 Hello and let's talk about the COVID-19 situation in India. The number of cases stands over 15 lakh, 30,000 as of today morning with over 5 lakh active cases. The number of deaths stands at over 34,100. In the past 24 hours as of today morning again, over 48,500 new cases were reported as of 768 deaths. The familiar pattern of a few states and regions having the bulk of the cases continues. Andhra Pradesh has emerged as a new hub now with close to 7,900 new cases as of today morning. Maharashtra and Tamil Nadu also continue to show lots of fresh infections at 7,700 and 6,900 cases respectively. Delhi on the other hand has begun recording substantially fewer number of cases. The data after the morning showed that just over a thousand cases have been recorded in the previous 24 hours. We talked to News Clicks Prabir Pulkarsan on some of these issues. Thank you Prabir for joining us. So we've seen the, we've taken a quick look at the numbers of course. We are still in the 48,000, 50,000 range every day in terms of new cases. And some of the states are really continuing to record numbers as excess of 5,000 and 6,000. So right now, how do we see the trajectory of the disease when we look at the new cases at this? You know, one shouldn't look at really a day's figures to reach much of a conclusion. The real issue is that the number of new cases has been rising continuously India. And it doesn't seem to have changed much in terms of percentage of new cases over total cases that we see. So effectively, we are seeing still a doubling rate between 20 to 25 days, depending on what percentage you take at one point. So that is a fairly constant figure. And 20 days is what we have been seeing for the last almost one and a half months. So if we take that, then what happens is your number of infections per day, new cases per day go up. And that's exactly what's happening. We are now globally the second highest number of new cases in the world, just about 10, 15,000 behind the United States. The United States has almost 4.5 billion people who are infected. We have 1.5 million. That means you're one third their numbers. But when it comes to the new infections, we're not that far behind, which means the rate of increase of India's infections have been pretty constant. And this is something that if we look at the charts that we have on our site, that you will see this very clearly, that while you have a number of countries which have flattened their curve, you will see that for instance, Brazil, India, the curve has almost been at the same slope for the last almost eight weeks. So if we look at the countries that have already been infected, had a fairly severe infection, severe pandemic, epidemic in their countries, you will see that curve has more or less flattened over a period of time. Whether it is China first, we'll do it in a very short period of time, about six to eight weeks. But even if you take at Italy, you look at Spain, you look at France, you look at UK, all of them are more or less flattened. The only ones who are still rising almost in the same rate, if you take the big numbers, that's basically Brazil, India, Mexico. And now also South Africa seems to be rising. But we'll have to see whether it's the same rate or not. The important part about these countries is these rates are not flattening. That means the rate of rise seems to be quite constant. And this is particularly true for India, where if you look at the rate of rise, it has been consistent for over the last two and a half months or probably even three months, you will see that we have been maintaining the same rate. So I think that is the cause for concern that we have, that we don't seem to be in control of the epidemic. And if you see now, it's spreading over into new areas, new states and other states are catching up pretty fast. Now the earlier figures that we saw were really from the big urban areas that you saw in Maharashtra, you saw Mumbai. Then you saw Mumbai and Pune, of course, also was there. Then you saw really the suburban area of Mumbai, the greater Mumbai area as it were, get infected. You can see that the infection started spreading there. And then you now see spread from that in Maharashtra, the Pune, Mumbai belt. And then further down, you see the spread. So you can see the infections are spreading. And if you take, for instance, Andhra Pradesh, it's not one city. And Andhra Pradesh yesterday had the highest number of new cases in the country, it even overtook Maharashtra and Delhi. Now if you see that, that shows that you have now actually a much larger community spread than what you were seeing earlier. Where you had hotspots, mainly in urban areas. Now you are seeing really community spread across different regions. And that means we are not in control of the pandemic at all. And in fact, what we are doing is running behind it. And there are two reasons for it. One is of course India's refusal to accept that we are in community transmission. Though we fulfill all the criteria of community transmission, we fulfilled it for months. So this is something which it's the refusal to accept the reality that is there. One of the things that we are not doing is the kind of testing we need to have. And if you remember Delhi at one point was cutting down its testing. Now when there was a human crime, there were protests, there were forced to go back on that, they really did increase the testing. And whatever the numbers may be, and there will be questions that the antigen tests are not that accurate, all of that is true. But nevertheless, you can see that they have a much better handle on the pandemic in Delhi today than they had earlier. And there is a significant drop in new cases that you can see in Delhi. So accepting the reality instead of hiding it gives you much better control. Because at the end of it, pandemic cannot be hidden. If people are falling in, it will become a panic. There will be so many other indicators. You will see the hospitals getting flooded. You will not be able to cope with the hospitals. And you will see number of deaths increasing. And whatever you do, you can't really hide deaths. So I think all of these figures are going to tell you that there is a problem. And this is what Gujarat tried earlier, hide the figures. And of course, the death figures became high enough for it to then become clear that there was a pandemic over there. So I think these are the kind of things that we need to look at. And clearly, we are in a stage where accepting community transmission is the way forward. And also then looking at how to quickly isolate people who are identified, how to give them at least information that they are in touch with somebody who has been detected, self-quarantine yourself, even in your house. Because it'll take five to six days before your symptoms will become apparent. A lot of the people are actually thinking that because they've got an antigen test done and they had interacted with somebody who has COVID-19, they're okay. But the point is the symptoms, antigen to develop takes five to six days. It's not a PCR test, which tells you how many virus particles that is there in the sample. So there's a very different kind of test. So I think much more knowledge and awareness and a community involvement. Unless the communities get involved, you cannot stop the pandemic. Or there is a New York Times article which has just come in which a person from West Africa has written that we did not stop Ebola with just medicines, vaccines and other measures. We stopped it because we involved the community. And it is that community's involvement which really stopped Ebola. Because this, mind you, with much lower infrastructure in areas with much lower infrastructure than India, forget about the United States, forget about Western Europe or about Brazil. We definitely have much higher infrastructure than West Africa had. But this is the crux of the issue that it is really communities which have to be involved, educated to be the first line of defencing is a pandemic. And that's not what we're seeing in India today. And I think that's one of the reasons that the centralized administration of the kind that Mr. Modi has does not react well to things which need human involvement, community involvement, societal involvement. That is not something that this current administration is good at. And that's why you have an emergency measure against COVID-19. Remember the Mahabharata war which in 18 days in case of the corona war would take 21 days? That kind of rhetoric might work. But unfortunately, that's not how you fight disease or how you fight the pandemic. And from in this context, the other key issue of course is about the drugs and medicines. You talked about it on various occasions. So today the news has come that the drug manufacturer Hetro has launched a drug which is being brand run by the name Favivir and it's basically the antiviral drug called Favipiravir. So how do you see the kind of options regarding drugs that are available to the people right now? Look, the randomized controlled trials have shown only two drugs which have shown some advantage, some modest gains. The one which has shown really significant gains is dexamethasone, which if you are serious, then you take. And if you take that, then yes, the anti-inflammatory response that the body has, which causes a lot of the damage, actually can be restrained to the level that it acts against the virus or doesn't damage the body too much. It's a very cheap corticosteroid widely available and therefore it needs to be used extensively in the hospital setting where people are on oxygen support or on ventilator. That's where it's the most effective. The more serious you are, the more effective it is. Now, this is the only real medicine that has been shown to work. Other than that, if you are very serious and you have blood clot, which is also one of the side effects of the infection, in that case it can you do what is traditionally done in hospital settings, use heparin, which is the blood thinner. Now, coming to the Favipere issue, and that's the one which is not remdesivir, remdesivir we have talked about, remdesivir has some modest advantages, again in randomized control crimes. Favipere and a couple of other things which are doing the round, Thocillizimab, Zoomab, Etholizimab, they all are prospective candidates. Favipere less so, but other two are prospective candidates where they can reduce inflammation. They're known to be anti-inflammatory. Now, have they shown themselves in randomized control trials? No. Are these therefore kind of used selectively? Perhaps yes, but they're very expensive. Thocillizimab is really expensive. It costs lakhs. Etholizimab, because it's a Cuban invention, it has been given to Biocon. Biocon has priced it at a certain price, which is at least well below that of Thocillizimab. But in the market, it is still costing 1.52 lakhs because it's calling it the black market stage because people believe that their relatives will be saved by this medicine. While it is much clearer that the larger effect will be if the use of corticosteroids, dexamethasone, not that many hospitals seem to be using it widely. One of the reasons could be that when you charge a patient, if the cost is very low, how much will you charge the patient? So maybe there is a, if it's a private hospital, there is a cost profit angle to this, which is why they want to go in for more expensive drugs. And Tadipir is essentially what your family, Pabirapiravir is the basic drug which has been used in other places. Again, no randomized control trials has shown its use. Therefore, its use at the moment is like hydrochloroquine was initially, while it was widely touted as a possible savior. Turned out it had no effect and in some cases even had adverse effects. And only now ICMR still sticks to it as a prophylactic, without any, I would say, without convincing evidence of it being so. So this is where we are. So I would put these medicines at the same level as the antiretrovirals, which are tried out, Lopinavir, Retinavir, all of these were tried out initially. Tadipir was also being talked of at that point. But these are all medicines I would put in the same budge. We have to see whether there is really any effect that can be seen from randomized control trials. And there's a very heavy investment families are being asked to make, which are really at the moment do not have much to support. Thank you so much for your talking to us. That's all. We have time for today. We'll be back tomorrow with major news developments from the country. Until then, keep watching NewsClick.