 Today we're going to do a review again on COVID-19 and its spread both in India and different parts of the world and some welcome news regarding a new vaccine, which has been declared to be patent free. Now, I think that's a very important step we have been talking about it. But this is the first example where those who have developed the vaccine have said that they are not going to put any patent charges, no patents on that. We also have said this is an easy technology which can be duplicated quite easily by a range of plants and range of companies. Satyajit, you have been with us from the beginning. If we look at the numbers right now in India, we have the charts and news click itself to show. Let's take into account what you had said last time that the cities are the ones to watch initially, but that's where it will spread. We start to see both things happening. Those cities which are not affected earlier like Bangalore for instance, are going up the vertical rise we had seen in other cities also taking place there, but in places like Mumbai, Calcutta, Delhi. And actually numbers starting to drop that it is a very high speed of rise, but it seems not to be a long plateau and then also fairly rapid fall, as we've seen in other countries as well. Is that what you also think is happening? Yes, absolutely. And you put it very well. It's following the earlier trends from over the past few weeks, first in South Africa where numbers went up and then they played toward and then they began to come down fairly rapidly. This is what happened initially in London, and then now beginning to see in the rest of the United Kingdom as well. So clearly what we are seeing is pretty much that it also underlines what I keep boringly and endlessly going on about that this is not one uniform wave that we saw major outbreak spikes in metropolitan areas. As they recede, we are going to see on a different dynamic altogether, outbreak spreading to outlying areas to the hinterland to the second tier cities and towns, and those numbers will also come up. So what we are looking at is a series of local outbreaks linked to each other, of course, by connection of spread, but that's what is going to result in those total numbers. Having said that, I think very many people have pointed out, we have also commented on it, I think it's time to remind ourselves that these total case numbers that we are watching obsessively all of us and comparing and contrasting and looking at milestones about this many lack, this many lack, that many lack need to be looked at with a new eye and a bit of caution. Good point. And again, on that also reports have been talked about that should we take the new cases numbers, how seriously should we take them, because you have two kinds of issues. Of course, we know from last time that the actual numbers in India with anything from six to 30 times what we have declared or we found through testing. This number, of course, is something which we have seen in other places also, but this time we have an added issue that not so much in India but not the places you can test at home, and those numbers do not enter the numbers anyway. We had pointed out last time as well, that the numbers of tests being found positive, provide us a trend, and that's important. If set of positivity ratios are rising numbers are rising, we know that the worst is yet to come. If the numbers start to fall, then we know, okay, we are probably over the hump, as far as this particular urban center is concerned. Public health, it's important, but otherwise, we should not take numbers that seriously. So absolutely, and let me add three quick points to this. In the first place, we've made the reference to this in past months as well, but even more so in the Omicron period of the pandemic. This is important. We should stop referring to these as cases. There are not cases of illness necessary. In fact, in the Omicron period of the pandemic, quite often not symptomatic illness at all. What we should be referring to these numbers that we are seeing reported every day as are identified infection numbers, not case numbers. This is one. The second issue is, if Omicron is spreading so rapidly, should we simply not test at all? Should we not give any credence to case numbers? The fine nuance there is what you have alluded to, which is that in localities, we need to have a reasonable statistical sampling of testing being done, not so much because we want to know the absolute numbers, but because we want to be able to follow the trend of what percentage of sampled examples are turning out to be positive. If that percentage begins to rise, then our past two years of experience is telling us that a couple of weeks later hospital admissions and intensive care numbers will rise and the health care system will begin to be strained and some preparation, some policies can then be put in place. So that's what we really need. And on this point, the regional inequities that we have in this kind of statistically robust sampling at local levels needs to be underlined and kept in mind. Of course, it is also true that apart from hospital preparation, some amount of social distancing or physical distancing as we have repeatedly talked about other measures to decongest heavily visited areas. Maybe look at cinema halls, gyms, hotels, restaurants, etc. All that are part of the public policies that you talk about. And of course, this time we are seeing a central government not imposing what I would call the Taliban down. So good senses prevail that there is a local need of action, and that should be left to the local authorities and I think that's happening. Yes, you wanted to add something to it. On that, on the one hand, I agree with you that this is a welcome transition, but I would like to give you an example of how modest the transition is. State governments are closing down schools statewide. This is why I keep pointing out that we're not dealing with a uniform wave that's equally distributed across the state. Locally, decisions of this sort need to be made and they need to be made to be made flexibly and dynamically taking local changing conditions into account. The informed, decentralized, enabled and empowered decision making is essential and we haven't quite gotten there yet. Empowered local governments and local bodies, including organizations of the people, they should all or should be involved, not only taking decisions but carrying them out. But you know some of the irrational parts of it for instance in Delhi, you decide alternate day shop should be open, or even that we saw about cars. The point is it just congestion then becomes more in the one particular shop than distributing it over to shops. These are also irrational decisions at some level. Curfews, for example, has no role at how stopping people but moving around on the streets at night helps control pandemic is a no brainer I would have thought but then we have people with brains doing this kind of things in the government. Other part of it that vaccines. Now, of course, though the 939 week gap that has been given for after the second dose, people can have a protective dose for health workers as well frontline workers as well, that's really not going to affect the pandemic. Precautionary dose. Precautionary dose. Yes, we're not calling it the booster dose just changing the name apparently make some difference. But essentially it's the same same booster dose that's been given elsewhere in the world, but this this particular third wave that has hit us. It is not going to be affected by that because of what we see as the numbers of people who are eligible for the third dose are really insignificant compared to the total numbers so it's really not going to affect this particular wave at all. That be true. Yes, absolutely. I want that if healthcare workers who are the ones who since last week have begun to be eligible for and have begun to receive the what I keep calling it an additional dose of the vaccine. It's useful. It's useful, particularly because as I said, the in micron increase in case numbers is unevenly distributed across the country. So in those parts of the country where that's still to come in the next coming days and weeks, if healthcare workers in those areas, get that additional dose of vaccine now 15 days from now their antibody levels will be high enough to provide them as at least a small but a significant more become of additional protection from catching infection, and that might well contribute to reducing the strain on healthcare services, which is being added to by healthcare workers being out of commission with infection. So, but there is that small nuance to be kept in mind, but in the broader scheme of things, it's not going to make any major difference. And the question that we had raised time and again, it seems it's now being its possibility is brighter because we have the sanctions or the results of the core of a backstrials, which shows that it is very effective on par with what has been talked about is vaccines and also certainly as good as anything we have seen in other vaccine trials. So the really important part of this is that it has been made patent free. In fact, the people who developed it in the, what is it, Baylor University Baylor College of Medicine, those people those who have developed it in the Baylor College of Medicine, one of them is Peter Hotez we have been discussing his work and what he's been writing about infectious diseases earlier as well that they have declared that this will be given patent free to anybody who wants it. And the second part and we have discussed this also in our COVID-19 discussions earlier that this technology, this is something which is quite known, can be done by a number of companies, and in fact, producing proteins in East, letting the East multiply this is something which is not something like an mRNA technology which is quite easy. And therefore, this potential of transferring technology is much simpler than what, for instance, Mr Bill Gates talks about that the third one really not technologically competent to manufacture vaccines unless it is helped by Bill and Melinda Gates Foundation. Well, let's, let's keep a few points about the Korobovax example in mind. Firstly, the stance that Peter Hotez and Maria Botats were taken at the Baylor College of Medicine, not to patent this and to make it freely available to any technologically competent industry anywhere in the world to manufacture and make it is entirely and sets an example, just no question about that. That said, let's keep in mind formally, we haven't seen the clinical trial results published as yet, even though the regulatory agencies in India have already approved Korobovax for usage. And even though the Hyderabad based private company Biological E is manufacturing Korobovax in fact that's how the application reached India's regulatory agencies. The fact still remains that we haven't seen the data published. On the other hand, as you point out, over the past two years, one and a half years the surprising thing has been how few vaccines for COVID have actually failed to show protection. So it's no great surprise for those of us who follow these different technologies of vaccines that the Korobovax technology shows very good protection. It shows excellent protection against the 2020 strains, it shows very, very good protection against the 21 strains, which is the Delta strain against Omicron, it still remains to be seen. But if you compare the antibody levels and other immune responses that are being claimed, then there should be reduced but still very good protection against serious illness. That's the second point. The third point is the technology, as we've discussed multiple times over the past year, the technology is both easy to transfer and finicky to optimize. So it's easy to transfer because as you pointed out, it's yeast fermentation, bioreactors with yeast fermentation are familiar technology to large scale manufacturers of drugs and other pharmaceuticals and therefore it's in that sense a very straightforward technology to transfer. However, keep in mind what the technology consists of. The yeast make the spike protein or a piece of the spike protein of the virus and therefore the spike protein is being made in unfamiliar conditions, in unnatural conditions. The spike protein is naturally made in ourselves by the machinery of the virus. When the spike protein alone is made in the yeast, it's being made from the point of view of the spike protein in unnatural conditions and therefore the protein doesn't necessarily fold exactly into the same shape that it does in our body. And that is where the finicky optimization comes in. Let's keep in mind that Novavax, Covavax which SIRMA Institute in India is piloting and which has also gotten approval in India is also a protein based vaccine and it has run into repeated delays over the past year, year and a half. In other, amongst other reasons because of this folding problem. So that still remains to be kept in mind, rather than inflating our expectations that this technology is going to lead to an explosive availability of easy cheap vaccines across the world. And in that tempering point needs to be made. My final point about this technology and the patent freeness that scientists at Baylor have shown by example, is that making protein based vaccines has been the default. Let's keep in mind and I'm going to give you two examples. Let's keep in mind the Cuban vaccines, Abdullah and Soberana. Both of those are exactly similar protein based vaccines. Both of them show in Cuban trials very respectable protection. Both of them have been used to provide the highest proportion perhaps in the world of full vaccine coverage of the adult population in Cuba. In India, such designs of vaccines have been ongoing with what I will politely call lukewarm support from the government of India. And we see the result which is that we are still talking about these vaccines being made overseas and being brought into India. So all in all, there is a complex landscape out there in which being rendered patent free is only one part of what will facilitate vaccine manufacture and availability for the people. So something quick question to you. One, of course, what you said is true that there is the optimization problem because what people may not be aware of that actually protein folding gives it the properties. Normally you think of chemical properties being a property necessarily only of the structure, but unfortunately for complex molecules biological as we are as such that his tribe told him what we get is complex molecules and large molecules, and how it falls should shows on the surface a certain kind of proteins and what is shown on the surface then gives it the property that not what is hidden inside the force, so to say. So therefore folding is obviously a very critical issue in all such cases, and particularly with large molecules it's obviously a much bigger issue. So the only one saving grace here, one silver lining is by logic he has already done this kind of vaccines as well, and therefore they have experience of this way, this problem that you talk about how to optimize the protein folding. So everyone is a new case so I'm not going to say the problems there for disappear, it's that they have some experience with it already. Oh, absolutely. And as a matter of fact, not only biologically, there is a whole basket, not fast numbers, but there is a whole basket of generic biological manufacturers in India, who are capable of doing this, and with the new developments there is hope that at least some of them will take it up and will execute it. The only thing that I would add here to what Satish said, we also need the government to come in with support support for buying vaccines, as well as support in terms of banks giving loans, not to suggest the big wigs of Indian industry, the Ammanis, the Adhanis, the Tatas and the Benlas, but also to vaccine manufacturers who need both financial support and commitment to buy vaccines in order to be able to break the initial market resistance. Satish, thank you for being with us, watching over the COVID scenario which is still developing. Hopefully we are over the hump, at least in certain cities. Yes, the hump is yet to come in other places, and therefore we need to watch carefully what's happening. This time seems to be, it's a sharper wave and it seems to wane also, not as rapidly as it rises, but fairly rapidly, and hopefully the hospitals will not get stressed the way it did in the Delta wave. This is all the time we have today for NewsClick, do keep watching NewsClick and do visit our website.