Expert Views Virology: How to Tackle Coronavirus Transmission and Possible Route of Exit from Lockdown

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by Prof Ramareddy V Guntaka, Professor, Department of Microbiology, Immunology & Biochemistry
University of Tennessee, USA.

First of all, about Coronavirus and its severity, this group of viruses contain a very large RNA genome with a complicated life cycle. Ordinarily this group causes seasonal colds in humans and mostly not serious illness. A variant caused severe acute respiratory syndrome (SARS) around 2003 and killed a few thousand people and disappeared. Later MERS emerged from camels in Middle East and killed few hundred people around 2012.

Now we are witnessing the emergence and spread of COVID19. By acting very quickly ad prudently Germany, South Korea, India and a few other countries with small number of cases could minimize the impact and saved lives.

We do not know the prevalence of Covid-19 (SARS-CoV-2 or SARS2) but we can fairly control by following these steps which can be understood by taking an example of 550 positive cases. Assuming that (big assumption but a reasonable one) each positive person came in close contact with 20 people, this means that we isolate them and carefully follow their conditions, by monitoring fever, cold and cough and breathing problems, we will know in 2 weeks (or earlier) how many actually developed serious disease. The same can be repeated with new cases that appear day or later and so on. This study with all the accumulated cases over a period of 9 to 10 days will give excellent data on the number of people with no symptoms to mild and serious disease i.e. morbidity and mortality. In my view, this will flatten the curve and will enable us to control the epidemic without making us face grave consequences- lives and business. This will be possible now as we have a less number of infected people.

For any virus to make it a epidemic or pandemic, would usually take about a decade. These viruses, like other RNA viruses, have unusually high rate of mutation, which make them constantly change. Another important feature of these RNA viruses is formation of defective particles and the more passages they go through in tissue culture or animals, the more defectives accumulate. Since in the present case, Covid-19 (SARS- 2), this mutated virus jumped from animals (Bats) to humans. Initially it might cause a serious disease, like the Covid-19 or a mild disease.

Obviously this virus caused mild or asymptomatic disease in 85% of the individuals, especially the people aged below 50 years. As we get older, the immunity system gets weakened and with other existing conditions, older people succumb to serious illness and consequently death in about 10% of the older patients. Even this virus will get less virulent as it passages from one person to another (especially youngsters), a phenomenon termed attenuation. Rarely the reverse could happen.

Very quickly. SARS2 can be tested by sequencing one or two thousand samples for Receptor Binding Domain. Only about 300 nucleotide region is sufficient which can be done very easily in Indian laboratories. Hundreds of sequencing machines are available in private and University laboratories. These patients can be young or old; comparison would indicate mutations in these populations in this very important region of the Coronaviruses; further they would tell us the differences, if any, among various patients who underwent different course of infection with a different outcome.

The most important now is whether the lockdown at homes should be continued or relaxed in a phased manner, starting as early as possible (one week). Some States are free of any coronavirus cases and more than 60 to 70% of the districts in each State that have no reported cases of coronavirus. They can immediately lift the lockdown orders and let then work or freely move within those confined districts and regions. In other places where they registered some cases, the Governments and Local bodies can let the employees who are under 40 years of age can let them work, since this group is at minimum risk. To minimize infection among them, they still can maintain distance in work places and wear masks if they have to come in close contact with another employee. If any person develop symptoms, he/she can be quarantined, carefully follow the disease course and treat them in hospital at an early stage.

All the scientific reports clearly indicate that our Ayurvedic medicines, derived from plants like Aswagandha and other plant extracts are effective in reducing the severity of the disease.

From all the information we have so far, the probability of developing a serious outcome may not be high as these people are mostly asymptomatic or go through mild infection. If the disease is progressing to a critical level (about 1 in 200 to 250 infected), they can be treated in the hospital. This way, nobody in this group have to sacrifice their lives. They can also minimize close contact with their elders at home.

Since most of this age group go to work on motorbikes wearing helmets, they will be protected. On top of it, since it is summer in India, the virus will not survive longer periods. Those who have to use public transportation, buses or trains can take less number of people and make them wear masks. Although uncomfortable, these buses and trains should not use air conditioners.

Depending on the progress, after watching one or two weeks, employees of ages 40 to 55 or 60 can be allowed to return to work, There may be some operational issues in some places like restaurants and downtown offices of big cities. Hopefully, in another month or two everything might come to normal.

Last but not least, people should refrain from watching too much media and social media. Panic and anxiety may worsen the situation and contribute to progress the ailment especially in people with other pre-existing health conditions.

About the Expert

Ramareddy V. Guntaka, Ph.D.
Professor, Department of Microbiology, Immunology & Biochemistry
University of Tennessee, Health Sciences Center, Memphis, TN, USA

Major contributions to science:
• Prof Guntaka was one of the four members team that discovered Proto-oncogenes, genes implicated in causing cancer. Two of the members (Bishop & Varmus) received 1989 Nobel Prize for this discovery.
• Prof Guntaka was the first one to molecularly clone the entire genome of Rous Sarcoma Virus, which is being used all over the world as a prototype virus for understanding cancer.
• Prof Guntaka was the key scientist behind the successful development of the Recombinant Hepatitis B Vaccine.by Shantha Biotech. This vaccine is now available throughout India at an affordable price to the common man that saved millions of lives from infection by this deadly virus.
• Prof Guntaka was also the key scientist behind the successful development of interferon alpha used to treat hepatitis B infections.
• Prof Guntaka was also the first scientist to clone and study the complete genome of the Indian strains of Hepatitis C virus, a silent killer virus, which already infected more than 30 million people in India. He also successfully produced all the antigens to detect Hepatitis C Virus, Hepatitis B Virus and Human Immunodeficiency Virus (AIDS Virus) infections at Sudershan Biotech in Hyderabad.
• Prof Guntaka is playing a major role in managing Sudershan Biotech Pvt Ltd which is undertaking development of various recombinant therapeutics and currently focusing on an epitope vaccine for Hepatitis C Virus. If successful, this will be first vaccine in the world.

Honors/Awards:
• American Cancer Society Senior Dernham Fellowship, 1973-1975
• Research Career Development Award, National Institutes of Health 1979-1984
• General Motors Cancer Research Professorship, Prague,
Czechoslovakia, June 1989
• Siromani Award, America Telugu Association, New York, July 1992
• Scientist Award, Telugu Association of North America, July 1995
• Sir C.V. Raman Professorship, University of Madras, India, January 1996
• N. Narayana Endowment Lecture, Indian Institute of Science, Bangalore, India, 1996
• Member, National Academy of Agricultural Sciences, India,
• Jawaharlal Nehru Professorship, University of Hyderabad, India, August 1998
• Genome Valley Excellence Award, Government of Andhra Pradesh, India. Feb. 2006

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