 19:

· First of all, immediately declaring “Health Emergency” in the country.

· Alert the public regarding their social responsibility.

· Stopping the people who are travelling from abroad and arriving the country.

· Providing sufficient funds, medicines and equipment.

· Like China, if existing hospitals and beds are not sufficient, immediately without loss of time, additional temporary hospitals should be constructed, and the number of beds should be increased.

· Additional number of doctors, nurses and para medical staff should be appointed according to the requirement.

· Local governments should keep their villages, towns, cities and metros cleanly.

· Above all, COMMITMENT of the Government is very essential. Because, as the saying goes “Yadha Raja Thadha Praja”, people will follow the Government.

· If necessary, government should declare ESMA (Essential Maintenance Service Act) to obtain health services (Doctors and Hospitals).

Social/Public Responsibility to Contain Covid 19:

· At this juncture of pandemic, public MUST support the government scrupulously in all respects and they should realize that government is there for their welfare only.

· For their safety and for the safety of the whole society, they should stay safely in their homes, support the government and realize their social responsibility.

· Public should not belief the unscientific methods and treatments which are circulating in social media i.e. in YouTube, Facebook, Twitter and WhatsApp.

· Dissemination of scientific information and to spread only necessary correct preventive steps to be followed to contain Covid 19.

· Spreading of superstitions is an offence and punishable, hence one should avoid.

· Supporting the doctors is vital. They should listen and follow what they say.

· People should contribute liberally donations to the PM & CMs Relief Fund.

· Maintaining neatness and keeping their surroundings cleanly.

NGOs Role: In this crisis, all Non-Governmental Organizations (NGOs) MUST support the government and extend all help to the public.

Medical & Health Role to Contain Covid 19:

· All the medical staff - doctors, nurses, para medical MUST work with COMMITMENT and RESPONSIBILITY.

· As a social responsibility they should inform the public through social media regarding the preventive steps to be taken to contain Covid 19.

· They should inform the government and get the required safety tools, medicines, medical equipment, and additional staff immediately.

· They should also alert the government regarding the establishment of new Virology Testing Labs, R&D Centers, and other requirements if any.

Police Role to Control to Covid 19:

· Police should play a key role in this crisis to make lock down a success.

· Police MUST NOT behave rudely and caning the public by following traditional methods of punishment, instead through counselling they should convince them.

They should act as a liaison between the public and government.

Who are Spreading Covid 19 Infections Widely:

People thinking, they are OK, spreading to people who also think they are OK, are behind the vast majority of infection transmissions.

Preventive Measures to Combat Covid 19: We all know that “Prevention is better than cure”. Hence, we should all follow the following preventive measures:

1. Spreading key measures to prevent the Covid 19 infection.

2. Taking actions for early detection and referral of suspected COVID-19 cases.

3. Maintain Social Distance. It will slow the virus down.

4. Avoiding gatherings in melas, markets, gatherings in religious places, social functions etc.

5. Staying at home.

6. Avoiding physical contact like handshakes, hand holding or hugs.

7. Avoiding touching surfaces such as table tops, chairs, door handles etc.

8. Washing hands frequently with soap water/sanitizer

9. Avoid sharing of objects like pen, paper, phone etc.

10. While coughing or sneezing covering nose and mouth with handkerchief. Washing the handkerchief at least once daily.

11. It is preferable to cough/sneeze into bent elbow rather than in palms.

14. Following persons should be quarantined for 14 days at home as a precaution:

(a). People who have travelled to COVID 19 affected countries/areas in past 14 days.

(b). Those who have come in close contact with a suspected/confirmed COVID 19 patient.

(c). Those who develop symptoms of Covid 19.

(d). Even people with the Covid 19 infection, but no symptoms.

16. If symptoms become severe, concerned person should call helpline or visit a health facility.

17. Sharing the information about people who have travelled to other countries or other states inside India in last 14 days.

18. Monitoring the people who have developed the symptoms of COVID-19.

19. To give instructions to the persons being Home Quarantined and to ask them to stay in a separate room at home, if possible with an attached/separate toilet.

20. Infected persons/others who go out of homes should wear a mask/clean cloth.

21. Not to touch eyes, nose and mouth with unclean hands.

22. Ensure that the surfaces and objects are regularly cleaned.

23. Prophylactic treatment should be given.

24. Take care of older people, pregnant women, newborns, sick children, Post Natal.

25. Avoid unnecessary visits to medical facilities so that doctors can serve better Covid 19 effected patients.

Immunity Development: Robust health plays a key role in containing Covid19. The following measures should be followed to develop immunity:

Eat Natural Fresh (Unprocessed) Vegetables and Fruits: For snacks, choose raw vegetables and fresh fruits rather than foods that are high in sugar, fat, or salt. Do not overcook vegetables as this can lead to the loss of important vitamins. When using canned or dried vegetables and fruits, choose varieties without added salt or sugar.

Drink Enough Water Every Day: Drinking enough water carry nutrients and compounds in blood, regulates body temperature, gets rid of waste, and lubricates and cushions joints. Drink 8–10 glasses of water every day. Water is the best choice, but one can take other drinks like lemon juice without sugar, tea, and coffee but not often, fruit juices (without sugar).

Eat Moderate Amounts of Fat and Oil: Consume unsaturated fats (found in fish, avocado, nuts, olive oil, soy, canola, sunflower and corn oils) rather than saturated fats (found in fatty meat, butter, palm and coconut oils, cream, cheese, ghee, and lard). Choose white meat (poultry) and fish, which are generally low in fat, rather than red meat. Avoid processed meats because they are high in fat and salt. Where possible, opt for low-fat or reduced-fat versions of milk and dairy products. Avoid industrially produced trans fats. These are often found in processed food, fast food, snack food, fried food, frozen pizza, pies, cookies, margarines, and spreads.

Eat Less Salt and Sugar: When cooking and preparing food, limit the amount of salt and high-sodium condiments (soy sauce and fish sauce). Limit daily salt intake to less than 5 gms (approximately 1 teaspoon) and use iodized salt. Avoid foods (snacks) that are high in salt and sugar. Choose fresh fruits instead of sweet snacks such as cookies, cakes, and chocolate.

Avoid Eating Outside: Eat at home to reduce the rate of contact with other people and lower the chance of being exposed to COVID-19.

Yoga & Meditation: Practice Yogasanas, Pranayama and meditation for at least 30 minutes every day.

Indian Food, Herbal Tea & Steam Inhalation : Add spices like Haldi (Turmeric), Jeera (Cumin), Dhaniya (Coriander) and Lahsun (Garlic) while cooking your food to keep your immune system healthy. Take 1 tbsp Chyavanprash 10gm every day in the morning. If diabetic, opt for the sugar-free version. Drink herbal tea twice a day having a combination of Tulsi (Basil), Dalchini (Cinnamon), Kalimirch (Black pepper), Shunthi (Dry Ginger). Practice steam inhalation with fresh Pudina (Mint) leaves once in a day. Lavang (Clove) powder mixed with natural sugar/honey can be taken 2-3 times a day in case of cough or throat irritation.

Balanced Diet: A balanced diet comprising nutrient-rich vegetables, fruits, pulses, cereals, and curd coupled with a healthy lifestyle is the key to boost the immune system.

Indian Council of Medical Research (ICMR)-National Institute of Nutrition (NIN) Advise: Take micronutrients (vitamins and minerals) and phytonutrients that are primarily available in fruits, nuts, vegetables, and wholegrains enhance both native and adaptive immune function and prevent infection.

Fresh Fruits, Vegetables and Meat: Fruits like papaya, guava, apple, grapes, mango, oranges, tangerines, lemons, sweet lime and goose berries, all seasonal vegetables, including green leafy, and spices, legumes, millets. Consuming meat, fish, poultry, and eggs is not risky in present circumstances, but hand wash hygiene must be followed after handling raw meat, eggs or even vegetables, thoroughly cooked meat, and poultry products.

Curd: Curd is a source of many nutrients, it improves gut health by regulating gut bacteria, aids immune function and reduces inflammation.

Sugar: Sugar is just calories with no nutrients, hence keep it to bare minimum.

Ideal Body: Maintaining ideal body weight, keeping body hydrated with adequate water intake, taking up moderate physical activity i.e. exercise, walking etc.

Less Carbohydrates: Eat low carbohydrate diets, this will help to control high blood sugar and pressure and slow down diabetes.

Other:

Do not Skip on Exercise, Avoid Stress, Do not Compromise Sleep (Sleep at least

minimum 8 hours), Avoid Smoking, Alcohol and Other Addictive Substances.

Vitamins: In particular, antioxidants otherwise known as vitamins A, C, and E, as well as the "sunshine" vitamin, Vitamin D. Antioxidant-rich foods include:

Vitamin A and beta-carotene: pumpkin, squash, carrots, spinach, sweet potatoes, cantaloupes, dark leafy greens, and mangoes.
Vitamin C: Citrus fruits, strawberries, bell peppers, cauliflower, broccoli, tomatoes, sweet potatoes, and asparagus.
Vitamin E: Vegetable oil, almonds, whole grains, wheat germ, sweet potatoes, and yams.
Selenium: Salmon and haddock (Food fish).

Some evidence shows vitamins C, D, E, and zinc supplements are beneficial for respiratory infections with symptoms similar to Covid 19.

Recent Updates of Covid 19: Central Government divided districts/areas in to Red, Orange, and Green Zones. Where sizeable number of cases (80%) were detected in the last 14 days are declared as Red Zones or Hotspots. In these areas all activities, except essential services like medical emergencies and law enforcement, will be stopped. Where only a few cases were found in the past 14 days with no increase in the number of positive cases are declared as Orange Zones. Where there is no single case of COVID-19 in the last 28 days are called Green Zones. In green and orange zones limited public transport, some agricultural activities with strict guidelines like social distancing are allowed. In these two zones, MSMEs and MNREGA will resume operations. In India, 400 districts were declared as Green Zones. On the basis of above said rules the zones will change. The containment zones are marked if more than 4 cases of Covid-19 are reported. Scientists at Delhi’s CSIR - IGIB have developed a paper-based test strip called “Feluda Test” for Covid-19. This test is 100 per cent accurate and cheap. Government recommended to download “Arogya Setu App” which is a corona virus tracker can help a user to identify possible corona virus 'hot spot'. In Kerala, Covid 19 curve flattened, while in Telangana the curve started bending downward. Corona virus mortality rate in Kerala is 0.66% but in the world it is 7%. The current (As on 30/04/2020) fatality rate for Covid-19 is 3.2 per cent in the country, with 65 per cent of the victims being males and 35 per cent females. “Looking at the age distribution of the deaths, 14 per cent case fatality was seen below 45 years, 34.8 per cent between 45-60 years and a 51.2% case fatality was noted among those above 60 years. “Further, if we divide the mortality cases above 60 years, then we see that the mortality has been 42 per cent in the age group of 60-75 years and 9.2 per cent in those above 75 years”. In India, due to lockdown impact, Covid-19 cases doubling rate slows down from 3.5 days to 11 days and recovery rate is 25.8%, while in Haryana and Kerala it is 67.4% and 62.7%. On 30/04/2020, Government passed an order to allow inter-state movement of migrants, students, and others to reach their respective destinations, subject to certain conditions i.e. they should travel by Special trains(Shramic Rails) with all preventive measures. It is declared that Oxford Vaccine Group, UK’s “Super Vaccine” for Covid 19 will be ready by Sept/Oct, 2020. It will be manufactured in India also. Started its clinical trial on Elisa Granato, the first volunteer in an initial group of 800. Covid toes infection among kids, a new symptom of navel corona virus is reported from Italy and Boston, US. Some doctors reported it as “Covid Toes”. Chinese top scientists say that Covid 19 will not be eradicated and will likely return in waves like flu. As, the lockdown is extended from 4/05/2020 to 17/05/2020, there will be no trains, domestic and international flights, schools and colleges, Hotels, No inter – State Buses, Cinemas etc. Inter – district buses are permitted. Extending the lockdown is only the temporary solution to contain Covid 19. Revival of economy is also more important. Hence, Government should examine all options and take necessary steps in this direction. Telangana State also extended lockdown from 7/05/2020 to 29/05/2020 and agreed to abide by Central Government guidelines strictly. Recently, The research published in the journal Environmental International, environmental scientists have warned that the potential spread of Covid-19 via sewage “must not be neglected” since the viruses shed from the digestive system of infected individuals tend to last for longer than those from the respiratory tract. The scientists have focused on preventing person-to-person transmission and cautioned that the virus might also spread in wastewater. All India Institute of Medical Sciences (AIIMS), Director said in June and July, 2020 Covid – 19 cases may reach peak. He further says that “COVID-19 curve remains flat but rise in cases at steady rate a cause of concern”. India has started clinical trials of Ayush medicines. Scientists in Israel and Italy claimed to have extracted Covid antibody to neutralize coronavirus. PM Modi also took stock on situation and around 30 Corona vaccines are in different stages of trial in India. American pharmaceutical giant Pfizer along with German biotech company BioNTech has begun human trials of a potential COVID-19 vaccine in the US. WHO says, per day 80,000 COVID-19 cases were reported in April,2020. Kerala has decided to send people aged above 65 years on “Reverse Quarantine”. (It is a method of protecting vulnerable people from getting infection). Italian Scientists have identified a gene highly specific to Covid 19 on particles of air pollution. Investigating is on, whether this could enable it to be carried over longer distances and increase the number of people infected. The work is in preliminary stage, and it is to be tested whether, the virus remains viable on pollution particles and in sufficient quantity to cause disease. India’s premier R&D organization, CSIR, has submitted 53 genome sequences of the virus to a global genome database, a move that may help in better understanding of the virus and developing a vaccine. It is also planning to submit additional 450 genome sequence data of corona virus by May 15. Chinese researchers report in a small study that Covid 19 can be found in semen, but it did not address whether sexual transmission is possible.

Concept of Herd Immunity Theory: It is defined as the proportion of individuals in a community who are immune to a disease. It is generally believed that all pandemics naturally stop spreading when a certain number of people in the population become immune to the virus. The logic here is that once these thresholds are reach, the virus is no longer able to find a host to infect. As a result, transmission slows down and stops. The percentage of people who need to become immune can vary between viruses. Herd immunity could also result from vaccination—as in the case of Polio. Herd effect refers to the indirect protection enjoyed by the remaining individuals in that community. As there is no vaccination available for the SARS-Cov-2 virus, the only option to get herd immunity appears to be by getting the infection. Epidemiologists generally agree that large segments of the world’s population will eventually get infected, albeit at a slower rate due to active efforts at flattening the curve. Sweden practiced “Herd Immunity Theory”.

Why Sweden chose Herd Immunity Theory: Sweden's decision to leave larger parts of society open than most of Europe came after Dr Tegnell's team used simulations which anticipated a more limited impact of the virus in relation to its population size. In addition, the Swedish Public Health Agency pushed the idea early on that a large proportion of cases were likely to be mild. But it denied its strategy was based on the overall goal of herd immunity. A core aim was to introduce less stringent social distancing measures that could be maintained over a long period time. Schools for under-16s have remained open to enable parents to keep working in key areas. It has higher death rates in relation to its population size than anywhere else in Scandinavia. Unlike in some countries, Sweden's statistics do include elderly care home residents, who account for around 50% of all deaths. Dr Tegnell admits that is a major concern. "There are too many people dying," says Claudia Hanson, an epidemiologist based at Karolinska Institute, Sweden's largest medical research facility. She is critical of the government's approach and argues more of society should have been temporarily shut down in March ,2020 while officials took stock of the situation. Dr Hanson is among 22 scientists who wrote a damning piece in Sweden's leading daily last week, suggesting "officials without talent" had been put in charge of decision-making. The Man Behind Herd Theory is Chief State epidemiologist Anders Tegnell, who is popular in Sweden. An experienced scientist with more than 30 years in medicine. History only will tell us, whether this theory would be successful or not. Ministry of Health, Government of India said as Covid 19 will last for longer time, we must learn, how to live with Covid 19. According to worldmeter.com, India is the 14^th worst effected country in the world. With 59,881 Covid 19 cases. Ten worst effected States/UTs in India are Maharashtra, Gujarat, Delhi, , Rajasthan Tamilnadu, M.P, UP, AP, West Bengal and Panjab. China conducts first successful corona virus vaccine test on monkeys. At last, China admits corona virus exposed “short comings” in its health care system. Due to comorbidity (people who have one or more diseases or conditions) Covid 19 cases are increasing. Elderly patients with hypertension and diabetes are more prone to Covid 19. The figures suggest that about 71 per cent of the total patients who died in Gujarat from March 23 to April 25 after contracting coronavirus, suffered from some kind of disease. Prime Minister Narendra Modi on 12^th May, 2020 announced economic package worth of Rs 20 lakh crore or 10 per cent of GDP, to revive economy and to make self-reliant in the post Covid 19. Modi said the economic package would focus on land, labour, liquidity and laws, and it will cater to various sections including cottage industries, MSMEs, labourers, the middle class, industries, among others. Economists calculating the cost of the stimulus said the additional cash outgo of the entire package was only about Rs 2 lakh crore or less than 1% of India’s Rs 211 lakh crore GDP and not of 10% of GDP. The Rs 8 lakh crore worth of steps unveiled by RBI will have no fiscal impact. India is among 62 countries that have moved a proposal at the World Health Assembly to “identify the zoonotic source” of the coronavirus and asked for an “impartial, independent and comprehensive evaluation” of the WHO’s response to Covid-19. China and the US are not part of the resolution. The proposal is part of a seven-page draft resolution moved by 35 countries and the 27-member European Union, and is likely to be taken up on Monday at the Assembly, which is the decision-making body of the WHO. The resolution is being backed by three of the five permanent members of the UN Security Council — UK, Russia and France — along with Japan, Australia, South Korea, New Zealand, South Africa and Turkey, among others. But Pakistan, Nepal, Sri Lanka, Maldives and Afghanistan are not signatories to the resolution. From the SAARC nations, only Bangladesh and Bhutan have signed up. Central Government gave liberty to States with regard to deciding of Red, Orange and Green Zones in recent 4.0 lock down.

Challenges of Covid 19: The following are the challenges of Covid 19:

1.     Prevention: Implementation of preventive measures.
2.     Government: Decisive government leadership.
3.     Information to the Public: Spreading information to the public widely.
4.     Public Response: People support to government.
5.     Detection and Reporting: Early detection and reporting for epidemics of potential international concern.
6.     Evaluation: Evaluation of medical resources and response systems.

Measures/Lessons for Future:
·        Ensure correct detection and diagnosis of viral diseases.
·        Providing clear guidance to the public about the degree and scope of lock downs.
·        Implementation of preventive measures down to individuals is vital.
·        Stern action against the people who are not cooperating to combat Covid 19.
·        Keeping essentials like food and supplies flowing through organized, government-controlled arrangements.
·        Designating infectious disease care and management facilities to isolate, monitor and treat positive cases.
·        Establishing electronic recording and tracking systems and local response teams to handle identified cases 24/7.
·        Establishing centralized reporting and communication channels to keep citizens informed.
·        To eliminate the source of infection, prevention and control is essential.
·        Government should encourage Research & Development by providing more funds to prepare vaccine and medicines to contain viral diseases.
·        Establish more Virology Labs to test the viral diseases.
·        A “Comprehensive Health System” should be designed to face viruses like Covid 19 in future.
·        At present India is just spending 1.17% of the GDP on health (National Health Profile 2019). It should be raised at least to 5-6 percent of GDP.
·        While protecting the health of the public, it is the primary duty of the governments to protect the livelihood of the public. Hence, Governments MUST take suitable measures in this direction.
·        Provide required infrastructure in hospitals to combat viral diseases.
·        Ensure required number doctors and para medical staff to combat viral diseases.

Conclusion: To conclude, WHO altered the whole world to be careful and warned that Covid 19 will last for longer time, if we neglect, it will ignite. At present, there is only symptomatic treatment, but no correct medicine/vaccine to fight Covid 19. Hence, prevention and stay at home is the only solution.

References:

https://www.researchgate.net/publication/339925460_The_origin_transmission_and_clinical_therapies_on_coronavirus_disease_2019_COVID-19_outbreak_-_an_update_on_the_status

https://economictimes.indiatimes.com/industry/healthcare/biotech/healthcare/community-transmission-of-covid-19-is-inevitable-icmr/articleshow/74621197.cms?from=mdr

https://www.sciencedaily.com/releases/2020/03/200317175442.htm

https://www.who.int/westernpacific/emergencies/covid-19

https://en.wikipedia.org/wiki/2019%E2%80%9320_coronavirus_pandemic

https://economictimes.indiatimes.com/small-biz/sme-sector/a-163-billion-industry-struggles-to-reduce-its-dependency-on-chinese-imports/articleshow/74942617.cms?from=mdr

https://en.wikipedia.org/wiki/Economic_impact_of_the_2019%E2%80%9320_coronavirus_pandemic_inIndia

https://en.wikipedia.org/wiki/Impact_of_the_2019%E2%80%9320_coronavirus_pandemic_on_education

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters

https://www.worldometers.info/coronavirus/?isci=010702

GOI, Aarogya Setu App.

https://telanganatoday.com/doubling-rate-of-covid-19-cases-at-11-days-centre