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   2020| April-June  | Volume 9 | Issue 5  
    Online since June 4, 2020

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COVID-19 infodemic: Unveiling the root causes through public perspectives
Jose Jom Thomas, Praveen Kulkarni, D Sunil Kumar, B Prakash, M R Narayana Murthy
April-June 2020, 9(5):31-37
INTRODUCTION: The novel coronavirus pandemic raises great concern due to its spread and collateral effects on the society. Nearly 30,000 cases are reported from India by the beginning of May 2020. The current pandemic is associated with a sudden surge of false information termed as infodemic. This study attempts to understand the root causes of COVID-19 infodemic. METHODS: This cross-sectional online study was conducted from April 20, 2020, to April 30, 2020, to collect information on the possible causes of COVID-19 infodemic. A fishbone diagram was developed from the data through iterative process to illustrate the root causes of the infodemic. RESULTS: The total of 179 people responded to the online survey. Among them, 99 were health-care professionals and 75 were representatives of the general public. The mean age of the respondents was 28.93 ± 9.99 years. The root causes for the COVID-19 infodemic were classified into five domains, namely, social media-associated causes, behavioral aspects, the novelty of the virus and related challenges, causes due to lacunae in policies and health systems, and difficulties in the verification of information. CONCLUSION: A comprehensive action plan has to be developed to contain the infodemic through adequate education of all stakeholders, warnings and legal actions, improvements in policy and health systems. The authorities should brainstorm to design activities that contain the spread of false information through social media at the origin itself.
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Adaptation of pharmaceutical marketing and drug promotion practices in times of pandemic COVID-19
Sunil S Chiplunkar, D Vishkanthe Gowda, HG Shivakumar
April-June 2020, 9(5):11-17
Pharmaceutical marketing is an essential societal activity that ensures the availability of medicines at the right time and place. Pharmaceutical marketers also provide timely information, perform after-sales service in the distribution chain, and organize medical conferences and seminars. Thus, therapy and product updating, ensuring availability, and usage of medications are catalyzed by pharmaceutical marketers; this also ensures access to medicines in society. Medical representatives are critical elements – they inform and persuade adoption of various products for patient welfare. To complement and supplement the ground-level pharmaceutical marketing activity, a host of digital marketing initiatives is also accoutering the pharmaceutical marketing process. During pandemics like the COVID-19 infection, face-to-face pharmaceutical marketing approach is thrown out of gear and digital marketing has gained increased adoption. This article reviews the adaptive response of pharmaceutical marketers during COVID-19 times.
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Activity of phytochemical constituents of black pepper, ginger, and garlic against coronavirus (COVID-19): An in silico approach
Kalirajan Rajagopal, Gowramma Byran, Srikanth Jupudi, R Vadivelan
April-June 2020, 9(5):43-50
BACKGROUND: In early 2020, many scientists are rushing to discover novel drugs and vaccines against the coronavirus, and treatments for coronavirus disease 2019 (COVID-19), because, the disease which was named as COVID-19, a life-threatening viral disease affected first in china and quickly spread throughout the world. OBJECTIVE: In the present article, in silico studies have been performed to explore the binding modes of chemical constituents for natural remedies such as pepper, ginger, and garlic against COVID-19 (PDB id-5R82) targeting coronavirus using Schrodinger suit 2019-4. METHODS: The docking studies are performed by Glide module, in silico ADMET screening was performed by qik prop module and binding energy of ligands was calculated using Prime Molecular Mechanics-Generalized Born Surface Area module. RESULTS: From the results, the chemical constituents from pepper like Piperdardiine, Piperanine and from ginger like 8-Gingerol, 10-Gingerol, significantly active against COVID-19 with significant Glide score when compared to currently used drug Hydroxychloroquine (-5.47). The docking results of the compounds exhibited similar mode of interactions with COVID-19, and the residues SER46, MET49, HIE41, GLN189, ARG189, ASP187, MET165, HIE164, THR24, THR25, LEU27, ASN142, and GLY143 play a crucial role in binding with ligands. CONCLUSION: The chemical constituents from pepper such as Piperdardiine, Piperanine, and from ginger like 8-Gingerol, 10-Gingerol are significantly active against COVID-19 which are useful for further development.
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Response to the COVID-19 pandemic in India: Case studies on leadership in crisis situations
Shubhashri Jahagirdar, Anirban Chatterjee, Sabyasachi Behera, Archisman Mohapatra
April-June 2020, 9(5):81-84
On January 30, 2020, India reported its first case of (COVID-19). In this article, we explore insights into leadership in crisis situations as the country combats the pandemic. We examine dimensions of leadership from two perspectives – positional, and systemic, and the success and challenges that lie therein. We consider the leadership-in-crisis vignettes using the address by the Prime Minister wherein the declaration of nation-wide lockdown was made (positional), and that of the Indian state of Madhya Pradesh, which suffered from a leadership vacuum as it combated the pandemic (systemic). We report that strategic communication could help bring stakeholders on-board with ease and enthusiasm, complementing a preemptive and graded national response, while systemic failures or stand-stills could compromise the pandemic response despite wide societal engagement and broad political will. Crises situations increase the demand on leaders exceptionally and make their role much more complex, expansive, and time-sensitive. However, at the same time, the system must build the inherent resilience to absorb and overcome shocks, and circumvent dependencies. In summary, leadership-in-crisis requires self-adequacy.
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Novel Coronavirus – 19 pandemic impact on private health-care services with special focus on factors determining its utilization: Indian scenario
Sathish Raju Nilakantam, M Kishor, M Dayananda, Amogha Shree
April-June 2020, 9(5):77-80
The novel coronavirus disease (COVID-19) outbreak, caused by severe acute respiratory syndrome coronavirus 2, has rapidly escalated into a global pandemic which leads to declaration of national health emergency in several countries and is having a profound impact on private health-care systems globally including India in unprecedented manner. However, the impacts are very serious, especially on global economics and health care due to COVID-19 pandemic. During this pandemic, private hospitals and clinics are experiencing a reduction of in patient footfalls due to nationwide lockdown and several other factors as well which are leading to inadequate utilization of health-care services by the patients and decrease in medical services volumes which resulted in acute economic crisis. In this article, various factors that caused a significant reduction in utilization rates of private health-care systems such as hospitals and clinics were outlined and discussed.
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Use of antiviral nanocoating in personal protective wear
Tafadzwa Justin Chiome, Asha Srinivasan
April-June 2020, 9(5):62-67
The emergence of the new coronavirus and its associated fatalities are growing at an alarming rate causing unprecedented losses worldwide. As the coronavirus disease 2019 pandemic accelerates in India, access to basic personal protective wear such as masks for health-care workers and for the general public is a key concern. Aerosol transmission of biological particles such as viruses is only one of several routes of exposure for contagion of which personal protection such as masks must be used by the general public. The protection level offered by N95 and surgical masks is defined by the percent of ambient particles penetrating across the protective mask. Recent interventions in nanotechnology have effectuated need-based virus resistance masks developed by impregnating nanomaterials or nanocoatings in the mask to combat the virus and augment protection levels. The aim of this review will be to highlight the coherent strategies of using versatile nanomaterials as an effective antiviral material coated onto masks and understanding the mechanism of “virus-nanoparticle” interaction. This viricidal effect is made possible by the use of functionalized nanoparticles through the addition of biomolecule covers or modified surfaces capable of interacting with active sites present on the membrane (capsid) allowing the virus to be deactivated.
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Impact of COVID-19 pandemic on the dimensions of health and well-being: Time to widen our gaze
Praveen Kulkarni, Basavanagowdappa Hathur, Prashant Vishwanath
April-June 2020, 9(5):97-100
Novel coronavirus disease termed as nCOVID-19 by the World Health Organization has posed serious threat to the health and well-being of humankind. The pandemic has caused unprecedented disruption of life and impacted almost all the sections of the society. Health-related emergencies and urgencies due to COVID-19 have drawn major attention of all the stakeholders involved in ensuring the well-being of the society. On the other hand, the pandemic has impacted the mental, emotional, social, educational, nutritional, and vocational dimensions of health. Nationwide lockdown, a measure taken toward achieving social distancing, thereby flattening the curve has resulted in a rise of mental health issues, emotional disturbances, migrant exodus, poverty, deficient food supply, hunger, academic stagnation, learning crisis, unemployment, and job insecurities among people. All these problems have the potential to impact the health and well-being of the society in the long run and hamper the attainment of sustainable development goals.
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COVID 19 in ayurvedic perspective
V Kirthana, B Venkataiah, M R Narayana Murthy
April-June 2020, 9(5):91-96
The age-old science of Ayurveda has many secrets hidden within. The coronavirus disease is a novel disease, as indicated by its nomenclature also. The plural medical system approach is being implemented to combat the disease. There are many references in the ayurvedic textbooks/classics/Samhitas about janapadodwamsa or epidemics in the age of gods and the management of such epidemics or janapadodwamsa can also be evidenced in the classics of Ayurveda. The principles of Ayurveda can be applied for both preventive and curative aspects of disease. The practical knowledge and the knowledge about the stage of the disease are essential to bridge the ayurvedic principles with the preventive and curative aspects of the disease. The efficiency of ayurvedic drugs is known by practice. However, new drugs can be formulated with a combination of drugs. The search for new drugs and new preventive practices in an integrated approach is what the approach is to be to tackle the novel virus. In this regard, the current paper aims to bridge the preventive aspects of COVID 19 with respect to various stages of disease in ayurvedic aspect.
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COVID-19 treatment: Possible role of itraconazole as new therapeutic option
Falah Hasan Obayes AL-Khikani, Raghdah Maytham Hameed
April-June 2020, 9(5):101-103
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Teledermatology practice in the COVID-19 pandemic
Garehatty Rudrappa Kanthraj, Jayadev B Betkerur
April-June 2020, 9(5):3-10
Pandemics like influenza and plague have posed a great threat to humanity in the past. Recent outbreak of COVID-19, a viral pandemic, has motivated the global community for social distancing and enforcement of lockdown. Teledermatology practice (TP) is an effective, safe, and fast medium to reach one who is difficult to reach. It is a medium for a dermatologist to cater the needy patients. Store-and-forward (SAF) teledermatology mobile apps (e.g., WhatsApp) perform to capture, transfer, and store the clinical images. This overview provides an insight to TP. In an Indian scenario, SAF TP meets the technical requirement, economical, and easy to practice. Spotters, pediatric, geriatric, and chronic cases are managed with TP. The Indian Association of Dermatologists, Venereologists, and Leprologists in view of COVID-19 situation encourages its members to perform TP and provide care. The members may practice TP after observing all conditions as in telemedicine guidelines prepared by the National Medical Council with due caution.
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Saving the savior in COVID19 pandemic: Face masks
Manas Ghosh, Ambarish Bhattacharyya, Kaushik Ghosh, Kabita Bhattacharya, Arup Halder
April-June 2020, 9(5):58-61
Using masks for self-protection has a long history. There are records of the use of masks ranging as far back as the Roman era to Medieval Europe, where masks were used as protective devices. During many festivities, masks were used as a fashion statement. Gas masks were commonly used during the world wars. As pollution started growing, people started using pollution masks. 2020 might be the only era when the entire human population has been forced to wear masks to protect themselves and to protect others. As expected, the healthcare workers, who are leading the fight against the COVID19, are the ones who are most at the need of these devices. Unfortunately, there is a shortage of personal protection equipment all over the world. Hence, we must understand their properties and strengths, and hence that we can achieve maximum benefits from the limited resources.
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”Watching the watchmen:” Mental health needs and solutions for the health-care workers during the coronavirus disease 2019 pandemic
Debanjan Banerjee, Hariprasad Ganapathy Vijayakumar, T S Sathyanarayana Rao
April-June 2020, 9(5):51-54
The coronavirus disease 2019 (COVID-19) has emerged as a global public health threat. As international borders are sealed, economies slashed, and billions quarantined at their homes to prevent the spread of infection, this pandemic has affected society at large, having a long-lasting psychological impact, more than ever. Certain vulnerable groups are more susceptible to this trauma. These include the health-care workers, one of the prominent frontline force against COVID-19. Their mental health needs are not only limited to work pressure, burnout, frustration, and guilt toward the family but also a constant fear of infection, health anxiety, paranoia, and depressive disorders. Complex posttraumatic stress and grief can be the added compounding factors leading to absenteeism and decreased efficiency. This commentary reviews the evidence for the various mental-health care needs of these frontline workers and highlights the possible solutions during such a biological disaster.
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Effective risk communication – An essential strategy in combating covid19 pandemic – Report from Tamil Nadu, a South Indian state
Aarthy Marimuthu, Priyadharshini Prasanna Venkateswaran, Balaji Ramraj
April-June 2020, 9(5):107-110
Risk communication is one of the eight core principles of pandemic preparedness by International health regulations, which is essential to prepare for, respond to and recover from serious public health hazards like emerging infectious diseases. Covid-19 being a novel disease, generates intense fear, misinformation, and rumors confusing both authorities and the population, thereby creating the necessity for prompt information. The communicator, when imparting or exchanging information, should be clear about the message, target audience, conveying medium, and the effect it will produce. Effective communication can minimize the spread of disease, limit the impact, and ultimately save lives. Risk communication is not a last-minute additive to publicize decisions. It should be an integral part of preparedness planning for effective risk management and has to be translated into action. The risk communication strategies should be analyzed as the situation evolves, reviewed and changed if needed, as different populations and affected groups may require different strategies.
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An insight into the use of transgenic animal models for conducting research on coronavirus
Supriya Bevinakoppamath, Shobha C Ramachandra, Prashant Akila
April-June 2020, 9(5):18-23
Novel coronavirus, severe acute respiratory syndrome coronavirus (SARS-CoV2) outbreak, which is a causal agent for coronavirus disease-19 (COVID-19), has gotten a pandemic in a very short timeframe and represents a global health threat. Since this virus crossed species boundaries, it has put the whole humanity at risk for the infection. We may expect to see the emergence of many other novel coronaviruses like this in future. It is of vital importance that effective standardized care protocols for serious cases are globally recommended to tackle the COVID-19 pandemic. As of now, there are no clinically approved vaccines for COVID-19, but the Phase1 vaccine development approach is on the way. In future, we may expect a dozen vaccines but to test the vaccines and to understand their role, animal models which reflect the clinical symptoms, replication of the virus and disease pathology as in the humans are in great demand. The vaccine development for SARS-CoV2 would depend on the immunological data collected from the severe acute respiratory syndrome coronavirus (SARS-CoV) that emerged late in 2003. Because the SARS-CoV and newly emerged SARS-CoV2 share ninety percent of sequence homology, previously used transgenic animal models to study the spread of the virus and the therapeutic response could be used for the development of systematic therapeutic drugs for SARS-CoV2. Here, in this review, we have summarized some of the animal models which were considered from the previous studies on SARS-CoV and the comparison between these animal models could be a good consideration for further developments in the treatment of COVID-19.
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IJHAS special issue on COVID-19: Supporting scientific surge
Suresh Bhojraj
April-June 2020, 9(5):1-2
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Laboratory testing in human coronaviruses
Ashis Kumar Saha
April-June 2020, 9(5):24-30
After 2002–2003 severe acute respiratory syndrome coronavirus (SARS-CoV) epidemic, 2012–2013 Middle East respiratory syndrome coronavirus epidemic, ultimately COVID-19 pandemic started in December 2019 and still is going on steadily affecting millions and millions of people taking the precious life of more than one and half millions of people throughout the world, the highest affected country being the United States followed by Italy, France, and so on. Remembering the methods of spreading of infection by droplets and aerosol, high infectivity of this organism, at the same time near absence of biosafety in highly populated areas in the world and the presence of large number of asymptomatic or very minimally symptomatic patients various methods of detection approved by the Food and Drug Administration or different national health organizations, such as rapid antigen test and reverse transcriptase polymerase chain reaction methods, should be started for detection of an infected person for treatment.
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COVID-19 pandemic highlights the need to reconsider psychiatry training of Indian medical graduate
M Kishor, Vikas Menon, HR Vinay, Manik C Bhise, Mohan Isaac, Suhas Chandran, Ajay Kumar, Naresh Nebhinani, Ravi Gupta, Shubhangi S Dere, Anil Kakunje, G Bharathi, MV Ashok, Anil Nischal
April-June 2020, 9(5):104-106
In the middle of COVID-19 crisis in India and the psychological impact on millions of peoples, is it time to reconsider psychiatry training for Indian medical graduate under the new competency-based curriculum? India has one of the highest numbers of medical colleges in the world and also has over a million doctors, including MBBS graduates working at the primary health-care centers who are important pillars for health-care delivery. In a major drawback that also plagued the earlier curriculum, the new competency-based curriculum has not incorporated a single mandatory skill in psychiatry which a medical trainee has to demonstrate to become doctor. Mental health and the COVID-19 pandemic are interlinked in a complex manner. Hence, millions are likely to have mental health consequences. With no skill required in psychiatry as a must for a medical trainee to become an MBBS doctor, the mental health services during or aftermath of a disaster are severely compromised and need urgent reconsideration under the new curriculum.
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Can herd immunity be relied on as a strategy to combat COVID-19?
Amrit Virk, Narottam Samdarshi
April-June 2020, 9(5):73-76
Herd immunity offers protection to a population when adequate numbers of people are immune to an infectious disease to prevent its spread. Those who recover from COVID-19 and those who receive a vaccine (as and when there is one) are expected to develop some immunity, at least for some period of time. With Severe acute Respiratory Syndrome- coronavirus-2 (SARS CoV-2), how long the immunity will last is not yet known as currently there is no vaccine. Achieving herd immunity to SARS-CoV-2 infection may be the biggest leap toward returning to a near-normal pre-COVID-19 life, as social distancing guidelines and lockdowns may carry on while the virus persists and people continue to get infected and die. This article is an attempt to throw some light on the concept of herd immunity in context to COVID-19 and the implications thereof.
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Hydroxychloroquine prophylaxis against coronavirus disease-19: Knowledge and practice among health-care professionals
HG Ashoka, CR Venkatesh, MC Smitha, SH Nandhini
April-June 2020, 9(5):38-42
INTRODUCTION: The Indian Council of Medical Research recommended chemoprophylaxis with hydroxychloroquine (HCQ) for asymptomatic health-care professionals (HCPs) treating coronavirus disease-19 (COVID-19). This questionnaire study was aimed at assessing the knowledge and the practice of HCPs on the use of HCQ for prophylaxis of COVID-19. OBJECTIVE: The objective was to assess the knowledge and practice of HCQ prophylaxis among HCPs. MATERIALS AND METHODS: This was a cross-sectional study targeting HCPs involved in the management of suspected/confirmed COVID-19. The data were obtained by convenience sampling, collected by a structured tested online questionnaire. Descriptive statistics and inferential statistics such as Chi-square analysis and Fisher's exact analysis and Mann–Whitney U-test were used. RESULTS: Among 135 study participants, about 76% were male and 26% were female, and the mean age was 37 years (standard deviation: 10.35). About 64.5% of the participants took HCQ prophylaxis, and 67.8% among them got an electrocardiogram. Thirty-two percent were using proper personal protective equipments (PPEs) and 11% were unaware of the use of appropriate PPEs. Apprehension associated with HCQ adverse effects in those who were suggested (70%) (P = 0.002) and made mandatory (33.3%) (P < 0.001) by their institutions (P < 0.001) was statistically significant. About 67.8% did not experience side effects. Gastrointestinal side effects were most common. Majority of the study participants who took HCQ prophylaxis were consultant doctors directly involved in patient care (71.2%) (P = 0.018). CONCLUSIONS: Knowledge and practice with HCQ prophylaxis for COVID-19 was not adequate among the HCPs, and appraisal on proper HCQ dose and need for adequate PPEs and provision of the same could mitigate the false sense of security with HCQ prophylaxis alone.
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Coronavirus disease-19 and access to medicines in Africa
Yusuff Adebayo Adebisi, Alaran Aishat Jumoke, Olaoye Omotayo Carolyn
April-June 2020, 9(5):120-121
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COVID-19 infection: The prospects of pharmacotherapy
Shashank M Patil, V B Chandana Kumari, Prithvi S Shirahatti, S Sujay, M Tejaswini, Lakshmi V Ranganath, MK Jayanthi, Ramith Ramu
April-June 2020, 9(5):111-113
The disastrous outbreak of coronavirus disease 2019 (COVID-19) has triggered the investigation of several therapeutic options following the redundancy of specific drugs against it. The virus possesses advanced molecular mechanisms to effectively invade the host cell compared to its counterparts. It results in a seamless and coherent infection and transmission, attributing to its enhanced pathogenicity. The drugs that are currently being employed against COVID-19 inhibit the viral load in different stages of infection, including host cell–virus interaction, viral entry into the host cell, and viral replication inside the host including genome replication and polypeptide chain production. This commentary emphasizes the pharmacotherapeutic options available from the perspective of viral life cycle and pathogenicity.
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Structured action plan for mental and behavioral preparedness against virus COVID19 outbreak in India (SAMBAV Bharath): Proposal for augmenting mental health services
M Kishor, Deeksha Ekanand
April-June 2020, 9(5):55-57
The world Health Organization (WHO) has designated the novel coronavirus outbreak (COVID19) as a pandemic. It is estimated that 125 million to 250 million people in India will be affected and 70% of humanity is likely to be infected within 1 year. The psychological impact can be from stress or economic-socio-occupational disruption, and people may suffer from fear of infection, anger, anxiety, depression, suicidal ideation, increased substance use, or relapse of psychiatric disorders. This can be of great concern for India, which already has high mental health morbidity but the lowest number of mental health experts, according to the WHO. Hence, it is imperative to consider the empowerment of available human resources. Here, we propose a structured action plan for mental and behavioral preparedness against virus COVID 19 disaster currently but virtually for any disaster in the country (SAMBAV Bharath). It designed to enable people by providing online training for individuals as mental health facilitators, who can assist the needy during and aftermath of the disaster.
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Role of medical institution amidst the crisis: Sustaining the academic milieu and contributing to components of COVID-19 pandemic response
Anil S Bilimale, Basavanagowdappa Hathur, MN Suma, M R Narayana Murthy, Praveen Kulkarni
April-June 2020, 9(5):114-116
In early March 2020, the whole world was startled due to the COVID-19 pandemic. Amidst the crisis, a private medical college relentlessly worked toward sustaining the academic momentum and contributing to the mitigation of COVID-19. The areas of involvement were as broad as it had its roots. Educating the larger public through schools, colleges, and primary health-care centers was initiated. The hospital was operationally segregated into COVID and non-COVID zones. The screening centers and isolation wards were made operational. The health-care personnel were trained and motivated. The outreach and public health activities were in tandem with district health priorities, namely mass screening, health system strengthening at district COVID hospital, answering public queries, panel discussions, webinars, and TV shows. Apart from these activities, teaching and learning went on, as usual, using online platforms. Research, innovations, and publications were accomplished without interruption.
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COVID 19 pandemic – A need for emerging concern in dental practice
Seema Deshmukh, Prashanth Sadashiva Murthy, S Ravindra
April-June 2020, 9(5):85-90
Outbreak of severe acute respiratory syndrome coronavirus 2 leading to respiratory symptoms associated with fever, cough, and respiratory distress, has been a major global concern leading to the declaration of worldwide lockdown. This rapid spread poses many challenges to the health-care system and, at the same time, provides innumerable threats for the return to the routine services. A part of the health-care system which would require many reformations in dentistry. Saliva being saturated with COVID-19 virus poses a major risk to dental professionals because of the aerosols being produced during the procedures being contaminated with saliva and blood. The disruption of dental services during the period of the pandemic may increase the burden of treatment requirements at a later period. There is also a need to bring about policies and recommendations that focus toward the modifications in treatment protocols. This article analyses the current situation and provides suggestions for modifications that provide effective infection control strategies in the prevention of nosocomial infection in dental settings.
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Assessing the effect of lockdown on COVID-19 pandemic through risk prediction model in major cities of India
S Kirubakaran, Balaji Ramraj
April-June 2020, 9(5):68-72
The World Health Organization declared COVID-19 outbreak as a pandemic on March 11. Models can be established for this process to analyze and study the transmission process of infectious diseases theoretically. This paper presents the prediction of the number of positive COVID-19 cases for different lockdown scenario being implemented in some of the major cities in India. The predictions and assessments were based on a newly developed mathematical model that divides the population into four classes, i.e., susceptible, exposed, infected, and removed. According to the model, total lockdown can produce an effect in the reduction of number of corona cases in the major cities. However, similar difference may not be noted for the entire country as per the prediction.
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India fights the invisible: A saga of strategies, hope, and resilience
Shweta Goswami, Mohit Dayal Gupta, Vishal Batra, MP Girish, Madhur Verma
April-June 2020, 9(5):117-119
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