looking-beyond-just-diagnosis-and-quarantine

There is a need for a rapid response research and development team to handle viral outbreaks leading to Pandemics.

Need for rapid response research and development:

  • The viral onslaughts has continued and will continue.Earlier, Ebola, Zika, Nipah, SARS, MERS, H1N1 and now COVID-19.
  • Mutations of known viruses  periodically cause havoc.
  • Spread of Zika virus: Though the virus spread from mosquitoes. However, the main reason for these viral infections seems to be the proximity and contact with animals including wild animals, either as exotic food menu or the use of animal parts as aphrodisiacs. 
  • Bats are usually seen as a constant source of  viruses but in case of seafood however, seafood are also seen as one of the reasons for Wuhan Outbreak.
  • Most of the viral infections and diseases occured recently have no vaccine like in case of typhoid and cholera.

Constraints

  • Lack of resources: India does not have the expertise to put a team together to respond much more than just diagnosis and quarantine.
  • Unsatisfactory hygiene,population density and uncleanliness in India can be the major reason for serious situations even though the disease may have originated elsewhere.

What needs to be done?

  1. Genome sequencing
    1. Sequencing  the genome of all the isolates from infected patients in India. Knowledge of the genome is crucial for the development of the drugs.
      1. For instance,COVID-19   is an RNA virus. 
        1. This would require conversion to DNA and then the sequence of the alphabets (ATGC) can be worked out. 
      2. COVID-19 is less than 30kb (30,000) alphabets in size and can be sequenced in 24 hours in India. 
  2. Need to understand the virus
    1.  The virus is evolving rapidly and the mutations seen in the virus isolates in the United States, for example, are different from those in China. 
    2. Sequencing should be done by two or three different institutions to ensure that sequencing errors are eliminated. 
      1. The errors in sequencing can cause differences in results.

Short term measures

  • Evaluate repurposed known drugs (a drug development strategy predicated on the reuse of existing licensed drugs for new medical indications) including natural products, for therapy.
    • For example, in the case of COVID-19, anti-HIV drugs are being evaluated. 
    • Hydroxychloroquine: an antimalarial, is suggested as an adjunct drug option, since it can make the acidic endosome compartment in which the virus replicates alkaline to prevent the process.
  • Try passive immunisation with plasma derived from convalescing patients, who have completely recovered.
  • Clone B cells from recovered patients to make therapeutic antibodies.

Long term measure

  • Clone the genome, make recombinant antigens and then test for vaccine potential and new drug design. 
  • Mimic of the virus needs to be cultured for drug screening.
  • Cooperation of the office of the Drug Controller General of India for clinical trials.
  • Cooperation between Institutes listed in parenthesis and private sector: cut across the territorial integrity of government science and technology departments and include the private sector.
  • Constitute  independent expert committee comprising senior, experienced scientists and administrators. 

 

Drugs controller general of India (DCGI)

  • Drugs Controller General of India (DCGI) is a department of the Central Drugs Standard Control Organization of the Government of India.
  •  It is responsible for approval of licences of specified categories of drugs such as blood and blood products, IV fluids, vaccines, and sera in India. 
  • DCGI sets standards for manufacturing, sales, import, and distribution of drugs in India.

Ultimately we need to make a country over the years to scientifically respond to such challenges in terms of therapeutic options that are at least as important as sending up satellites into space or landing a man on the moon.

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Source

Image Source: Economic times