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THE COUNT
  • India’s health ministry has confirmed 625,544 Covid-19 cases (379,892 active cases) and 18,213 fatalities. 20,903 fresh cases were recorded on Thursday. The Times of India, based on state figures, reported 18,216 fatalities and 22,045 new cases. Total cases were 627,023
  • Fatalities across the world are 521,337 (over 10.87 million infections).

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

TODAY’S TAKE
Concerns over availability of Remdesivir
Concerns over availability of Remdesivir
Remdesivir, the antiviral drug approved for treatment for Covid-19, is in short supply. Earlier this week, The Guardian reported that the US has emptied Gilead Sciences’s shelves of the drug, depriving other countries for at least three months. The first 140,000 doses, supplied to drug trials around the world, have been used up. The Donald Trump administration has now bought more than 500,000 doses, which is all of Gilead’s production for July and 90% of August and September. Now, the Economic Times reports that Gilead won’t launch the drug in India in July as earlier planned.

Gilead, which holds the patent to the drug originally developed for Ebola, had last month said it anticipated the drug to be available in the domestic market in July, “with supply continuing to increase through the end of this year and into next year”, ET reports. The bulk purchase by the Trump administration has now derailed plans.

The company, though, has highlighted the fact that it has shared the licence with as many nine drugmakers, six of them Indian, to make generic versions of Remdesivir. The licence holders include Hetero, Cipla, Dr Redddy’s, Zydus Cadila, Jubiliant Life Sciences, and, most recently, Syngene/Biocon. Of this, thus far, only Cipla and Hetero have received the approval for their generic versions from the Drug Controller General of India, and only Hetero has begun supplies to hospitals. Hetero has supplied 40,000 doses of the generic, brandname Covifor (priced Rs 5,400 per vial); the company said it can produce 1 million doses. Cipla is likely to begin sales of 10,000 doses of its generic, brand name Cipremi, from July 9, ET reports.

The hospitals, meanwhile, are fretting over the lack of supply. In Maharashtra, the worst-hit state in India, public hospitals have not yet received the drug as local authorities are yet to place orders for Remdesivir, ET reported on Thursday. In Mumbai, an estimated 5,877 patients are on oxygen support, and thus would be candidates for receiving Remdesivir (or its generic).

TELL ME ONE THING
Why some women can’t donate plasma
Why some women can’t donate plasma
  • Convalescent plasma — the liquid part of the blood containing antibodies against SARS-Cov-2 developed in patients who have recovered from Covid-19 — has become a sought-after therapy in several cases to cure people suffering from the viral infection. There are however, certain conditions about who can and who cannot donate plasma — and one category is women who have ever been pregnant.
  • Why is that? According to medical experts, women, during their pregnancy develop antibodies — called human leucocyte antigens (HLA) — against the father’s genetic material. In fact, greater the number of successful pregnancies a woman has, greater the HLA count. Once developed, they are present in the blood forever. Though HLA antibodies are not harmful to the person who made them, if transfused to another person they can cause a rare but serious complication in the transfusion recipients known as Transfusion-Related Acute Lung Injury (TRALI). Since Covid-19 patients requiring plasma transfusion usually have their lungs weakened by the virus, transfusing the plasma of a woman who’s been pregnant in her life could prove fatal.
  • It isn’t just women though — several men too won’t make the list of plasma donors since the requirements are extremely strict. For one, plasma can only be donated after a minimum of 14 days from recovery. Donors need to be at least 18 years old and not more than 60 years of age, weigh at least 50 kg, have a haemoglobin count of at least 8, do not suffer from any chronic kidney, heart, lung or liver disease and don’t suffer from diabetes. Even cancer survivors aren’t eligible for plasma donation. More importantly, their blood pressure needs to be not more than 140 and diastolic not less than 60 or more than 90.
STAY SAFE
Is Covid a disease of the blood vessels?
Is Covid a disease of the blood vessels?
  • From reports of ‘sticky blood’ raising the risk of deep vein thrombosis, heart attack or stroke, to neurological effects, to painful red and swollen areas on the feet known as ‘Covid toe’ — many of these symptoms are thought to be linked to effects on our blood vessels.
  • In particular, these symptoms may be caused by the way that Covid-19 affects the lining of the blood vessels, called the endothelium. This layer of cells is not a solid barrier — it can allow or block certain substances through depending on conditions in the body. And a healthy, well-functioning endothelium helps to keep our blood vessels relaxed and open to the flow of blood. It also releases substances that help to prevent harmful blood clots and inflammation. But if damaged, the processes may not work effectively.
  • In April 2020, a paper published in The Lancet gave the first evidence that SARS-CoV-2 can infect endothelial cells. The molecule ACE2 (which the virus binds to in order to enter our cells and reproduce itself) can be found on the surface of endothelial cells. Another study found higher ACE2 levels in lung endothelial cells, alongside evidence of severe injury to blood vessels. The formation of tiny clots within capillaries (our smallest blood vessels) in the lungs was nine times more in Covid-19 victims compared with the lungs of people who died from flu.
  • By damaging the endothelium, the coronavirus has the potential to cause abnormal blood clotting, ‘leaky’ vessels and reduced blood flow. In the lungs, these effects cause clots and fluid to accumulate, meaning the lungs are less able to get oxygen into the body.
  • In the brain, damage to endothelial cells in the blood-brain barrier could lead to inflammation. In limbs, reduced blood flow could lead to ‘Covid toe’. Further, overactivation of our inflammation systems can also make the blood more likely to clot.
  • This may explain why people with certain heart and circulatory conditions seem to be at a higher risk of developing severe complications. If another condition, such as diabetes or high blood pressure, has already damaged the endothelium, the virus’s impact is magnified.
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Written by: Rakesh Rai, Judhajit Basu, Sumil Sudhakaran, Tejeesh N.S. Behl
Research: Rajesh Sharma

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