“I never imagined in my wildest fantasies that someday a benefit to smoking would be found, that too inside a pandemic,” this friend told me laughing. He was reacting to research that shows that the novel coronavirus seems to be - non-euphemistically speaking - repulsed by smokers.
Considering him though, he’s more likely to meet a smoky grave from all the ailments he has accumulated from smoking, before COVID-19 ever has the chance to say hello.
Yet, we cannot deny that discovering nicotine’s protective power, is one step towards a possible cure. And it’s not the only one. Since women were less likely to die from COVID-19, a US study was left to warn men of tender breasts and hot flashes after they were administered estrogen.
Then there’s the one which will make Kafka guffaw in his grave: testes could be the ‘pair of vulnerabilities’ that could make men more prone to COVID-19. Does this mean men should rush to get themselves neutered, at least for Kafka’s sake?
What these and other findings point to, is something promising: maybe we don’t need to wait for a vaccine to open the world. Maybe we can make it a workaround crutch with some of these findings.
Don’t get me wrong. We NEED to find a vaccine. My argument is, it shouldn’t be at the cost of saving lives by hook or crook right now. Some of the sharpest minds in the world should also be put to studying and collating some of these out of the box discoveries to try reduce mortality.
I have two key reasons for making this argument. First is the time it takes to make a vaccine. The fastest we have made a vaccine so far is 4 years. It is true that today we have the advantage of many new technologies. Yet, the key to making an effective vaccine is observation and tweaking. That takes years.
The other problem is dire. Some who have been cured of COVID-19 are getting reinfected. This goes against the very idea of the vaccine because you are supposed to develop immunity once you get it. More study is needed to find out how severe the second bout is in these patients. If the second bout is milder than the first, it still means some sort of immunity.
Then there’s mutation. Already the SARS-Cov-2 has mutated into 30 strains and is mutating further. Would one vaccine work on them all?
As you can see, a vaccine against SARS-CoV-2 won’t be as easy as desperate governments and media clutching at straws are projecting it to be. Besides,m waiting years under lockdowns would crush millions under economic burdens.
Hence, maybe the focus needs to shifts to two things that can give instant results: testing, and the effective combination of existing medicines that can reduce the severity of infections and symptoms to ensure survival.
‘Testing, testing, testing’, these three words uttered by Tedros Ghebreyesus, director of WHO will become the phrase of the decade decades from now. Governments should take it as a guru-mantra. I have already written about it in another column and I won’t repeat it here.
Here I’ll focus on a cocktail of half-cures. The ideal cure is an injection you take or pills you pop that clears the infection. Till we find that we have alternatives, a combination of which could save lives.
Covid pneumonia causes a form of oxygen deprivation called ‘silent hypoxia’. Even when the infection is filling lung air sacs with fluid or pus, reducing oxygen levels, patients don’t feel short of breath. By the time they do, they have such low oxygen levels, the only way to save them is a ventilator. The problem is: ventilators are messy, expensive, and too few (India has just 40,000). One could be prevented from reaching that point by checking oxygen levels through a non-invasive pulse oximeter available over the counter. Pulse oximetry screening – either at home, clinics, or hospitals, could provide an early warning system for Covid pneumonia.
Pulse oximeters could also be a way to – though not 100% accurate – of finding out if you have undetected COVID-19. So can lung x-rays, which can help spot pneumatic patches so coronavirus cases can be detected early.
In some countries, deep learning algorithms are helping diagnose, triage, and monitor coronavirus cases from lung images. It also helps predict who will need a ventilator.
Remdesivir - a broad-spectrum antiviral medication – after showing initial positive results, is being issued for emergency use authorization in some US hospitals with severe cases.
Hydroxychloroquine – with or without Azithromycin is still under test (despite a dubious French study quoted by President Trump that claimed 100% success but was debunked later) and so are Lopinavir/ritonavir and other HIV protease inhibitors. Clinical data to recommend or not recommend these, as well as convalescent plasma or hyperimmune immunoglobulin is still insufficient despite plasma therapy trials beginning in India which seems to have shown positive results.
Then there are monoclonal antibodies. They act like short term vaccines to protect uninfected people and in those who have it, it lessens symptoms.
Researchers at the Israel Institute of Biological Research claim to have successfully developed a monoclonal antibody with the potential to “neutralize" the SARS-CoV2 virus. A group from the Netherlands claim to have done something similar.
Then there is the case of an expensive immunomodulatory drug from an Indian firm Biocon that is said to have shown some remarkable results on critically ill COVID-19 patients at Nair Hospital, Mumbai.
The only issue with these and other half-cures is they are so many and so spread out, it’s hard to keep track of or find a right mixture from among them. It needs a global body like the WHO to monitor, help test, gather data, and if they show positive results, to recommend to hospitals.
Yet, the benefits of focussing on streamlining these are immediate. While a vaccine will save millions of lives tomorrow, these can save thousands today.
What do we do after we fracture a leg? We don’t wait for it to heal completely to resume life. We fashion a crutch and go about our life as best as we can. Perhaps this cocktail of half-cures could provide the world that crutch till we find a vaccine or a cure to heal it.
In the 60s when the US and USSR faced off at the dawn of the space age, both encountered a peculiar problem. Pens need gravity to work which is missing in space. USA spent millions, used their best minds to create a pen that worked on all surfaces, even without gravity. The Russians used a pencil.
What the world needs in the corona wars is both a magic pen and a pencil. While our best minds are busy making the pen, the rest could get together to find the proverbial pencil in the COVID-19 crisis.
(Satyen K Bordoloi is a scriptwriter, journalist based in Mumbai. His written words have appeared in many Indian and foreign publications.)