The hunt for an effective treatment for COVID-19 has led one team of researchers to find an improbable ally for their work: According to US and Belgian scientists, a four-year-old llama named Winter who lives in a secret location in Belgium could hold the key to a cure and help scientists find a treatment for COVID-19. The team — from The University of Texas at Austin, the National Institutes of Health and Ghent University in Belgium — reports their findings of a potential avenue for a coronavirus treatment involving llamas on May 5 in the journal Cell.

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Amid the panic around COVID-19, alternative medicine is being desperately promoted as a treatment, especially to boost immunity. At such a juncture, scientists from the country have issued a public statement on such cures and immunity boosters with a scientific explanation that there is no evidence suggesting successful use of any of these treatments in COVID-19. They have cautioned that these are not alternatives to other precautions that need to be taken such as social distancing, washing hands, etc.

The statement reads, "As of now, no scientific studies show that any substance boosts the immune system specifically against COVID-19, be it modern medicines like hydroxychloroquine or homoeopathic solutions like Arsenicum Album D30 or ayurvedic preparations. These so-called remedies and/or immunity boosters may give people a false sense of security. Some people may wrongly assume that they won't be affected by COVID-19 anymore, leading to risky behaviours such as not using a masks, not washing hands, or not following physical distancing protocols. Such unintentional violation of guidelines may have disastrous results."

While there are several social media posts, there have been instances when even people from government have backed such practices. For example AYUSH ministry supporting homoeopathic and ayurvedic products as defence against COVID-19 and the TN government issuing a circular about the efficacy of a herbal powder. Explaining the need for such a statement, Aniket Sule, scientist at Tata Institute of fundamental Research, said, "There are lots of social media forwards suggesting unproven treatments to fight COVID-19. We want to caution people that there is no scientific evidence to suggest that they work against COVID-19."

The statement concludes, "Colloquially, many people use the word "immunity" when they actually just mean "good health". While a healthy diet and exercise improves a person's general health (and the capacity of their immune system), this cannot make him/her immune to COVID-19. The most severe cases of COVID-19 are made worse by an overreaction of the immune system. So trying to boost general immunity or trying to interfere with its regulation using untested methods, may be risky. Claims such as benefits of drinking cow urine, exposing people to UV light or injecting with disinfectants, are not supported by scientific evidence, and are harmful to the human body. Similarly, while some supplements such as garlic may be harmless, others such as zinc or Datura seeds, if taken in excess, are toxic."

Busting hoaxes

'The Hoaxbusters' — a group from the Indian Scientists' response to COVID-19 has issued new set of slides answering several questions around COVID-19 at https://indscicov.in/

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Even as the world is frantically seeking a cure for or a vaccine to curtail the spread of COVID-19, senior health experts in India feel that in a thickly populated country like ours, needs an individualised approach. This means ending the lockdown so that herd immunity can be developed. This immunity is an indirect protection from infectious diseases, which has worked well during pandemics like measles, H1N1, etc, where some people were affected while others became immune to it. Sweden has successfully adopted this method for COVID.

Dr Wiqar Shaikh, senior allergy and asthma specialist, said, "This will be the only solution to tackle COVID-19. Interestingly, even in India, many who have tested positive for the virus were asymptomatic, which might be an indication of herd immunity developing. However, we have to be wary of these asymptomatic carriers as they can spread the virus to others with co-morbidities who are at a much higher risk of developing symptoms."

"A stringent lockdown in the country will not allow herd immunity to develop in India, and the fear is being touted by other COVID-affected countries like China, Europe, USA and even WHO has warned about a second wave of COVID-19 outbreak soon. If herd immunity is not developed in India, the second wave will spell disaster," Dr Shaikh said.

In Sweden, till date, there have been more than 22,000 COVID-19 affected patients out of a 10 million population and more than 2,600 deaths. However, the country has no stringent lockdown and their COVID-19 graph is showing a downturn.

Experts say
Shaikh added, "This virus is here to stay and our only solution is to develop herd immunity. Moreover herd immunity is more likely to work in our country because 90 per cent of our population is under 60 and herd immunity works best in a younger population."

Dr Ketan Vagholkar, professor and head of the department Surgery, DY Patil Medical College, said, "Traditional herd immunity refers to the proportion of people with immunity in a given population. The term herd effect is reduction of infection in the unimmunised segment as a result of immunising a proportion of the population. In the context of COVID-19, we are expecting a herd effect. The only option now is to achieve herd effect, which has shown good results in the past."

He added, "There are three ways this can take be achieved: a) Allowing a large part of the population to get infected. However, this will lead to extremely high mortality. b) Vaccination, which is not available at present. c) Take advantage of the lockdown to prevent rapid community spread. However, a gradual easing of the lockdown for the young working population will increase the infectivity of the virus in this group thereby leading to protective immunity."

He said, "It is the young who are responsible for the spread and need to be protected by herd immunity. Only then can herd effect be achieved," he said.

Dr Vagholkar added, "Testing of the swabs is important to achieve herd immunity. Individuals who are positive but asymptomatic must be clustered together, and those with symptoms must report to a designated hospital immediately. This will reduce community spread as well as COVID mortality."

About the assessment of herd immunity, Dr Vaghalokar explained that one needs to evaluate antibodies. Unfortunately, in COVID patients there is no consistent level of antibodies that can confer protection against future re-infection. This makes the concept of herd immunity and herd effect a little complicated and risky. However, the time has come to weigh the importance of life v/s livelihood, and with no treatments available, the concept of herd immunity should be seriously taken up, especially during lockdown.

Dr Vagholkar said the priority in easing the lockdown should be guided by medical experts to prevent a COVID surge. The government has achieved excellent control over community spread and kept the situation under control. Therefore, the advantage gained should be utilised for effective control of the spread during the lifting of lockdown.

Dr Om Shrivastava, a senior infectious disease expert, said, "It is too early to say anything. We will need to test more people. For every 10 people we test, at least six should have antibodies of a certain level to confirm herd immunity. We may have to eventually opt for herd immunity as a recourse."

How herd immunity works

Dr Wiqar Shaikh said in the absence of a vaccine, there had been in the past certain percentages of the population, who were exposed to a given infection, which resulted in 'herd immunity' for the entire population. For instance such an exercise was adopted in the influenza outbreak in 1918. Researchers at the time found that if nearly 33-44per cent of the actual population was exposed to the influenza virus, the remaining 67 to 56 per cent developed 'herd immunity'. This means the influenza virus could affect only a certain percentage of the population and not everyone. Similar percentages were during the outbreak of measles in the US in 1930, where nearly 90 per cent of the population was affected. The entire population developed herd immunity after that, Dr Shaikh said.

What the government needs to do

Dr Wiqar Shaikh said that in order to achieve herd immunity the Centre and states should end the lockdown in a staggered manner immediately. The lockdown should be stringent only in containment zones like Dharavi, Govandi, Mankhurd, etc, as people here are carriers. The rest of the population should be allowed to continue with their daily routine. But, theatres, malls banquets halls, religious places, swimming pools, gyms, restaurants and bars should be shut, and elderly people and small children stopped from venturing out until we have solid signs of herd immunity developing. And, because Maharashtra and Mumbai conduct the highest number of tests in the country, and also have the highest number of COVID positive patients they will have the best chance of developing herd immunity.

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A top UK government scientist, who was behind the country's strategy to impose strict lockdown measures to curb the spread of coronavirus, has resigned after a media report revealed that he broke the rules and allowed a woman he was said to be in a relationship with to visit his home during the lockdown. Professor Neil Ferguson, an epidemiologist whose modelling convinced Prime Minister Boris Johnson to press ahead with a UK-wide lockdown, quit the Scientific Advisory Group for Emergencies (SAGE) after allegations emerged in The Daily Telegraph. He admitted that he had allowed a woman Antonia Staats to visit him at his London home after travelling across the UK capital from her home, which she shares with her husband and children, on at least two occasions.

The movement goes against the very strict stay at home and save lives advice of the government, put in place by British Prime Minister Boris Johnson prompted by the scientific team led by Ferguson. The incidents took place soon after the 51-year-old leading epidemiologist from Imperial College London had completed a two-week spell self-isolating after testing positive for coronavirus. "I accept I made an error of judgement and took the wrong course of action. I have therefore stepped back from my involvement in SAGE, said Ferguson after the report.

"I acted in the belief that I was immune, having tested positive for coronavirus and completely isolated myself for almost two weeks after developing symptoms. I deeply regret any undermining of the clear messages around the continued need for social distancing," he said. The scientist, however, stressed that the government's advice on social distancing remains "unequivocal", adding that it was there "to protect all of us". UK Security Minister James Brokenshire said the senior scientist "made the right decision" and that the government will "continue to be informed" by SAGE.

"We have a range of experts that will continue to support ministers," he said. The first of the visits by Staats, 38, was on March 30, which coincided with a public warning by Prof Ferguson that the UK's one-week-old lockdown measures would have to remain until June. Staats, a left-wing campaigner, made a second visit on April 8 despite telling friends she suspected that her husband, an academic in his 30s, had symptoms of coronavirus, the newspaper report claims. He has peculiarly breached his own guidelines, and for an intelligent man I find that very hard to believe. It risks undermining the government's lockdown message," said Conservative Party MP and former minister Ian Duncan Smith.

Ferguson's resignation comes a month after Scotland's Chief Medical Officer, Dr Catherine Calderwood, had to resign when it was revealed she had broken lockdown rules by making two trips back and forth to a second home. Under the government's guidelines in the UK, people are expected to stay at home and allowed to move out only for one form of daily exercise and essential shopping.

The measures have been in place since March 23 to try and flatten the curve of the rising number of cases of COVID-19, the UK death toll from which reached 29,427 on Tuesday the highest number of virus deaths in Europe. However, figures from the Office for National Statistics (ONS), which includes deaths where the virus is suspected and not just where tests have been carried out, brings the total number even higher to 32,375.

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