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THE COUNT
  • India’s health ministry has confirmed 1,531,669 Covid-19 cases (509,447 active cases) and 34,193 fatalities. 48,512 fresh cases were recorded on Tuesday.
  • Fatalities across the world are 660,407 (over 16.73 million infections).

The numbers are as of Wednesday, 12:30 pm IST. Check out the latest data here

TODAY’S TAKE
How to equitably distribute a Covid-19 vaccine?
How to equitably distribute a Covid-19 vaccine?
The pandemic has prompted an unprecedented scale of scientific research on potential vaccines and treatment. But now, “vaccine nationalism” threatens to play spoilsport.

The wealthy nations are financing vaccine research to reserve doses for their population. The economics is straightforward: They hedge their bet on a project, and if it succeeds, they get early access — if it fails, the investment is written off. Then there is the United States, which is financing multiple research — the US has provided $955 million to Moderna, $1.95 billion to Pfizer and BioNTech, $1.2 billion to AstraZeneca, and $456 million to Johnson & Johnson. The US targets to acquire 300 million doses of the successful vaccine by January 2021.

Needless to say, the low- and middle-income countries get the short end of this deal. To address this, Gavi, an international vaccine alliance founded by the Bill and Melinda Gates Foundation, has launched the COVAX Facility in partnership with the World Health Organisation and the CEPI. COVAX aims to pool the financial resources of the world to fund multiple vaccine research, and to equitably distribute the one that succeeds among poor and wealthy countries, starting with the high-risk groups. COVAX’s pitch to donor nations: Invest in us rather than hedging your bet on a single project that is not guaranteed to succeed, and in return be assured of doses of the successful vaccine. And by enabling production at scale, Gavi hopes to drive down the price of the vaccine.

Gavi has a track record: It has helped vaccinate more than 760 million children against yellow fever and Japanese encephalitis, among others. Dr. Seth Berkley, CEO of Gavi, says a collaborative and multinational approach is critical to address a pandemic because “with infectious disease, no one is safe until everyone is safe”. Early in June, Gavi raised $8.8 billion from 31 countries and the Gates Foundation. More funds are coming through. WHO has said COVAX aims to distribute 2 billion doses by the end of 2021.

But not all are impressed. The Associated Press reports that Gavi has promised donor governments that they would receive doses for 20% of their population. Anna Marriott of Oxfam International says since wealthy nations have already struck bilateral deals with vaccine makers, this would mean “they may end up buying up all the supply in advance, which then limits what Gavi can distribute to the rest of the world”.

Thomas J Bollyky of Council on Foreign Relations and Chad P Bown of the Peterson Institute for International Economics point out that Gavi has no power to enforce if a vaccine-producing nation decides to hoard supplies. Hence, they call for an agreement at an established international forum — say, the G20.

TELL ME ONE THING
What a survey says about Covid’s spread and symptoms
What a survey says about Covid's spread and symptoms
  • A sero survey conducted in the first fortnight of July by Brihanmumbai Municipal Corporation (BMC) has found that 57% of the city’s slum dwellers have developed antibodies against Covid-19 — which also means that while they got infected, they recovered silently, without exhibiting any symptoms. Added to that were 16% people living in non-slum areas who have developed antibodies.
  • The high prevalence of antibodies among slum dwellers was directly attributable to the use of shared facilities as also congestion, which make social distancing next to impossible — compared to people living in non-slum areas who are better positioned to maintain social distancing. The Mumbai results are in stark contrast to Delhi’s where 23% of the population was found to have antibodies against Covid-19 in a sero survey.
  • The sero survey, conducted jointly by the BMC and the Tata Institute of Fundamental Research (TIFR), collected about 7,000 samples — of which 4,000-4,500 were from slum areas, while the number of samples from non-slum areas was much fewer due to “non-cooperative” residents. What the results of the sero survey also indicate is that since more than half the slum population in Mumbai was asymptomatic, they may be much closer to achieving herd immunity than other segments of the population.
  • However, Dr Om Srivastava, epidemiologist and member of the state’s Covid task force, cautions against reading too much into the sero survey results. He said that since “antibodies stay in the body from four weeks to a few months depending on the infection” and the survey sample isn’t representative of the actual population, it will be premature to say there’s herd immunity. The BMC plans to conduct another sero survey from August 10, which may give a better picture about the possibility of herd immunity.
STAY SAFE
The toll on the heart
The toll on the heart
  • Two new studies from Germany paint a sobering picture of the toll that Covid-19 takes on the heart, raising the spectre of long-term damage after people recover, even if their illness was not severe enough to require hospitalisation.
  • The first examined the cardiac MRIs of 100 people who had recovered from Covid and compared them to heart images from 100 people who were similar but not infected. Their average age was 49 and two-thirds of the patients had recovered at home. More than two months later, infected patients were more likely to have troubling cardiac signs than people in the control group: 78 patients showed structural changes to their hearts, 76 had evidence of a biomarker signalling cardiac injury typically found after a heart attack, and 60 had signs of inflammation.
  • “The fact that 78% of ‘recovered’ [patients] had evidence of ongoing heart involvement means that the heart is involved in a majority of patients, even if Covid-19 illness does not scream out with the classical heart symptoms, such as anginal chest pain,” Valentina Puntmann, a cardiologist at University Hospital Frankfurt who led the MRI study, told STAT. Read an opportunity to take proactive action and to look for heart involvement early.
  • The other study, which analysed autopsy results from 39 people who died early in the pandemic and whose average age was 85, found high levels of the virus in the hearts of 24 patients. “We don’t know the long-term consequences of the changes in gene expression yet,” Dirk Westermann, a cardiologist at the University Heart and Vascular Centre in Hamburg, said in an interview. “I know from other diseases that it’s obviously not good to have that increased level of inflammation.”
  • The two studies together suggest that in many patients, Covid could presage heart failure, a chronic, progressive condition in which the heart’s ability to pump blood throughout the body declines. It is too soon to say if the damage in patients recovering from Covid is transient or permanent, but cardiologists are worried.
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Written by: Rakesh Rai, Judhajit Basu, Sumil Sudhakaran, Tejeesh N.S. Behl
Research: Rajesh Sharma

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