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Unearthing new dimensions

The current pandemic has brought viral infections to public notice and yet misinformation abounds. Dr Arvind Kumar from Sri Ganga Ram Hospital, in an interview, gives clarity on some of this information

Unearthing new dimensions
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Not too long ago, people were not really aware of viruses and their various characteristics. To most, viruses were an abstract, invisible threat, occasionally felt but largely ignored in favour of more immediate problems associated with modern living. However, that has changed ever since the Coronavirus pandemic started to wreak havoc across the globe. With every passing day, researchers are unearthing a new angle with regards to SARS-CoV-2, commonly known as COVID-19.

Arvind Kumar, founder trustee of the Lung Care Foundation and Chairman of Chest and Robotic Surgery at the Sir Ganga Ram Hospital in Delhi was recently interviewed regarding this deadly contagion. Here are the excerpts:

Does pollution increase the spread of Coronavirus or its mortality rate?

The answer is a very clear cut yes. There is enough data available from Italy and the US which has clearly shown that this virus can get attached to particulate matter. In North Italy, areas having very high levels of vehicular pollution showed a faster spread of the virus.

They also showed that for every one microgram increase in PM 2.5, there was a 15 per cent increase in the mortality rate. They have studied a death pattern from nearly 300 counties across the US and have found that there is a direct relation between PM 2.5 level and chances of death. Therefore, this COVID-19 virus will affect pollution affected communities much faster and with more severity.

Some say that COVID-19 patients put on ventilator mostly succumb to the disease and therefore it is preferable to put them on oxygen. Is this true?

There are three stages to this disease. Eighty-five per cent of the people are in a stage where they do not need anything more than paracetamol. In 15 per cent of the cases, lungs get involved and need oxygen. Out of this, 10 per cent of the people will make do with oxygen alone and about 5 per cent of the total will go on a ventilator. Of the 5 per cent who go on a ventilator, 50 to 90 per cent will die. The use of ventilators in COVID-19 cases is a hyped-up thing. If somebody thinks that having 1 lakh ventilators in the country means there will be no death, it is a misunderstanding. If ventilators could save people from death, there would not have been any deaths in the US. When someone is on a ventilator, a tube is put into his windpipe and it is attached with a machine which pushes air under pressure into

the windpipe and through them into the lungs. A foreign body inserted into your body is an invitation to more infection. You also have a chance of contracting secondary pneumonia due to more diseases, as your lungs give up.

Why is Hydroxychloroquine being suggested in COVID-19 cases, which is a viral infection, while this drug is given to malaria patients, which is caused by protozoa?

Hydroxychloroquine (HCQ) is used for malaria but it is also used for another group of diseases which are called auto-immune diseases where the body starts acting against its own organs. HCQ is supposed to be immunomodulator and helps in these cases. People want to use this immunomodulatory role of HCQ to regulate the immunity of the body, thereby decreasing the chances of contracting the infection or curing the infection quickly. The fact is that this drug was put into effect in France where it was used on a small number of patients but the conclusive evidence is still very weak. There are many side-effects of this medicine and that's why the ICMR has still not permitted it for mass consumption for the public but only for healthcare workers or family members who look after COVID-19 patients and have high chances of contracting the virus.

However, people are taking it on their own without even knowing about its doses. It can cause irregularity in heart rhythm. If everybody starts consuming HCQ, there will be no medicine left for malaria patients. Therefore, its misuse should be stopped.

Does this virus share some characteristics of HIV as well?

'Virus' is a generic term. Every virus belongs to a different family and has different characteristics. This virus is from the same category as SARS and MERS. This virus has nothing to do with HIV or Polio vaccine. There are few reports on Bacille Calmette-GuErin vaccine (BCG) but there is no final decision on the effectiveness of the same for fighting the COVID-19 contagion.

Can the weather aggravate or retard the spread of COVID-19?

Past experiences cannot be applied to this disease. Every virus has a different character. SARS had caused 7,000 deaths in the world, but this virus has already killed more than 1,25,000 people. We do not know where it will stop. This is a heavyweight virus. The infectivity of this virus is very high. Old people are more vulnerable. Scientists in their latest research have found that this virus can survive even in 45-50 degree Celsius temperature. In our country, the maximum temperature hovers over 45 degree Celsius and that too for a very short period of time and in limited geographical areas. Therefore, expecting this virus to be less effective in summers is misleading.

It's good to be hopeful about the theory of rising temperature, but scientific facts do not point towards this theory as of now. As far as wind is concerned, there is not much danger of spreading this virus due to wind because it spreads through droplets and there is no evidence of it travelling far via wind as yet. Our knowledge about this virus is so dynamic that it is changing on a daily basis. What is true today may not be true tomorrow. Till today, there is no evidence of it becoming less or more efficient due to temperature, humidity or wind. If any evidence emerges tomorrow cannot comment on that now.

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