 Hello and welcome to NewsClick. Today we are joined by Praveep Rukhaya to discuss the recent developments in the COVID-19 pandemic. So Praveep, we know that this disease, this virus is only continuing to spread across the world. There are already over 190,000 cases and there are very few countries which are now left unaffected. So can we first start by focusing on Europe which has become the new centre of this pandemic? Can you tell us how Italy and other countries, Italy which is now the second worst affected or I think it has more cases and more active cases in China? How Italy and how the other countries in Europe are coping with this? Well, coping or not coping with it because it does seem that the hospitals are in a state of partial collapse, particularly Northern Italy, the Lombardi region which has been the most affected. It has also happened because the number of people who are coming to the hospital are much larger than the hospital infrastructure. This is partly because Italy has an older population and that it does show that the COVID-19 epidemic affects older people much more than the younger people. If we take the mortality rates, we will see that for the 0 to 9 virtually no mortality. If we come between say 10 to 19 or even 10 to 40, again the mortality rate is only 0.2 percent, the case fatality ratio. If you go to 40 to 50, it rises to 0.4 percent. These are Chinese figures. And then if you go over the next day signs, this 50, 50, 60, 70s and 80s, there is a disproportionate rise and above 80 you get figures of something like 18 percent. Now that is a very, very high figure. So the kind of people, the demography of the people who are infected also tells us the nature of the fatalities and as you can see the number of people dying in Italy is very high. So that is perhaps one of the things that we need to take away from this. I will come to why the infection spread the way it did just a little later. But right now looking at the crisis of the hospital systems, there is also the issue did the actually infection spread in the hospitals itself because as the people came in that how the infections were controlled, how prepared were the hospitals for that, all of this been raised as a question. But it is also true that the older people what you are getting is also bacterial infection. So most of the patients have not only the viral infection but also what would be called the co-bacterial infection and that is making the cases much more difficult to handle. Coming back to why is it that Italy faced this kind of epidemic and it is really Italy which was the first one to exhibit this runaway epidemic so to say in Italy, in Europe and it is now being followed by Spain, being followed by France, followed by Germany. Spain seems to be the next one which is following Italy, not very far and then France and Germany. So why did this happen in Italy? Now again the issue is that when you start testing initially when you have what is called the containment phase at that stage the argument is that you have to test the incoming people who are coming who have the infection and their contacts. A lot of the people who seem to have come with infection did not exhibit any symptoms. That is why testing in the airport is not enough. You need to really follow up the testing and then you can silently as it were spread the infection amongst the community. Once it becomes a community spread the containment phase is over and if you do not recognize through enough testing or enough checking up follow-ups of the people who have come in from outside when they are likely to show symptoms. All of that if you do not do that you follow up closely. Then what can happen is there is a silent community spread which you are not catching. This is what seems to have happened in Washington state in the United States and seems to have happened in the Lombardi region which is the one most effective in which Milan is of course the key city. Now given this what happens is once it is in the community then lockdowns is only one part but that is not enough. As Bruce Aylward who was a part of the WHO he co-headed the team, the WHO's team to China in which there were Chinese WHO and a joint team to look at all the lessons as he says very clearly that this is only the first step the lockdowns that that's not what stops the disease. After that what the Chinese did was to find out very quickly by setting up fever clinics. Anybody who was felt he had a fever could be a possible case was sent to fever clinics. They were tested there, they waited there and if they were found positive the test had to be completed within a certain period of time in which they actually stayed in the fever clinic at a suitable social distance from other such people who are being tested and this then those who were found to be infected were transferred in the first instance to larger facilities which could be gymnasiums, could be stadiums, could be warehouses where large numbers of people were there with what would be the first phase or the mild phase of the disease and the minute they were serious they were transferred to the hospitals. So they isolated the people who could be infected from even the family members because otherwise you get family transmission. So young kid is infected, he doesn't feel any effect but the grandma, the grandpa then are also infected. So that's what they had to stop and they did that. So as Elver himself says about Italy that people reached out to him and said we have done the lockdown and the quarantine he said you have done the heart part but the really heart part comes now. How to isolate the cases and remove them from the family, from other settings so that they could don't infect others. Other than the family infection also sees another rate of infection, every person can infect you for others so you don't really stop the cycle of infection. So I think this is the takeaway, the lesson that we have to learn from Italy and all those countries who are saying oh it's a Chinese problem, you know it's only the Chinese authoritarianism these lockdowns don't work and so on, they really did not do what was required. That understand what the Chinese were doing, build solidarity with the Chinese, learn those lessons. They had this, I will call it the western underlying racist attitude that all countries including China are not developed, they will not be able to cope with this thing, that's natural but we who are superior, the western world will actually be much more effective in dealing with it because we have a superior system. Now it shows that one thing the germs, viruses don't recognize is race, you know countries and so on. So I think this has been a great leveler and I think European Union, the countries now are showing what the Chinese did was right and they didn't learn the lessons that China had actually developed and it is this lack of learning, the slowness with which they mime these lessons for which they are paying a price today. Unfortunately it is really not the leadership of the countries but the people of those countries will pay this price. And India if we talk about India then Indian authorities are still saying that we are still in the containment phase although WHO has said that there is local transmission. So why is this contradiction there? Is it because of the very little testing that is being done? Well at the moment from what we see it could still be, we are in the containment phase that people who are actually getting infected are the people who have either come in from outside with carrying the virus, virus disease or those who have come in contact with it. So we are doing extensive contact tracing by all accounts and if we are able to successfully isolated after contact tracing, quarantining, self-isolation, all this measures that we are talking about before there is any infection visible then it is possible that we will be able to contain it. So at the moment I would not say that WHO is saying that we should test everybody. WHO has also said that the containment phase this is what you should do. Either somebody is in contact with somebody who has been infected, known to be infected or who has come from these countries. So India, I think ICMR has 12 countries it is identified. I think they have increased the number to more countries yesterday or today. So I think we are doing a certain set of steps if it gets into the population. We are going to have a big crisis on our hands. The only saving grace as of now is those countries which seem to be little warmer do not seem to show as yet questions on this because Malaysia is very similar to India climatically but it is showing some numbers going up. So is the temperature going to stop the rapidity of the infections? That is something we need to watch. Maybe yes, maybe no. Jury is out on that one as yet but that only will postpone shall we say the epidemic because then it will come back when it is really much colder. So I think at the moment fingers crossed India still seems to be in a containment state. It also seems that ICMR's you know random testing of others who are infected have respiratory problems testing them would or could track some of these cases if they have already got COVID-19. It seems that these test cases that they have done random sampling of those who are sick with respiratory diseases haven't shown any COVID-19 cases. So as of now we could be still in the containment phase but fingers crossed on that. What do you feel about UK's herd immunity strategy which was Johnson's sort of the plan they were thinking of taking on protecting the country do you think that can actually be effective? Well I think they've given it up after about five days when a team did a model modeling exercise to show if a herd immunity needs to be created how many people are going to fall sick. We lead to fall sick it's 60% of the population which is 36 million Brits have to fall sick. Now that if you extrapolate means anything between 1 to 5% fatality as we saw Italy's figures Wuhan's figures once you have a very large number of infections the hospital systems collapse and therefore your fatality rate goes up. So anything between 1 to 5% is possible Wuhan had something like 4.7 or 5% rest of China had less than 1% so this is this is what happens when you have a very large number of cases. So if you have 36 million people it could be anything between if it is 1% then it's 360,000 if it is 5% we are talking about 1.8 million people getting dying of the disease. I think after this numbers they have now gone back to what everybody is doing which is you know social distancing and starting to we are starting to see lockdowns. But the point is as Dr. Aylward has said this is not enough that lockdowns will only create a basic environment within which you then have to step in with identifying, testing and then isolating those who are found infected. So that's where the WHO director general statement comes test, test and test continuously. So that is the issue that UK has to face and again how their health services which has been hollowed out partly by the Tory governments over the last 10 years how that will shape up to this this is something that we have to see. And if we look at the US not only is it facing a crisis in its own country because of well the lack of testing but also the US is continuing to impose new sanctions on Iran, Venezuela even after this pandemic which is making it difficult for these countries to cope with the crisis so what can you tell us about this situation? You know the US seems to have entered into a completely heartless state. There is no human empathy that you see in the Trump administration. They decided that they could keep the disease out into the foreign disease even now Trump insist on calling it a Chinese disease. The germs are not Chinese, the viruses are not Chinese. It's now cross borders so it's now in European disease if you will. But the belief that foreigners bring disease is something which is fundamental to the Trump psyche. The second problem of course why did they not do testing of the scale that is required even now it's much slower than most other countries. Now was it because they wanted to hide figures or because they had already disempowered the CDC and their epidemic fighting apparatus. That led to this fiasco over testing we don't know. It's also true that Trump did not want the figures initially to come out because he thought it would affect his reelection. But given the nature of the epidemic now they are sort of coming out in the open and they cannot deny that they have these figures that they have to do something about it. So now they're taking the other tack. Private sector will solve our problems. Google will solve our problems. Some director chairman has told me that he has a vaccine which is going to give in three months. All of this wishful thinking that capital will solve all the problems of the country. But what you raised is essentially in these conditions instead of solidarity. What you find is this essentially an extension of the war extending it even to the issue of fighting the disease. That's why you see sanctions in Iran and Venezuela at this stage. You also see bombing in Iraq. Now this is taking place. Iraq is supposed to be an ally. You're bombing Iraq and at the same time Chinese are sending medical teams to Iraq because they're also sending to Iran. They're also sending it to Italy and Jackie Ma the richest man in China has also sent masks to the United States. So you have this complete lack of empathy with the world that Trump's and his administration seems to show. And I think that the most brutal part of this attitude is when you try to buy the German vaccine company thinking that then you will have a monopoly on this and then you can fleece the rest of the world. This these are you know something which is so heartless. I cannot understand how the American people can even look at what their government is doing without actually reacting to it. At the moment the reaction is to Trump and it is fairly unpredictable lines Republicans versus Democrats. But the larger issue of what the US administration represents as you said under these conditions is not relaxing the sanctions so that these countries cannot get medical equipment quickly. This is completely a continuation of its brutal policies which they imposed both in Iran and on Venezuela which has seen millions of people being affected by various problems including hunger you know disease and so on. I don't think you are going to see a change in the American American attitude. This is simply make America great again at the expense of the rest of the world. That's the policy they seem to be following and the epidemic pandemic makes no difference to them. Finally what do you think is going to be the future course of this pandemic. Will we see a fall in numbers anytime soon. Well this is the big unknown that as of now the global south has been less affected. Now are we going to see it increase in these countries. If it does we have an even bigger disaster in our hands because it's the public health system in these places will not stand up to the kind of epidemic we are seeing in Italy. So then we really are going to see 1918 Spanish flu all over again. I'm hoping it will not happen. This is a fond hope. We don't know whether it will really transpire or not. So it may be just a fond hope. But at the same time we still have to prepare to the extent we can and for all countries like India we have the double problem. If we do lockdowns on the scale where it is happening in Italy for example a very large section of our people depend on their daily earnings. They don't have any cushion. How will they survive? We had demonetization. They survived the difficulty. How will they survive? On the top of that you have the disease. So I think we are in for very hard times if you cannot contain the disease because the vaccine is the only long-term solution and that is a good 12 months away still. The only other issue that we seem to, which gives a little bit of hope is that the chloroquines, hydrochloroquines, basically the anti-milarials which can be produced very cheaply, generic drugs that are widely available they seem to be working also. You see the anti-aids drugs are expensive which is the Ritonivar and Lipanivar, this kind of combinations which are being seen. The other thing that Gilead Science is talking about which is even more expensive you have the biotech out from interferon from Cuba but all of those are going to be more complex, bulk production is difficult and they are not small molecules. So therefore this is an expensive process even if the pated part is not taken into account. But if you have small molecules which is what the chloroquines are then this anti-milarial drugs then there is there can be a lot more effective treatment. So we really have to see are there small molecule drugs which can produced in bulk to address the disease. At the moment again fingers crossed hope that this work let's see whether we get more drugs which can aid us in this. Thank you for talking to us today and that's all the time we have. In this click today keep watching news click.