How to live with the virus and fight it: the way ahead

Virus attacks weak immune systems. Therefore, good health of the people is the key to combat it. But even as scientists race to find vaccines to develop immunity, different protocols are being tried

Photo courtesy- social media
Photo courtesy- social media
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M  Zahid Ashraf and Aastha Mishra

‘The microbe is nothing, the terrain is everything’ is one of the last words of Louis Pasteur - the father of modern microbiology and proponent of the ‘Germ Theory’ of the disease. These words are so apt in today’s scenario where we are clueless about this new pathogenic coronavirus, SARS-CoV-2. The time has come to start working on terrain instead of fighting the unknown.

Terrain here refers to ‘good health’ that could be cultivated only through nutritious diet, hygiene and healthy lifestyle practices to boost our immunity. COVID-19 outbreak testifies that this virus attacks the person with weak immune system. This possibly could be one of the reasons why people with pre-existing medical conditions such as diabetes, hypertension and asthma, and the older people, endure maximum risk. Therefore, we should start restoring the wellness of our body and mind to win the war against the pandemic.

Surprisingly, a larger percentage of positive cases remain asymptomatic, making the situation much more challenging since asymptomatic individuals become the silent spreader. As a consequence, stricter precautionary and preventive measures such as lockdown and physical distancing to clog the chain of transmission remain the key. Nonetheless, the strategy of aggressive testing, tracing people infected by the virus and treating them to prevent the spread of Covid-19 should be followed strictly.

Know yourself and know the enemy: The first strategy to win a war:

Testing, usually, is the first tool that we deploy against assault from any kind of unknown health emergency (enemy). Diagnostic testing capacity of any country demonstrates its preparedness for the outbreak and plays a major role in controlling the spread as has been seen in Germany and South Korea.


So far globally, the reverse transcription–polymerase chain reaction (RT-PCR) based test for COVID-19 remains the most reliable one but comes with the downside of being time-consuming and expensive. The continuous efforts of Indian research community have shown some success in developing alternative options that are shorter and inexpensive. Rapid antibody testing kit measuring IgG antibody produced as a response to the virus by our body is one such option.

However, in the beginning of this pandemic consistency in quality of imported kits remained a big deterrent on the complete dependency on these kits that were projected to be helpful in the screening of larger populations.

Few national or state-level institutions have been successful in decoding the genome sequencing of Indian strains of the virus and further continue with its sequencing for tracing the spread of the virus and in identification of new and random mutations for their close monitoring.

Vaccines, a chink in the armour to eliminate the enemy: Vaccines for immunization certainly remain the best solution to overcome this challenge. As per the WHO, more than 20 life-threatening diseases are now prevented by vaccination, which is saving millions of lives all across world.

In the last two months, dozens of confirmed COVID-19 vaccine candidates designed on different aspects of corona virus have already entered clinical trials. The most prominent ones are based on the outer crown of virus, the signature spike protein that allows the entry of virus in the human cells and infect them. The goal of such vaccine is to direct the body’s defence system to produce antibodies in response to spike protein.

Lately, an adenovirus (common cold virus) based vaccine candidate ‘ChAdOx1 nCoV-19’ from Oxford University has created the maximum buzz with human trials already in line. In fact, hope from this vaccine is so strong that Serum Institute of India and Astra Zeneca have partnered with the university for its production and distribution at the earliest if the vaccine comes out successful in trials in terms of efficacy and safety.


Last week, Moderna Inc. USA was cleared for phase II trial by the Food and Drug Administration, USA for their synthetic messenger RNA based vaccine. Likewise, a few Indian companies are also working on vaccine development; both Zydus Cadila and Bharat Biotech have taken some lead. Thus, we are positive on the path of breakthrough in vaccine deliveries but until then, all of our focus should be on exploration of different options of treatment.

Treatment options that corner enemy to checkmate it finally: In the beginning of April, hydroxychloroquine, an anti-malarial and anti-inflammatory drug, emerged as popular treatment option in USA and a few European countries.

Conversely, there has been a word of caution for patients associated with cardiac problems and not enough clinical data are there to either recommend or oppose the usage of hydroxychloroquine. The newer options such as antiviral therapies are endorsed by giant research-based biopharmaceutical company such as Gilead Sciences, Inc.

Once a virus infection is established, antiviral therapy is the most logical option for the control of the viral spread in the body. Remdesivir, an antiviral therapy candidate, is being seriously considered in patients with severe COVID-19. It has worked against the Middle East respiratory syndrome virus, a related coronavirus and therefore, it is hoped, will be effective in countering SARS-CoV-2.

A human body’s response to coronavirus infection is associated with severe lung injury due to inflammatory reactions. These reactions, eventually, result in difficulty in breathing and increases the capacity of the body to cause blood clot and are major factors for deterioration of patients in intensive care units.

Corticosteroids and tocilizumab are the class of drugs that affects the immune system and are used in relieving inflammation in Covid-19 patients. The ICMR’s approval for clinical trial of Sepsivac, a drug approved to treat gram-negative sepsis developed by CSIR has been suggested to ameliorate the cytokine surge. Perhaps, the combination of therapies with blood thinners, low molecular weight heparin or available as enoxaparin could be the new norm in treating patients-to-patients variability that is seen in Covid-19.


One of the oldest therapies that can stretch back to the 1918 influenza pandemic and is still consultable is the convalescent plasma therapy. It is basically the infusion of a fraction of the blood called plasma from recovered COVID-19 patients into sick patients' bodies. The idea behind this is that a patient who survived COVID-19 should have built up antibodies in their plasma. The portion of their antibodies is then infused into seriously ill patients to help them fight against the virus.

There are now many studies all over the world that have shown clear evidences of the effectiveness of this therapy. This has also influenced a few Indian states to explore its possibilities with encouraging initial outcomes. ICMR recently allowed the trial of this therapy that could be benefited by as simple as plasma donation but one cannot overlook the potential risks of tissue damage or the risk of transmission of infection via blood products.

Every cloud has a silver lining: A nation cannot continue with a prolonged lockdown as it has its own severe economic and social repercussion. During this unprecedented challenge for saving both life and economy, the Swedish model of adopting limited restriction for building community immunity should be given serious consideration so that we may all come out from this stronger and wiser.

Eventually immunity generated through natural infection resulting in herd immunity in larger populations can break the outbreak as was with the case with other viruses. Vaccines too work on the same principles of making people learn to live with the virus.

(The authors are from the Department of Biotechnology, Jamia Millia Islamia)

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