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Subject: Health

  • Understanding infections after Covid-19 vaccination

    Breakthrough infections

    • There have been several cases of Covid-19 vaccinated people, even those who have received both doses, testing positive for the virus.
    • Such cases are referred to as “breakthrough” infections, indicating that the virus has been able to break through the defences created by the vaccine.
    • Such cases have led to some doubts being expressed about the effectiveness of the vaccine, and contributed to the already prevailing vaccine hesitancy. 
    • However, vaccines protect not against the infection, but against moderate or severe disease and hospitalisation.
    •  It typically takes about two weeks for the body to build immunity after being vaccinated.
    • So, the chances of a person falling sick during this period are as high — or as low — as the chances for any person who has not been vaccinated.
    •  Also, those in the priority list of vaccination, such as healthcare workers and frontline workers, have been prone to getting infected due to prolonged occupational exposure to the virus

    Full protection not possible

    • It is very well understood that no vaccine offers 100% protection from any disease.
    • However, according to the Centers for Disease Prevention and Control (CDC) in the United States, vaccinated people are much less likely to get sick, but it is never entirely ruled out.
    • Then there is the emergence of new variants of the virus.
    • Some variants of the virus are able to evade the human immune response, and therefore have a greater chance to break through the defences created through the vaccine.

    Breakthrough cases in India

    • Among 10.03 crore people who had taken only the first dose of Covishield vaccina, 17,145 had got infected.
    • That translates into a 0.02% prevalence.
    • Among the 1.57 crore people who received the second dose as well, 5,014, or about 0.03%, had got infected later.
    • About 1.1 crore doses of Covaxin have been administered until now.
    • Of the 93.56 lakh who took only the first dose, so far 4,208 have got the infection.
    • That is about 0.04% of the total.
    • Among the 17.37 lakh who have taken the second shot, only 695 had been infected, again 0.04%.

    Challenges

    • “Given the scope of the pandemic, there’s a huge amount of virus in the world right now, meaning a huge opportunity for mutations to develop and spread.
    • That is going to be a challenge for the developers of vaccines.

  • Emergency use nod for Virafin

    About the drug

    • It is used in treating people with chronic hepatitis B and C. 
    • The Drug Controller General of India (DCGI) granted emergency use approval for pharma major Zydus Cadila’s antiviral drug ‘Virafin’, to treat moderate COVID-19 disease in adults.
    • When administered early on during COVID, Virafin will help patients recover faster and avoid much of the complications.
    • It significantly reduces viral load when given early on and can help in better disease management.

    Findings of the clinical trials

    • A single dose subcutaneous regimen of the antiviral Virafin [a pegylated interferon alpha-2b (PegIFN)] will make the treatment more convenient for the patients.
    • When administered early on during COVID, Virafin will help patients recover faster and avoid much of the complications.
    • In the phase-3 trials, the drug was able to achieve “better clinical improvement in the patients suffering from COVID-19”.
    • A “higher proportion (91.15%) of patients administered the drug were RT-PCR negative by day seven as it ensures faster viral clearance”.
    • The drug reduced the duration for supplemental oxygen to 56 hours from 84 hours in moderate COVID-19 patients.

    How the drug works

    • Type I interferons are the body’s first line of defence against many viral infections.
    • In old people, the ability to produce interferon alpha in response to viral infections gets reduced, which might be the reason for higher mortality.
    • The drug when administered early during the disease can replace this deficiency and help in the recovery process.

  • Centre to give 5 kg foodgrains free to poor

    The Central Government announced that 5kg of free wheat or rice per monthwill be provided to around 80 crore people for the next two months, May and June.

    Major Highlights:

    • This will be extended to beneficiaries under the National Food Security Act(NFSA).
    • Nearly 8 million tonnes of food grains will be distributed under this scheme.
    • The scheme is expected to bring relief to NFSA beneficiaries as it will be in addition to the regular entitlement of 5kg highly subsidised foodgrains to each beneficiary at Rs 3, 2 and 1 per kg of rice, wheat and coarse grains.

    Pradhan Mantri Garib Kalyan Anna Yojana (PMGKAY):

    • Pradhan Mantri Garib Kalyan Anna Yojana is a food security welfare schemeannounced by the Government of India in March 2020.
    • PM-GKAY is a part of Atma Nirbhar Bharat to supply free food grains to migrants and poor.
    • The program is operated by the Department of Food and Public Distributionunder the Ministry of Consumer Affairs, Food and Public Distribution.

    Aim:

    • To feed the poorest citizens of India by providing grain through the Public Distribution System to all the priority households (ration card holders and those identified by the Antyodaya Anna Yojana scheme).
    • PMGKAY provides 5 kg of rice or wheat (according to regional dietary preferences) per person/month and 1 kg of dal to each family holding a ration card.

    Eligibility/ Beneficiaries:

    • Families belonging to the Below Poverty Line – Antyodaya Anna Yojana (AAY) and Priority Households (PHH) categories will be eligible for the scheme.
    • PHH are to be identified by State Governments/Union Territory Administrations as per criteria evolved by them.
    • AAY families are to be identified by States/UTs as per the criteria prescribed by the Central Government:
      • Households headed by widows or terminally ill persons or disabled persons or persons aged 60 years or more with no assured means of subsistence or societal support.
      • Widows or terminally ill persons or disabled persons or persons aged 60 years or more or single women or single men with no family or societal support or assured means of subsistence.
      • All primitive tribal households.
      • Landless agriculture labourers, marginal farmers, rural artisans/craftsmen such as potters, tanners, weavers, blacksmiths, carpenters, slum dwellers, and persons earning their livelihood on daily basis in the informal sector like porters, coolies, rickshaw pullers, hand cart pullers, fruit and flower sellers, snake charmers, rag pickers, cobblers, destitute and other similar categories in both rural and urban areas.
      • All eligible Below Poverty Line families of HIV positive persons.

  • Very few post-vaccine infections

    Breakthrough infection

    • ICMR said that a small fraction of those vaccinated with either Covaxin or Covishield have tested positive (i.e. breakthrough” infections).
    • However, these instances do not undermine the efficacy of the vaccines.
    • The immune response begins to develop usually two weeks after every dose and there are variations within individuals, too.
    • Of the 9.3 million who received the first dose of Covaxin, 4,208 tested positive; and of the 1.7 million who received the second dose, 695 tested positive.
    • For Covishield, of the 100.3 million who received the first dose, 17,145 tested positive; and of the 15 million who got the second dose, 5,014 tested postive.

    What explains infections after vaccination

    • Healthcare and frontline workers, who were among the first to be vaccinated, were as a population far more exposed to the virus and therefore more susceptible.
    • Secondly, the emergence of “the highly transmissible second wave (newer variants) ” may have contributed to instances of infection among those vaccinated.
    • Several variants, which have mutations that have been shown to avoid detection by the immune system, and in some cases reduce the efficacy of vaccines, have been reported globally, including in India.

  • Tackling second Covid wave

    The article suggests ways to deal with the second wave of Covid in India.

    What explains the bigger second wave

    • The size of any epidemic is a function of three things:
    • 1) The size of the pool of the susceptible population.
    • 2) The pattern of contact between the members of the population (frequency, mix, closeness and duration).
    • 3) Probability of spread during that contact (infectiousness of the agent).

    Let us have a look at these 3 factors in the current context

    • As many people have already been infected in the first wave, the pool of susceptibles should be smaller.
    • Serosurveys also support this as they found that about 25 per cent of people had already been infected nationally.
    • However, this is an average and hides significant variations by state, age and place of residence.
    • Populations with lower seroprevalence become the potential pool for the second wave.
    • Given India’s large population base, the actual number of people are sufficiently large to enable multiple waves till we achieve a more even spread of protected people.
    • The persistence of protectiveness of antibodies of those already infected and their cross-protectiveness to newer strains is not well established.
    • Vaccination would reduce the pool of susceptibles.
    • However, the current level of vaccination coverage is not sufficient to make a significant difference to this wave, given the fact that we are already riding it.
    • It is a good strategy to prevent the next wave, if we can achieve substantial coverage with it.
    • Vaccination also prevents severe disease, and hence reduces the death toll.
    • With the removal of most restrictions, the probability of contact between individuals has risen sharply.

    Way forward

    • What can and should be avoided are super-spreader events like a crowded park, the Kumbh mela, election rallies, etc.
    • A much stronger community engagement with a robust communication strategy and lesser emphasis on “criminalising” inappropriate behaviour is required.
    • A nuanced communication campaign is the need of the hour and is conspicuous by its complete absence.
    • What is urgently needed is a robust evidence-based communication campaign.
    • Such a campaign would involve proactive serial assessment of the community perceptions and concerns, testing and refining messages through an evolving campaign.
    •  A district-specific strategy of “test, trace, treat” along with containment measures (isolation and quarantine) is still the best way to deal with the situation.
    • We also need to put a stop to political bickering; it erodes public trust and confidence.

    Conclusion

    Dealing with the second wave should be based on the experience drawn from dealing with the first wave and complemented by a better communication strategy.

  • [pib] MANAS Platform

    The MANAS App to promote wellbeing across age groups was recently launched.

    Name, acronym and the purpose; thats all. The rest of the theory is of less importance.

    MANAS Platform

    • MANAS is an acronym for Mental Health and Normalcy Augmentation System.
    • It is a comprehensive, scalable, and national digital wellbeing platform and an app developed to augment the mental well-being of Indian citizens.
    • MANAS was initiated by the Office of the Principal Scientific Adviser to the Government of India and jointly executed by NIMHANS Bengaluru, AFMC Pune and C-DAC Bengaluru.
    • It was endorsed as a national program by the Prime Minister’s Science, Technology, and Innovation Advisory Council (PM-STIAC).
    • It integrates the health and wellness efforts of various government ministries, scientifically validated indigenous tools with gamified interfaces developed/researched by various national bodies and research institutions.

  • NCAHP Bill 2020

    The article highlights the key aspects of NCAHP Bill 2020 which recognises the allied healthcare professionals and seeks to regulate and set the standards of education.

    Regulating allied health professions

    • The National Commission for Allied and Healthcare Professions Bill, 2020 (NCAHP) was passed by Parliament in March.
    • Global evidence demonstrates the vital role of allied professionals in the delivery of healthcare services.
    • They are the first to recognise the problems of the patients and serve as safety nets.
    • Their awareness of patient care accountability adds tremendous value to the healthcare team in both the public and private sectors.
    • The passage of this Bill has the potential to overhaul the entire allied health workforce by establishing institutes of excellence and regulating the scope of practice by focusing on task shifting and task-re distribution.

    What the Bill provides for

    • This legislation provides for regulation and maintenance of standards of education and services by allied and healthcare professionals and the maintenance of a central register of such professionals.
    • It recognises over 50 professions such as physiotherapists, optometrists, nutritionists, medical laboratory professionals, radiotherapy technology professionals, which had hitherto lacked a comprehensive regulatory mechanism.
    • This Bill classifies allied professionals using the International System of Classification of Occupations (ISCO code).
    • This facilitates global mobility and enables better opportunities for such professionals.
    • The Act aims to establish a central statutory body as a National Commission for Allied and Healthcare Professions.
    • The Bill has the provision for state councils to execute major functions through autonomous boards.

    Shift in perception and policy in healthcare delivery

    • There has been a paradigm shift in perception, policy, and programmatic interventions in healthcare delivery in India since 2017.
    • In the past, curative healthcare received substantially greater attention than preventive and promotive aspects.
    • Ayushman Bharat as a programmatic intervention, with its two pillars of Health and Wellness Centres (HWCs) and Pradhan Mantri Jan Arogya Yojana (PMJAY), operationalised certain critical recommendations of the National Health Policy, 2017, emphasising wellness in healthcare.
    • With PMJAY, the neediest are protected from catastrophic expenditure and India took the first step towards delivering comprehensive primary healthcare with HWCs.

    Conclusion

    Caring for patients with mental conditions, the elderly, those in need of palliative services, and enabling professional services for lifestyle change related to physical activity and diets, all require a trained, allied health workforce. The NCAHP is not only timely but critical to this changing paradigm.

  • [pib]  ‘Anamaya’ Initiative

    Anamaya, the Tribal Health Collaborative was recently launched.

    Simply keep in mind, the name and purpose.

    ‘Anamaya’ Initiative

    • The Collaborative is a multi-stakeholder initiative of the Tribal Affairs Ministry supported by Piramal Foundation and Bill and Melinda Gates Foundation (BMGF).
    • It aims to build a sustainable, high-performing health eco-system to address the key health challenges faced by the tribal population of India.
    • It will converge efforts of various Government agencies and organisations to enhance the health and nutrition status of the tribal communities of India.
    • This collaborative is a unique initiative bringing together governments, philanthropists, national and international foundations, NGOs/CBOs to end all preventable deaths among the tribal communities of India.

    Terms of references

    • It will begin its operations with 50 tribal, Aspirational Districts (with more than 20% ST population) across 6 high tribal population states.
    • Over a 10-year period, the work of the THC will be extended to 177 tribal Districts as recognised by the Ministry of Tribal Affairs.

  • Integrated Health Information Platform (IHIP)

    The Union Minister of Health & Family Welfare has launched the Integrated Health Information Platform (IHIP).

    About IHIP

    • The new version of IHIP will house the data entry and management for India’s disease surveillance program.
    • In addition to tracking 33 diseases now as compared to the earlier 18 diseases, it shall ensure near-real-time data in digital mode, having done away with the paper mode of working.

    Various functions

    • IHIP will provide a health information system developed for real-time, case-based information, integrated analytics, advanced visualization capability.
    • It will provide analyzed reports on mobile or other electronic devices. In addition, outbreak investigation activities can be initiated and monitored electronically.
    • It can easily be integrated with another ongoing surveillance program while having the feature of the addition of special surveillance modules.

    Unique features

    • This is the world’s biggest online disease surveillance platform.
    • It is in sync with the National Digital Health Mission and fully compatible with the other digital information systems presently being used in India.
    • The refined IHIP with automated -data will help in a big way in real-time data collection, aggregation & further analysis of data that will aid and enable evidence-based policymaking.
    • With IHIP, the collection of authentic data will become easy as it comes directly from the village/block level; the last mile from the country.
    • With its implementation, we are fast marching towards AtmaNirbhar Bharat in healthcare through the use of technology.

    Also read:

    [Burning Issue] Rolling-out of National Digital Health Mission

  • What is Happiness Curriculum?

    The Delhi Deputy CM has said that during the pandemic, the Happiness Curriculum immensely helped them to apply life skills to deal with stressful situations.

    Try this question:

    Q.What is Happiness Curriculum? Discuss the scope of introducing happiness curriculum supplementary to the regular curriculum across the country.

    What is Delhi’s ‘happiness curriculum’?

    • The curriculum calls for schools in India to promote development in cognition, language, literacy, numeracy and the arts along with addressing the well-being and happiness of students.
    • It further says that future citizens need to be “mindful, aware, awakened, empathetic, firmly rooted in their identity…” based on the premise that education has a larger purpose, which cannot be in isolation from the “dire needs” of today’s society.
    • For the evaluation, no examinations are conducted, neither will marks be awarded.
    • The assessment under this curriculum is qualitative, focusing on the “process rather than the outcome” and noting that each student’s journey is unique and different.

    Objectives of the curriculum

    The objectives of this curriculum include:

    • developing self-awareness and mindfulness,
    • inculcating skills of critical thinking and inquiry,
    • enabling learners to communicate effectively and
    • helping learners to apply life skills to deal with stressful and conflicting situations around them

    Learning outcomes of this curriculum

    The learning outcomes of this curriculum are spread across four categories:

    • becoming mindful and attentive (developing increased levels of self-awareness, developing active listening, remaining in the present);
    • developing critical thinking and reflection (developing strong abilities to reflect on one’s own thoughts and behaviours, thinking beyond stereotypes and assumptions);
    • developing social-emotional skills (demonstrating empathy, coping with anxiety and stress, developing better communication skills) and
    • developing a confident and pleasant personality (developing a balanced outlook on daily life reflecting self-confidence, becoming responsible and reflecting awareness towards cleanliness, health and hygiene).

    How is the curriculum implemented?

    • The curriculum is designed for students of classes nursery through the eighth standard.
    • Group 1 consists of students in nursery and KG, who have bi-weekly classes (45 minutes each for one session, which is supervised by a teacher) involving mindfulness activities and exercise.
    • Children between classes 1-2 attend classes on weekdays, which involves mindfulness activities and exercises along with taking up reflective questions.
    • The second group comprises students from classes 3-5 and the third group is comprised of students from classes 6-8 who apart from the aforementioned activities, take part in self-expression and reflect on their behavioural changes.